Podcast appearances and mentions of paul hodges

LONDON (ICIS)--In the wake of the European Petrochemical Association (EPCA) conference in Berlin, Germany, players are looking inward to find the levers for growth in the face of expectations that the industrial downturn will continue to drag on.   In this ICIS Think Tank podcast, ICIS insight editor Tom Brown interviews Paul Hodges, chairman of New Normal Consulting.  

In an increasingly unstable world, chemicals executives need to be aware of the important issues which are likely to steer the global economy, and markets, for the rest of 2025. President Trump's tariff trade war Russia's war with Ukraine China's property bubble Potential for another Asian financial crisis Crude oil market convulsions In this ICIS Think Tank podcast, Will Beacham interviews Paul Hodges, chairman of New Normal Consulting.

As a completely new chemical industry landscape unfolds before us, leaders should harness AI, innovation and consolidation opportunities in high cost regions.  Industry faces structural—not cyclical—challenges Overcapacity and competition squeeze Europe Demand decouples from GDP, shrinking market size AI can boost efficiency and forecasting accuracy. Specialties and low-carbon products need careful thinking Global chemical companies withdraw from Europe Local chemical companies can gain market share via mergers & acquisitions (M&A) M&A and national champions may drive consolidation Defence sector offers immediate, well-funded opportunities  In this Think Tank podcast, Will Beacham interviews Richard Carter from Carter Consultancy and Paul Hodges, chairman of New Normal Consulting. 

Rising overcapacity, AI and protectionism may drive a swift transition in chemical production and markets in the next 5-10 years.-          Commodity chemicals may be produced mainly by large state-owned enterprises-          Smaller, privately-owned companies may switch to high value composites, specialties, low-carbon chemicals-          High-cost regions such as Europe could protect their essential commodity chemicals production-          Protective measures need to be taken in next 3-6 months to rescue EU commodity chemicals-          A lot more commodity capacity closures required to keep operating rates healthy-          AI will have a massive impact on chemical companies and markets-          AI will enable us to navigate and analyse increasingly chaotic markets-          AI could drive job losses, disrupt economies-          Climate change will alter seasonal and geographic demand patterns-          Electronics, property, auto markets are depressed-          Q2 chemicals results are very poor in all regionsIn this ICIS Think Tank podcast, Will Beacham interviews John Richardson from the ICIS market development team, ICIS Insight Editor Tom Brown and Paul Hodges, chairman of New Normal Consulting. 

Slowing demand growth and a battle for market share between Saudi Arabia and the US could see crude oil prices drop significantly by the end of the year. -          High oil prices stimulate more production, low prices less-          Saudi Arabia and the US battle for market share-          Global demand for oil is around 100 million barrels/day-          Electric vehicles (EVs) have destroyed 2 million barrel/day of oil demand -          Globally around 20% of vehicle sales are EVs-          Oil prices could fall to $40-$45/barrel by the end of the year-          Oil demand growth weakest in 16 years-          Low oil price is double-edged sword for chemical markets In this ICIS Think Tank podcast, Will Beacham interviews ICIS Insight Editor Tom Brown and Paul Hodges, chairman of New Normal Consulting. 

As the existing global trading system crumbles, and overcapacity keeps growing, Europe's chemical industry must move back to a more national or regional business model.  -          Trade war shows global trading system is breaking down-          Chemical industry could move back to a national or regional business model-          Would be a return to pre-1990s industry structure-          Europe has smaller chemical plants, ideal for regional markets-          EU must now act fast to protect chemical and industrial value chains-          China chemicals has been based on 6-8% GDP growth per year-          Now real GDP growth is only 1-4%, according to unofficial estimatesIn this ICIS Think Tank podcast, Will Beacham interviews John Richardson from the ICIS market development team, ICIS Insight Editor Tom Brown and Paul Hodges, chairman of New Normal Consulting. 

LONDON (ICIS)--As geopolitical tensions have cooled, the chemicals industry did not have time to react to the spike in oil prices, and the seasonal demand drop in Europe could be more severe than the traditional summer lull. China polypropylene flooding global market, outpacing domestic demand Chemicals industry as leading indicator warns of wider economic ill health Shutdown of plants in Europe is massive crisis Vietnam 20% tariff from US will weigh on both economies Risks of US cutting social security, international relief funding Key economies not as strong as presented Climate change needs to be a priority for businesses CEO beset with challenging conditions Working patterns reshaped by climate change Stark landscape provides opportunities for innovators to thrive In this Think Tank podcast, Morgan Condon interviews John Richardson from the ICIS market development team, and Paul Hodges, chairman of New Normal Consulting.

Europe's chemical distribution sector is bracing for the impact of multiple geopolitical and economic challenges, including the Israel/Iran conflict. -          All Iran's mono ethylene glycol (MEG), urea, ammonia and methanol facilities have been shut down -          For methanol this represents more than 9% of global capacity, for MEG it is 3%-          Brent crude spiked from $65 to almost  $75/bbl, reports of attacks on gas fields and oil infrastructure-          If Iran closes the Strait of Hormuz this will severely disrupt oil and LNG markets -          Expect extended period of volatility and instability in the Middle East-          European distributors brace for a VUCA (Volatile, Uncertain, Complex, Ambiguous) world-          Suffer prolonged period of poor demand, in tandem with producers, with no sign of an upturn-          Global overcapacity driven by China, subsequent wave of production closures across Europe both a threat and opportunity for distributors-          Suppliers and customers turn to distributors to help navigate impact of tariffs and geopolitical disruptionClick here to download the 2025 ICIS Top 100 Chemical DIstributors list.In this ICIS Think Tank podcast, Will Beacham interviews Dorothee Arns, director general of the European Association of Chemical Distributors and Paul Hodges, chairman of New Normal Consulting. 

The worst chemicals downturn in living memory is forcing ratings agencies to downgrade more companies and raising fears of bankruptcies. -          Chemical company earnings have been bottom-of-cycle since 2023-          Leverage (borrowing) is high compared to historical levels-          Low earnings increase pressure on leverage, raises risk of default-          Fitch has downgraded more chemical companies over last 12-18 months-          Extended trough in chemicals may lead to bankruptcies-          Operating rates have not recovered as they did after Global Financial Crisis-          Fitch expects gradual recovery from 2026-          A lot more closures needed to rebalance market – could delay recovery-          Ratings agencies look at company costs, strategies and compare to peers-          Diversification of geography and product helps manage riskIn this ICIS Think Tank podcast, Will Beacham interviews Guillaume Daguerre who leads Europe chemicals for ratings agency Fitch, John Richardson from the ICIS market development team, ICIS Insight Editor Tom Brown and Paul Hodges, chairman of New Normal Consulting. Click here to register for the ICIS/European Association of Chemical Distributors (Fecc) distributors CEO round table on Monday 16 June. 

Paul Hodges hosts a conversation with Grainne Donnelly and Linda McLean about the ICS Physiotherapy Committee workshop Ultrasound Imaging of the Structure and Function of Pelvic Floor Muscles in Men and Women at ICS 2024 Madrid. Recorded at the ICS Live Lounge on Wednesday 23rd October at ICS 2024 Madrid.  Through its annual meeting and journal, the International Continence Society (ICS) has been advancing multidisciplinary continence research and education worldwide since 1971. Over 3,000 Urologists, Uro-gynaecologists, Physiotherapists, Nurses and Research Scientists make up ICS, a thriving society dedicated to incontinence and pelvic floor disorders. The Society is growing every day and welcomes you to join us. If you join today, you'll enjoy substantial discounts on ICS Annual Meeting registrations and free journal submissions. Joining ICS is like being welcomed into a big family. Get to know the members and become involved in a vibrant, supportive community of healthcare professionals, dedicated to making a real difference to the lives of people with incontinence.

Chemical companies all over the world will suffer if the new US tariffs trigger a full-blown trade war.-          Tariffs will be bad news for the US and for the global economy-          Europe polymers producers might get short-term relief if EU imposes tariffs on US polyethylene (PE)-          US tariffs means China may now target other countries-          Chemical industry will become more regional-          If US becomes more isolated China could move closer to Europe, form new trading bloc-          Europe's chemical industry has its back against the wall-          3.4% of European chemicals capacity has shut down -          EU attitude to energy pricing has reversed – they now want to reduce them-          Chemical industry now has unprecedented access to high level Commissioners-          Energy demand will soar – AI will use as much as chemicals-          Electricity production needs to double to full electrify chemicals, other sectors-          Survival of EU as a free trade zone is important-          Chemicals CEOs can seize an opportunity if competitors closeIn this Think Tank podcast, ICIS journalist Will Beacham interviews Cefic director general Marco Mensink, John Richardson from the ICIS market development team and Paul Hodges, chairman of New Normal Consulting.

In this episode of The New Rules, host Alan Pentz is joined by Paul Hodges, Chairman of New Normal, to discuss the insights from the latest PH Report. They explore the impact of demographic shifts on the economy, the challenges of government debt, and the evolving landscape of investment strategies. Tune in for a thought-provoking conversation that navigates the complexities of today's financial world!

Paul Hodges, Founder of Near Normal Consulting draws on over 30 years of experience in the chemicals, energy and IT industries to outline the most likely scenarios in the wake of the recent US Presidential election, asking to what extent Donald Trump will be able to implement his stated agenda given the secular forces at work in the global economy. ----more---- Hodges sets the scene through his analysis of how demographic trends will impact supply and demand through the major developed economies, along with the major secular changes facing key industries such as chemicals and energy. Against a backdrop of widespread overcapacity and declining demand, Trump's proposals for tariffs even if only partially implemented, will accelerate the reversion to 'local for local' supply chains with unpredictable consequences for investors, who are already grappling with very high levels of valuations, most notably in the US equity market.

Chemicals sector executives are increasingly facing up to the idea that the sector is going through a process of reinvention, with no big recovery on the horizon and a return to pre-crisis normalcy less likely. Executives are now looking at what the next steps for the sector will be.In this Think Tank podcast, Tom Brown interviews Paul Hodges, chairman of New Normal Consulting, Katherine Sale,  ICIS head of editorial strategy, and Chris Barker, senior editor covering PVC and caustic soda, on impressions from the EPCA assembly.

In this episode, Til and Whitney dive into strategies for addressing low back pain (LBP) with hands-on work, exploring LBP's prevalence, causes, and treatments. Sharing the insights they've gained from experts such as Nikolai Bogduk, Stewart McGill, Paul Hodges, Lorimer Moseley, Helene Langevin and Antonio Stecco, they lay out the diverse views on both the structural and non-mechanical origins of LBP. Listeners will also learn about therapeutic approaches, the significance of practitioner confidence, and the importance of comprehensive evaluations. Tune in for a fascinating look at how practitioners and clients alike can better understand and work with low back pain. Key Topics: 1. Prevalence of low back pain Over 60-70% of people have episodes of low back pain at some point [01:51]  Leading cause of disability worldwide Huge economic impact 2. Potential evolutionary factors contributing to low back pain Transition to bipedalism and upright posture Differences in spinal curvature and hip mobility between cultures [05:45] 3. Causes and contributors to low back pain - [07:39] Overemphasis on disc and structural issues in the past Importance of comprehensive evaluation beyond just structural issues Role of soft tissue, muscular, and neural factor 4. Influence of practitioner perspective and confidence on outcomes [30:20] Importance of the therapeutic relationship and rapport Unexpected interventions can sometimes be effective [35:53] 5. Personal experiences with low back pain Overuse vs. underuse/immobility as contributors Debates about the significance of posture, load, and context [41:31] Limits of expertise vs. scope of practice for massage therapists Get the full transcript at Til or Whitney's sites!  Whitney Lowe's site: AcademyOfClinicalMassage.com  Til Luchau's site: Advanced-Trainings.com  Resources mentioned in this episode: ABMPs' CE Summit on LBP: live Oct 1, 2024 and free to everyone in the profession: abmp.com/summit Portions also available by recording to ABMP members and next year, to A-T Subscribers  Sponsor Offers:  Books of Discovery: save 15% by entering "thinking" at checkout on booksofdiscovery.com.  ABMP: save $24 on new membership at abmp.com/thinking.  Advanced-Trainings: try a month of the amazing A-T Subscription free by entering “thinking” at checkout at a-t.tv/subscriptions/,. Academy of Clinical Massage: Grab Whitney's valuable Assessment Cheat Sheet for free at: academyofclinicalmassage.com/cheatsheet About Whitney Lowe  | About Til Luchau  |  Email Us: info@thethinkingpractitioner.com (The Thinking Practitioner Podcast is intended for professional practitioners of manual and movement therapies: bodywork, massage therapy, structural integration, chiropractic, myofascial and myotherapy, orthopedic, sports massage, physical therapy, osteopathy, yoga, strength and conditioning, and similar professions. It is not medical or treatment advice.)

Physiotherapists Lori Forner and Paul Hodges recount their experience of the ICS Physiotherapy Forum at ICS 2023 Toronto with Marie-Pierre Cyr. Early registration for ICS 2024 Madrid is now open at www.ics.org/2024The ICS annual meeting is the must-attend, multidisciplinary event for clinical and research scientists interested in: Urology Urogynaecology Female and functional urology Gynaecology Bowel dysfunction Neurourology Pure and applied science Physiotherapy Nursing Geriatrics The ICS 2024 Madrid conference fosters collaboration between all disciplines involved in continence care.

Chemical distributors are seeing signs of a sequential improvement in demand, but increasing geopolitical volatility threatens any recovery, according to the head of trade group Fecc. -          Sequential improvement in demand, destocking winds down-          Red Sea disruption highlights continuing fragility of supply chains-          Geopolitics creates growing instability and volatility -          Europe chemicals need political support -          Permitting needs to speed up to enable low carbon energy transfer-          South Korea chemicals under intense pressure to consolidateClick here to download the 2024 ICIS Top 100 Chemical Distributors In this Think Tank podcast, Will Beacham interviews Dorothee Arns, Director General of Fecc (European Association of Chemical Distributors), ICIS Senior Consultant Asia John Richardson and Paul Hodges, chairman of New Normal Consulting. 

China's population is shrinking. The National Bureau of Statistics reports that it has fallen by about three million in two years. This puts pressure on the economy, as the number of people in work is also in decline, at the time as the group of retired and elderly people is increasing. One hope is that 2024 will see a bump in births, as it is the year of the dragon in Chinese astrology, a symbol of good fortune. In this podcast, Paul Hodges, Chairman of New Normal Consulting considers China's demographic dilemma during a discussion with regular host, Duncan Bartlett.

Paul Hodges of New Normal Consulting and publisher of The pH Report returns to Forward Guidance to update viewers on the state of the chemicals and automotive industry. Hodges sees significant overcapacity in chemicals and persistently low price of ethene, propylene, and other chemicals suggests that demand is weakening. Jack asks about whether the fall in inflation in the U.S. economy, which occurred while the labor market and spending stayed strong, indicates that a “soft landing” is a likely outcome in the U.S. or might have even already occurred. Filmed on January 5, 2024. Public dot com has just launched its new high-yield cash account, offering an industry-leading 5.1% APY. Learn more at https://public.com/forwardguidance. A High-Yield Cash Account is a secondary brokerage account with Public Investing. Funds from this account are automatically deposited into partner banks where they earn a variable interest and are eligible for FDIC insurance. Neither Public Investing nor any of its affiliates is a bank. US only. Learn more at https://public.com/disclosures/high-yield-account __ Follow Paul Hodges on Twitter https://twitter.com/paulhodges1 New Normal Consulting https://t.co/d5mkV0QuBb pH Report https://new-normal.com/the-ph-report-overview/ Follow Jack Farley on Twitter https://twitter.com/JackFarley96 Follow Forward Guidance on Twitter https://twitter.com/ForwardGuidance Follow Blockworks on Twitter https://twitter.com/Blockworks_ __ Use code FG10 to get 10% off Blockworks' Digital Asset Summit in March: https://blockworks.co/event/digital-asset-summit-2024-london __ Timestamps: (00:00) Introduction (26:09) The Bank of Japan Faces A Dilemma (29:09) Why China's Economy Could Remain Weak For Longer Than Many Expect (43:25) The Chemicals Market Remains Weak (55:42) Will The U.S. Continue To Be Immune To Global Slowdown? (01:09:13) Euphoria In The Stock Market (01:10:43) Hodges' Concerns About The Bond Market (01:17:59) Why Can't The Printing Continue? (01:27:52) The Federal Reserve In 2024 (01:34:12) Why Paul Is The Most Risk Averse He's Ever Been (01:40:12) Geopolitics (01:42:05) Green Energy and Electric Vehicles __ Disclaimer: Nothing discussed on Forward Guidance should be considered as investment advice. Please always do your own research & speak to a financial advisor before thinking about, thinking about putting your money into these crazy markets.

Welcome back to Spybrary, the ultimate podcast for spy books, spy movies, and spy TV series. In today's 'intel' episode, we share more about an upcoming Sandbaggers fan-organized virtual event featuring Roy Marsden (Neil Burnside.) Paul Hodges of the Sandbaggers Facebook community shares 'that The Sandbaggers Facebook Group will be hosting our first global event, named “Sandbagger Two”, to commemorate the 45th Anniversary of the initial UK broadcast of The Sandbaggers. It will be a virtual voice+presentation event held via Zoom on Saturday, October 7, 2023 at 11am EDT, 8am PDT, 4pm BST, etc. for 120 minutes. Besides a robust agenda, I am so excited to share the news that Roy Marsden and Greg Rucka will be the keynote speakers at Sandbagger Two. More information is available at our Facebook Group which can be found by searching Facebook for The Sandbaggers Yorkshire Television 1978-1980. I hope to see you at Sandbagger Two. We asked Paul what fans can expect, what was Roy Marsden's reaction to being invited, and why Paul thinks the spy TV show has maintained such a loyal following after all these years.

Industries, policymakers and households are braced for a tough close to 2023 and a lean 2024, but a substantial demand rebound may be more elusive even than that, with current economic conditions potentially indicating a fundamental shift in the dynamics of the global economy, rather than the low point of a cycle.In this Think Tank podcast, chief news correspondent Tom Brown interviews ICIS Insight Editor Nigel Davis, ICIS Senior Consultant Asia John Richardson and Paul Hodges, chairman of New Normal Consulting. 

The UK government has taken a relatively hawkish approach to China, with the Prime Minister, Rishi Sunak, declaring that Beijing poses the “biggest challenge of our age to global security and prosperity”. Nevertheless, Foreign Secretary James Cleverly travelled to Beijing with the goal to stabilise relations. In this podcast Duncan Bartlett discusses Britain's dilemma over China with guest presenter, Paul Hodges, Chairman of New Normal Consulting.

BIO: Paul Hodges is a trusted adviser to major companies and the investment community and has a proven track record of accurately identifying key trends in global marketplaces. He is chairman of New Normal Consulting and a Global Expert with the World Economic Forum.STORY: Paul invested in a company in the cinema industry, which according to his research, was a well-performing business. After investing, his bank's asset manager advised him to sell this stock. The stock grew 10-fold after that. Paul missed out on that windfall.LEARNING: There's no substitute for judgment. Distinguish between opinion and knowledge. Opinions are not knowledge. “Distinguish between opinion and knowledge. There'll be many people who know more than you do, but they don't actually know what they're talking about.”Paul Hodges Guest profilePaul Hodges is a trusted adviser to major companies and the investment community and has a proven track record of accurately identifying key trends in global marketplaces. He is chairman of New Normal Consulting and a Global Expert with the World Economic Forum.His consulting work focuses on the major paradigm shifts taking place in the global economy in Demand Patterns, Reshoring of Supply Chains, Renewable Energy, Circular Economy, Advanced Manufacturing, and Financial Markets. He is a regular speaker at international and industry conferences.Worst investment everPaul was lucky enough to work for one of the UK's biggest companies, where he had access to the best pension fund advisors. Paul went to one of those advisors and told them he had 20,000 pounds to invest. The advisor gave him a portfolio of eight businesses.A couple of years later, Paul started seriously thinking about a company he had kept an eye on for a while. It was in the cinema industry. The company was paying a very high dividend of 10%. It had quite a lot of cash in the bank, but everybody hated it. However, Paul went to the cinema a lot. He figured many other people also went to the cinema, so it would be a good company to invest in. Paul invested some money into that stock and added it to his portfolio.One day his bank wrote to him, saying they'd happily give him an expert review of his portfolio. They told him he had an excellent portfolio but advised him to sell the cinema company, which he did. The stock went up 10-fold after Paul sold his shares.Lessons learnedThere's no substitute for judgment.The key to success in anything is persistence.Distinguish between opinion and knowledge.Andrew's takeawaysEverybody's got an opinion, but not everybody has knowledge.Opinions are not knowledge.Paul's recommendationsPaul recommends reading a lot to continue learning.No.1 goal for the next 12 monthsPaul's number one goal for the next 12 months is to focus on his family, especially his kids and grandkids.Parting words “It was great being here!”Paul Hodges [spp-transcript] Connect with Paul HodgesLinkedInTwitter

Maggie Lake is joined by Paul Hodges, author of the pH Report and chairman of New Normal Consulting, to talk about where financial stress will break out next. This episode is sponsored by KraneShares's KRBN EFT is the 1st, largest and most liquid carbon ETF. Please read prospectus before investing at https://rvtv.io/krbn Investing involves risk. Principal loss is possible. KRBN is distributed by SEI Investment Distribution Company (SIDCO). Learn more about your ad choices. Visit podcastchoices.com/adchoices

The Japanese prime minister, Fumio Kishida issues regular warnings to the leaders of other G7 countries about risks to international security. His concerns include Russia's invasion of Ukraine, North Korea's growing missile prowess and rising tensions around Taiwan – including Chinese military exercises that involve firing missiles into waters near Japan. In this podcast, regular presenter Duncan Bartlett gives his views on the relationships between Japan, the G7 countries and China. The guest presenter is Paul Hodges, Founder of New Normal Consulting.

In 2022, China's population fell by an estimated 850,000 people, triggering dramatic reporting in the media. A headline in The New York Times said it heralded a demographic crisis. Reuters talked of "alarm", while a writer on the South China Morning Post insisted that the demographic shift marked "a watershed moment in Chinese history". In this podcast, Paul Hodges, Founder of New Normal Consulting shares his considered view of the demographic challenges faced by China. He is interviewed by Duncan Bartlett, Editor of Asian Affairs magazine.

Join us for the fantastic insight into Dr. Rachel Worman's work trying to disentangle the great web of confusion around pelvic floor muscle tone.  Rachel has taken a deep dive into all the research looking into high tone/overactive/hypertonic pelvic floor muscles and its relationship with symptoms, and produced for us all a systematic review. She has been working with the team at the University of Queensland, including Ryan Stafford and Paul Hodges, and recently produced this epic piece of brilliance: "Evidence for pelvic floor muscle increased tone/overactivity in pelvic health conditions?: a systematic review”   Rachel is a fellow MSK and pelvic health clinician and researcher. She too has been trying to understand the difference in “types of tone” in the pelvic floor muscles and how this relates to symptoms.    Rachel has a Bachelor or Science, Biopsychology, Masters in Physical Therapy, Doctorate in Physical Therapist and current PhD Candidate at the University of Queensland.    We hope this episode helps you get some clarity around pelvic floor muscle activity and tone and how we can better describe, measure, and treat those with issues surrounding greater or increased tone.   Thanks for listening.    Lori, Tam and Jo

To get $1,000 off The pH report and receive a free sample report, email phodges@new-normal.com or jack@blockworks.co, or visit https://new-normal.com/the-ph-report-overview/. Having shared his dire warnings about the chemicals market, Paul Hodges, and author of The pH Report and chairman of New Normal Consulting, returns to Forward Guidance to share equally grim tidings about the global automotive industry, which Hodges argues is entering a severe recession. Hodges notes that sales volumes and car prices are falling sharply around the world, and he discusses cyclical as well as secular themes in Asian, European, and American automobile markets.  Disclosure: The pH Report is a research partner of Forward Guidance. Blockworks receives a share of proceeds for each conversion to The pH Report. For any questions, email phodges@new-normal.com or jack@blockworks.co. -- Paul Hodges on Twitter https://twitter.com/paulhodges1 Follow Jack Farley on Twitter https://rb.gy/uesguv Follow Forward Guidance on Twitter https://rb.gy/cy0dki Follow Blockworks on Twitter https://rb.gy/igyzsj -- Get top market insights and the latest in crypto news. Subscribe to Blockworks Daily Newsletter: https://rb.gy/5weeyw Market commentary, charts, degen trade ideas, governance updates, token performance, can't-miss-tweets and more. Subscribe to the Blockworks Research “Daily Debrief” Newsletter: https://rb.gy/feusos -- Timestamps: (00:00) Introduction (00:50) The Health Of The Global Car Market (05:08) The U.S. Auto Market (13:49) Car Values Are Falling - What's Next? (24:32) Slowdown in Chinese Auto Market (30:30) Tesla (33:43) Autonomous Vehicles (AVs) - When WIll They Become Mainstream? (45:23) Europe's Auto Market (51:23) Investing In Electric and Autonomous Vehicles (01:06:51) China's Relationships with Non-Chinese Automakers (01:10:33) The pH Report As a Research Partner of Forward Guidance (01:14:05) The Chemicals Market Remains Stupendously Bearish -- Disclaimer: Nothing discussed on Forward Guidance should be considered as investment advice. Please always do your own research & speak to a financial advisor before thinking about, thinking about putting your money into these crazy markets.

LONDON (ICIS)--Global holidays loom large, with Thanksgiving taking place this week, Christmas a month away and the Chinese Lunar New Year celebrations on the horizon, taking place at the end of January 2023.While in some ways the world is in a markedly different place, following the Russian invasion of Ukraine and the ensuing energy and cost of living crisis, in some ways the same challenges persist as the pandemic and pressure to save the environment remain prevalent issues.·         The shutdown of the Yansab plant in Saudi Arabia in 2023 indicates about poor demand pickup anticipated in China·         China's continuing zero-COVID policies, continue to weigh on both manufacturing and services sectors ahead of the Lunar New Year celebrations ·         The key takeaways from the COP 27 summit and how this will impact the chemicals industry·         Industry needs legislative guidance on sustainability metrics but market forces are determining an increased rate of change On the Think Tank podcast this week Senior Reporter for Europe Morgan Condon, talks to ICIS Insight Editor Nigel Davis, ICIS Senior Consultant Asia John Richardson and Paul Hodges, chairman of New Normal Consulting about the current trends impacting the chemicals sector.

To get $1,000 off The pH report and receive a free sample report, email phodges@new-normal.com or jack@blockworks.co, or visit https://new-normal.com/the-ph-report-overview/. Paul Hodges, author of The pH Report and chairman of New Normal Consulting, returns to Forward Guidance to share the grim tidings from the chemicals industry, whose troubles Hodges argues are indicating that consumer demand will slow rapidly around the globe. After reviewing how and why the chemicals industry is a bellwether for the global economy, Hodges tells Jack Farley how the collapse in chemical prices is a harbinger for a severe global recession. Unrelenting high energy prices, which are a key input to chemical production, are making the chemical refining business even more challenging. Hodges and Farley also discuss the future of inflation and how it is affected by central banks, geopolitics, and demographics. Disclosure: The pH Report is a research partner of Forward Guidance. Blockworks receives a share of proceeds for each conversion to The pH Report. For any questions, email phodges@new-normal.com or jack@blockworks.co. -- Paul Hodges on Twitter https://twitter.com/paulhodges1 Follow Jack Farley on Twitter https://rb.gy/uesguv Follow Forward Guidance on Twitter https://rb.gy/cy0dki Follow Blockworks on Twitter https://rb.gy/igyzsj -- Get top market insights and the latest in crypto news. Subscribe to Blockworks Daily Newsletter: https://rb.gy/5weeyw Market commentary, charts, degen trade ideas, governance updates, token performance, can't-miss-tweets and more. Subscribe to the Blockworks Research “Daily Debrief” Newsletter: https://rb.gy/feusos Find out more about the Blockworks video editor role here: https://blockworks.co/careers/ -- Timestamps: (00:00) Intro (01:51) Chemicals Market Is Indicating The Recession Will Be Deep (14:03) The Mood Is Grim" In The Chemicals Business (19:21) Demographics Are Not Helping! (23:25) The Yield Curve Is Not The Be-All End-All (32:35) Chemical Prices Are Collapsing (40:04) Has Inflation Peaked? (44:44) In A Recession, Earnings Go Down (46:19) The Fed Put Is No More (52:51) A Food Crisis Is Brewing (55:46) Oil and Natural Gas (01:03:31) How Will Europe Handle This Winter? (01:11:17) There Is Considerable Downside Risk" (01:14:42) Discount To pH Report, Paul Hodges' Research Service -- Disclaimer: Nothing discussed on Forward Guidance should be considered as investment advice. Please always do your own research & speak to a financial advisor before thinking about, thinking about putting your money into these crazy markets.

LONDON (ICIS)—Sustainability continued to dominate conversations at this year's annual European Petrochemicals Association meeting, but progress in the chemicals sector has been slow as players negotiate the pandemic and the current market down-cycle.-        EPCA attendees trying to grapple with the paradigm shifts in the market-        Expectations for autumn and winter bearish-        Focus on repositioning businesses towards sustainability-        Energy crisis dominates the agenda-        Downturn could last into 2024-        Energy crisis spells end of fossil fuels, which will mean end of naphtha and ethane -       Players facing the most significant down-cycle in years amid slowing China growth-        EPCA conversations centre around how to adapt to sustainability evolution-        Sustainability shift in chems sector remains early stage despite how long the topic has been on the agenda-        Companies that look to the future and act on it will have the advantage-        Players that are slower or less ambitious in responding could face an existential threat In this Think Tank podcast, Tom Brown interviews ICIS Insight editor Nigel Davis, ICIS senior consultant John Richardson, and Paul Hodges, chairman of New Normal Consulting. 

All the views discussed in this podcast are strictly Terry Sawchuk's opinion.In the latest episode of The Lion's Den, Terry Sawchuk is joined by returning guest, Paul Hodges. Paul is a trusted advisor to major companies and has a proven track record of accurately identifying key trends in global marketplaces. He is the chairman of New Normal Consulting and a Global Expert with the World Economic Forum.In this episode Terry and Paul discuss some of the following topics: Auto Loan Market Europe Food Price Inflation Putin Geopolitics Ukraine Vs Russia Horsemen of the Apocalypse Like what Paul Hodges has to say? Read all of Paul's articles at https://new-normal.com/author/paul-hodges/ Any information discussed in this article is for educational purposes only. It is not meant to be any kind of recommendation or financial advice. The information contained in this video is intended for informational purposes only. Any opinions are those of Terry Sawchuk and not necessarily those of JW Cole Financial, Inc. or JW Cole Advisors, Inc.Securities offered through J.W. Cole Financial, Inc. (JWC) Member FINRA/SIPC. Advisory services offered through J.W. Cole Advisors, Inc. (JWCA). Sawchuk Wealth and JWC/JWCA are unaffiliated entities.

Here's a full-length episode from Real Vision's original series, My Life in 4 Trades - be sure to subscribe. Paul Hodges of the pH Report and New Normal Consulting joins Maggie Lake for another compelling episode of My Life in 4 Trades. Hodges, a 40-year financial veteran, talks about when markets will stop Fed-watching and refocus on core fundamental principles and the process of price discovery. He also explains why every trade has four possible outcomes. Learn more about your ad choices. Visit megaphone.fm/adchoices

Paul Hodges of the pH Report and New Normal Consulting joins Maggie Lake for another compelling episode of My Life in 4 Trades. Hodges, a 40-year financial veteran, talks about when markets will stop Fed-watching and refocus on core fundamental principles and the process of price discovery. He also explains why every trade has four possible outcomes.

One of the loudest messages from the Chinese Communist Party is that it has delivered wealth to citizens by creating an environment in which the economy grows and thrives. However, as a result of the zero-Covid policy and other factors, the economy has hit the buffers. Gross domestic product rose just 0.4% year-on-year in the second quarter of 2022 missing expectations and suggesting a recession could be on the way in parts of China such as Hong Kong and Shanghai. In this podcast, Paul Hodges from New Normal Consulting considers China's economic outlook with host, Duncan Bartlett.

Here's a full-length episode from Real Vision's original series, The Next Big Trade - be sure to subscribe. Paul Hodges of The pH Report and New Normal Consulting joins Harry Melandri for a fascinating conversation on global macro. Hodges believes investors must stop paying attention to every move the Federal Reserve makes and must start paying attention to the fundamentals of equity analysis again. Learn more about your ad choices. Visit megaphone.fm/adchoices

Paul Hodges of The pH Report and New Normal Consulting joins Harry Melandri for a fascinating conversation on global macro. Hodges believes investors must stop paying attention to every move the Federal Reserve makes and must start paying attention to the fundamentals of equity analysis again.

Paul Hodges returns in a deep discussion on inflation, China, and the Federal Reserve. Paul joins Jack Farley to discuss recession and recession risk in Europe, China, and the U.S., as well as the fate of inflated hyper-growth stocks. -- Paul Hodges on Twitter https://twitter.com/paulhodges1 Jack Farley on Twitter https://twitter.com/JackFarley96 Blockworks on Twitter https://twitter.com/Blockworks_ -- Bit.com is a full-suite cryptocurrency exchange launched by Matrixport, an integrated financial services firm headquartered in Singapore. Since August 2020, Bit.com has been online supporting the spot, perpetual, futures, fixed income and options products, with a particular highlight being pioneers to launch BCH options. Bit.com is the second-largest in the BTC and ETH options market. Call to action: For any further enquiry, please contact vip@bit.com. Sign up URL: https://bit.ly/3KlgLR3 App download URL: https://bit.ly/3xer6uI -- (00:00) Introduction (13:45) Why Is Inflation Bad For Stocks? (21:24) Fate of Hyper-Growth Tech Stocks (23:15) Tesla (27:23) Ben Graham's Valuation Rules (30:03) Bit.com Ad (30:34) Recession In Europe (42:39) Recession Risk in the U.S. (46:10) Housing (49:05) The Federal Reserve (52:14) Chemicals Market Flashing Warning Signals (56:00) Recession in China (1:07:07) Electric Vehicles (EVs) and Autonomous Vehicles (AVs) -- Disclaimer: Nothing discussed on Forward Guidance should be considered as investment advice. Please always do your own research & speak to a financial advisor before thinking about, thinking about putting your money into these crazy markets.

In this episode, you will learn:1. The two parts of the "core"2. How this term came to be used in mainstream fitness3. What core activation and timing is and why you need it4. A simple exercise you can do to illustrate this conceptTHANK YOU to Dr. Paul Hodges for the research!!!!WAYS TO GET MORE INFORMATION:1. Subscribe to The Body.....Uncovered and share on social media or however you see fit.2. Visit michelebond.com to read and subscribe3. Purchase your copy of "5 Fitness Fallacies" and get a deeper understanding of this concept4. You can sign up HERE for the FREE Overcoming Your Weakest Link webinar!Support the Show.

South Korea's new president is enjoying attention from both the United States and China. Yoon Suk-yeol spoke with President Biden just a few hours after he was elected and is preparing to host the US leader in Seoul in May. Mr Yoon has also spoken on the telephone with Xi Jinping, who assured him that China and South Korea are “inseparable partners”. It is a delicate balancing act but there are strong indications that Mr Yoon is more inclined to strengthen the alliance with the US than to draw closer politically to China. In this podcast, Paul Hodges, founder of New Normal consulting, discusses South Korea's strategy towards China with Duncan Bartlett, the Editor of Asian Affairs.   China In Context: Episode 64 Broadcast date: 10 May, 2022

On today's episode of Forward Guidance, Jack Farley is joined by Paul Hodges of New Normal Consulting & writer of the pH report. By using leading indicators, Paul predicts cyclical changes in the economic cycle months ahead of most. After correctly calling for inflation in 2021, Paul now warns of an inflationary recession throughout 2022 & runs through the characteristics of this recessionary cycle. Paul goes on to discuss the effect of energy market disruptions in Europe, what this will mean for green energy over the next decade & beyond, how to invest in this environment & potential trouble in the CLO market whilst most investors are distracted by the current news cycle. -- BCB is Europe's leading provider of business accounts and trading services for the digital asset economy. With a dedicated focus on institutional payment services, BCB Group provides business banking, cryptocurrency and foreign exchange market liquidity for some of the world's largest crypto-engaged financial institutions. BCB Business Accounts allow businesses to load fiat currency and cryptocurrencies for payments, operations and trading purposes. BCB's clients can trade FX and cryptocurrencies quickly and at scale, with market-leading value. BCB's BLINC network is the European crypto industry's first instant settlements network and one of the first real-time payment networks of its kind to allow free, real-time transactions across fiat and digital currencies. For more information, please visit https://bcbgroup.com/jack. -- If you like this episode be sure to subscribe to our newsletter at https://blockworks.co/newsletter Timestamps (00:00) Introduction (02:17) Forecasting Inflation In 2021 (03:57) Forecasting A Recession (08:15) Energy's Effect On Inflation (14:04) Natural Gas Disruption in Europe (16:42) Oil Market Outlook (19:50) A Historical Reversal In German Policy (25:12) BCB Group Ad (26:00) Can Europe Cut Reliance On Russian Energy? (39:20) Forecasting A Recession Using Oil (41:55) We Are In A Deflationary World (57:45) Trouble In The CLO Market (1:01:04) Investment Opportunities For The Next Decade & Beyond

 Chemicals players are waking up to a new era for the global economy, where supportive monetary policy and rock-bottom interest rates  give way to a lengthy period of high inflation, sped by the Russia-Ukraine war.  In this Think Tank podcast, Tom Brown interviews ICIS senior consultant for Asia John Richardson, and New Normal Consulting chairman Paul Hodges. 

In this special episode of The Lion's Den, Paul Hodges, chairman of New Normal Consulting and trusted economist for the World Economic Forum, returns for a timely discussion with Sawchuk Wealth's Terry Sawchuk about the Russian invasion of Ukraine and its potential big-picture impacts on world markets and economies. Some of the topics Sawchuk and Hodges discuss during this conversation include: -       Why Hodges believes the markets and world economies will experience more downside-       The possible motivations of Russian President Vladimir Putin and the future steps he may take-       Whether or not Hodges believes that Russia will ultimately occupy the entire country of Ukraine-       The potential impact of today's high oil prices on the economy and why it may lead to a recession -       Why raising interest rates is likely not the most effective solution for our current inflationary environment -       The possible political impacts of the crisis and how the U.S. can handle it diplomatically through a historical lens-       The chances of an internal regime change occurring within the Russian government-       How Hodges would allocate his portfolio right now in the current environment-       The signals that may indicate it is time for investors to re-enter the equity markets This entire episode is available on Apple Podcasts, Spotify, YouTube and more. Also, never miss an episode by subscribing today!  Any information discussed in this article is for educational purposes only. It is not meant to be any kind of recommendation or financial advice. The information contained in this video is intended for informational purposes only. Any opinions are those of Terry Sawchuk and not necessarily those of JW Cole Financial, Inc. or JW Cole Advisors, Inc. Securities offered through J.W. Cole Financial, Inc. (JWC) Member FINRA/SIPC. Advisory services offered through J.W. Cole Advisors, Inc. (JWCA). Sawchuk Wealth and JWC/JWCA are unaffiliated entities. 

LONDON (ICIS) Global chemicals markets have been dominated by the Russian invasion Ukraine as the conflict has caused costs to take an immediate upswing. TotalEnergies response to the invasion The impact on upstream prices across the world Pressure on energy trade flows Downstream demand could collapse in response to rising costs Bottlenecks could shift trading to more localised level as supply routes disrupted UN Environment Assembly plastics pact, what this means for sustainability and the industry In this Think Tank podcast, Senior Reporter Morgan Condon interviews ICIS Insight Editor Nigel Davis, ICIS Senior Consultant Asia John Richardson and Paul Hodges, chairman of New Normal Consulting.Editor's note: This podcast is an opinion piece. The views expressed are those of the presenter and interviewees, and do not necessarily represent those of ICIS.

In this episode of The Lion's Den, host Terry Sawchuk, founder and chairman of Sawchuk Wealth, interviews Paul Hodges, chairman of New Normal Consulting, from the U.K. to help U.S. investors gain a third-party perspective on our markets and economy. As a trusted expert who provides economic guidance to the World Economic Forum, Hodges understands how demographics influence the markets over the long run, which is something we believe many investors overlook but should be aware of.  Some of the topics Sawchuk and Hodges discuss during this conversation include: The current state of the global equity markets and where they may be headed  How changes in populations and demographics impact the markets and economy Potential ways for the U.S. to earn enough capital for our spending without raising taxes How inflation shifts government policies and consumer perspectives Effects the labor crisis may, or may not, have on the markets Thoughts on Tesla's market performance and the future of the automotive industry Whether or not we are in the midst of a financial cold war with Russia and China The risks and potential solutions if China and the U.S. cut off economic ties Do not forget to subscribe and leave a review!

Obtaining vast amounts of renewable energy, plus a more supportive regulatory environment, are most important for Europe's petrochemical industry on its path to low carbon production. Hear Hartwig Michels, president of the European Petrochemical Association and head of BASF's global petrochemical operations, in conversation with Paul Hodges, chairman of New Normal Consulting and Nigel Davis, ICIS Insight editor.      -          Availability of green electricity is the key challenge for low carbon chemical production-          Decline in refinery petrochemical feedstocks will push recycling-          Out of 30m tonnes/year of plastic waste in Europe, 70% is not recycled-          Chemical industry must accelerate moves to net zero-          Sustainability will have a cost for industry and society-          Supply chain, logistics crisis could last at least six months-          Container logistics still disrupted, prices rising again-          Supply shortages, higher prices impact customers-          Record-breaking gas, electricity prices push up production costs-          Slowing demand may alleviate supply chain woes-          Short-term and long-term approaches required to strengthen supply chains

Key economic indicators point to a global slowdown, with margins for many chemicals either contracting or expected to contract.In the ICIS Think Tank podcast, chief news correspondent Tom Brown talks to insight editor Nigel Davis, senior consultant John Richardson, and Paul Hodges, chairman of New Normal Consulting, about Shell's dramatic move, the clean energy transition, supply and demand shifts in the global polyethylene market, and a potential correction to global inflation in the near future.

The crisis at the Chinese property group Evergrande Group has brought into focus the exorbitant lifestyle of its chairman, Hui Ka Yan. After vying with Jack Ma for the title of Asia's richest man, Mr Hui's fortune is plunging, as his company defaults on crucial debt repayments. Neither the government nor the central bank seem prepared to bail him out. Yet with liabilities running into hundreds of billions of dollars, Evergrande is seen by investors as a reminder of the risks of doing business with China. In this podcast, Paul Hodges, Chairman Of New Normal Consulting discusses the issues with Duncan Bartlett, Editor of Asian Affairs magazine.    China In Context: Episode 38   Broadcast date: 26 October, 2021

The American Chemistry Council's chief economist analyses the impact of Storm Ida and reflects on key changes which have shaped the chemical industry over the last 30 years. -          Storm Ida will delay US inventory rebuild into 2022-          After Storm Uri consensus was for inventory rebuild by Q3/4 2021-          Around 15% of US ethylene capacity could be offline for 2-3 weeks longer-          Ida adds to existing difficulties in global supply chains-          Ida outages impact Europe's ability to import from the US-          Shortages may continue to inflate prices -          Constant supply chain disruption could spell end of globalisation-          Only 30% of shipping is arriving on time-          Shale gas revolutionised US chemicals-          Focus on quarterly results at expense of long-term vision-          Climate emergency, low carbon production will drive industryKevin is joined by ICIS Insight Editor Nigel Davis, and Paul Hodges, chairman of New Normal Consulting. 

Global operating rate races past 90% for the first time in 30 years, says the American Chemistry Council Healthy downstream production, except for automotive Pandemic restrictions, logistics crisis has driven tight supply/demand for chemicals New Asia crackers about to start up Low vaccination rates threaten economic recovery, especially in Asia Long-term logistics, production disruption will boost local supply chains China manufacturing hurt by logistics costs, delays on exports Weaker China demand will reduce need for chemical imports In this Think Tank podcast, Will Beacham interviews Nigel Davis, ICIS Insight Editor, John Richardson, ICIS Senior Consultant Asia, and Paul Hodges, chairman of New Normal Consulting.

Hosted by  Cristiane Carboni with guests Paul Hodges and Jo Milios.Recorded on 3 June 2021. 

RV Live replay: Paul Hodges of The pH Report and New Normal Consulting returns to Real Vision to update viewers on the health of the global economy and what that means for financial markets. Hodges and his team see big changes on the horizon and, through their analysis of the chemical industry, auto market, and technology sector, see a return to the "old normal" as being highly unlikely. In this interview with Max Wiethe, Hodges highlights the important data leading him to believe that post-COVID the world will look very different as demand patterns shift, reshoring continues, and momentum for "the green recovery" grows. An excerpt from the most recent edition of The pH Report looking at the auto market can be found here: https://www.realvision.com/issues/auto-markets-shaken-by-covid-and-evs. To access Hodges' charts, please use this link: https://rvtv.io/3bvZXqA. Learn more about your ad choices. Visit megaphone.fm/adchoices

Hosted by Lori Forner with guest Paul Hodges. Plus an introduction to the series from Cristiane Carboni and Melanie Morin.Recorded on 12 April 2021.

The International Continence Society Podcast is coming! On behalf of the ICS Institute of Physiotherapy, I had the pleasure of interviewing Professor Paul Hodges for Episode 1 on Balancing Mobility and Stability within the #pelvicfloor and am excited to be able to share some of it here first. This episode on The Pelvic Health Podcast is only half of our discussion - you can catch the entire episode as of June 1 (2021) on the new ICS Podcast through their website and all major podcast platforms like iTunes and Spotify. The ICS Podcast series line-up is not to be missed and aims to highlight the amazing speakers in pelvic health that will be presenting at this year’s ICS Virtual Conference on October 14-17. So sit back and get ready to be floored by only some of the wisdom of Prof Paul Hodges on concepts and research on pelvic floor muscle stiffness, movement, pain, strength and so much more. Don't forget to look for the new ICS Podcast in June to listen to the rest of this episode and so much more!   Thank you to Always Discreet for sponsoring this episode of The Pelvic Health Podcast.  

Paul Hodges, the accidental café owner. We're sorry the sound quality isn't brilliant on this episode. It was never Paul's dream to own the number one outdoor cafe in the UK. Paul used to run large and successful construction company, but life chances, happenstance and fortunate meetings led him Capel Curig and to what is now the Siabod Café. Find out about Paul his journey and how he, with his fantastic team, have turned the Moel Siabod Cafe in to your number one destination. Find out about Paul charity works, his running and what he thinks about Snowdonia and what might lay ahead

Brexit can be compared to a slow puncture, where future decisions on investment might see the country's chemical industry and value chains gradually lose out to other places.- Chemicals may see long-term damage as investment diverted elsewhere- UK chemicals face complex customs procedures with or without a trade deal in place- Under no deal tariffs will apply each time a product crosses the border- For downstream automotive, aerospace this could add significant costs - Expect more logistical and regulatory challenges such as UK Reach- Biden administration will give a big boost to climate change, sustainability agenda- US chemical companies will quickly wake up to this challengePodcast interview with Paul Hodges chairman New Normal Consulting; Nigel Davis, ICIS Insight Editor and John Richardson, ICIS senior consultant, Asia.

The news that ExxonMobil will write down up to $20bn in asset values shows that the era of fossil fuels is drawing to a close, so chemical companies must focus on completely new strategies for long-term success. - ExxonMobil write downs signal the end of reliance on fossil fuels - Companies need to understand demand trends on a micro basis- Four key megatrends for chemicals strategies are pandemic, sustainability, demographics, geopolitics- Chemical return on capital employed is falling as over-capacity increases- China self-sufficiency in chemicals will force plant closures, moves downstream - With or without a deal, Brexit is a disaster for UK industry- Boston Consulting Group analysis shows Jan-June 2020 chemicals Total Shareholder Return (TSR) was -11% driven by falling sales and profits- By 2021 expect significant bounceback to 2019 levels driven by prices and volumes - Chemical companies must analyse role in circular economy/sustainability agendaPodcast interview with Andreas Gocke, managing director and senior partner at Boston Consulting Group; Nigel Davis, ICIS Insight Editor; Paul Hodges, chairman of New Normal Consulting and John Richardson, ICIS senior consultant for Asia.

Manufacturing hundreds of millions of coronavirus vaccine shots could boost demand for polypropylene (PP), but not enough to compensate for losses in other end use markets.- Coronavirus vaccine packaging may boost demand for polypropylene (PP)- But not enough to replace lost demand from other end uses- Refinery closures will restrict petrochemical feedstocks- End use markets shifting to renewables, low carbon technologies- Danger that fiscal tightening could stifle recovery, raise unemployment- Current wave of lockdowns not as damaging to economies- Lack of visibility on demand patterns beyond Q4Podcast interview with Rhian O'Connor, ICIS lead analyst for demand modelling and Paul Hodges, chairman of New Normal Consulting.

Whether Donald Trump or Joe Biden wins the US election, inexorable market forces will push the US away from fossil fuels and towards adoption of low carbon technologies.- Market forces are more powerful than presidents- Market forces will force switch away from fossil fuels to recycled feedstocks- Biden likely to push solar, wind, electrification of transport- Biden unlikely to reverse Trump's China trade tariffs- Fundamental shift in US-China relations unlikely to reverse- Signing back up to Iran nuclear deal would increase oil and chemical supply Listen to this podcast interview with ICIS Chemical Business deputy editor, Joseph Chang; and chairman of New Normal Consulting, Paul Hodges.Interview by Will Beacham

China is expected to unveil far-reaching plans which will impact the chemical industry around the world at this week's Fifth Plenum meeting. - China could come to dominate global plastics recycling technology- Could dominate global renewable energy and electric vehicles- Build global alliance of countries which believe human activity creates climate change- Big strides in cleaning up China's environment- More petrochemical self-sufficiency - Expansion of Belt and Road initiative- Rapid action on pandemic, allies to receive vaccines- Growth of domestic self-sufficiency and poverty reductionPodcast interview with Paul Hodges, chairman New Normal Consulting; Nigel Davis, ICIS Insight editor and John Richardson, ICIS senior consultant, Asia.

On this episode of the Healthy, Wealthy and Smart Podcast, I welcome Dr. Sarah Haag to talk about exercise and urinary incontinence. This interview was part of the JOSPT Asks interview series. Sarah is the co-owner of Entropy Physiotherapy and Wellness in Chicago. Sarah was awarded the Certificate of Achievement in Pelvic Physical Therapy (CAPP) from the Section on Women's Health. She went on to get her Doctorate of Physical Therapy and Masters of Science in Women's Health from Rosalind Franklin University in 2008. In 2009 she was awarded a Board Certification as a specialist in women's health (WCS). Sarah also completed a Certification in Mechanical Diagnosis Therapy from the Mckenzie Institute in 2010. In this episode, we discuss: The prevalence of urinary incontinence Is urinary incontinence normal Pelvic floor exercises Pelvic floor exam for the non-pelvic health PT Sports specific pelvic health dysfunction And much more Resources: Entropy Physiotherapy and Wellness JOSPT Facebook Page JOSPT Journal Page More Information about Dr. Haag: Sarah graduated from Marquette University in 2002 with a Master's of Physical Therapy. Sarah has pursued an interest in treating the spine, pelvis with a specialization in women's and men's health. Over the years, Sarah has seized every opportunity available to her in order to further her understanding of the human body, and the various ways it can seem to fall apart in order to sympathetically and efficiently facilitate a return to optimal function. Sarah was awarded the Certificate of Achievement in Pelvic Physical Therapy (CAPP) from the Section on Women's Health. She went on to get her Doctorate of Physical Therapy and Masters of Science in Women's Health from Rosalind Franklin University in 2008. In 2009 she was awarded a Board Certification as a specialist in women's health (WCS). Sarah also completed a Certification in Mechanical Diagnosis Therapy from the Mckenzie Institute in 2010. Sarah has completed a 200 hour Yoga Instructor Training Program, and is now a Registered Yoga Teacher. Sarah looks at education, and a better understanding of the latest evidence in the field of physical therapy, as the best way to help people learn about their conditions, and to help people learn to take care of themselves throughout the life span. Read the full transcript below: Read the Full Transcript below: Speaker 1 (00:06:25): So, and hopefully it doesn't want to lose what we're doing here. We'll see. Okay. Going live now. Okay. Welcome everyone to JLS. PT asks hello and welcome to the listeners. This is Joe SPT asks the weekly chat where you, the audience get your questions answered. My name is Claire Arden. I'm the editor in chief of Joe SPT. And it's really great to be chatting with you this week, before we get to our guest. I'd like to say a big thanks for the terrific feedback that we've had since launching [inaudible] a week ago. We really appreciate your feedback. So please let us know if there's a guest that you'd like to hear from, or if you have some ideas for the show today, we're in for a very special treat because not only are we joined by dr. Sarah hake from entropy physio, but guest hosting [inaudible] asks today is dr. Karen Litzy who you might know from the healthy, wealthy and smart podcast. Dr. Lexi is also a new Yorker. And I think I can speak for many of us when I say that New York has been front of mind recently with the coronavirus pandemic. And I'd like to extend our very best wishes to everyone in New York where we're thinking of you. So I'm going to throw to Karen now. We're, I'm really looking forward to chat today on pelvic floor incontinence and exercise over to you, Karen. Speaker 1 (00:08:25): Hi everyone, Claire. Thank you so much. I really appreciate your giving me the opportunity to be part of J O S P T asks live stream. So I'm very excited about this and I'm also very excited to talk with dr. Sarah Hagar. Sarah is an educator, a clinician, and an author. She is also co-owner of entropy wellness and our physiotherapy and wellness in Chicago, Illinois, and is also a good Speaker 2 (00:08:56): Friend of mine. So it's really a an honor for me to be on here. So Sarah, welcome. Thank you so much. I was really excited that all this came together so beautifully. Yes. And, and again like Claire had mentioned, we're all experiencing some pretty unprecedented times at the moment. And the hope of these J O S P T asks live streams is to continue to create that sense of community among all of us, even though we can't be with each other in person, but we can at least do this virtually. And as Claire said, last week, we want to acknowledge our frontline healthcare workers and colleagues across the world for their dedication and care to those in need. And again, like Claire said before, a special shout out to my New York city colleagues, we are they are really working like no other. Speaker 2 (00:09:52): And I also want to acknowledge not just our healthcare colleagues and workers, but the scientists, the grocery store workers, the truck drivers the pharmacist, police, firefighter paramedics, they're all working at full capacity to keep the wheels turning around the world. So I just want to acknowledge them as well and thank them for all of their hard work during this time. Okay. So, like Claire said today, we're going to be talking about the pelvic floor, which is something Sarah loves to talk about because what I also, I also failed to mention is she is a certified pelvic health practitioner. So through the American physical therapy association. So she is perfectly positioned to take us through. And as a lot of, you know, we had, you had the opportunity to go onto Slido to ask questions. You can still do that. Even throughout this talk, just use the code pelvic that's P E L V I C, and ask some questions. Speaker 2 (00:10:57): So we do have a lot of questions. I don't know if we're going to get to all of them. So if we don't then certainly post them in the Facebook chat and maybe Sarah can find those questions in the chat below. And we'll try and get to those questions after the recording has finished. All right, Sarah. So like I said, lots of questions and the way the questions were, were written out, kind of corresponds quite well with maybe how you would see a patient in the clinic. So let's start with the patient comes into your clinic. They sit down in front of you. Let's talk about the words we would use in that initial evaluation. So I'll throw it over to you. Okay. So being a pelvic health therapist, obviously most people when they're coming to females, Things that happen in the pelvis, I like to acknowledge it, that there's a lot of things happening in the past. So I have Speaker 1 (00:11:54): Them tell me kind of what are the things that have been bothering them or what are the things that have been happening that indicate something might be going on? Like if something's hurting, if they're experiencing incontinence, any bowel issues, any sexual dysfunction. And, and I kind of go from there. So if the talk that's the title of the talk today includes incontinence. Continence is a super common issue that let's see in general might pop in. And if you would bother to ask there's actually, I think it's like one out of two people over 60 are experiencing incontinence of some kind. The answer is going to be yes, some, so you can start asking more questions. But starting out with what, what is bothering them is really what I like to start with. Then the next thing we need to know is after we vet that issue or that priority list of things that are bothering them in the pelvis, and it's not uncommon actually to have. Speaker 1 (00:13:00): So let's say they start with a discussion of incontinence. I still actually ask about sexual function, any pain issues, any bowel issues, just based on the innervation of the various, the anatomical arrangement of everything. It's not uncommon to have more than one issue, but those other issues might not be bothersome enough to mention. So it's kind of nice to get that full picture. Then the next thing we really want art. So there are times I've met women who come in and they're like, Oh yeah, you know, I have incontinence. And you're like, okay. So when did it start now? Like 25 years ago. Okay. Do you remember what happened then? Typically it was a baby, but sometimes these women will notice that their incontinence didn't happen to like four or five years after the baby. Hmm. So that's information, that's very help if they say my baby that was born six weeks ago, our interventions and expectations are going to be very different than someone who's been having incontinence for 25 years. Speaker 1 (00:14:05): So again, knowing how it started and when it happens, when the issues are happening, I just kind of let them, it's like a free text box on a form. Like just, they can tell me so much more excuse me. And when we are talking about things, we, I do talk anatomy. So when it comes to incontinence, I talk about the bladder and the detrusor, the smooth muscle around the bladder, the basically the hose that takes the urine from the bladder to the outside world. I do talk about the vagina and the vulva and the difference between the two. And then actually we do talk about like the anus and the anal sphincters and how all of that is is all there together and supported by the pelvic floor. Speaker 1 (00:14:54): Cause that's in physical therapy, it's going to be something with that pelvic floor or something. Drought, does it need to be more, more pelvic floor focused or does it need to be behaviorally focused, which is the case sometimes, or is it that kind of finding that perfect Venn diagram of both for those issues that the person's having? And let's say you're in a part of the world. One of the questions was what if you're I think this question came from Asia and they said, what if you're in part of the world where you have to be a little bit, maybe more sensitive around even the words that you use. I know we had gotten a question a couple of years ago about a woman in the Southern part of the United States that was from very conservative area. And do we even use these words with these patients? Speaker 1 (00:15:48): So what is your response to that? My response is that as healthcare providers, we are responsible, I think for educating people and using appropriate words and making sure people understand the anatomy like where things are and what they're supposed to be doing. However, definitely when I'm having this conversation with someone I want them to feel at ease. So like I will use the Ana vagina anus, anal sphincters Volvo, not, it's not a vagina, it's a Volvo it's on the outside. But then if they use different terms to refer to the anatomy, we're discussing, I'm happy to code, switch over to what they're most comfortable with because they need to be comfortable. But I think as, as again, healthcare practitioners, if we're not comfortable with the area, we're not going to make them feel very comfortable about discussing those issues. Right. Speaker 1 (00:16:43): And that makes a lot of sense. Thank you for that. So now let's say you, the person kind of told you what's going on and let's, let's talk about when you're taking the history for women with incontinence, especially after pregnancy, are there key questions you like to ask? Yes. So my, my gals that I'm seeing, especially when they're relatively relatively early in the postpartum period, are the things I'm interested in is did they experience this incontinence during their pregnancy? And did they have issues before pregnancy? And then also if this is not their first, tell me about the first birth or the, or the first two birth. So the first three birth to really get an idea of is this a new issue or is this kind of an ongoing marked by so kind of getting a bigger picture of it. Speaker 1 (00:17:49): And then also that most recent birth we want to know, was it vaginal? Was it C-section with vaginal birth? If there's instrumentation use, so if they needed to use forceps or a vacuum that increases the likelihood that the pelvic floor went over, went under a bit of trauma and possibly that resulted in a larger lab. And even if there isn't muscles, it's understandable that things might work well, if it's really small and if it's still healing you know, different, different things like that. So understanding the, kind of like the recent birth story, as well as their bladder story going back. So you've met first baby or before that first baby so that we know where, where we're starting from. And the, the reason why I do that is because again, if it's a longterm issue, we have to acknowledge the most recent event and also understand there was something else happening that, that we need to kind of look at. Speaker 1 (00:18:58): So would I expect it all to magically go away? No, I wouldn't. There's probably something else we need to figure out, but if it's like, Nope, this onset happened birth of my baby three months ago, it's been happening since then three months is, seems like forever and is also no time whatsoever. It took 10 months to make the baby. So it's you know, if you tear your hamstring, we're expecting you to start feeling better in three months, but you're probably not back to your peak performance. So where are we in that? And sometimes time will cure things. Things will continue to heal, but also that would be a time like how good are things working? Is there something else going on that maybe we could facilitate or have them reach continence a bit sooner. Okay, great. And do you also ask questions around if there was any trauma to the area? Speaker 1 (00:19:56): So if this birth was for example, the product of, of a rape or of some other type of trauma, is that a question that you ask or do you, is that something that you hope they bring up? It's, that's honestly for me and my practice, something, I try to leave all of the doors wide open for them to, to share that in my experience you know, I've worked places where it is on it's on the questionnaire that they fill out from the front desk and they'll circle no to, to any sort of trauma in the past. Speaker 1 (00:20:34): Yeah. They just, they don't want to circle yes. On that form. So and also I kind of treat everybody like they might have something in their past, right. So very nonjudgmental, very safe place, always making them as comfortable in a safe as possible. And I will say that there's anything I can do to make you feel more comfortable and more safe. We can do that. And if you don't feel safe and comfortable, we're not doing this w we're going to do something else. Cause you're right. That it's always one of those lingering things. And the statistics on abuse and, and rape are horrifying to the point where, again, in my practice, I kind of assume that everybody has the possibility of having something in their past. Okay, great. Thank you. And now another question that's shifting gears. Another question that came up that I think is definitely worthy of an answer is what outcome measures or tools might you use with with your incontinence patients? So with incontinence, honestly, my favorite is like an oldie buddy, but a goodie, like just, it's an IC, it's the international continents questionnaire where it's, I think it's five or six questions. Just simple. Like how often does this happen? When does it happen? Speaker 1 (00:21:58): There's a couple of other outcome measures that do cover, like your bladder is not empty. Are you having feelings of pressure in your lower abdomen? It gets into some bowel and more genital function. Can you repeat that? Cause it kind of froze up for a second. So could you repeat the name of that outcome tool as it relates to the bladder and output? Oh, sorry. I see. IQ is one and then, but like I see IQ vs which renal symptoms, right? So there are, there's a lot of different forms out there. Another one that will gather up information about a whole bunch of things in the pelvis is the pelvic floor distress bins questions about bowel function, bladder function, sexual function discomfort from pressure or pain. So that can give you a bigger picture. I'll be honest. Sometimes my, the people in my clinic they're coming in, and even though I will ask the questions about those things, when they get the, the questionnaire with all of these things that they're like, this doesn't apply to me. I'm like, well, that's great that it doesn't apply to you, but they don't love filling, filling it out. So sometimes what I will go with is actually just the pale. Speaker 1 (00:23:24): Can you say that again? Please help me. Oh yeah. Oh, so sorry. The patient's specific functional scale where, where the patient says, this is what I want to have happen. And we kind of figured out where they are talk about what would need to happen to get them there, but it's them telling what better. Right. Cause I've had people actually score perfect on some of these outcome measures, but they're still in my office. So it's like, Oh, I'm so patient specific is one of my one of my kind of go tos. And then there's actually a couple of, most of these pelvic questionnaires finding one that you like is really helpful because, because there's so many and they really all or discomfort. So if you have a really good ability to take a really good history, some of the questions on that outcome measure end up being a bit redundant. Speaker 1 (00:24:26): So I like, and you know the questions on there, make sure people are filling them out. You look at them before you ask them all the questions that they just filled out on the form for you. Yes. Good. Very good advice. So then the patient doesn't feel like they're just being piled on with question after question and cause that can make people feel uncomfortable when maybe they're already a little uncomfortable coming to see someone for, for whatever their problem or dysfunction is. So that's a really good point. And now here's a question that came up a couple of times, you know, we're talking about incontinence, we're talking about women, we're talking about pregnancy. What about men? So is this pelvic floor dysfunction? Is this incontinence a women only problem? Or can it be an everybody problem? So it very much can be an everybody problem. Incontinence in particular for men, the rates for that are much lower. And typically the men are either much older or they are they've undergone frustrate removal for prostate cancer. Speaker 1 (00:25:33): Fleur plays a role in getting them to be dry or at least dryer. And then it's like the pelvic floor is not working right. That can result in pain. It can result in constipation. It can result in sexual dysfunction. It can result in bladder issues. So it's, so yes, men can have all of those things. In fact, last night we had a great talk in our mentorship group at entropy about hard flacid syndrome. So this is a syndrome with men where everything is normal when they go get, get tested, no no infections, no cancers, no tumors, no trauma that they can recall. And, but the penis is not able to become functional and direct. And with a lot of these men, we're finding that it's more of a pelvic floor dysfunction issue, or at least they respond to pelvic floor interventions. Speaker 1 (00:26:30): So having a pelvic floor that does what it's supposed to, which is contract and relax and help you do the things you want to do. If, if we can help people make sure that they're doing that can resolve a lot of issues and because men have pelvic floors, they can sometimes have pelvic floor dysfunction. Okay, great. Yeah. That was a very popular question. Is this a woman only thing? So thank you for clearing up that mystery for everyone. Okay. So in going through your evaluation, you've, you've asked all your questions, you're getting ready for your objective exam. What do you do if you're a clinician who does not do internal work, is there a way to test these pelvic floor muscles and to do things without having to do internal work? My answer for that question is yes, there are things that you can do because even though I do do internal exams, I have people who come to see me who are like, no, we're not doing that. Speaker 1 (00:27:31): So, so where can we start? And so the first one is pants on and me not even touching you pelvic floor, I wouldn't really call it an assessment or self report. So even just sitting here, if you, if you were to call me up and and this actually goes into, I think another question that was on Slido about pelvic floor cues. So there is actually then it seems more research on how to get a mail to contract this pelvic floor then actually females. But I would ask you like like this is one that my friend Julie, we would use. So like if you're sitting there and you just sit up nice and tall, if you pretend you're trying to pick up a Ruby with your PA with your vagina is not on the outside, but imagine like there's just a Ruby on the chair and you'd like to pick it up with no hands, breathe in and breathe out and let it go. So then I would go, did you feel anything and you should have felt something happen or not. So if, if you did it, would you mind telling me what you built? You're asking me, Oh my goodness. Oh yes. I did feel something. So I did feel like I could pick the Ruby up and hold it and drop it. Speaker 1 (00:29:04): Excellent. And that's, and that, that drop is key. Excellent. So what I would say is this is like like a plus, like a, I can't confirm or deny you that you did it correctly, but I like, I would have watched you hold your, like she holding my breath. Is she getting taller? Cause she's using her glutes. Did she just do a crunch? When she tried to do this, I can see external things happening that would indicate you're might be working too hard or you might be doing something completely wrong. So then we'll get into, I mean, you said, yes. I felt like I pick up the Ruby, but if it's like, Hmm, I felt stuffed, but I'm not really sure we would use our words because they've already said no to hands to figure that out. But again, I can't confirm it. People are they're okay with that. Speaker 1 (00:29:48): And I'm like, and if what we're doing based on the information you gave me, isn't changing, we might go to step two. If you can send in step two is actually something, any orthopedic therapist honestly, should not feel too crazy doing. So if anyone has ever palpated the origin of the hamstring, so where is the origin of the hamstring facial tuberosity? If you go just medial to that along the inside part get, don't go square in the middle. That's where everyone gets a little nervous and a little tense, but if you just Pell paid around that issue, tuberosity it's pretty awesome. If you have a, a friend or a colleague who's willing to let this happen is you ask them to do a poll of our different cues with that in a little bit. You say that again, ask them to do what to contract the pelvic floor. Speaker 1 (00:30:44): Okay. And again, figuring out the right words so that they know what you're talking about. We can talk about that in a minute, but if they do a pelvic floor contraction, you're going to feel kind of like the bulging tension build, right there may be pushing your fingers. You should feel it kind of gather under your fingers. It shouldn't like push your fingers away, but then you can be like, well, you could test their hamstring and see that you're not on the hamstring and you can have them squeeze your glutes and you can kind of feel the differences. The pelvic floor is just there at the bottom of the pelvis. So you can palpate externally, even through BlueJeans is a bit of a challenge, but if they're in you know, like their workout shorts for yoga pants, it's actually very, very simple. And, and honestly, as long as you explained to them what you're doing and what you're checking for, it's no different than palpating the issue of tuberosity for any other reason. Speaker 1 (00:31:36): And with that, I tell them that I can, it's more like a plus minus, so I can tell that you contracted and that you let go. That's all I can tell. So I can't tell you how strong you are, how good your relaxation Wells, how long you could hold it for any of those things. And then I tell them with an internal exam, we would get a lot of information we could, we can test left to, right? We can, I could give you more of like a muscle grade. So like that zero to five scale be use for other muscles. We can use that for the pelvic floor. I can get a much better sense of your relaxation and see how was that going and I can even offer some assistance. So so we have two really good options for no touching. Speaker 1 (00:32:19): And then just as long as we understand the information we might gain from an internal exam, we can, we can, the information we gathered from the first two ways, isn't sufficient to make a change for them. And then as let's say, the non pelvic health therapist, which there might be several who are gonna watch this, when do we say, you know, something? I think it's time that we refer you to a pelvic health therapist, because I do think given what you've said to me and you know, maybe we did step one and two here of your exams. I think that you need a little bit more. So when do, when is that decision made to reach the point of, they have a bother that I don't know how to address so we can actually go to like the pelvic organ prolapse. So pelvic organ prolapse is, is when the support for either the bladder, the uterus, or even the rectum starts to be less supportive and things can kind of start to fall into the vaginal wall and can give a feeling of like pressure in with activity the sensation can get. Speaker 1 (00:33:39): So then we have two options, which is more support from below with perhaps a stronger meatier pelvic floor by like working it out to hypertrophy. So like if, if I had someone who had that feeling when they were running and we tried a couple are lifting weights, let's go lifting weights. No, like I feel it once I get to like a 200 pound deadlift. Okay, well, let's see how you're lifting when you're doing 150 and let's take a look at what you're doing at 200 in fresh with your mechanics or what's happening. And if there's something that is in your wheelhouse where you're like, well, can you try this breath? Or can you try it this way and see if that feeling goes away? I'm good with that. And if the, that the person who's having issue is good with that. Awesome. But if you're trying stuff or the incontinence is not changing, send them to a pelvic floor therapist, because what we love to do is we can check it out. Speaker 1 (00:34:41): We're going to check it out. We're going to give some suggestions. And then my, the end of every one of those visits that I get from my, from my orthopedic or sports colleagues is I'm like, excellent. So you're going to work on this, keep doing what you're doing. Cause another really common thing is like, is I don't really believe that they can make a lot of these things worse doing the things that they're doing. And by that, I mean, they can become more simple MADEC, but in many cases you're not actually making the situation worse. So if the symptoms seem to be not getting better or even getting worse, doing the things they're doing, they go come back to the pelvic floor therapist. And then that pelvic floor therapist also has a responsibility that the things I'm asking them to do, isn't helping them get there. Speaker 1 (00:35:29): You can try something a little more intense, still not helping. Then that's when I actually would refer for females, especially with like pelvic pressure. So Euro gynecologist for an assessment in that regard. Yeah. So I think I heard a couple of really important things there. And that's one, if you are the sports therapist or the orthopedic physiotherapist, and you have someone that needs pelvic health support, you can refer them to the pelvic health therapist and you can continue seeing them doing the things you're doing. So just because they're having incontinence or they're having some pressure, let's say it's a pelvis, pelvic organ prolapse. It doesn't mean stop doing everything you're doing. Speaker 3 (00:36:12): Okay. Speaker 1 (00:36:15): Correct. Okay. Yeah. It may mean modify what you're doing. Stop some of what you're doing, listen to the pelvic floor therapist. And I'm also seeing, well now we're, aren't we this great cause we're creating great team around this, around this person to help support them in their goals. So one doesn't negate the other. Absolutely correct. And I, and I think too often even, even within the PT world is people start to get kind of territorial. But it's not about what each one of us is doing. It's that person. Right. so telling them to stop doing something, especially if it's something they love it seems like a bad start. It's like, okay, let's take a look at this. Tell me what you are doing. Tell me what you want to be doing. Tell me what's happening when you do that. And let's see if we can change it. Speaker 1 (00:37:02): Cause like I said, like the, the other, that being something they're going to make worse and worse and worse is if symptoms get worse and worse and worse, but they're not causing damage, they're not causing, I mean, what they're doing and say leaking a bit. Got it. And now I'm going to take a slight detour here because you had mentioned pelvic organ prolapse. You had mentioned, there comes a time when, if that pressure is not relieving, you've tried a lot of different things. You would refer them to a urogynecologist now several years ago. They're so you're, you're a gynecologist. One of their treatments might be surgery. So there was pelvic mesh sweats. It's hard to say pelvic mesh surgery that years ago made some people better and made some people far, far worse with, with some very serious ramifications. So can you talk about that pelvic mesh mesh surgery and where we are now? Speaker 1 (00:38:04): Oh, the last bit cut out a little bit. So the pelvic mess, mess surgery and, and Oh, the most important part and kind of where we are now versus maybe where we were, let's say a decade ago or so. Awesome. Yeah. So, so the pelvic mesh situation certainly here, I think it's not a universal problem. I think it's a United States problem is if you're at home during the day, like most of us are now you will see law commercials, lawyers looking for your business to discuss the mesh situation on what's happening is there was there were, it was mesh erosion and the resulting fact that that was a lot of pain because they couldn't just take it all out. And it was several women suffered and are still sad. Speaker 3 (00:38:55): Mmm. Speaker 1 (00:38:55): But that was from a particular type of surgery with a particular type of surgical kit, which thankfully has, was removed completely from the market and isn't being used anymore and mesh surgeries, I would say at least for the last five to 10 years, haven't haven't been using that and mesh surgeries are being done with great success in resolving symptoms. So I think it's important that if a woman isn't responding Speaker 3 (00:39:27): Yeah. Speaker 1 (00:39:30): Well changing their breath or making a pelvic floor or changing how they're doing things is to have that discussion with the Euro gynecologist because they do have nonsurgical options for super mild prolapse. There are some even like over the counter options you can buy like poise has one where it's just a little bit of support that helps you. Actually not leak because if you're having too much movement of the urethra, it can cause stress or it can be contributing to stress incontinence. But so there's some over the counter things or there's something called a pessary, which I think about it. Like I'm like a tent pole, but it's not a pole. It's a circle don't worry or a square or a donut. There's so many different shapes, but it's basically something you put in the vagina and that you can take out of the vagina that just kind of holds everything back up where it belongs, so it can work better. Speaker 1 (00:40:21): And that it's not awesome. But there are also people who are like due to hand dexterity, or just due to a general discomfort with the idea of putting things in their vagina and living them there that they're like, no, I'd rather just have this be fixed. So, so there are, it's not just surgery is not your only option. There are lots of options and it just depends on where you want to go. But with the surgery, if that's what's being recommended for a woman, I really do. Some women aren't worried at all. They've heard about the mash, but they're sure it won't happen to them, but there are when we're still avoiding surgery, even with significant syndromes, because they're worried about the mesh situation. And I would still encourage those women to at least discuss us, to see if that surgeon can, can educate them and give them enough confidence before they move forward with the surgery. Speaker 1 (00:41:18): Because the worst thing I think is when I had one patient actually put it off for years. Not, not just because of the mesh because of a lot of issues, but the first time the doctor recommended it, she had a grade four prolapse. Like that means when things come all the way out. And she it was so bad. Like she couldn't use the pastory okay, so she needed it, but she avoided it until she was ready and had the answers that made her feel confident in that having the surgery was the right thing to do. So it might take some time and the doctor, the surgeon really should, and most of them that I've met are more than happy to make sure that the patient has all the information they need and understand the risk factors, the potential benefits before they move forward. Speaker 2 (00:42:03): Excellent. Thank you so much for that indulging that slight detour. Okay. Let's get into intervention. So there are lots of questions on Slido about it, about different kinds of interventions. And so let's start with lot of, lot of questions about transverse abdominis activation. So there is one question here from Shan. Tall said studies in patients with specific low back pain do not recommend adding transverse abdominis activation because of protective muscle spasm. What about urinary incontinence in combination? What do you do? So there is a lot on transfer subdominant as you saw in Slido. So I'll throw it over to you and, and you can give us all your share your knowledge. Speaker 1 (00:42:55): Okay, well, let's all do this together. So I don't know how many people are watching, but if we just sit up nice and tall and I'm going to give a different cue for the pelvic floor. So what I want you to squeeze, like you don't want to urinate, like you want to stop the stream of urine. Okay. So as we're pulling that in anything else other than the underneath contract, what did you feel Karen? Speaker 2 (00:43:24): Well, I did feel my TA contract. I felt that lower abdominal muscle wall started to pull in. Speaker 1 (00:43:32): Yes. So, so the, the way I explain it is that the pelvic floor and the trans versus are the best is to friends. And this makes sense when you think about when you remember the fact that the pelvic floor, isn't just there regarding like bowel bladder and sexual function. It's one of our posture muscles. So if we're totally like, like slacked out and our abs are off and all of that, our pelvic floor is pretty turned off as well. And then if I get a little bit taller and like, so I'm not really clenching anything. Right. But this is like stuff working like it should, my pelvic floor is a little more on, but not, I'm not acting. It's just but then I could like, right, if I'm gonna, if I'm expecting to hit, or if I'm going to push into something, I can tend to set up more and handle more force into the system. Speaker 1 (00:44:21): So I like to think about it in those in those three ways, because the pelvic floor, isn't just hanging out, down there and complete isolation it's, it's part of a system. And so in my personal, like emotional approach to interventions is I don't want them to be too complicated. So if I can get someone to contract their pelvic floor, continue to breathe and let go of that pelvic floor, then we start thinking about what else are you feeling? Cause I don't know that there's any evidence that says if I just work my transverses all the time, my pelvic floor will automatically come along for the ride. So a great quote. I heard Karrie both speak once at a combined sections meeting and she goes, your biceps turn on. When you take a walk, it's not a good bicep exercise. So just the fact we're getting activity in the pelvic floor when we're working other muscles, what's supposed to work. And also if you want to strengthen that muscle, you're going to need to work out that muscle. Speaker 1 (00:45:26): And that makes a lot of sense and something that people had a lot of questions around where we're kind of queuing for these different exercises. And I really love the can. You've made it several times comparisons to other muscles in the body. So can you talk about maybe what kind of queuing you might use to have someone on? I can't believe I'm going to say this turn on and I use that in quotes because that's what you see in, in a lot of like mainstream publications for, for layman. So it might be something that our patients may see when they come in. So how do you cue that? To, to turn on the pelvic floor? So honestly I will usually start with floor and I do if I'm able to do a public floor exam, that's usually, again, a lot more information for me, but I'm like, okay, so do that now. Speaker 1 (00:46:27): And I watched them do it or I feel them do it and I'd be like, Oh, okay. What did you, what did you feel move? And I start there. And then I always say it's a little bit, like I get dropped into a country and I'm not sure what language people are speaking. So sometimes excuse me, one of the first cues that I learned was like, so squeeze, like you don't want to pass gas. Okay. So everybody let's try that. So sitting squeeze, like you don't care and you got taller. So I think you did some glutes. Speaker 1 (00:47:00): It's like, OK. So like lift, lift your anal sphincter up and in, but activating mostly the back part. So if you're having fecal issues, maybe that's a good place to start, but most people are having issues a little further front. So then we moved to the, can you pick a upper with your, with your Lavia? I had a, I learned the best things for my patients. One woman said it's like, I'm shutting the church doors. So if you imagine the Lavia being churched doors, we're going to close them up. And that, that gives a slightly different feeling. Them then squeezing the anal sphincter. Now, if you get up to squeeze, like you don't want to like pee your pants, like you want to stop the stream of urine. That will activate more in the front of the pelvis. Look, men who are like if it gets stopped the flow of urine, I wouldn't be here. Speaker 1 (00:47:57): So what else do you get? What's really cool is in the male literature. So this is a study done by Paul Hodges is he found that what activated the anterior part and the urinary sphincter, this rioted urinary speaker, sphincter the most for men. What a penis or pull your penis in to your body now for women. So when I was at a chorus and it's like, so let's, let's think of like other cues and other words, but even if, so, I don't have a penis this fall that probably don't have a penis. Even if you don't have a penis, I want you to do that in your brain, shorten the penis and pull it in. Speaker 1 (00:48:42): And did you feel anything happen? Cause we do have things that are now analogous to the male penis, if you are are a female. So I'll sometimes use that. Like I know it sounds stupid, but pretend to draw on your penis and it works and it does feel more anterior for a lot of people. So I'll kind of just, I'll kind of see what's, like I said, sometimes it's like the 42nd way of doing it that I've asked them to do where they're like, Oh, that, and you're like yeah. So then also just another, it's a little bit of like a little bit of a tangent, but so as you're sitting, so if you're, if you're sitting I want you to pick the cue that speaks most to your pelvic floor, and I want you to slouch really, really slouch, and actually to give yourself that cue and just pay attention to what you're feeling. So when you squeeze, give yourself that cue, breathe in and breath out and then let go, we should have felt a contraction, a little hole and a let go. Now, the reason why I say breathe in and breathe out is if you breathe in and out, that's about five seconds and also you were breathing. Cause another thing people love to do when they're trying to contract their pelvic floors, just basically suck it in. Speaker 1 (00:50:10): And so that's, that's not great, but we want to feel the contraction and we want to feel it, let go. And that's super important. I think that was another question on the Slido is that yes. For any muscle we're working, you should be able to contract it and let it go. There's not a muscle in our body where I just keep it contracted. It's going to do much. It might look great. Eventually, but like I couldn't get my coat on, like getting a drink of water would be a little weird. It's not very functional muscles have to relax so that they can contract. So that's a big, yes, it's just as important that the contraction pelvic floor that cue and we felt where it happened, not tall, like, like you're sitting out at a restaurant and you just saw someone looking at you and you're like, Oh, what are they looking at? And then you're going to do the exact same cue and you're gonna breathe in and breathe out and let it go. Speaker 1 (00:51:07): And then did it feel different than menu or slouch that it did it change position? I feel like Karen's Miami. It feels different. Now what I want you to do is if you can, depending on how you're sitting really give me like an anterior pelvic tilt, really happy puppy and then do the exact same thing and then let it go. And so again, some more EMG work from, from Paul Hodges is that when you're in a posterior pelvic tilt, you tend to activate the posterior portion more, which is fine. And if you're not having problems in the front, if you're having problems activating and maintaining continence in the front, actually increasing that lordosis can favor the front a bit. So this is, that's really awesome when people can feel that difference. Because I want you to think about, if you start to leak on your fourth mile of a half marathon, there's no way, no matter how awesome you are, but you're going to be able to squeeze your pelvic floor for the rest of that race. Speaker 1 (00:52:15): Like there's just, there's no way. But sometimes if, because remember your pelvic floor is still doing its thing while you're running is if you're like, well, hold on, when you're at your fourth mile, are you starting to get tired or hopefully not if it's a half marathon, but you know, like is something changing and how you're using your body. And can you, when you get to that point, remember to stay tall or lift your tail a little bit, or is there a cue or something they can change that will help them favor the front instead of going about four steps with the contracted pelvic floor and then losing it anyway. So there's, there's a lot of different ways you can actually make that your intervention for the issue you're having and then let's just get it functional. Perfect. And since you brought up running a question that's been, got, gotten a couple of likes on Slido is how would you approach return to running after pregnancy? Speaker 1 (00:53:15): Do you have any tips on criteria for progress, timeframe and a recreational runner versus a full time athlete? Because I would think the majority of physiotherapists around the world are seeing the recreational runner versus the professional or full time athlete. So first, how would you approach return to running any tips for progress? So that's going to be after pregnancy, sorry. After pregnancy. Yeah. So this is where I was really excited. So just last year I'm going to say her name wrong, but Tom goom Gran Donnely and Emma Brockwell published returned to running postnatal guidelines for health professionals managing this population. And the reason why I was super excited is because even though it was just published last year, it's the first one. There was definitely a lot of emotion and feelings about, about women getting back into sport after having a baby, but to be perfectly Frank, there's very few actual solid guidelines for recreational or others. Speaker 1 (00:54:30): So I have not personally had a child, but I will tell you of all the women I've seen over the years, basically doctors are like, it's been six weeks ease back into it, see how it goes. I'm not really even mentioning if you have a problem come back so we can figure it out. It's just kind of like good luck with that. And as a result, what happens is a lot of women don't get back into exercise or they get back into exercise and and kind of freak themselves out because stuff feels different. So to get back to the question of what do I do, actually this this guide from Tom and team really, really helpful. I think, and, and it's just basically it's it does have a series of exercises that I've actually started to use with my postpartum moms to go like, look, if you can do these things without feeling heaviness, you're good. Speaker 1 (00:55:30): You're good to start easing back into your running program, but get up, get walking because I'm going to post Sandy Hilton and like, you can't rest this better, like just waiting, isn't going to make it all go away. But it can also be deceiving because again, with polo, you don't feel that heaviness and you don't leak. And so I'm just going to stay right here where everything is fine. So that's obviously not a good option longterm option for a lot of reasons. So, so what do I do? I do look at the patient's goals, their previous running history, and if they're having any options I recently had a patient who she was runner exercise or sr after baby number two for a bit, some feeling of happiness that got completely better, baby number three came along. So I saw her a bit while she was pregnant because she got, I think two thirds of the way through pregnancy before she started to feel that heaviness. Again, she was still running, Speaker 1 (00:56:38): Tried to see if we could change that feeling while she was running. And she could until about the, when did she start? I think she didn't stop running to her 35th week, which is pretty impressive. But then she wanted to do a half marathon. I think it was just three months postpartum. Right. So this is like going from having baby to running 13. You think that a lot of people would probably feel that was too soon, too much too fast, but she was able to do it completely symptom-free. So as she was training and she was really fast, she was timing it so that she could get back in time to breastfeed. Like I was like, Oh my gosh, like I, that would disqualify me. Like, there's no way I could run fast enough to make that happen. But she was able to, to work it out where she could perform at her level without symptoms. And I was really happy that I was able to support her in that she did all the hard work. For general people recreational, where you a runner before, or is this completely new and are you having any symptoms and is there any thing you're worried about? Again, a lot of women are worried about giving. Speaker 1 (00:57:53): It's actually really hard to perhaps to give yourself one baby babies are a great way to do it. But that's like the risk factors I look up for something else a couple of years ago, I haven't looked recently, but like you really have any prolonged lifting. So not like your CrossFit three days a week, but like your, your physical labor for eight, eight hours, 10 hours a day every day could eventually do it also having babies. So like once you get to every baby increases your risk of pelvic organ prolapse, which makes good sense. And that, and that is what it is. So kind of looking at what are their risk factors, are there any, and letting them know that if they feel it more, it doesn't mean they made it worse. They just made it more symptomatic. Got it. Great. Speaker 1 (00:58:40): All right. So we have time for maybe one or two more questions, and then I'm going to throw back to Claire. Cause we're coming up onto an hour here, maybe time for one more it's so w what am I going to ask? I think I'm going to go with the gymnasts I work with all believe it's normal to leak a little urine during training or competition. And this is something we talk about a lot. It might be common, but is it normal? You already gave me the answer. What is it, Karen? No, no, no. And so, yeah, so the, the short answer for that is no. Or I agree with the question where it is very, very, very common, and it is still, I would say, not to leak urine. Unfortunately, so there's any researchers out there who want to get together. Speaker 1 (00:59:26): Let me know. We haven't, we have information on athletes and incontinence, but mostly it's prevalent that it happens a lot and gymnastics and dancing and volleyball. There's, there's even some swimmers who have it, right? So there's, there's incontinence across the spectrum, which basically tells me, yep. People have incontinence. Some of the some of the sports are more likely to have urgent continents. A lot of them though, we're looking at stress incontinence, however, for none of the athletes, have, we really had a great study that says, this is what we're finding. We're thinking, this is the cause of this incontinence. And we certainly haven't gotten to the point where it's like, and this is what we should be doing for these women in particular. So I'm, I'm pretty curious as to what we would have to do as, as a profession, as, as a team with researchers to figure out what do we need to look at in these athletes, especially the female athletes, because most of these are also they've never had babies, right? So a lot of these athletes are the liberos. And so we can't, we can't blame them. There's something with how things are working. That seemed to be the situation it's not necessarily trauma or anything like that. So what do we need to look at? What do we think is happening? Can we measure it and assess it? And then can we get an intervention? Speaker 1 (01:00:56): My brain, obviously, something isn't working as well as it could. So could something like that improve their performance, even I don't, I don't know. I'd like to think so. Yeah. That would be distinct study. Yeah. But we ultimately don't know. So if anyone has any ideas for studies or doing studies, let me know, because I can't wait to read them. But I think maybe the first step is to let coaches and parents and young gymnast know very common. Don't be ashamed. Don't let it stop you from doing what you want to do. But also don't just ignore it. Maybe we can figure this out. Speaker 2 (01:01:30): All right. One more question with a short answer, if you can. So, and I'm going to ask this question because I feel like the person who posted this I think posted this in earnest. So that's why I'm asking, this is the last question. So a female patient age, 20 years still bedwetting from her childhood, otherwise she is normal, no incontinence. So other than this, just while sleeping, she tends to urinate any thoughts on this or any place you can direct this. Speaker 1 (01:02:04): Yeah. So I did, I was like, Oh, great question. And I did actually do a little research for this specific question. There's a lot of reasons why nocturnal enuresis, which is what bedwetting is called in the literature happens. And I think it's really important. So I don't know what kind of tests or studies this person has had done or what other issues they may be having. So things like sleep apnea is is something that could be related if there's any medications, any sort of diuretics, any kind of sleeping medications. Again, the fact it's kind of carried on since childhood, I, I would really wonder about how, how is the bladder functioning? The fact that it's working fine throughout the day makes me wonder what's changing at night. And I did find a study where it talked about when they look compared adolescents or adults who were bedwetting to people who weren't, they did have like detrusor overactivity. So like basically like an overactive bladder that they could see on the testing. So I would, I would really encourage this person to find a urologist that they trust if they haven't already and really to maybe investigate some of those other, other factors that could be contributing so that they can get some better sleep and not have that problem anymore. Speaker 2 (01:03:28): Excellent. Excellent. Oh, okay. Claire says we can go for one more question. So I'm going to listen to the boss here. Speaker 1 (01:03:36): And, Oh boy, are you ready? Because this is a question that did kind of get a lot of thumbs up. Okay. So we spoke about Speaker 2 (01:03:44): Briefly before we started. Speaker 1 (01:03:47): So let's see treatment of nonspecific, pelvic girdle pain, not related to pregnancy, which strategy with no susceptive pain mechanisms and which strategy with non nociceptive pain mechanisms would you incorporate with this patient? Okay. So I would say in the clinic, it's, it can be pretty hard. Like, I don't know how I would distinguish being nociceptive and non nociceptive or what even like non nociceptive might be if we're talking more central issues or stuff like that. I don't, I don't know. But honestly I would just look at, so in Kathleen's Luca has a great book about looking at the different types of pain or the different categories of pain and the most effective medications for it. Right. So we're really good in pharmacology. Like if you had this inflammatory process and, and inflammatory and anti-inflammatory should help, if you're having neuropathic pain, you want a drug that addresses that when we get into like physical therapy interventions, what's really cool is exercise is in all the categories. Speaker 1 (01:04:59): And it's one of the things we have the best evidence for. So regardless of pelvic girdle pain in pregnancy or not pregnancy, and regardless of how it may have been labeled by somebody else is I would, I would mostly want to know when did the pain start? Is there anything that makes it better? Anything that makes it worse and see if I could find a movement or change something for that person. Or that made me sound like I was going to do a whole lot of work. If I could find something for that person to change for themselves to have that hurt less and have the I tend, I would tend to keep it simple, mostly cause in the clinic again, we could do a lot of special tests that might say, Oh, Nope, they definitely hurt there, but it's still, if we're looking at what's going to be an effective intervention, that that patient is going to tell me what that is. Speaker 1 (01:05:54): Sorry. It would help a fire mute myself. So looks like we have time for one more. And I, I really, Claire was not clarity did not pop up yet. So we've got time for one more and then we're going to work. We're wrapping it up. I promise stroke patients, dementia patient. We just got the no go. Yes, no, it's a super short answer if you want Claire super short answer. Okay. So stroke dementia patients with urinary incontinence, any useful ideas for the rehab program? Yes, but not get an idea of their bladder habits, their bowel habits, their fluid intake. Because a lot of that's going to end up being outside caregiver help with the, with the stroke, it's much different. It depends on the severity and where it is and all of that. But for people with dementia is if you just get that, like if you can prompt them or take them to the toilet, a lot of the times that will take care of the incontinence. Speaker 1 (01:06:48): It's not a matter of like Cagle exercises. It's more management. All right, Sarah, thank you so much. I'm going to throw it back over to Claire to wrap things up. Thank you both for a wonderful and insightful discussion. Sarah and Karen. So many practical tips and pointers for the clinician, especially I was loving learning about all of the things that I could take to the clinic. So I hope our audience find those practical tips really helpful as always the link to this live chat will stay up on our Facebook page and we'll share it across our other social media channels. Don't forget. You can also follow us on Twitter. We're at Dow SPT. You can also follow us here on Facebook. Please share this chat with your friends, with family colleagues, anyone who you think might find it helpful. And if you like JSP T asks, please be sure to tell people about it at that what we're doing so they can find this here, please join us. Speaker 1 (01:07:46): Next week when we host our special guest professor Laurie from the university of Southern California, Larry is going to be answering questions on managing shoulder pain. We'll be here, live on Wednesday next week. So Wednesday, April the eighth at 9:00 AM Pacific. So that's noon. If you're on the East coast of the U S it's 5:00 PM. If you're in the UK and at 6:00 PM, if you're in Europe, before we sign off for the evening, there's also really important campaign that I'd like to draw your attention to. And it's one that we at Joe SPT supporting and it's get us PPE. So we're supporting this organization in their quest to buy as much a, to buy much needed personal protective equipment for frontline health workers who are helping us all in the fight against the coronavirus pandemic. So if you'd like to support, get us PPE, please visit their website, www dot, get us ppe.org, G E T U S P p.org as always. Thanks so much for joining us on this stale SPT asks live chat, and we'll speak to you next week. Bye. Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter, instagram and facebook to stay updated on all of the latest! Show your support for the show by leaving a rating and review on Apple Podcasts!

Super excited to have one of my most favourite macro analysts on the pod. Paul Hodges is a world-renowned expert on the Chemicals industry and Macro in general, and also the author of the pH Report. The Chemicals industry is the 3rd largest in the global economy and is interconnected with almost all physical products; the trends within it are one of the best leading macro indicators We dive into the ticking demographic time bomb facing the world, and its many ramifications for people, business and governments. How COVID has changed most industries and now presents great opportunities for step changes in technology, and decentralisation - especially for budding entrepreneurs The next 20 years will see far more new technology than the last 20 years as technology builds upon previous advances in an exponential manner, so it's healthy to not listen too much to people that say your latest 'crazy idea' is impossible! As always, if you have any feedback good/bad/ugly please DM me on Twitter @Darky999

How to capture growth from sustainability amid rapid changes to end use markets and the energy mix topped the agenda at this year's virtual European Petrochemical Association (EPCA) meeting. - Industry must change rapidly to meet need for low carbon, sustainable Europe- With oil refineries closing, less naphtha availability may drive recycling- Coronavirus has accelerated existing paradigm shifts- BASF's troubles reflect industry situation in Europe- Polyethylene (PE) demand could fall rapidly if furlough schemes cutListen to this podcast with Caroline Ciuciu CEO, EPCA; John Richardson, ICIS senior consultant, Asia; Paul Hodges, chairman New Normal Consulting and ICIS Insight editor, Nigel Davis.

The pandemic is pushing Europe's petrochemical sector in new directions, but with a more flexible approach the industry can emerge stronger for long-term success. - Very limited visibility means maximum flexibility required- End use markets behaving in new and unusual ways- Pandemic has accelerated pre-existing trends- Europe faces new trends such as energy abundance, re-shoring of supply chains- EU Green Deal is a big opportunity for Europe petrochemicals- Europe will compete with China for dominance in green energy- Europe could “scrap and build” to transform chemical industry- Less naphtha supply will drive more recyclingListen to this podcast interview with European Petrochemical Association president Marc Schuller; Paul Hodges, chairman of New Normal Consulting, and author of the pH Report; John Richardson, ICIS senior consultant, Asia and ICIS Insight editor, Nigel Davis.

Coronavirus is accelerating the shift from a linear to circular economy, putting $400bn in petrochemical investments at risk or redundancy. - “Peak Plastic” reached on switch from linear to circular economy - $400bn in petrochemical investments may become redundant - No deal Brexit increasingly likely from January 2021- Chemical companies must ensure they and their suppliers are ready- Must understand complexity of customs procedures, rules of origin requirements- Extra time for UK Reach compliance welcome but questions over data access- Suppliers/manufacturers may withdraw from UK market- Coronavirus means more companies may cut UK and focus on larger EU27- China polyester recovery is supply, not demand-led- Pessimism on export demand for Christmas/Thanksgiving - Only weak bounce back evident in petrochemicals- Pandemic hurting emerging nations badly, could take a generation to recoverListen to this podcast interview with Paul Hodges, chairman of International eChem; John Richardson senior consultant, Asia for ICIS and Nigel Davis, ICIS Insight editor.

The downturn for global chemicals began back in December 2017, and has accelerated through the pandemic, coupled with a lack of visibility on future demand patterns.- Muted bounce back is underway for chemicals Chemical capacity utilisation has fallen since December 2017- Accelerated during pandemic, and has not recovered - 2008/9 saw stimulus for automotive, construction- 2008/9 China implemented huge package to compensate for collapsed export markets- Aging populations will now drag on growth- Sustainability, affordability now key trends- Emerging economies held back by poor export markets, lack of governance- China needs to reform its economy to allow a middle class to emerge- Coatings hit badly by downturn in commercial property- Chemicals must move on from GDP-related demand growth assumptions- Forensic focus on new demand patterns can identify opportunities- Companies must accept the lack of visibility as a starting pointListen to this podcast interview with John Richardson, ICIS senior consultant, Asia and Paul Hodges, chairman of International eChem.

An effective coronavirus vaccine could be years away so chemical companies must pivot their business strategies now to address permanent changes in demand patterns.- Science suggests effective vaccine for coronavirus could be years away - Huge technical challenges for scale up and delivery plus access in developing countries- We must get used to permanent changes to chemicals end use markets- Aerospace, automotive may never recover- Chemical companies need thorough bottom-up analysis of impact on demand- Big jump in unemployment will drive job creation through local supply chains- Virus and trade war will drive creation of two trading blocs centred on China and US- US and allies could lose access to fast-growing emerging markets- Carbon taxes and circular agenda will accelerate recycling, local supply chains- Focus on products which help reduce waste, such as food waste- Pandemic means companies are even less prepared for Brexit than beforeListen to this podcast interview with Paul Hodges chairman, International eChem and author of the pH Report; and John Richardson ICIS senior consultant, Asia.

Chemicals demand may never return to pre-pandemic levels so a radical shake up in business models is required, with a focus on local supply chains, recycling, and meeting people's basic needs. - Short-term “sugar lift” from furlough and unemployment schemes- As these end, could be major unemployment and social problems in H2- PE demand has been resilient as more low-paid people have had spare liquidity- V-shaped recovery in China is driven by production, not true downstream demand- Chinese companies have built massive inventory on expectations of higher future prices- Floods also dampening China recovery- Measuring economic recovery in percentage terms does not give true picture- You need to look at absolute figures to judge recovery- Demand may never return to pre-pandemic levels due to lower car ownership, less flying, aging population - Could take a generation to fix the global economy- Chemical industry business models need radical shake-up for new opportunities- India needs to put in basic infrastructure of healthcare, education, sanitation before it can advance- If chemical industry can serve basic needs of developing countries it can unlock demand- Iran and China are developing a symbiotic relationship- $280bn investment by China in Iran could stimulate petrochemicals- US could be shut out of China export markets as it switches to Iran, Belt and Road- Re-shoring of supply chains driven by pandemic disruption, lower demand, circular economy Listen to this podcast interview with John Richardson, senior consultant, Asia for ICIS and Paul Hodges, chairman of International eChem and author of the pH Report.

Europe's new €800/tonne levy on waste plastic packaging will force chemical supply chains to take recycling more seriously and could drive product substitution. - What we know and don't know about the €800/tonne EU levy on plastic packaging waste - Tax could lead to polymer substitution away from polymers which are less easy to recycle, or to other materials- The levy could accelerate adoption of recycling technology and infrastructure- But huge challenges as recycled polymer sector not yet developed enough- Polymer and carbon taxes will act as a “short, sharp shock” for chemical companies and supply chain- Move to local, sustainable production will accelerate- Oil prices propped up by China and India building reserves which are now full- China may switch from being the world's largest net importer of polypropylene (PP) to net exporter by 2022- Global PP moving towards “perfect storm” of over-capacity amid structural changes to demand- PP producers must focus on sustainability, affordability, local supply chainsInterview with Paul Hodges, chairman of International eChem; John Richardson, ICIS senior consultant Asia; Mark Victory, ICIS senior recycling editor and Helen McGeough ICIS senior analyst, plastics recycling.

BP's decision to sell the bulk of its petrochemicals assets raises questions over the narrative that the sector as a saviour of the oil and gas industry, as some players start to look beyond the hydrocarbon era.Also discusses the recent rise in coronavirus infection rates, China's imminent move to polypropylene independence, and paradigm shifts in the pandemic.ICIS deputy Europe news editor Tom Brown talks to Paul Hodges, chairman at consultancy International eChem; John Richardson, ICIS Senior Consultant, Asia; ICIS Insight Editor Nigel Davis.

Coronavirus impact may accelerate China's self-sufficiency in chemicals, leaving the global industry struggling with overcapacity as that huge export market closes. - Industry pulling out of depths of downturn- But risk of second wave is high, infection rates rising globally- China's drive for chemicals self-sufficiency will increase- China PX imports could fall from 16m tonnes to 9m tonnes in 2020- China refineries likely to run hard, flooding markets with gasoline and other products- Refinery/petrochemical interface under pressure- Global economy was in trouble before Coronavirus- Paradigm shifts accelerating – shift from fossil fuels, regional value chains, service-driven business models - Europe isocyanate markets gradually improving from very low levels- Demand from automotive still poor- Chemicals face changing auto market on switch to electric, autonomous Listen to this podcast interview with Paul Hodges, chairman at consultancy International eChem; John Richardson, ICIS senior consultant, Asia; ICIS Insight Editor Nigel Davis and Fergus Jensen who reports on Europe isocyanates.

Hopes of a recovery in demand in June and July may not be realistic and the chemical industry should focus on steps to retool for different future market needs, senior chemicals commentators said on Monday.Expectations for June/July and rest of 2020Economy could be permanently at 70-90% of previous levelsEU's €750bn rescue package and what that could mean for chemicalsHow a move to local supply chains could transform the chemical industryRevolution in Europe's PMMA sheet market - from doldrums to new investmentsFears about increasing social unrest in the US and globallyListen to this podcast interview with Paul Hodges, chairman at consultancy International eChem, ICIS Insight Editor Nigel Davis and Katherine Sale, senior editor in Europe for acrylates, polymethyl methacrylate (PMMA) and methyl methacrylate (MMA).Podcast interview by Will Beacham

With economies collapsing around the world, and chemical supply chains under intense pressure, the circular economy and sustainability agenda faces disruption. - Recycled polymer markets squeezed as virgin prices fall- Bankruptcies and closures possible May/June- Commitments/targets likely to remain in place- Crisis may make it more difficult to meet targets- Move from global to local supply chains will support recycling Listen to this podcast interview with Paul Hodges, International eChem chairman; John Richardson, senior consultant, Asia, for ICIS; Matt Tudball, ICIS senior editor Europe for recycled polyethylene terephthalate (R-PET) and Mark Victory, ICIS senior editor for Europe recycled polyethylene (R-PE) and polypropylene (R-PP).Podcast interview by Will Beacham

Welcome to this special ICIS chemicals podcast where we hear from our European customer and editorial advisory board about the challenges their organisations or sectors have faced because of coronavirus.We also discuss how the world might look different as we emerge from the lockdowns, and how the industry can prepare for this new post-virus reality. The board meets once a year to discuss market trends and advice ICIS on its strategic development. Its members include senior figures from the world of chemical production, distribution and consulting. They discuss:- impact of coronavirus so far and through 2020 - Longer-term structural changes to industry and markets - How the industry can emerge stronger from this period of unprecedented disruptionListen to this podcast interview with Paolo Cescutti, chief procurement officer at AMB Packaging; Marco Hesselink, senior commercial director, at detergent group Sirius International; Paul Satchell, industry consultant; Paul Hodges, chairman of International eChem; Guenther Eberhard, managing partner at DistriConsult and Dean Curtis, president and CEO of ICIS.Podcast interview by Will Beacham

The Connected Yoga Teacher Podcast 151: Male Pelvic Health & Yoga with Dr. Susie Gronski   Description: Pelvic health is a recurring topic on this podcast, but most of the time, it is about pelvic health in general or particular to female-bodied people. However, pelvic health is something important to male-bodied people too, so on this episode Dr. Susie Gronski sheds some light on male pelvic health and the issues surrounding that.   Dr. Susie Gronski describes herself as “the physiotherapist for your privates”. She is a licensed doctor of physical therapy, board certified pelvic rehabilitation practitioner, and a certified health coach. On her podcast In Your Pants, Dr. Susie approaches the topic of pain, pelvic health, and sexuality with open and transparent conversations. Apart from providing 1:1 hands-on consultations with her patients to teach them how to be the expert in treating their pelvic pain, Dr. Susie is also a Registered Yoga Teacher, and brings that aspect into her work.   What are some of the concerns that male-bodied people have regarding their pelvic health, and how can yoga or PT help? In this interview, Dr. Susie addresses a variety of topics - from pelvic pain, to urinary issues, from how pelvic health relates to sexual function, to myths around pelvic health.    If you know someone who is male-bodied, or are a male-bodied person yourself - this episode has great information that will be beneficial in understanding more about male pelvic health.   Key Takeaways: [6:55] Shannon introduces her guest for this episode - Dr. Susie Gronski. [7:53] What is the work that Dr. Susie does and who does she do it for? [8:38] What has the challenge been as a female-bodied person addressing male body part issues? [12:58] Be aware of the language and terms you use around the topic of pelvic health! [14:27] What are some of the main issues that male-bodied people face with regard to pelvic health? [19:10] Dr. Susie shares an anecdote of a patient she is working with. [22:15] Pain is a very personal experience that varies greatly from person to person, and particularly with men, there is a lot of stigma around how they should act or seek help. [23:50] Lower back pain can also be related to pelvic health. Dr. Susie explains how. [26:29] How does the male pelvic floor function differently from the female pelvic floor? [30:50] What is the relationship between between pelvic pain and stressful images or experiences? [35:47] What are the benefits of going to see your pelvic health PT or going to yoga class for some of these issues? [40:33] It is important to not always be focused on engaging the pelvic floor muscles but to maintain some balance to optimize function. [45:52] How can we encourage men to attend a pelvic health class or a yoga class? [47:50] When should men see a pelvic health PT for any issues they're experiencing? [53:53] Dr. Susie recommends that people should see a PT who specializes in male pelvic health, and she explains why. [56:19] What are some resources Dr. Susie recommends to find a male pelvic health specialist? [58:13] What is Dr. Susie's podcast about? [58:38] What is the biggest myth or misconception men have about their pelvic health? [1:01:59] What are Dr. Susie's thoughts on hernias and exercise in male bodies? [1:05:53] What were your key takeaways from this episode?   Links: Dr. Susie Gronski In Your Pants Podcast with Dr. Susie Gronski The Connected Yoga Teacher Podcast Episode 150: Start a Membership Site with Amanda McKinney Other resources on Pelvic Health Mayday! Mayday! My Pelvic Floor Is Malfunctioning…, By Dr. Susie Gronski Pattern of activation of pelvic floor muscles in men differs with verbal instructions: Pattern of Activation of Pelvic Floor Muscles, by Paul Hodges et. al.  Study of stress and relation to pelvic floor Pelvic Pain Support Program The Connected Yoga Teacher Podcast Episode 009: Kegels, Mula Bandha and Pelvic Health with Shelly Prosko The Connected Yoga Teacher Podcast Episode 129: Pelvic Floor 101 with Marie-Josée Forget Find a pelvic health PT: Pelvic Guru - Global Pelvic Health Solutions - Canada American Physical Therapy Association (APTA) Sex is a Funny Word: A Book about Bodies, Feelings, and YOU, by Cory Silverberg and Fiona Smyth Yoga for Pelvic Health Teacher Training   Gratitude to our Sponsor Schedulicity and Pelvic Health Professionals   Quotes from this episode:   "There's a lot of isolation and stigmatization and taboo around helping male-bodies."   "The prostate has been blamed for a lot of male pain issues, but if you look at the research and the literature, the stats are about 95-97% of them have no correlation to an infection at all."   "Part of my role is to help them to be aware of that protective response, and question whether or not that's necessary for them in that moment."   "Sexual health issues, they often are intertwined with psychological or psychogenic components as well."

In a bonus edition of the MoneyWeek Podcast, Merryn and economist Paul Hodges have a wide-ranging chat about the state of the global economy and the key indicators that are now starting to point to just how bad things are. Plus, China, globalisation, the slide in the London prime property market, and a host of other subjects, including demographics, fertility and the oil price.

F. Scott Feil sits down with Sandy Hilton, Sarah Haag, & Karen Litzy while they are all at CSM 2018 in New Orleans to talk about international conferences. They talk about the benefits of going to international conferences, how to navigate international conferences, how to navigate which conference is best for you to attend, differences between conferences in the U.S and conferences outside of the U.S, the guests pitch their favorite conferences, and much more!   Join Karen and others at the Women in PT Summit!! The Early Bird rate expires on August 1st so be sure to grab a ticket at the discounted rate! Women in PT Summit: http://womeninpt.com/   Karen Litzy's Website: https://karenlitzy.com/  The Healthy, Wealthy & Smart Podcast Website: http://podcast.healthywealthysmart.com/  The Healthy, Wealthy & Smart Podcast on Itunes: https://itunes.apple.com/us/podcast/healthy-wealthy-smart/id532717264?mt=2  Karen's Interview on Therapy Insiders on "Why Aren't There More Women Leaders?" : https://itunes.apple.com/us/podcast/why-arent-there-more-women-leaders-special-episode/id609009250?i=1000384711690&mt=2  Karen's Facebook Page: https://www.facebook.com/karen.litzy  Karen's Twitter Page: https://twitter.com/karenlitzyNYC  Karen's Instagram Page: https://www.instagram.com/karenlitzy/  Entropy Physio Website: http://entropy-physio.com/  Pain Science & Sensibility Podcast: https://itunes.apple.com/us/podcast/pain-science-and-sensibility/id1003630972?mt=2  San Diego Pain Summit Website: https://www.sandiegopainsummit.com/  Sandy's Facebook Page: https://www.facebook.com/sandy.hilton.73  Sarah's Facebook Page: https://www.facebook.com/sarah.haag.129  Sandy's Twitter Page: https://twitter.com/SandyHiltonPT  Sarah's Twitter Page: https://twitter.com/SarahHaagPT  Sandy's Instagram Page: https://www.instagram.com/sandyhiltonpt/  Sarah's Instagram Page: https://www.instagram.com/ssarahjopt/  The PT Hustle Website: https://www.thepthustle.com/  Schedule with Kyle Rice : www.passtheptboards.com    HET L.I.T.E Tool: www.pteducator.com/het  Biographies: Sandy Hilton graduated from Pacific University (Oregon) in 1988 with a Master of Science in Physical Therapy and a Doctor of Physical Therapy degree from Des Moines University in December 2013. She has worked in multiple settings across the US with neurologic and orthopaedic emphasis combining these with a focus in pelvic rehabilitation for pain and dysfunction since 1995. Sandy teaches  Health Professionals and Community Education classes on returning to function following back and pelvic pain, has assisted with Myofascial Release education, and co-teaches Advanced Level Male Pelvic Floor Evaluation and Treatment. Sandy's clinical interest is chronic pain with a particular interest in complex pelvic pain disorders for men and women.  Sandy is the co-host of Pain Science and Sensibility, a podcast on the application of research into the clinic.    Sarah Haag graduated from Marquette University in 2002 with a Master's of Physical Therapy. Sarah has pursued an interest in treating the spine, pelvis with a specialization in women's and men's health.  She went on to get her Doctorate of Physical Therapy and Masters of Science in Women's Health from Rosalind Franklin University in 2008. In 2009 she was awarded a Board Certification as a specialist in women's health (WCS). Sarah also completed a Certification in Mechanical Diagnosis Therapy from the Mckenzie Institute in 2010.  Most recently, Sarah completed a 200 hour Yoga Instructor Training Program, and is now a  Registered Yoga Instructor. Sarah plans to integrate yoga into her rehabilitation programs, as well as teach small, personalized classes.  Sarah looks at education, and a better understanding of the latest evidence in the field of physical therapy, as the best way to help people learn about their conditions, and to help people learn to take care of themselves throughout the life span.   Karen Litzy started her physical therapy career in an inpatient hospital in Scranton, Pa. Moving to New York a few years later she had the opportunity to work for the New York public school system, Broadway musicals and orthopedic outpatient clinics. While the work was rewarding, she always felt like she could do more to serve her clients.  As she was searching for ways to provide a more comprehensive approach to practicing physical therapy she became overwhelmed with requests from clients to be seen in their home or office. This was an opportunity to provide not just convenience, but a different kind of practice. By adopting a “concierge” model, she could dedicate a full hour of one-on-one treatment to each and every client. Now she had ample time to evaluate, treat and re-evaluate. The concierge model allowed me the time to provide vital client education. Her clients would now benefit from a comprehensive home education program.  As part of her commitment to her clients and her career, She is constantly engaging in continuing education. She has been lucky enough to learn directly from some of the best in the profession. She has received certificates from Dr. David Butler, Dr. Lorimer Moseley, Dr. Adriaan Louw, Dr. Paul Hodges, The Institute of Physical Art, The American Physical Therapy Association, Hospital for Special Surgery, and many more. She graduated from Misericordia University with her masters degree in Physical Therapy in 1997 and then graduated from the same university in 2014 with a Doctorate of Physical Therapy.  She is the host of the podcast, Healthy, Wealthy, and Smart. The podcast provides up to date clinical information combined with business strategies from the best and brightest thought leaders in physical therapy, wellness and entrepreneurship. The show promotes the profession and provides a channel to get the most accurate information out there for both practicing physical therapists and everyday people.  She is a proud member of the American Physical Therapy Association (APTA), the Orthopedic Section of the APTA, the Section on Women's health, the Home Health Section and the Private Practice Section of the APTA. She is also an official spokesperson for the APTA as a member of their media corps.  Physical therapy is an ever evolving practice and for her, a personal journey. That's why she's committed to staying at the forefront of the industry. Through continuing education and her practice, she works to enrich myself so she can impart to others the true value of physical therapy. Her mission is to show people how physical therapy can improve their lives. This is what drives her to help her clients attain their own goals and for herself to build upon the work of those who have helped lead the way

Merryn Somerset Webb talks to Paul Hodges about how the current wave of refugees could be the answer to Britain's demographic time bomb.