Podcasts about who guidelines

Jake & Pete get schooled again on dehumidification by Nikki. - Nikki introduces the acronym HVACD to make dehumidification in equal standing with heating, air conditioning and ventilation.- Great discussion of the differences between portable ("big box") and whole house dehumidifiers.- Importance of the change in measurement standards for DEHUs from "80/60" (80 degrees F & 60% RH) to "65/60" for portable units & "73/60" for whole house units (more real conditions).- Jake closes out by "dibbing" "Dehumidifier Graveyard" as a rock band name...Pete's Resources:1. "WHO Guidelines for Indoor Air Quality: Dampness and Mould:" https://www.ncbi.nlm.nih.gov/books/NBK143947/2. Santa-Fe Performance Data over different test conditions: chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://www.santa-fe-products.com/wp-content/uploads/2024/10/TS-2076-Ultra-Series-RNC-Trifold-A2L-1.pdf 3. Santa-Fe Dehumidifier Calculator App - https://www.santa-fe-products.com/resources/calc-app/4. Munters PsychroApp - https://www.munters.com/en-us/knowledge-bank/apps-and-calculators/psychroapp-psychrometric-calculations-tool/

Now more than ever, it's important to challenge the world's food and beverage manufacturers to address nutrition issues like obesity and undernutrition. Today, we're going to discuss the 2024 Global Access to Nutrition Index, a very important ranking system that evaluates companies on their nutrition related policies, product portfolios, marketing practices, and engagement with stakeholders. The index is an accountability strategy produced by ATNI, the Access to Nutrition Initiative, a global nonprofit foundation seeking to drive market change for nutrition. Our guest today is Greg Garrett, Executive Director of ATNI. Interview Summary You know, I very much admire the work you and your colleagues have done on this index. It fills such an important need in the field and I'm eager to dive in and talk a little bit more about it. So, let's start with this. You know, we've all heard of the concept of social determinants of health and more recently, people have begun talking about corporate determinants of health. And your organization really is focused on corporate determinants of nutrition. Let's start with a question that kind of frames all this. What's the role of industry in nutrition, according to the way you're looking at things? And how does the Global Index shine a light on this topic? Thanks for the question. We're working primarily quite downstream with large manufacturers and retailers. But we hope to affect change across the value chain by working with that group. Of course, when we talk about private sector in food, that's a very, very broad terminology that we're using. It could include farmers on the one hand, looking all the way upstream, all the way through to SMEs, aggregators, processors, manufacturers. SMEs are what? Small and medium enterprises, small and medium enterprises, local ones. All the way through to the multinational food and beverage manufacturers. But also catering organizations and restaurants. When we talk about business what we're trying to do is ensure that business cares about portability, and access to safe and nutritious food. And I think we can say pretty safely, based on the data which we'll talk about, that the health aspects of food are still not as, they're not at the forefront like they should be. Yet. We'll dive in and talk a little bit more about what the index is and what it shows in a minute. But let's start with a kind of broader question. What is the role of diet and consumption of processed foods in influencing health? Yes, so they say now one in five deaths are related to poor diet. It's arguably now the biggest risk factor related to global morbidity and mortality. We've seen in the last 20 years a slight slowing down of our efforts to combat malnutrition and undernutrition. Whereas we've seen over nutrition, obesity, really taking off. And that's not just in high income countries, but also low- and middle-income countries. So, you know, it might be too little good food and that can lead to at the extreme end of things wasting. It might be too little micronutrients, which can lead to all kinds of micronutrient deficiencies or hidden hunger that leads to many adverse outcomes. Including, for example, cognitive decline or reduced immune system. And then, in terms of diabetes and obesity, we're seeing that really skyrocket. Not only in countries where we have excessive food intake, but also in low- and middle-income countries where they have too much food with a lot of, say, empty calories. Not enough nutrients that are needed. In fact, the recent numbers that we've been working with, it looks like in the last 20 years, obesity rates have gone from about 7.9 percent to 15.9 percent. And by 2030, it might be that 20 percent of global population is considered obese if we don't mitigate that. Right, and of course that number is many, many times higher in the developed countries. So, you've got a tough job. You talked about the complexity of the food industry going all the way to the farmers, to the big companies, and caterers even, and things. And a lot of different health outcomes are involved. How in the world do you construct an index from all that? Why don't you tell us what the Global Index is, and then some of what you found in the most recent report. Yes, so the Global Index, we've been running it for 11 years since ATNI was founded. And it has gone through multiple iterations. This latest one was the biggest we've done and we tried to capture about a quarter of the world's market. So, what we did is we took the 30 largest food and beverage manufacturers by revenue. We looked at 52,000 of their products, and that's where we know the market share was about 23 percent global market share. We profiled the foods. We tried to understand their governance structures and how much nutrition features in the way they run their business. We tried to understand, for example, how they market the foods. Are they marketing them responsibly, according to the World Health Organization guidelines? Really dive deep. It's dozens and dozens of indicators where we ask lots of questions of the companies over a 10-month period. And, by doing that, we hope to understand how financially material is nutrition to these companies. We want to give something of use, not only for the companies, but to policymakers. Because we know there's a big role for policymakers to both incentivize the production and the marketing of healthy foods, but also disincentivize unhealthy foods. We want this to be useful for investors. So, we spend a lot of time, through collaborative engagements, working with the shareholders of these companies as well so that they can invest more responsibly in the food company. And then the other group that we hope to eventually work with are the consumer associations. The groups that would represent consumers so that they can put appropriate pressure on the demand side, you know. They can demand healthier food. It's not that we believe by running an index somehow companies are going to start doing everything right. No. We want to provide data and analysis to the sector so that all the stakeholders can use it to help influence change. That makes perfect sense to have some data driven enterprise to figure out what's actually going on. Otherwise, you're just having to go on intuition. So, what did the most recent index find? Right, so out of those 30 companies, what did we find? There's some good news. Let's start with the good news before we get into the bad news. There's maybe more bad news than good news. In aggregate, we're actually now seeing that 34 percent of the revenue derived from the products that we profiled, those 52,000 products, is based on healthier sales. Meaning 34 percent could be considered healthier foods. That doesn't sound great, maybe, but consider just 4 years ago when we ran this index, it was at 27%. So, there's some marginal increase and maybe if we can accelerate things, and that's what we're trying to do, it's our big strategic objective. We hope that by 2030, we could say that at least half of business' revenue is coming from healthier food options. There's a lot of changes that need to take place to get to that point, but some companies are doing it. Also, we noticed a lot more companies are now starting to use a government endorsed nutrient profile model to define the healthiness of the food products, to measure and monitor the healthiness of their food portfolios, and then to disclose that. That's really good. It's the beginning. First step is measure, disclose. The second step would be put targets on that and actually start to get substantive change towards 2030. But there was a lot of unfortunate news too. We had some backsliding from some of the major companies. For example, low- and middle-income countries actually had the lowest health score. What we think is happening, based on the data we looked at, is that if you're a low-income country, you're getting the lowest healthiness score of these products in your country. So, brand X would be slightly healthier in Europe, but less healthy in the low-income country. So there's a need for regulation there. Can I stop and ask you a question about that? I've got a million questions just flying out of my head that I'm dying to ask. But what you reminded me of is the history of the tobacco industry. When the policies came into play, like very high taxes and banning smoking in public places in the developed countries, US specifically, the smoking rates went way down. But the companies made more money than ever because they just went outside the US. Especially the developing countries and were selling their products. So, it sounds like the food companies might be engaged in a similar enterprise. But why in these countries would they be pushing their least healthy foods so aggressively? I'll start with the facts, because there's some speculation here. But the fact is, if you look at your own monitored data, the highest growth of the modern food retailers is in Africa. So, you've got, for example, 80 to 300 percent growth over the last 5 years in Africa of these modern food retail shops. And in Asia, that's, that's already happened. Still happening in some countries. So, you have enormous opportunity for packaged foods, right? Because that's usually what they're selling, these retailers. I think you have some aspiration going on there, too. I think there's consumers who aspire to have convenient foods. They're more affordable now as incomes increase in those settings. Now, regulation is definitely, in general, in those countries, not as mature as it might be in Europe when it comes to colorants, and taxing, say, sugar sweet beverages. So, what you've asked, I think there's some truth to it. I don't want to come out and say that that's exactly what's happening, but we ran the numbers and the healthiness score. So, we use a five-star rating system. The Health Star rating system, one to five. Anything 3.5 or above, we would consider healthier in a diet. 3.4 and below would be considered unhealthy. And the score in low-income countries was 1.8. And in middle to high income, it was 2.4. So, it's quite a, quite a big difference. That's really very striking. You know, I guess if I'm a food company and I just want to maximize my profits, which of course companies are in business to do, then what I'm going to sell are the foods that people eat the most of. Those are the ones that are triggering the brain biology, the 'over consume'. And the ones that have the greatest shelf life and are easiest to produce and things like that. So, I'm going to make processed foods and push those into new markets as aggressively as I can. So, I'm not asking you to think through the corporate mindset about what's driving this. But it sounds like the data that you have, the end product of all these practices, would be consistent with thinking like that. We like to think that there could be a role for healthier processed foods. But it has to be in moderation. So, what we looked at is the materiality of nutrition. Are companies actually able to have their business and have a healthier food portfolio? So, before we ran the global index, we did an assessment of this. And what we found is that if you're a mixed food company, and you decide to reformulate so that over time you have a healthier food portfolio, in fact, we found that their capital valuations and how they did on the market was slightly better. Not a lot. Than their say, less healthy counterparts. So, what we see is the beginning of a 'health is wealth' sort of narrative. And we hope that we can drive that forward. And of course, policy would help a lot. If policy would come out and say, let's tax the bad, subsidize the good. Then I think industry is going to fall in line. So, we're not sympathetic with industry because a lot of what's happening is not good. On the other hand, we're realists. And we know that these companies are not going away. And we need to make sure that what they offer is as healthy as it should be. And there's a role for everybody in that. All right, that's such an interesting perspective. So, you talked about the global findings. What can you say about the US in particular? What I'd like to do is actually refer to our 2022 US index. So, we did a deep dive just recently; October 2022, right after Biden's Nutrition Conference in DC. And, it wasn't really positive in the sense that we looked at 11 companies. The 11 biggest companies representing 170 billion revenues in the US. And 30 percent of all US food and beverage sales were based on healthier food options. Now, that was 4 years after we ran a 2018 US index. So, 2018, same thing, 30%. There's no change. It's still as unhealthy as ever. I think we need the US to come on board here because it is such a leader. A lot of these companies are headquartered in the US. So, we need to see that healthiness score go up in the US. You know, it's interesting some of the things you mentioned companies might be doing outside the US would be helpful if they did take place in the US. Like front of package labeling would be one example of that. So that would be a place where American companies are behind the curve, and it would be helpful if they caught up. It'd be interesting to dissect the reasons for why they are. But it's interesting that they are. What are some of the things businesses are doing to improve nutrition outcomes? Let's talk maybe on the more positive side. Do you think there's progress overall? It sounds like it from the numbers that you're presenting. But are there signs also of backsliding? And what do you think some of the successes have been? Yes, and I think we can get specific on a few. There's a company headquartered in Mexico, Grupo Bimbo. They rose up in the rankings six places between our 2021 Global Index and this one in 2024. They've been reformulating. They've been making their product portfolio healthier overall. It's about 50 percent now. I think some of that was their own initiative, but it was also prompted by a lot of Latin America's regulations, which is great. I think we can learn a lot from Latin America when it comes to front of pack labels and taxes. So, Group of Bimbo was a good success story. Arla, a Danish dairy company, they came out on top in the index in terms of marketing. So, they have basically said they're not going to market unhealthy foods to children under the age of 16. And they try to even go to 18, but it isn't quite being monitored across all digital platforms. And that's the next level is to take it to the digital platforms and monitor that. And that was a bit disappointing in general, just to find that out of the 30 companies, not one is able to come out and say that they followed the WHO Guidelines on Responsible Marketing 100 percent. The latest index shows that nine out of the 30 companies now, or 30%, nine out of the 30 companies are now using a government endorsed nutrient profile model to define healthy, and then monitor that across their portfolios. And that's a lot of progress. There were only a handful doing that just four years ago. We would ask that all 30 use an NPM, a nutrient profile model, but nine is getting somewhere. So, we're seeing some progress. Boy, if not a single company met the WHO Guidelines for Food Marketing it shows how tenacious those practices are. And how important they are to the company's bottom line to be able to protect that right to market to kids, vulnerable populations, to everybody really. So it really speaks to keeping that topic in the limelight because it's so important. We'd like investors to come out and say they will only invest in companies that are moving towards a 2030 target of marketing response. Zeroing in on 1) responsible marketing and 2) the healthiness food product. Zero in on those two things make really clear what the metrics are to measure that. So, you've mentioned several times, a very important, potentially very important group: shareholders. And you said that that's one of the stakeholders that you interact with. Are there signs out there of activist stakeholders? Shareholders that are putting pressure on the companies to change the way they do business. Yes. So, institutional investors have the ability to talk directly to the board, right? And they have the power in many cases to remove the CEO. So, they're a powerful group, obviously, and we've worked with over 80 now. And had them work with us to understand what investing in a progressive food company would look like. It's making better and better decisions, continuous improvements on nutrition. We have 87, I think is the latest count, who have signed a declaration to invest like this in a food healthier business. They represent $21 trillion of assets under management. It's a very powerful group. Now are all 80 actively, like you mentioned activist shareholders, you know, pushing, say, for example, for resolution. No. Some are. And they're using our data for that. And we applaud any kind of action towards better nutrition, healthier foods, better marketing using our data. We, as ATNI, do not sign these shareholder resolutions. But we absolutely will make our data available as a public good so that they can be used by this powerful group to yeah, hold the companies to account and hopefully invest in the long term. That's what it comes down to. Because it's true that this will take time for the benefits to come to both business and to people, but it's worth it. And I think the longer-term investors get it. And that's why they're doing these shareholder resolutions and different other investor escalation strategy. That strikes me as being pretty good news. Let's go down this road just a little bit further, talking about this, the shareholders. So, if the shareholders are starting to put, some at least, are putting pressure on the companies to go in a healthier direction, what do you think is motivating that? Do they see some big risk thing down the road that they're trying to anticipate and avoid? Is it policies that if the companies don't behave, governments might feel more emboldened to enact? Is it litigation that they see? What are they trying to avoid that's making them put pressure on the companies to move in these directions? That's a great question. When we ran the materiality assessment on nutrition earlier this year, we interviewed many of the investors and it seemed to come down to three things. One, there is coming regulation. There's more and more evidence that when you regulate the food system and you regulate food industry, and you do it in a smart way through a two-tiered levy system, for example, on sugar sweetened beverages. You tax the company, not the consumer. It actually does work. You have a decrease in consumption of these beverages. So coming regulation. The other one is increasing consumer demand for healthier options. Now, that might not be happening yet everywhere. And I think it only really happens when people can afford to demand healthier foods, right? But it seems like it's a trend everywhere as incomes increase and people's knowledge and understanding of nutrition increases, they do want healthier options. So, I think investors see that coming. And the third one is healthcare bills. Now, the investors don't always pick that up. Although in the case of some of our insurance companies who we work with, like AXA, it does. But they see the big macroeconomic picture. And we were talking to one of the investors last week, and they said it's all about megatrends. For them it's about investing in the megatrends, and they see this as a mega trend. This, you know, growing obesity, the cost related to obesity, growing costs related to diabetes and all NCDs. And they don't want to be investing in that future. We need to be investing in a healthier future. I think those are the three things we're gathering from the investors. So, Greg, there's sort of this jarring reality, it seems to me. And other people have written about this as well. That if the world becomes healthier with respect to its diet; let's just say you could wave a magic wand and obesity would go from its very high levels now to much lower levels or even zero. It means the world would be having to eat less food and the companies would be selling less food. And then you superimpose upon that another jarring reality that people simply buy more, eat more, of less healthy options. So, if a child sits down in front of a bowl of plain cornflakes, they're going to eat X amount. If that's sugar frosted flakes, they're going to eat, you know, 1.5 X or 2 X or whatever the number is. So, how can the companies try to make as much money as possible and be true to its shareholders and shareholders while at the same time, facing these realities. That's a great question. It goes to the heart of what we're trying to do at ATNI. That's why we say we're transforming markets for nutrition. Because if we don't help support that underlying market change, then we won't get very far in a sustainable way. You mentioned calories and over consumption. And that, of course, is part of the problem, but I think it's equally fair to say not all calories are treated the same and we need to look at the ingredients going into these food products to begin with. You know, why is sugar or any kind of corn derivative such an attractive cheap ingredient to put into food? And so bad for people if it's not eaten with anything else, if it's just an empty carb, for example. It's because of the subsidies, the billions of dollars of subsidies going into sugar around the world. In the United States, a very large subsidy going to the corn industry. And so, corn is then turned into many types of derivatives, many different types of ingredients that go into our foods. So, that's one thing. I think the other is that there's a big role for food policy to level the playing field. We hear this all the time from our industry partners, and we tend to agree. You know if two or three of the 30 companies that we just indexed stick their neck out and do something good, it'll work for two or three years until the other 27 start to undercut them. And if they're somehow making, you know, better money, bigger profits, more market share it's going to be very tempting for the three that made the good decisions to go back to what they were doing before. We have to change the market structure and end the perverse market incentives. Makes sense. One final question. What can policymakers do? I think we've touched on it a little bit. There's the fiscal policy space, which we're very excited about at ATNI. There are over 100 jurisdictions now that have put in place some kind of sugar sweetened beverage tax. But why not expand that take it to any kind of product which is too high in sugar, right? And again, make it like a proper levy on the company and not the consumer. Because that's where the evidence is that it works. Subsidies, you know, there's very few countries which are subsidizing healthier foods. Instead, you're seeing subsidies, as we just mentioned, going to the wrong kind of product. So that's one. And here's a new one: environmental, social, and governance investing metrics. As countries start to mandate the disclosure requirements for publicly listed companies, why not include two nutrition metrics? One on marketing, one on healthiness, so that every food company is mandated to disclose information on these things. That would be a real innovative way for policymakers to help regulate things. And front of pack labeling. You mentioned it yourself earlier. We would agree clear front of pack labels. So, the consumers know what's healthy and what's not. BIO Greg S Garrett is the Executive Director of ATNI (Access to Nutrition Initiative), a global foundation supporting market change for nutrition. Greg has held several leadership roles over the past twenty years, including serving on the Global Executive Team of the Drugs for Neglected Diseases initiative (DNDi), directing Abt Global's health reform in Kyrgyzstan and leading strategy at ThinkWell, a global health organization. During his eight years with the Global Alliance for Improved Nutrition (GAIN), Greg served as Director of Food Fortification and Director of Policy & Financing during which time he established a multi-million-dollar financing facility and managed a portfolio that reached one billion people with fortified foods. Greg serves on the Global Nutrition Report's Stakeholder Group and is a member of the Blended Finance TaskForce. He holds a BA and an MSc in International Development from the University of Bath, UK.

Episode Notes The Society of Infectious Diseases Pharmacists is excited to invite you to the first ever meeting (via Breakpoints) of The Tortured Stewards & Surgeons Department. Today's agenda items: optimal management of perioperative antibiotics and prevention of surgical site infections. Drs. Trisha Peel (@DrTrishaPeel), Michael Calderwood (@CalderwoodMD) and Patch Dellinger join Dr. Jillian Hayes (@thejillianhayes) to discuss some of the controversies we encounter while managing antibiotics in the perioperative space. Does anyone really need post-op antimicrobial prophylaxis longer than 24 hours? Where should vancomycin be fitting into surgical prophylaxis regimens? Can we truly give pre-operative cefazolin to patients with a penicillin allergy? Tune in for the answers to these questions and more! Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About X: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp If you'd like more information about the CALIPSO trial, please visit this link: https://www.anzca.edu.au/profiles/ctn-trials/underway/calipso Bibliography SSI Infection Prevention Review: https://jamanetwork.com/journals/jama/article-abstract/2800424#:~:text=Six%20are%20supported%20by%20randomized,use%20a%20chlorhexidine%20gluconate%2Dalcoho Strategies to prevent surgical site infections in acute-care hospitals: 2022 Update: https://www.cambridge.org/core/journals/infection-control-and-hospital-epidemiology/article/strategies-to-prevent-surgical-site-infections-in-acutecare-hospitals-2022-update/2F824B9ADD6066B29F89C8A2A127A9D American College of Surgeons and Surgical Infection Society: Surgical Site Infection Guidelines, 2016 Update: https://journals.lww.com/journalacs/citation/2017/01000/american_college_of_surgeons_and_surgical.8.aspx  2017 CDC Guidelines: https://jamanetwork.com/journals/jamasurgery/fullarticle/2623725  2018 WHO Guidelines: https://arthroplasty.biomedcentral.com/articles/10.1186/s42836-022-00113-y  ASHP Clinical Practice Guidelines for Antimicrobial Prophylaxis in Surgery: https://www.ashp.org/surgical-guidelines  Surgeons as Stewards: https://journals.lww.com/journalacs/citation/2020/12000/perioperative_antibiotic_prophylaxis__surgeons_as.23.aspx  Li et al, Arthroplasty 2022: https://arthroplasty.biomedcentral.com/articles/10.1186/s42836-022-00113-y  Dutch Arthroplasty Register Study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8023957/  de Jonge Meta-Analysis on duration and incidence of SSI: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30084-0/abstract  Prolonged Antibiotic Prophylaxis After Cardiovascular Surgery and Its Effect on Surgical Site Infections and Antimicrobial Resistance: https://www.ahajournals.org/doi/10.1161/01.cir.101.25.2916?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed RCT - Nasal Iodophor Antiseptic vs Nasal Mupirocin Antibiotic in the Setting of Chlorhexidine Bathing to Prevent Infections in Adult ICUs: https://jamanetwork.com/journals/jama/article-abstract/2810510  NYU Langone Study - Preventing Surgical Site Infections: A Randomized, Open-Label Trial of Nasal Mupirocin Ointment and Nasal Povidone-Iodine Solution: https://citeseerx.ist.psu.edu/document?repid=rep1&type=pdf&doi=91dee3e1445adb80d533f2c210816a3285254e3a  Trial of Vancomycin and Cefazolin as Surgical Prophylaxis in Arthroplasty: https://www.nejm.org/doi/full/10.1056/NEJMoa2301401 What Is the Primary Driver of Preoperative Vancomycin Use? It's Not Methicillin-resistant Staphylococcus aureus—or Allergy: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7744972/  Drug allergy: a 2022 practice parameter update: https://www.jacionline.org/article/S0091-6749(22)01186-1/fulltext  Perioperative use of cefazolin without preliminary skin testing in patients with reported penicillin allergy: https://www.surgjournal.com/article/S0039-6060(18)30307-6/abstract#%20  Timing of Surgical Prophylaxis RCT: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(17)30176-7/abstract  Propensity Score-Weighted Analysis of Postoperative Infection in Patients With and Without Preoperative Urine Culture: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2815528

Drug Resistant TB is a growing problem with some exciting advances over the past decade. With the recent Rapid Communication from the WHO and the advent of the B-PALMS regimen, drug resistant TB is a changing and exciting field of tuberculosis around the world.In this episode Professor Greg Fox from the University of Sydney speaks with Dr Jack Callum about the latest changes in the treatment of Drug Resistant TB in light of the WHO Rapid Communication as well as the NIX, ZeNIX and TB Practecal Trials. Professor Fox also addressing the implications for clinical practice and what the future might hold in this ever challenging field of TB.REFERENCES:1) Gegia, Medea, et al. "Treatment of isoniazid-resistant tuberculosis with first-line drugs: a systematic review and meta-analysis." The Lancet Infectious Diseases 17.2 (2017): 223-234.2) NIX Study: Conradie, Francesca, et al. "Treatment of highly drug-resistant pulmonary tuberculosis." New England Journal of Medicine382.10 (2020): 893-902.3) ZeNIX Study: Conradie, Francesca, et al. "Bedaquiline–pretomanid–linezolid Regimens for drug-resistant tuberculosis." New England Journal of Medicine 387.9 (2022): 810-823.4) TB Practecal Trial (not yet published but study protocol available):  Berry, Catherine, et al. "TB-PRACTECAL: study protocol for a randomised, controlled, open-label, phase II–III trial to evaluate the safety and efficacy of regimens containing bedaquiline and pretomanid for the treatment of adult patients with pulmonary multidrug-resistant tuberculosis." Trials 23.1 (2022): 1-16.5) WHO Guidelines for DR TB Update: World Health Organization. Rapid communication: key changes to the treatment of drug-resistant tuberculosis. No. WHO/UCN/TB/2022.2. World Health Organization, 2022. 6) Commentary on the WHO Update: Migliori, G. B., and S. Tiberi. "WHO drug-resistant TB guidelines 2022: what is new?." The International Journal of Tuberculosis and Lung Disease: the Official Journal of the International Union Against Tuberculosis and Lung Disease26.7 (2022): 590-591.

The importance of clean air has increased rapidly and despite popular opinion, it is not due to Covid.On this episode, we get the world view on clear air today, why it's being adopted so fast and the financial & health benefits it brings.  We also discover which governments and world organisations are leading the way and why legislation is able to adapt so fast.Keeping us up-to-date is Simon Birkett, a world-leading advisor on clean air working who has the latest from the World Health Organisation, the European Union and the UK parliament.TOPICS WE COVER Why clean air is enjoying a new lease of life The shocking pre-Covid numbers driving the change Who sets the rules and how they are able to legislate so fast The importance of considering pollution with indoor air How the benefits of clean air reap rich rewards for business Why clean air as a human right could be enshrined in UK law  ABOUT OUR GUESTSimon Birkett is an environmental campaigner. As founder and Director of Clean Air in London (CAL), he has campaigned since 2006 for full compliance with World Health Organisation (WHO) guidelines for air quality throughout London and elsewhere. Between 2015 and March 2019, Simon was the air pollution stakeholder on the High-Level and Intergovernmental Stakeholder and Advisory Group for UNEP's sixth Global Environment Outlook (GEO6). This was the United Nations' most comprehensive report on the totality of the global environment since 2012. At a local level, Simon chairs the Knightsbridge Neighbourhood Forum which produced the first ‘made' neighbourhood plan in central London in December 2018. Every one of the 40 policies in the Knightsbridge Neighbourhood Plan aligns to one or more of the United Nations Sustainable Development Goals. Simon is currently advising Baroness Jenny Jones on her Clean Air (Human Rights) Bill which topped the ballot of Private Members Bills in the House of Lords earlier this year and is progressing through Parliament.  The Bill would enshrine the human right to clean air precisely and explicitly in UK law including indoor air. Camfil has been the sole sponsor of CAL's campaign to build public understanding of indoor air quality since it started in 2011.  LINKSWebsite: https://cleanair.londonLinkedin: https://www.linkedin.com/in/simon-birkett-02613249/WHO Guidelines: https://cleanair.london/hot-topics/new-who-air-quality-guidelines/Covid Filtration Results: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8689842/ 

Prof. Wojtek Chodzko Zajko is the Shahid and Ann Carlson Khan Endowed Professor of Applied Health Sciences and Dean of the Graduate College at the University of Illinois. In his role as Dean of the Graduate College, Chodzko-Zajko leads campus efforts in setting policies, defining standards, and enabling excellence in graduate programs, graduate research, and graduate student life. With graduate programs in more than 100 disciplinary areas, the Graduate College at the University of Illinois fosters a vibrant campus community of scholars. In his professional life, Chodzko Zajko remains active in the dissemination of information about healthy aging through his work on several major professional advisory boards.  He served on the World Health Organization committee that developed the WHO Guidelines for Physical Activity among Older Persons. Chodzko-Zajko was the Principal Investigator for a series of projects charged with developing a national strategy for promoting healthy aging in the USA. He currently serves on the Executive Committee of the AAU Association of Graduate Schools and on the Board of Directors of the GRE. Chodzko-Zajko was the founding Editor of the Journal of Aging and Physical Activity from 1992-2002.  He served as Chairman of the Board of Directors of the American Council on Exercise and is a Past-President of the American Kinesiology Association. Prior to assuming his current position, Chodzko-Zajko served for many years as the head of the department of Kinesiology and Community Health at the University of Illinois at Urbana-Champaign.    This podcast episode is sponsored by Fibion Inc. | The New Gold Standard for Sedentary Behaviour and Physical Activity Monitoring Learn more about Fibion: fibion.com/research --- Collect, store and manage SB and PA data easily and remotely - Discover new Fibion SENS Motion: https://sens.fibion.com/

Prof. Wojtek Chodzko Zajko is the Shahid and Ann Carlson Khan Endowed Professor of Applied Health Sciences and Dean of the Graduate College at the University of Illinois. In his role as Dean of the Graduate College, Chodzko-Zajko leads campus efforts in setting policies, defining standards, and enabling excellence in graduate programs, graduate research, and graduate student life. With graduate programs in more than 100 disciplinary areas, the Graduate College at the University of Illinois fosters a vibrant campus community of scholars. In his professional life, Chodzko Zajko remains active in the dissemination of information about healthy aging through his work on several major professional advisory boards.  He served on the World Health Organization committee that developed the WHO Guidelines for Physical Activity among Older Persons. Chodzko-Zajko was the Principal Investigator for a series of projects charged with developing a national strategy for promoting healthy aging in the USA. He currently serves on the Executive Committee of the AAU Association of Graduate Schools and on the Board of Directors of the GRE. Chodzko-Zajko was the founding Editor of the Journal of Aging and Physical Activity from 1992-2002.  He served as Chairman of the Board of Directors of the American Council on Exercise and is a Past-President of the American Kinesiology Association. Prior to assuming his current position, Chodzko-Zajko served for many years as the head of the department of Kinesiology and Community Health at the University of Illinois at Urbana-Champaign.    This podcast episode is sponsored by Fibion Inc. | The New Gold Standard for Sedentary Behaviour and Physical Activity Monitoring Learn more about Fibion: fibion.com/research --- Collect, store and manage SB and PA data easily and remotely - Discover new Fibion SENS Motion: https://sens.fibion.com/

In this episode from the series “Key Decisions in HIV Care,” Milena Murray, PharmD, MSc, BCIDP, AAHIVP, and Jonah Musa, MBBS, MSCI, PhD, discuss important considerations for ART use in pregnancy, including DHHS and WHO guideline recommendations and data supporting recommended ART regimen options in pregnancy from IMPAACT 2010, Tsepamo, and DoLPHIN-2. They also discuss pharmacokinetic considerations and drug–drug interactions. Following their dialogue, the faculty field questions from healthcare professionals.Presenters:Milena Murray, PharmD, MSc, BCIDP, AAHIVPAssociate Professor  Pharmacy PracticeMidwestern University College of Pharmacy, Downers Grove CampusDowners Grove, IllinoisHIV/ID Clinical PharmacistNorthwestern Memorial HospitalChicago, IllinoisJonah Musa, MBBS, MSCI, PhDProfessor, Obstetrics and GynecologyUniversity of JosHonorary Consultant Obstetrician and GynecologistJos University Teaching HospitalJos, NigeriaContent based on an online CME program supported by educational grants from Gilead Sciences, Inc.; Janssen Therapeutics, Division of Janssen Products, LP; and ViiV Healthcare.Follow along with the slides at:https://bit.ly/3GRxpGQLink to full program:https://bit.ly/2TXTYWx

As the coronavirus leaves many people housebound, the World Health Organisation says people need to get more active, insisting that up to 5 million deaths worldwide could be avoided each year if people would run, walk and simply move more.The U.N. health agency, launching updated guidelines  on physical activity and its first advice on sedentary behaviour, is pointing to figures that one in four adults — and four in five adolescents — don't get enough physical activity, a situation that's complicated by the Covid-19 crisis that has shut up many people indoors.It recommends at least 2 1/2 hours of "moderate to vigorous aerobic activity" for adults per week, and an hour per day for kids and teens. A lack of physical activity leads to extra health care costs of $54 billion per year, plus another $14 billion in lost productivity, WHO said.The findings come as the Geneva-based agency released an update on "WHO Guidelines on physical activity and sedentary behaviour" — building upon, revising and expanding recommendations in the previous guidelines published a decade ago."Physical activity of any type and any duration can improve health and well-being, but more is always better," said Dr. Ruediger Krech, WHO's director of health promotion. "If you must spend a lot of time sitting still, whether at work or school, you should do more physical activity to counter the harmful effects of sedentary behaviour.""The old adage — prevention is better than cure — really applies here," Krech said. "WHO urges everyone to continue to stay active through the COVID-19 pandemic. If we do not remain active, we run the risk of creating another pandemic of ill-health as a result of sedentary behaviour."Dr. Fiona Bull, who heads the physical activity unit at WHO, said the guidelines offer advice on "sedentary behaviour" for the first time.She added that experts previously believed physical activity should be done in blocks of at least 10 minutes. But the increasing use of fitness-monitoring devices has generated new science showing that it's really most important to get 150 minutes at least per week."In fact, that 10-minute minimum is not so important and every move counts," she said. "It's the total amount we all achieve: Reaching 150 (minutes) and extending."Bull said only 78 countries, based on WHO's most recent survey, have national guidelines on physical activity. She encouraged nations to leverage the new guidelines "as the basis for fast-tracking their policy development."Regular physical activity is important to help prevent heart disease, diabetes and cancer while also reducing symptoms of depression and anxiety, and "boosting brain health," WHO said. People aged over 65 should focus on balance, coordination and muscle strength to help prevent falls, it said.

Cell Phone plus auxiliary cord to Vehicle Audio = Action Radio on your Radio! Patreon memberships:  https://www.patreon.com/ActionRadio Facebook page:   https://www.facebook.com/radiolegislature/ Twitter:  GregPenglis@ActionRadioGP Bill writing site:  www.WriteYourLaws.com *****  Show Notes:  6/23/20.    *** Wow!!!   What an explosion of energy and information today!!! Intro - Jean Virnig's Life Coach Report.  Choices, choices, choices!!!  What is it with all this instant gratification?  Can't you wait to see if you really need it?? 30:00 - Cruise and Travel, with Shelby Frenette.  Cruise season postponed again.  It's all about liability and public relations.  And the CDC guidelines don't make much sense either given that the WHO Guidelines contradict them. 45:00 - Special Investigations, with Karen Hoffman.  Is AOC a CIA asset designed to split up the Democrat Party into Socialists and Liberals?  It takes someone really smart to act that dumb!!  For more on this go to the Action Radio Special Investigations Project on Facebook. 1:00:00 - Main Topic, Guests and Callers.  Is Black Lives Matter the new equivalent of the KKK as the new militant arm of the Democrat Party designed to terrorize their "enemies" to obtain political objectives again using race in a way that fits the time they are in.  But the real story is how the non-profit Black Lives Matter takes in millions in corporate, foundation and individual donations worldwide, launders them through a holding company known as ActBlue, and then after 60 days, ActBlue can avoid the political restrictions because they are not, non-profit, and can donate all the BLM money to the Democrat Party.   *****

Welcome back to episode 405 of the Whole View. (0:27) Today Stacy and Sarah are talking about a super interesting topic submitted a listener. Which, if you didn't know this already, we love it when you email us. Sarah shared some behind the scenes information on where listener questions come from. There are Stacy's requests, listener questions, and the really challenging listener questions. The question in discussion in this episode is one of those really hard ones that has been in the queue for a long time. Sarah was able to pull together the information for this show because she actually did a lot of research on this topic for her gut microbiome book. And of course, Sarah did extra research to address the many facets of this challenging question. Stacy is excited about this science rich show.   Listener Question Is the EWG's dirty dozen list based on strong science? (3:37) My husband listened to two episodes of the Skeptoid podcast on organic vs. conventional farming. Mr. Dunning said that we are being duped into paying extra for organic produce. It is sprayed with larger amounts of pesticides than those used in conventional farming and the organic pesticides have been shown to cause disease. My husband believes Mr. Dunning because he provides references and appears to be liberal and non-biased in other podcasts.   I have been purchasing organic produce according to the Environmental Working Group's dirty dozen list. It says on the Activist Facts website that "There’s really only one thing you need to know about the Environmental Working Group when it comes to its studies of toxins: 79 percent of members of the Society of Toxicology (scientists who know a little something about toxins) who rated the group say that the Environmental Working Group overstates the health risk of chemicals. I am walking around with holes in my shirts, and I haven't gotten the air conditioning fixed in my car, so that I can afford organic food. Am I wasting my money? I feel like I cannot trust anyone but you.   Preface Stacy wanted to refer listeners to listen back to previous episodes for information on how both Stacy and Sarah have evolved the way they purchase and prioritize their own foods within their budget. (5:06) Neither Stacy nor Sarah buys everything organically. Nothing that Stacy and Sarah are going to discuss in this episode is intended to be a judgment on you or your family or what you did in the past or what you are doing now. This is all education so that you can be empowered to make the choices that are best for your family at the correct time for you. Where Stacy's family is today, ten years later, is a lot different than where they were ten years ago. The goal of this episode is to help you so that you can walk away and ask questions. There is a larger philosophy that each family needs to adapt to what works best for them. No one is perfect. If you are starting in your journey, you don't need to forego the necessities to have organic food. There is a way to prioritize your budget in a way that is consistent with what your family believes in. Healthy living choices are so personal.   Foundational Choices & Next Level Choices Sarah wanted to emphasize that there are foundational health principles. Nutrient density diet, eating a lot of fruits and vegetables, getting enough sleep, managing stress, and living an active lifestyle. Then Sarah thinks of the next level steps like adding some biohacks, supplements, purchasing grass-fed beef, and organic fruits and vegetables. We need to first make sure that we are focusing on the foundational principles and adding in the next level choice if and when it makes sense. Eating organic is beyond the basic principles, but is overall a better choice. The EWG's overall approach is in many ways more rigorous than the American regulatory agencies. The EWG tends to align with the European Union, Health Canada, and these other regions of the world where the criterion for approving a chemical or pesticide is firmer. In America, the thought process is that chemicals are assumed fine unless proven bad. In Europe, a chemical is not ok until proven safe.   Conventional Evaluation of Pesticide Safety The FDA's safety assessment for chemicals in foods have a variety of criteria. (13:11) They look at acute chronic and subchronic toxicity, carcinogenicity, genotoxicity, reproductive and developmental toxicity, neurotoxicity, and immunotoxicity. Pesticides also go through additional impact evaluation on the environment and ecology. The vast majority of the studies evaluating the effects of pesticides show problems to human health only with occupational exposure, rather than the much lower exposure the majority of us would have simply by eating produce from crops treated with these chemicals. However, there are some challenges with this. We can see high exposure in rodents causing all kinds of problems. The assumption is that acute exposure is not the same as low dose chronic exposure.   Where the Standards Differ One of the challenges that we have in evaluating pesticides is that our exposure is already so vast. There are no humans that don't already have multiple points of exposure to pesticides. There are studies that are linking the chronic low dose exposure to pesticide residues that have correlated pesticide exposure in the food supply with a number of health issues. In the United States, there are 72 pesticides that are routinely used that are completely banned or are in the process of being completely phased out in Europe. Of the pesticides used in USA agriculture in 2016, 322 million pounds were of pesticides banned in the EU. Twenty-six million pounds were of pesticides banned in Brazil and 40 million pounds were of pesticides banned in China. Pesticides banned in the EU account for more than a quarter of all agricultural pesticide use in the USA. It is important to understand that the European Union is looking at the same science as the EPA. And they are making a different judgment based on the strength of the data. We have a challenge that our metric is, 'is it toxic' and 'does it cause cancer'. WHO Guidelines for Safety of Chemicals in Food are much more thorough, and add to the above. They include general system toxicity, allergy and hypersensitivity, and GI Tract Considerations (includes microbiome).   Pesticides and the Microbiome (Sarah’s Biggest Concern) Microbial diversity is generally considered to be the most important measurable criteria for a healthy microbiome. (24:31) The more different species you have, they tend to keep each other in balance. The bacteria basically control the growth of each other. We are also looking for the growth of these really important probiotic strains. In addition, we are looking for completely absent levels of pathogens. We are also looking at the balance between the two main phylum of bacteria in the gut. It is important to understand that rodent studies are actually really good studies for understanding the gut microbiome. We would want to eventually be able to do a similar study in humans. But what Sarah wants to emphasize is that these rodent studies are a really good model for understanding what is happening in humans. Let’s go through some of the most commonly-used pesticides in agriculture for food crops. Permethrin is a broad-spectrum chemical often used as an insecticide for cotton, corn, alfalfa, and wheat crops—unfortunately, it’s also lethal to bees. It’s also used to treat lice, ticks, and scabies.  For more on this, visit this link here. PEM has higher antibacterial activity against some beneficial bacteria, (including Lactobacillus paracasei and Bifidobacterium). Than against pathogens (such as Staphylococcus aureus and Escherichia coli, which only respond to higher concentrations of PEM). Carbendazim (CBZ) is a broad-spectrum benzimidazole fungicide, widely used in agriculture. In mice, 28 days of exposure to CBZ resulted in gut dysbiosis. It suppresses the growth of some of the most important probiotic families while increasing the growth of some problematic families of bacteria. And it decreases bacterial diversity. To learn more about this pesticide, see here. Epoxiconazole (EPO) is a broad-spectrum fungicide often used on grain crops, and that works by inhibiting the metabolism of fungal cells. It reduces the production of conidia—the asexual spores of a fungus that facilitate reproduction. In rats, EPO for 90 days decreased the relative abundance of Firmicutes and increased the abundance of Bacteroidetes and Proteobacteria, while also selectively enriching Lachnospiraceae and Enterobacteriaceae. To learn more about this pesticide, see here.   More Commonly Used Pesticides Imazalil (IMZ) is a systemic fungicide used to combat fungi on vegetables and fruit (especially citrus), as well as tubers during storage. (30:39) In mice, IMZ exposure (at doses of 100 mg per kg of body weight daily for up to 14 days) reduced the cecal relative abundance of Bacteroidetes, Firmicutes, and Actinobacteria, while also reducing microbiota richness and diversity. The IMZ-treated mice also exhibited colonic inflammation. In another study of mice, low-dose, environmentally relevant exposure to IMZ (0.1, 0.5, or 2.5 mg per kg of body weight daily) for 15 weeks resulted in gut microbiota changes. These changes included reduced mucus secretion, decreased the expression of genes related to cystic fibrosis transmembrane conductance regulator (CTFR) in the ileum and colon, and generally disturbed intestinal barrier function. Stacy shared her perspective on how she looks at this information. Think through the way how these pesticides are more heavily used on grains. Chlorphyrifos (CPF) is an extremely common organophosphate pesticide used to kill insects and worms, by interfering with acetylcholine signaling and disrupting their nerve processes. It’s commonly used on fruit and vegetable crops, as well as vineyards. This is one that was going to be banned in the USA, but Scott Pruitt reversed the planned ban. You can learn more about this here. Sarah shared on this study, this study, this study, and this study. This information should stimulate a reevaluation of the use of these chemicals in the food supply. Diazinon is an organophosphate insecticide used on a variety of crops—including fruit trees, rice, sugarcane, nuts, potatoes, and corn. You can learn more about this pesticide here. It causes different changes in male rodents versus female rodents. The researchers speculated that these differences—with male mice experiencing the most severe changes—were due to sex-dependent gut microbiota profiles present before treatment. You can read more about this study here.   Two More Commonly Used Pesticides Propamocarb (PMEP) is a systemic fungicide used to control root, leaf, and soil diseases caused by oomycetes (water molds) by interfering with fatty acid and phospholipid biosynthesis and therefore changing the membrane in fungi. (41:41) It can accumulate in fruit at high levels, thus reaching humans.  You can find more information on this pesticide here. In mice, 28 days of exposure to PMEP (at levels of 300 mg/L in drinking water) induced gut dysbiosis and changes in 20 fecal metabolites, including SCFAs, succinate, bile acids, and TMA. You can read more about this study here. Glyphosate is a broad-spectrum herbicide that can kill both grasses and leafy weeds. It works by inhibiting an enzyme (5-enolpyruvylshikimic acid-3-phosphate synthase, or EPSP synthase), which is used by bacteria, archaea, fungi, algae, some protozoans and plants to synthesize folates (vitamin B9), ubiquinone, menaquinones (vitamin K2), phenolic compounds, and the aromatic amino acids tyrosine, tryptophan, and phenylalanine. The pathway this affects doesn’t exist in animals, which is part of why glyphosate has historically been considered to have low toxicity in animals.  Now that we understand that we have at least as many bacterial cells living within our body as we do human cells and that those bacteria are essential to our health, the relevance of glyphosate exposure comes into focus. Many bacterially-derived compounds that benefit human health are produced via the shikimate pathway. One rat study evaluated the impact on the microbiome of two weeks of glyphosate consumption, and showed a dose-dependent increase in fecal pH attributable to a reduction in acetic acid production, implying the metabolomic impact of glyphosate exposure.   More on Glyphosate It's not that glyphosate is necessarily directly impacting our cells, but it is dramatically impacting the gut microbiome at levels that we are already being exposed to in the food supply. (48:50) In studies in poultry, cattle, and pigs, glyphosate exposure increases the ratio of pathogenic bacteria to probiotic microbes, reducing Bifidobacteria, Lactobacillus, and Enterococcus while increasing Salmonella and Clostridium. In a long-term rat study, the impact on the gut microbiome was evaluated following nearly two years of glyphosate exposure via drinking water at three different doses. Glyphosate caused a large increase in the Bacteroidetes family S24-7 (associated with obesity and inflammation) and a decrease in Lactobacillus species in females (more modest changes in males). It also altered the Firmicutes to Bacteroidetes ratio to one more closely associated with chronic disease. The authors concluded “our data suggests that the exposure to an environmental concentration of [Roundup] residues could have a role in the current epidemic of gut dysbiosis”. This occurs even at levels well below the US ADI of 1.75 mg/kg body weight /day.  There is no strong dose-response. Sarah wants to emphasize that our glyphosate exposure in food is quite high. It is definitely above the cusp for an impact on our gut microbiome composition. The FDA has a report where they have been mandated to measure glyphosate residue in the food supply. In their 2016 report they measured measurable levels of glyphosate residues in 63% of corn food crops and in 67% of soybean food crops. However, they did not say how much residue was there. The 2018 report goes to a dead link now. A Swiss study of foods purchased at a grocery store showed that legumes had the highest concentrations of glyphosate residues, up to 2.95 mg/kg. United Kingdom government testing of glyphosate residues in wholegrain bread showed levels up to 0.9 mg/kg. A study of foods purchased in Philadelphia, USA metropolitan area showed 59 percent of honey samples contained glyphosate residues, and 36 percent of soy sauce contained glyphosate residues. Third-party testing of popular breakfast cereals, crackers, and cookies by the Detox Project and Food Democracy Now! showed alarming levels of glyphosate residues in all products. Roundup Ready GMOs have the highest level of glyphosate residues. Studies prove that our current levels of exposure are sufficient for measurable amounts of glyphosate to get into our bodies.  One study showed that 44% of city dwellers in 18 countries in Europe had detectable glyphosate residues in their urine, despite Europe’s more aggressive campaign against GMO foods. A pilot study in the United States of America evaluating 131 urine samples from across the country detected glyphosate residues in the urine of 86.7% of them. The highest observed detection frequency in the Midwest was at 93.3% and the lowest in the South at 69.2%.   How to Look at this Science The EWG is looking at this much more broad group of criteria and they are taking a very similar standpoint to the European Union. (58:09) A small effect is still an effect and we need to be concerned about it. When Sarah does a deep dive look to look at the impact on the gut microbiome this is where Sarah sees the biggest area of concern. Sarah thinks it is especially important because it is not currently part of the criteria by the FDA and the EPA for whether or not these chemicals are going to be approved for use. This is the thing that Sarah really thinks needs to change. The good news is that a healthy gut microbiome and high fiber consumption can actually protect us from absorbing a lot of these pesticides.  There have been studies that showed that lactobacilli can help reduce how much pesticide on our food gets into our bodies.  There are also studies that show that higher fiber consumption can at least partially reverse the gut dysbiosis. As we get back to the heart of this question, there are studies that show that the answer is no. High vegetable consumption is still really important because it does support a healthy gut microbiome, to begin with. And a healthy gut microbiome is going to protect us in a lot of ways. For example, they can protect us against heavy metals. Even if we can't afford organic to not let that dissuade us from eating that high vegetable consumption because of this. Sarah sees this as an exciting two-way street. Even though pesticide residues are impacting the composition of our guts, the composition of our gut is influenced by more than just that. It is influenced by how many fruits and vegetables we eat, mushrooms, nuts and seeds, variety, how much fish, how quality the olive oil is that we are consuming, etc. All of these things help to determine the composition of our gut microbiome. Doing all of these foundational things becomes more important when we are not necessarily in a position to be able to seek out and afford the highest food quality. It is still really important to eat a vegetable-rich diet. That's why Sarah wants to classify all of this science as the next level. The foundational principle is still eating a lot of fruits and vegetables, even if our only access to that is conventional. Beyond that, yes the Dirty Dozen and Clean Fifteen lists from the EWG are a wonderful tool. Not that Sarah agrees with everything the EWG has said, Sarah thinks that these are spot on in the sense of trying to minimize our exposure to pesticide residues.   How to Limit Pesticide Exposure Stacy feels that the podcast referenced and the information they are sharing aren't so far apart. (1:02:10) Sarah and Stacy discussed a point shared in the documentary Food Inc. that really hit this information home. We do the best that we can with what we can, and become educated on what other things we can do to support healthy living. Nothing is ever perfect. Prioritize the foods you purchase and do the best you can. It is not good to stress about these things. The dirty dozen list includes strawberries, spinach, kale, nectarines, apples, grapes, peaches, cherries, pears, tomatoes, celery and potatoes The clean fifteen list includes avocados, sweet corn, pineapple, onions, papaya, sweet peas (frozen), eggplants, asparagus, cauliflower, cantaloupes, broccoli, mushrooms, cabbage, honeydew melon, and kiwifruit. If you are going to get something off the dirty dozen conventional, look at ways that you can wash that food very well or ways you can peel the food to remove the majority of the pesticide residue. USDA certification is very expensive, so a lot of small family farms are growing organically, but don't have the certification. Talk to farmers and find out how they are growing their food. Stacy can't handle the sight of bugs in her fresh vegetables. Eating fruits and vegetables is a good thing. Perfection is not the goal. Neither Stacy nor Stacy eats 100% organic, they both do the best that they can. Sarah has found that the prices at her local farmer's market are best. Develop relationships with your local farmers, and shop at the end of the market. Stacy subscribes to Hungry Harvest, which has a waiting list right now. Sarah prescribes to MisFit Market, there is also one called Imperfect Produce. One of the things that Sarah loves about her subscription is the surprise element of it, which forces her to get creative with her meal planning. At Stacy's house they meal plan when their box arrives, based on what they received. Stacy shared more information on their meal planning process as a family, and how focused they have become to make sure they are not wasting food. Building relationships with your local farmers is a point that Stacy echoed from Sarah. Buying things in season or frozen can also be a helpful way to save money. Stacy's organic box is at least 30% off had they purchased those items at a grocery store regularly. The thing that Stacy most loves about Hungry Harvest is that they give back to the community.   Closing Thoughts Stacy thanked Sarah for all the research she did for this show! (1:23:13) If you have any follow up questions on all of this, you are welcome to email Stacy and Sarah using the contact forms on their blogs. You can comment on social media posts as well. Stacy and Sarah are always happy to hear from you! If you have been loving this show, please help spread the word to others by sharing a link to an episode you enjoyed with a family or friend, or leave a review. Stacy and Sarah so greatly appreciate your support! Thank you again for tuning in! Next week is another science-heavy show that builds off of this week's episode. We will be back again next week! (1:25:57)

In this episode New Normal Project podcast host, Dr Andrew Davies, encourages you to take action. In an aim to inspire and empower you to live a more plant-based, body-moving and mind-focused lifestyle, and to move towards your new normal, Andrew discusses what's been happening recently for him. Andrew talks about: How he's been going with some of the recent guest-inspired challenges he took on What’s been recently happening for him personally in one of the healthy lifestyle pillars - mindfulness Two recently published scientific papers he thinks are worth knowing about What he's been reading and listening to in the form of books and podcasts The information and stories you hear on this podcast should inspire you to make choices in the way you lead your life so you can live vibrantly, happily, purposefully, for a long time, disease-free, and above all with a low risk of ever being admitted to the Intensive Care Unit, the place Andrew works. Hopefully you'll hear something that will help you make a better choice about the way you live your life. And perhaps you might take on a challenge yourself for the next 28 days. Or even 7 days. Small steps are important. Incremental change, particularly around habits, might be the most beneficial thing you ever do for your health.   Live well, feel well, do well.   Andrew   ------------------------------------ About the New Normal Project podcast: The podcast is aimed to inspire and empower you to live your most plant-based, body-moving and mind-focused lifestyle, by hearing about healthy lifestyle pillars such as nutrition, exercise, mindfulness, sleep, connection and purpose. You’ll hopefully glean insights to help you make choices about your habits so you become more healthy, fulfilled and conscious.   ------------------------------------ Links to people and other resources (in order of mentioning) New Normal Project podcast (Episode 57) - New Normal in Action (Oct 2019) One Year No Beer New Normal Project podcast (Episode 46) with Andy Ramage Dr John Orchard New Normal Project podcast (Episode 53) with John Orchard Natalie and Stuart McIntosh New Normal Project podcast (Episode 52) with Natalie & Stuart McIntosh Ashley Jubinville New Normal Project podcast (Episode 54) with Ashley Jubinville PlantProof podcast Adam Guthrie New Normal Project podcast (Episode 58) with Adam Guthrie Headspace (Meditation app) Calm (Meditation app) Scientific paper on soft drinks - JAMA Intern Med. 2019 Sep 3. doi: 10.1001/jamainternmed.2019.2478 Article in The Age on running 50 minutes a week Scientific paper on running - Br J Sports Med. 2019 Nov 4. pii: bjsports-2018-100493. doi: 10.1136/bjsports-2018-100493 WHO Guidelines on Physical Activity Audio Book: “The Other Side of History: Daily Life in the Ancient World” (by Robert Garland) Professor Robert Garland Book “Two Hours: The Quest to Run the Impossible Marathon” (by Ed Caesar) Ed Caesar Video of Eliud Kipchoge running 1:59:40 marathon Geoffrey Mutai Rich Roll Podcast with Dean Karnazes Finding Mastery Podcast with Mick Fanning Howie Games Podcast with Scott McLaughlin The Game Changers   Links related to New Normal Project podcast resources New Normal Project podcast New Normal Project website New Normal Project on Facebook New Normal Project on Instagram: @newnormalproject New Normal Project on Twitter: @newnormalproj Email Andrew Davies Andrew Davies on Instagram: @andrewdavies66 Andrew Davies on Twitter: @andrewdavies66 Andrew Davies on Facebook Subscribe to the New Normal Project newsletter

In Kenya, according to the 2018 Economic Survey by the Kenya National Bureau of Statistics (KNBS), diseases of the respiratory system are the leading cause of morbidity, followed by malaria. They accounted for 34% of all incidences in 2017, compared to malaria’s 18.7%. Kenya experiences 19,112 deaths annually because of air pollution, and of these, 6,672 are children. These are diseases such as pneumonia, tuberculosis and lung cancer, among others. The 2017 survey estimated that 19.9 million Kenyans suffer from respiratory ailments that are exacerbated by poor air quality. We're joined by Dr. Kanyiva Muindi of the Africa Population Health Research Centre (APHRC) to talk about air quality in Kenya at large, and Nairobi in particular. Press play! Resources Economic Survey 2018 - Kenya National Bureau of Statistics Air Quality Regulations (2014) Environmental Management and Coordination Act (1999) (Amended) Environmental Management and Coordination Act (2015) Air Pollution in Nairobi Slums: Sources, Levels and Lay Perceptions Invisible and ignored: air pollution inside the homes of Nairobi’s residents There is no escape: Nairobi's air pollution sparks Africa health warning EVERY BREATH YOU TAKE: Who is monitoring air quality in Kenya? Why Nairobi’s air pollution is deadly Nairobi Air Quality Monitoring Sensor Network Report - April 2017 The Air Pollution in Nairobi, Kenya Measuring Nairobi’s air quality using locally assembled low-cost sensors WHO Guidelines for indoor air quality - household fuel combustion (2014) WHO Guidelines for indoor air quality - selected pollutants (2010) WHO Air quality guidelines for particulate matter, ozone, nitrogen dioxide and sulfur dioxide - Global update 2005 9 out of 10 people worldwide breathe polluted air, but more countries are taking action Image Credit: Environmental Justice Atlas

Malaria control requires an integrated approach with an emphasis on prevention and prompt treatment with effective antimalarials. This presentation will review some of the key points of the WHO Guidelines for the Treatment of Malaria and the key elements of the Global Malaria Action Plan. Key interventions to control malaria include: prompt and effective treatment with artemisinin-based combination therapies; use of insecticidal nets by people at risk; and indoor residual spraying with insecticide to control the vector mosquitoes

This week IAQ Radio welcomes Dr. Michal Krzyzanowski to the show. Dr. Krzyzanowski is a Head of the Bonn Office of the World Health Organization (WHO) European Centre for Environment and Health, belonging to the WHO Regional Office for Europe. He is also a Program Manager, Living and Working Environments. His technical work focuses on the preparation of scientific evidence on health impact of environmental hazards, in particular of air pollution. The global update the WHO Air Quality Guidelines is one of the products of his team. Currently, he is coordinating the development of WHO guidelines on indoor air quality. LEARN MORE this week when we discuss the WHO indoor air quality program and two recent publications "Dampness and Mold" and "WHO Guidelines for Indoor Air Quality: Selected Pollutants". Don't miss this opportunity to gain an international perspective on IAQ issues from a world renowned leader Dr. Michal Krzyzanowski!

This week IAQ Radio welcomes Dr. Michal Krzyzanowski to the show. Dr. Krzyzanowski is a Head of the Bonn Office of the World Health Organization (WHO) European Centre for Environment and Health, belonging to the WHO Regional Office for Europe. He is also a Program Manager, Living and Working Environments. His technical work focuses on the preparation of scientific evidence on health impact of environmental hazards, in particular of air pollution. The global update the WHO Air Quality Guidelines is one of the products of his team. Currently, he is coordinating the development of WHO guidelines on indoor air quality. LEARN MORE this week when we discuss the WHO indoor air quality program and two recent publications "Dampness and Mold" and "WHO Guidelines for Indoor Air Quality: Selected Pollutants". Don't miss this opportunity to gain an international perspective on IAQ issues from a world renowned leader Dr. Michal Krzyzanowski!