Saturday, 21 April 2018

GENERIC EARTH DAY


“Earth Day has become a very general celebration festooned with music, food and feeling good about being with others who are politically correct, acknowledging the importance of Mother Earth on the most abstract terms, specific foci for action being impotent in the face of our real authentic challenges.” — A teen attending the Flannery O’Connor Academy
“The future of the bison and many other species that the two countries share is at stake at the border.” — Rurik List, an ecologist at Universidad Autonoma Metropolitana-Lerma in Mexico, writing in an issue of Jornada Ecologica
Research published by ecologists from the Mexican National Autonomous University has shown that an impassable physical barrier placed into ecosystems inhabited by jaguars, black bears and bighorn sheep will so disrupt patterns of migration as to cause “a natural catastrophe”… irreparable damage that will impact — distort abominably — the entire biological history of North America.
The U.S.-Mexico border is made up of mountains, jungle, coastline and many other diverse ecosystems. Wildlife has populated these regions for millions of years, and has always had the freedom of movement to hunt, reproduce and migrate. To make these animals suffer as a result of man’s political agenda is entirely immoral. Worse, it’s ecocidal, suicidal.
Of the 800 species that will be affected by President Trump’s border wall, 140 are in danger of extinction, including the bald eagle, grey wolf, armadillo and jaguar, a big cat of which remain only 10 in the highlands of the Sonora Desert that straddle Arizona. Those animals whose range will be halved by the border wall’s construction will be impeded in their ability to reproduce with other members of their species, thereby creating a shallower gene pool and heightening the chance of inbreeding.
It goes against the very principles of evolution that has created these amazing natural environments. But Earth Day will not be addressing this, not in any way that will have a shot at stopping the building of the wall in the name of the endangered species or the human beings who are being targeted inhumanely, senselessly.
I was in on the first Earth Day, founded by Gaylord Nelson. That first celebration on April 22nd was monumentally important, truly attempting to deal with our war momentum and the environmental dangers down the road represented by the 1969 Santa Barbara oil spill. But look at how little Earth Day “festivities” have helped over the decades to deal with that oft-repeated abomination. Or others.
Sunday seems like it’s slated to be a Generic Earth Day.
Richard Martin Oxman has been an educator for over half a century, and an activist for longer than that. He can be reached at aptosnews@gmail.com. The author — in the spirit of what’s touched upon in the opening quote above — wants to recommend Past Imperfect, one of many excellent volumes addressing the gap which exists between History as per the movies and History as per the so-called real world… which is not the whole story either.

Friday, 20 April 2018

Global Weirding

Oh, what fun it truly was to experience the “bomb cyclone” in January in New England: the snowfall gave a sense of peace and calm, the winds were less strong than predicted, and the snow, while heavy, was not dense enough to take down trees and power lines in most areas. The following period of intense cold through February and March in the eastern half of the US, on the other hand, seems a harbinger of climate instability which will most likely worsen in upcoming years. As the jet stream weakens and buckles due to climate change, storm intensity and temperature fluctuations are certain to get worse.
The biggest danger for East coasters will remain the hurricane, as September 2017 registered as the most active month in recorded history for the Atlantic.
On the West coast, things are getting a bit Biblical: raging fires alternate with intense flooding and mudslides in Montecito and southern California a few months ago. The 2017 fire season set aflame over eight million acres mainly in the Western states. It’s not just a domestic issue: Portugal faced an epic firestorm in June of last year, killing close to 100, partly due to the monocultures of eucalyptus trees planted across the country. Millions face conditions of famine and drought worldwide.
Sadly, most reporting and discussion of global warming and climate change serves to abstract the issues into a diversionary attitude that the Earth is in crisis. Well, the planet, as a self-regulating super-organism, will do just fine without us, even if it takes millennia to recover from our misdeeds. It is stable and abundance-providing ecosystems that are in crisis, species that are going extinct at 1000 times the background rate, and humanity is the culprit.
Even though man-made global warming is acknowledged by most people, there is still a conflation going on in the West that the all-devouring Earth-mother is out to get us. Rather, it is Western civilization which is stalking any chance for future generations to live and prosper.
Ecosystems in Crisis
In Germany, a study was done measuring insect populations in nature reserves, and it was discovered that there was a 75% drop in total insects collected in only 25 years. Scientists estimate that 30-50% of all species may become extinct by 2050.
Tragically, regarding honeybees, scientists have discovered an important link between fungicide use and the herbicide glyphosate (Round-Up), showing a negatively synergistic effect on bee colonies and resistance to fungal infection. Bees seem to actually prefer honey set in traps with a small percentage of Roundup or fungicides added. Humans are not the only species to enjoy mind-altering drugs, even poisonous ones.
All of our problems involving the destruction of habitat are ultimately bound up in the fact that there are too many of us, conditioned to respond in violent outbursts, consuming too many resources, leading to stress, war, and unimaginable acts of cruelty. These acts are often sanctioned by the state or the corporation or religion or patriarchal vertical hierarchies.
The exponential population growth from the industrial revolution is already slowing and bound to top off at anywhere from 10-12 billion people by 2050-2100, if we manage to avoid the many catastrophes hurtling our way. Thus the growth curve will resemble an S-curve barring unforeseeable circumstances, with small waves and ripples due to the complexities of changing times, food sources, and a multitude of variables. In theory this population model could then lead to a steady decrease in total population due to a voluntary decision by humanity to slowly and carefully have fewer children due to stresses on ecosystems and natural resources. If we don’t convert to decentralized renewable energy and organic, communal-based agriculture, however, there is another model we may follow, and it’s not pretty one. Fossil fuel use is the habit that must be kicked for humanity to help recreate a sustainable world.
One of the most famous examples from studying mammalian populations is the debacle of St. Matthew Island, a warning to humanity. A tiny island located in the Bering Strait, with no carnivores, some lonely US coast guard officers decided to introduce reindeer onto the island. From a starting population of 29 in 1944, the hungry caribou ate through the entire island’s many lichen species, ballooning to 6,000 by 1963. Within two years and no other food source, the die-off was drastic, and only 42 remained in 1965. The entire population vanished by the 1980s. If our coal, gas, and oil run out without a democratic and scientific plan to make the leap to renewables, we are doomed to the same path.
The Unspoken Links
It would be simplistic to relegate these new and unprecedented levels of strangeness to the spheres of ecology and climate science. The deep wounds Western man has inflicted on fellow species and the planet are also inflicted on ourselves. From everything to decreased attention spans, the rise of xenophobia and mistrust towards minorities and immigrants, and billions living in poverty, these are by and large self-inflicted wounds. We must learn to see ourselves in the other, and see the other in ourselves.
Cell phone, TV, tablet, and computer use, dubbed “screen time”, can now be understood to have a net-negative effect on human communities when consumed in vast quantities, as it drives anti-social behavior and isolation from the wider community. A recent study concluded the average screen time for US adults was around 70 hours per week. Keep in mind, that means for every person getting 40 hours of screen time there is another getting 100 hours per week.
The rising rates of cancer, autism, diabetes, auto-immune diseases, heart disease, and many other chronic conditions may be partly due to the stressors and conditions of modern life, including longer lifespans, but they do not account for the majority. Our polluted world and environmental crises play a mostly invisible role in the West, as our federal agencies such as the EPA and FDA have become corrupted by pharmaceutical and corporate interests.
With no way to systemically study or properly account for the rise of ill health and mental stupefaction of the public, medical and health professionals, shackled in their dim caves staring at shadows, have designated the “genetic” component to dis-ease as the Holy Grail. There is some truth to this: undoubtedly certain forms of breast cancer are linked to specific areas on chromosomes, etc. The idea, however, that billions of dollars in research must be shunted into the reductionist model of DNA manipulation and gene therapy is a huge waste of time, resources, and brainpower. (No, I don’t have mainstream “credentials” or a PhD, but I was happy to have my suspicions about targeted gene therapy confirmed straight out of the mouth of a former top researcher at the National Cancer Institute.)
The best way I’ve heard it phrased, regarding chronic disease and our toxified world, is like this: genetics is the loaded gun, and the environment is the finger pulling the trigger. Yes, many people are at risk due to genetic inheritance for many forms of cancers, diabetes, and the list goes on, but magnifying the capacities of the double helix as the primal cause of these conditions is not only dubious, it’s intellectually dishonest and dangerous. One may be at higher risks for certain disorders, but a healthy lifestyle can often slow, negate, or reverse chronic disease.
Many of today’s chemical dangers are invisible and thus fly under the radar of doctors and scientists. Yet, there are visible changes in our bodies that have manifested with the rise of industrial agriculture after World War Two. One change being the rise in obesity worldwide. Yes, we have increased meal portion sizes and live more sedentary lifestyles, and yes, food serves as a palliative for depression and anxiety.
Yet, this does not explain the study (summarized in an Atlantic article here)which concluded that, between 1988 and 2006, a person with the same diet, nutrient and exercise routines would be 10% heavier in 2006. This is a historic finding, and I can find nothing in the literature which reports a change in size of any other species in such short a time frame (18 years), other than weight gain in the abhorrent factory farming conditions of chickens, pigs, and cows.
The problem is, as the authors of the study note, there are so many factors it’s nearly impossible to determine what the culprit is. There are persistent organic pollutants, hormones in our food which act as endocrine disruptors, prescription drug overuse which leads to weight gain, and the possibility of a change in our gut bacteria due to mass antibiotic use in animal produce. In all likelihood, it is a combination of all of these factors that is driving the obesity and cancer epidemics. While many researchers are waking up to effects from increasing use of digital technology and social media, hardly anyone in the scientific community and academia have bothered to think about the huge changes to our bodies in the past few decades.
For every one human cell in our bodies, there are about 10 symbiotic bacterial cells. We are in very real sense super-organisms, and the huge influx of herbicides, pesticides, and antibiotics in our food is forming a negatively synergistic effect on our ability to reason, to exercise, to relax, and to resist these new forms of genetic-biologic oppression.
This comes down to the nexus of corporate agribusiness, complicit federal health “experts”, lack of funding for research and grants for responsible scientists, and a poisoned food and water supply which has hijacked and somehow rewired our metabolism, endocrine system, and immune-response pathways. Have no doubt, this is an uncontrolled experiment being run on us all, without our permission.
The rise in cancer in particular can be tied to the atmospheric nuclear tests in the 1950s, as I and many others have posited. Estimates range that anywhere from 1 million to 50 million or even higher have already died/may die in the coming century earlier than they otherwise would have, because of cancer due to nuclear radiation from these tests.
The chance of getting cancer in one’s lifetime is expected to rise to a 33% chance for women and a 50% chance for men by 2050. This is the microcosm within the macrocosm of a world system based on infinite growth on a finite planet. The ideology of capitalism is death, and there should be no mystification as to why the clear unhealthiness of the hegemonic socio-economic system has been transported into our very bodies via cancer.
A major problem is that modern medicine has become ideological and insular, with predictably deadly results. There can be no patents for plants, herbs, mushrooms, meditation, yoga, and mindfulness practices, thus no conglomerate, multinational, corporate money to be made.
If it becomes clear on a mass scale that traditional practices including, but not limited to, herbal medicine, meditation, yoga, holistic traditional healing, Ayurvedic and Traditional Chinese Medicine has immense value beyond the instrumental rationality of allopathic medicine, the gig is up for mainstream pill-pushers. Most health professionals would be unveiled as the educated fools that they are, drug pushers promoting dangerous drugs for children and the elderly, not to mention endless unnecessary tests and procedures which make billions for Big Pharma and medical technology companies.
Let me be clear here: I am not by any means trying to scapegoat every medical professional, as researchers and people who treat medical emergencies, trauma, surgeons, and doctors dealing with acute medical conditions do amazing work every day. What I’m driving at is the allopathic way of treating most chronic conditions is a farce, and our society should return to promoting preventative, holistic treatments.
Thanato-politics
Sadly, there is a legitimate reason why so much of society is organized around ignorance, fear, violence, denial of the body, and consumption: the death-drive. One does not have to subscribe to Freud’s exposition of thanatos to understand this: the proliferation of nuclear weapons, the desertification of our world, the razing of habitat shows this quite clearly.
Modern civilization does not only lead to obedience, submission, and structural violence, but also to a certain form of captivity. Humans tend to rebel against such a depraved social order, even if only symbolically, with varying amounts of success. Some do so constructively, forming social movements and protests, yet masses have fallen prey to the siren-songs of nationalism, consumerism, addiction, and war. Along with the enclosure of public land and the destruction of the commons (“There is no such thing as society”) comes a culture of fear, cruelty, and ultimately projections of the outer world as scary and downright evil.
Captivity in action: consider the recent missile alert in Hawai’i. Was this not an example of a captive audience, doomed by elites to worry and scatter over a phantom nuke over the horizon? None of us asked for this. Most of humanity simply wants to be left alone from the vagaries of government and corporate rule to live stable, happy lives. Yet the sad truth of the matter is the elites are not going to leave us alone. Their appetite is insatiable, and they will in fact drag down the entire biosphere, because in their current state of mind, they hate life, and want to transcend this world, either to heaven (the Christian fundamentalists) or have their consciousness uploaded or bodies cryogenically frozen for future immortality (the Kurzweillian techno-futurists).
Evil, or rather, a disdain for authentic living, is banal in many senses: one of these is the utter unimaginativeness resting in the dark hearts of our political leaders. Evil is a lack, a poverty of the soul. It is incapacity to create, an absence of imagination, spontaneous creativity, and compassion. You can sense this in our “technocratic” leadership, pushing us ever closer to the abyss of economic depression and ecological ruin.
It often conjures up a chuckle when I remind people of David Graeber’s comments (paraphrasing here) on the elitist corporate/managerial/bureaucratic mindset: “These are the most unimaginative people ever.” This is basically a gallows humor, as the elite are numbing citizens of the will, mental capacities, and physical abilities to organize and resist effectively, and are setting up the masses for collapse of our civilization.
Reclaiming Eros
If there does exist some sort of death drive (most explicitly recognized in Nazi, Italian, and Spanish fascist ideology: “¡Viva la muerte!”) that modern civilization is imposing on us, is there a countervailing force?
Countering the bleak pessimism of Freud’s Civilization and its Discontents, Herbert Marcuse’s Eros and Civilization offers clues. We can extrapolate and widen their focus on libido to consider Eros as an analogy for life-force or life-energy, similar to Eastern notions of prana and chi. If modern society has in fact regimented our lives around a Marcuse-esque performance principle, it does so at the cost of our very souls. It was no mythological coincidence that the ancient Greeks wedded the god Eros in immortal bliss with Psyche. One cannot exist without the other.
Alienation in the workplace is so all-pervasive it often goes unnoticed or unremarked upon. Perhaps this orientation around surplus repression is most visible in leisure activities such as today’s gyms, the insular form of physical exercise for the corporate workers and bosses. Regimenting the mind in the office is not enough: bodies must be splayed across endless rows of treadmills and metal strength-enhancing machines like legions of marching ants, with the requisite phone or Ipod and headphones attached. As for the flabby and out-of-shape, it is once again a lack of discipline and failure to take individual responsibility, rather than any oppressive social structure which is the causal factor.
These are the pod people, exemplified in a New York Times piece about a former Nike exec and artist who has refused to watch or read any news since Donald Trump became elected, who even goes to far as to use noise-canceling headphones blaring white noise in coffee shops to not overhear any chatter about world affairs. Why not just play music? “Stray conversation can creep in between songs.” The same game goes for the power elite: stray news about the poor and oppressed, and any possibilities of social transformation, are simply shushed away.
Thus, when the business and political elite blurt the snide “Be reasonable!” they are at the same time using the cynical trope of “no grand ideologies” (read: Marxism) which, of course, hides behind the moral relativism and lack of conception of the good life which liberal democracy has always played at, which is ideology at its purest: “the end of history”, “there is no such thing as society”, “there is no alternative”.
These people, whose ideas simply parrot the cultural hegemonic ruling class framework, are asserting the “logic of domination”. Drawing on Arendt and Orwell, Alexander Stern has dubbed this “Bingespeak”. Following Marcuse:
“Reason is to insure, through the ever more effective transformation and exploitation of nature, the fulfillment of the human potentialities. But in the process the end seems to recede before the means: the time devoted to alienated labor absorbs the time for individual needs- and defines the needs themselves. The Logos shows forth as the logic of domination. When logic then reduces the units of thought to signs and symbols, the laws of thought have finally become techniques of calculation and manipulation.” (1)
This corrupted Logos seems to have pushed aside Eros in the modern world. Nietzsche would call it Apollonian overtaking the Dionysian. As the socially-constructed ego has developed under patriarchy, civilization, and capitalism, it has done so with the fear of the maternal-based clan, and the Earth-based tribal modes of life. Returning to Marcuse:
“The Narcissistic phase of individual pre-genitality ‘recalls the maternal phase of the history of the human race. Both constitute a reality to which the ego responds with an attitude, not of defense and submission, but of integral identification with the ‘environment.’ But in the light of the paternal reality principle, the ‘maternal concept’ of reality here emerging is immediately turned into something dreadful, negative. The impulse to re-establish the lost Narcissistic-maternal unity is interpreted as a ‘threat,’ namely, the threat of ‘maternal engulfment’ by the overpowering womb. The hostile father is exonerated and reappears as savior who…protects the ego from its annihilation in the mother.” (2)
Does this fear not play out between the lines of today’s discourse around the environment? It cannot be the patriarchal, murderous version of global capitalism which is at fault, but rather, an all-consuming mother planet bent on destroying us all (even though it’s all our own fault due to rampant fossil fuel use). In fact, the father figure of global capital now swoops in to act as a savior for everything he has destroyed.
Contrast, for example, the rush to space and immortality that the Silicon Valley techno-utopian folk seem to prefer, or even the “pragmatism” of Steward “we are as gods and have to get good at it” Brand; with the ecocentric approach of Lynn Margulis and James Lovelock, co-creators of Gaia theory. Corporate funded mainstream environmentalists would have us geo-engineer the planet and proliferate dangerous 5G technology via an internet-of-things around the globe. Rather, we should convert to small scale, decentralized renewable tech, and attempt to live in harmony with the biosphere by adhering to an ecological precautionary principle.
Thus, the “primal father” version of the future which Brand and his “green capitalist” (an oxymoron) acolytes believe in necessarily involves sacrifice of the masses and more exploitation of natural resources. We are told this everyday: “austerity” is needed for economic recovery; delay gratification to pay off debts; foreigners must be killed and are simply collateral damage to protect the world from terrorism, public land is off-limits or only for recreation, not sustainable agriculture and agroforestry; etc.
Reconciling Apollo and Dionysus, Logos and Eros, a less repressive society would not simply focus on what we must sacrifice, but allow space for passion, imagination, and desire. A democratic society would allow for collective decision-making regarding the scale and scope of a host of socioeconomic issues, including sustainable agriculture, genetic research, preventative medicine, animal testing, as well as chemical use in farming and industry.
With a healthy balance between Logos and Eros, we can transcend the deadly framework of instrumental reason and positivism to build a livable future. Some like to call this a “supra-rational” outlook, a transpersonal and holistic view of the world, where emotional intelligence is blended with the analytic, intuition with abstract logic.
What lessons can we draw here? There must be a concerted effort to blend work and play, especially in regards to communal farming, collective homebuilding, and low-scale renewable energy, to create the grounds for authentic liberation from capitalism.
Sustained and coordinated efforts to build autonomous zones free from governmental and hierarchical organization are paramount: indigenous movements throughout South America and worldwide, the mass strikes in France, Christiania in København, freedom fighters in Chiapas and Rojava, and the MST in Brazil offer models of resistance.
We are going to have to adopt a type of bricolage (Levi-Strauss) culture, scavenging what has not been absorbed by global capital, to create beauty in the ruins of empire. Thus, we can begin the Herculean effort to deterritorialize (as in Deleuze and Guattari) and thus reassemble a heterogeneous, co-evolving, transformational commons; to decolonize our minds from a simulated, mechanical mode of life; to detach from the Spectacle; to unlearn and deschool ourselves (Illich) from the oppressive social systems designed to rob and eventually destroy everything we know and care for.
Notes:
1)      Marcuse, Herbert. (1974) Eros and Civilization: A Philosophical Inquiry into Freud. Boston: Beacon Press. Originally published 1955. pp. 111-112.
2)     Ibid., p. 230.
William Hawes is a writer specializing in politics and environmental issues. He is author of the ebook Planetary Vision: Essays on Freedom and Empire. His articles have appeared online at CounterPunch, Global Research, Countercurrents, Gods & Radicals, Dissident Voice, The Ecologist, and more. You can email him at wilhawes@gmail.com. Visit his website williamhawes.wordpress.com.

Thursday, 19 April 2018

mail

http://www.onlymyhealth.com/healthy-diet-kids-in-hindi-1298022607

Sunday, 15 April 2018

NHA3


Dear All,

The JSA NCC meeting on 31st March has taken a decision to organise a National Health Assembly in Raipur in September 2018. See excerpt below from the minutes of the meeting below:

National Health Assembly
Sulakshana presented a proposal to organize the Third National Health Assembly (NHA3) in Raipur, Chhattisgarh in September – for 3 days between 15-25 September, 2018. The Assembly, it was proposed, could be linked with 10th anniversary celebrations of Public Health Resource Network (PHRN).
It was felt, during the discussions, that the NHA should be seen as a part of a process of continuous mobilization that challenges the neoliberal character of current policies, leading up to the next general elections in 2019.
The NCC endorsed the proposal to organize NHA3 in Raipur in September
Decisions regarding NHA3:
1.      JSA will organize a 2 ½ day NHA3 in Raipur in September (between 15-25 September)
2.      JSA Chhattisgarh and PHRN will explore possible venues and finalise the dates in the next weeks
3.      The meeting felt that all major responsibilities for NHA3 should be with younger activists (preferably below 45).
4.      It was decided to form the following sub-committees to coordinate the work for NHA (other members will need to be included):

·         Mobilization:Gargeya,Amulya, Sanjeev, Satnam, Anoob
·         Program: Abhijith,  Muneer, Osama, Sulakshana,Rep. from NAPM, Susana, Richa, Indranil, Ameer
·         Logistics &Accommodation: local team in Raipur
·         Fund Raising: Ganapathy, Raman.

5.      A preliminary list of persons and organisations who could be contacted for donations will be prepared. In addition, a crowd sourcing campaign was also proposed.
6.      The meeting felt that the main conference themes should be around: defence of public services; resistance to privatization and unethical practices in private facilities; social determinants of health; recognition of the Right to Health.
7.      A possible slogan could be: The time to make health and healthcare a fundamental right is Now!

--
Jan Swasthya Abhiyan (JSA) is the Indian Chapter of the People's Health Movement. JSA brings together organisations and individuals in India working to promote health equity across all population groups. Also visit our website: www.phmindia.org
--- 

Thursday, 12 April 2018

POLLUTION --LSANCET

That pollution is bad for our health will come as a surprise to no one. That pollution kills at least 9
million people every year might. This is 16 percent of all deaths worldwide – 3 times more than AIDS,
tuberculosis and malaria combined, and 15 times more than all wars and other forms of violence. Air
pollution alone is responsible for 6.5 million of these 9 million deaths. Nearly 92 percent of
pollution-related deaths occur in low- and middle-income countries. All this is according to the Lancet
Commission on Pollution and Health, a recent report by dozens of public health and medical experts from
around the world. This important report is sounding the alarm about a too-often neglected and ignored
‘silent emergency’ – or as author Rob Nixon calls it, ‘slow violence.’

In one media article about the report, the Lancet’s editor-in-chief and executive editor points to the
structural economic forces of “industrialisation, urbanisation, and globalisation” as “drivers of
pollution.” Unfortunately, however, the report itself doesn’t elaborate upon this crucial observation
about root causes – in fact, when it moves from documentation of the pollution-health crisis to social-
economic analysis, some of the report’s conclusions go seriously awry, espousing debunked ‘ecological
modernization theory’ and reinforcing a tired Eurocentric framing that paints the industrialized West
in familiar ‘enlightened’ colors, while the ‘developing’ countries are portrayed as ‘backward’.

For example, one of the Commission’s co-chairs and lead authors Dr. Philip Landrigan (for whom I have
the greatest respect for his pioneering work in environmental health), points out that since the US
Clean Air Act was introduced in 1970, levels of six major pollutants in the US have fallen by 70
percent even as GDP has risen by 250 percent. According to fellow author Richard Fuller, this sort of
trend proves that countries can have “consistent economic growth with low pollution”.

Coupled with the fact that about 92 percent of pollution-related deaths occur in low- and middle-income
countries, this would indeed appear to validate one of the core doctrines of ecological modernization
theory –– ‘decoupling’ –– which posits that while pollution necessarily increases during the early
‘stages’ of economic development, it ultimately plateaus once a certain level of wealth is achieved,
whereupon it falls even as growth continues ever upward.

It is understandable why the Commission might want to package its message in this way: it makes an
‘economic’ case for addressing pollution that is palatable to policymakers increasingly ensconced
within an economistic worldview, one that is increasingly blind to non-economic values (including,
apparently, the value of life itself – one would have hoped that 9 million deaths would be reason
enough to take action against pollution). The economic costs of pollution, along with the apparent
happy coexistence of economic growth and pollution reduction, are marshaled to challenge “the argument
that pollution control kills jobs and stifles the economy.” This favorite bugbear of industry and big
business is certainly spurious – forget about pollution control ‘killing jobs’; the absence of such
control is killing millions of people every year!

But, as I showed in a previous blog post (Globalization’s Blowback), much of the rich countries’
pollution has been outsourced and offshored during the corporate globalization era. It is disingenuous
at best to cite instances of local pollution reduction alongside increased economic growth in the rich
world as evidence of decoupling, when those reductions were made possible only because of much larger
pollution increases elsewhere. A global perspective – where true costs cannot be fobbed off on the poor
and colonized – is necessary for gaining a meaningful and accurate picture of the relationship between
wealth, growth, development and environmental integrity and sustainability. Panning out to this broader
global perspective shows that, in fact, GDP growth and pollution continue to be closely coupled. And
because a large percentage of the pollution in poorer countries is a consequence of corporate
globalization, so is a large percentage of pollution-caused deaths.

Choking – and dying – on globalization

China’s export-oriented industrial spasm, powered largely by burning coal, has bequeathed it
notoriously lethal air pollution, so much so that, according to one study, it contributes to the deaths
of 1.6 million people per year (4,400 per day), or 17% of all deaths in the country. Another study puts
the total at two-thirds of all deaths, and concluded that the severe air pollution has shortened life
expectancy in China by more than 2 years on average, and by as much as 5.5 years in the north of the
country.

Interestingly, some studies have actually calculated the number of globally dispersed premature deaths
from transported air pollution and international trade. One such study found that deadly PM2.5
pollution (particulate matter of 2.5 micrometers or smaller) produced in China in 2007 was linked to
more than 64,800 premature deaths in regions other than China, including more than 3,100 premature
deaths in western Europe and the USA. At the same time – despite manufacturing- and pollution-
offshoring – about 19,000 premature deaths occur in the US from domestically emitted pollution for the
production of exports – 3,000 of which are linked to items exported to China.

But this is far less than what the Chinese are suffering because of consumption in the West. According
to the study, “consumption in western Europe and the USA is linked to more than 108,600 premature
deaths in China”. (Worldwide, pollution emitted for the production of goods and services consumed in
the US alone caused 102,000 premature deaths; European consumption caused even more: 173,000 premature
deaths). Note that the above fails to take into account the costs of various other air pollution-
related chronic illnesses. And of course, air pollution isn’t the only harmful human cost of China’s
coal-driven industrial growth and export-orientation. According to Chinese government statistics,some
6,027 Chinese coal miners died in the course of work in 2004, though analysts point out that official
estimates are usually highly conservative, and “the real number is probably higher”. Since 2004, coal
extraction has grown significantly in China.

Shipping

What about the transport of incomprehensible quantities of materials back and forth across the planet?
Coal to China, commodities from China, waste back to China (the undisputed locus of global waste trade)
– nearly all of it is done via oceanic shipping, which carries heavy ecological costs. The statistics
on the scale and impact of the global shipping industry are arresting: a 2014 study found that ship
traffic on the world’s oceans has increased 300 percent over the past 20 years, with most of this
increase occurring in the last 10 years. According to one analysis, emissions from international
shipping for 2012 were estimated to be 796 million tons of CO2 per year (or 90,868 tons per hour), more
than the yearly emissions of the UK, Canada or Brazil. (An earlier study put the amount of annual
emissions from the world’s merchant fleet at 1.12 billion tons of CO2.) Whatever the actual figure,
shipping accounts for at least 3 to nearly 4.5 percent of global CO2 emissions.

Much worse, shipping contributes 18-30 percent of the world’s total NOx and 9 percent of its sulphur
oxide (SOx) pollution. A single giant container ship can emit the same amount as 50 million cars: “just
15 of the world’s biggest ships may now emit as much pollution as all the world’s 760m cars”. By 2015,
greenhouse gas emissions from shipping were 70percent higher than in 1990, and, left unchecked, were
projected to grow by up to 250percent by 2050; this would make shipping responsible for 17 percent of
global emissions. According to the University College London’s Energy Institute – whose astonishing
ShipMap may be one of the best visualizations of globalization available – “China is the center of the
shipping world; Shanghai alone moved 33 million units in 2012”.

And this is only maritime shipping. Air freight is even more pollution-intensive: though much less
merchandise and material is moved by air, some estimates are that the relatively minor 1% of the
world’s food traded by air may contribute upwards of 11 percent of CO2 emissions.

In sum, the toll of the global shipping industry makes the ‘death footprint’ of globalization’s air
pollution even larger. A 2007 study conservatively estimated that just the PM (particulate matter)
emissions of global shipping – estimated at 1.6 million metric tons – kill 60,000 people per year,
which the authors expected to increase 40 percent by 2012.

Conclusions

To point out the harms of global pollution outsourcing is emphatically not to argue that US
corporations, for example, should simply return their outsourced production and pollution to the
territorial US. This was the erstwhile ‘Trumpian’ right-populist recipe. Under this ideology, the way
to facilitate ‘insourcing’ is not to insist on higher labor and environmental standards abroad, but to
systematically dismantle the framework of laws in the US (however weak many of them already are thanks
to corporate-captured government agencies) – that is, to bring the race to the bottom home. Whether
generous tax cuts and other hand-outs will entice the outsourcers back remains to be seen: it’s
becoming evident that the Trump/Koch brothers enterprise is about both eviscerating domestic
environmental and labor laws, and accelerating global transnational corporate pillage – the worst of
all worlds.

An anti-corporate, degrowth, eco-localization stance is the unequivocal opposite. Firstly, it rejects
the broader ends and means of the entire consumerist, throw-away project. Rather than merely bringing
the disposable extractive economy back home, localization is about reconnecting cause and effect and
overthrowing irresponsible and unethical environmental load displacement on the global poor.
Localization is about re-orienting the entire economy towards sufficiency and simplicity of
consumption, towards needs-based, ecologically-sustainable and regenerative production, and towards
fair, dignified and democratic work and production. By definition, localization connotes less
dependence on external resources and globalized production chains that are controlled by global
corporations and are congenitally undemocratic. Putting power into workers’ hands is to not have
globally–outsourcing, hierarchically–owned and managed corporations, tout court.

Of course Dr. Landrigan is right that reducing pollution doesn’t ‘stifle the economy’ – quite the
contrary, if ‘the economy’ is understood in a much more holistic sense than mere GDP. But, as has been
pointed out previously on the Economics of Happiness Blog (here and here), we also shouldn’t equate a
healthy economy with a growing economy. The converse is more often the case. To reduce global pollution
deaths, we not only need robust pollution control regulations, we must reduce corporate power,
globalization, and the scale of the economy as well.

—
Alex Jensen is a Researcher and Project Coordinator at Local Futures. He has worked in the US and
India, where he coordinated Local Futures’ Ladakh Project from 2004-2015. He has also been an associate
of the Sambhaavnaa Institute of Public Policy and Politics in Himachal Pradesh, India. He has worked
with cultural affirmation and agro-biodiversity projects in campesino communities in a number of
countries, and is active in environmental health/anti-toxics work.

Originally published on the Economics of Happiness Blog at https://www.localfutures.org/globalizations-
deadly-footprint/.

Wednesday, 11 April 2018

CARCINOMA PROSTATE

Clinically Localized Prostate Cancer: AUA/ASTRO/SUO Guideline

Part I: Risk Stratification, Shared Decision Making, and Care Options


The AUA (American Urological Association), ASTRO, and SUO (Society of Urologic Oncology) have formulated an evidence-based guideline based on a risk stratified clinical framework for the management of localized prostate cancer. Part 1 focuses on risk stratification, shared decision making, and care options.
The guideline appears in the recent issue of Journal of Urology, the official journal of AUA. It is structured to provide a clinical framework stratified by cancer severity to facilitate care decisions and guide the specifics of implementing the selected management options.
RISK STRATIFICATION
CARE OPTIONS BY CANCER SEVERITY/RISK GROUP
Very Low Risk and Low risk Prostate Cancer
• Clinicians should not perform abdominopelvic CT or routine bone scans in the staging of asymptomatic very low or low risk localized prostate cancer patients (Strong Recommendation; Evidence Level: Grade C)
• Clinicians should recommend active surveillance as the best available care option for very low risk localized prostate cancer patients (Strong Recommendation; Evidence Level: Grade A)
• Clinicians should recommend active surveillance as the preferable care option for most low risk localized prostate cancer patients (Moderate Recommendation; Evidence Level: Grade B) 
• Clinicians may offer definitive treatment (i.e. radical prostatectomy or radiotherapy) to select low risk localized prostate cancer patients who may have a high probability of progression on active surveillance (Conditional Recommendation; Evidence Level: Grade B)
• Clinicians should not add androgen deprivation therapy (ADT) along with radiotherapy for low risk localized prostate cancer with the exception of reducing the size of the prostate for brachytherapy (Strong Recommendation; Evidence Level: Grade B) 
• Clinicians should inform low risk prostate cancer patients considering whole gland cryosurgery that consequent side effects are considerable and survival benefit has not been shown in comparison to active surveillance (Conditional Recommendation; Evidence Level: Grade C)
• Clinicians should inform low risk prostate cancer patients who are considering focal therapy or HIFU that these interventions are not standard care options because comparative outcome evidence is lacking (Expert Opinion)
• Clinicians should recommend observation or watchful waiting for men with a life expectancy  ≤5 years with low risk localized prostate cancer (Strong Recommendation; Evidence Level: Grade B) 
• Among most low risk localized prostate cancer patients, tissue based genomic biomarkers have not shown a clear role in the selection of candidates for active surveillance (Expert Opinion)
Intermediate Risk Prostate Cancer
• Clinicians should consider staging unfavorable intermediate risk localized prostate cancer patients with cross-sectional imaging (CT or MRI) and bone scan (Expert Opinion)
• Clinicians should recommend radical prostatectomy or radiotherapy plus ADT as standard treatment options for patients with intermediate risk localized prostate cancer (Strong Recommendation; Evidence Level: Grade A) 
• Clinicians should inform patients that favorable intermediate risk prostate cancer can be treated with radiation alone, but the evidence basis is less robust than for combining radiotherapy with ADT (Moderate Recommendation; Evidence Level: Grade B)
• In select patients with intermediate risk localized prostate cancer, clinicians may consider other treatment options such as cryosurgery (Conditional Recommendation; Evidence Level: Grade C)
• Active surveillance may be offered to select patients with favorable intermediate risk localized prostate cancer; however, patients should be informed that this comes with a higher risk of developing metastases compared to definitive treatment (Conditional Recommendation; Evidence Level: Grade C) 
• Clinicians should recommend observation or watchful waiting for men with a life expectancy ≤5 years with intermediate risk localized prostate cancer (Strong Recommendation; Evidence Level: Grade A)
• Clinicians should inform intermediate risk prostate cancer patients who are considering focal therapy or HIFU that these interventions are not standard care options because comparative outcome evidence is lacking (Expert Opinion)
High Risk Prostate Cancer
• Clinicians should stage high risk localized prostate cancer patients with crosssectional imaging (CT or MRI) and bone scan (Clinical Principle)
• Clinicians should recommend radical prostatectomy or radiotherapy plus ADT as standard treatment options for patients with high risk localized prostate cancer (Strong Recommendation; Evidence Level: Grade A) 
• Clinicians should not recommend active surveillance for patients with high risk localized prostate cancer. Watchful waiting should only be considered in asymptomatic men with limited life expectancy (≤5 years) (Moderate Recommendation; Evidence Level: Grade C) 
• Cryosurgery, focal therapy, and HIFU treatments are not recommended for men with high-risk localized prostate cancer outside of a clinical trial (Expert Opinion) 
• Clinicians should not recommend primary ADT for patients with high risk localized prostate cancer unless the patient has both limited life expectancy and local symptoms (Strong Recommendation; Evidence Level: Grade A) 
• Clinicians may consider referral for genetic counseling for patients (and their families) with high risk localized prostate cancer and a strong family history of specific cancers (e.g., breast, ovarian, pancreatic, other gastrointestinal tumors, lymphoma) (Expert Opinion)
About AUA/ASTRO/SUO
Founded in 1902, the AUA (American Urological Association) is a premier urologic association, providing invaluable support to the urologic community. The AUA is committed to supporting urologic research through funding, advocacy and scholarly exchange. ASTRO (the American Society for Radiation Oncology) is a leading professional association in radiation oncology that is dedicated to improving patient care through professional education and training, support for clinical practice and health policy standards, advancement of science and research, and advocacy. The SUO (Society of Urologic Oncology) was found in 1984, its mission is to enable qualified members primarily interested in the care of patients with malignant GU diseases to meet for the purpose of discussion, development and implementation of ideas to improve care.

Note: This list is a brief compilation of some of the key recommendations included in the Guidelines and is not exhaustive and does not constitute medical advice. Kindly refer to the original publication here: https://goo.gl/NboS9R

ABOUT AUTHOR
Dr. Prachi Chhimwal
Dr. Prachi Chhimwal is a Research analyst at PlexusMD and is a part of the Editorial Team. She curates the Technical Content posted daily on the news feed. She graduated from Army College of Dental Sciences (B.D.S) and went on to pursue her post-graduation (M.D.S) in Oral & Maxillofacial Pathology. After a decade in the field of dentistry she took a leap of faith and joined PlexusMD. A badminton enthusiast, when not working you can find her reading, Netflixing or enjoying stand-up comedy shows.
ABOUT PLEXUSMD LEARNING
PlexusMD Learning tracks 1000+ Journals, Health agencies and Medical associations worldwide and engages with senior medical professionals across specialties to discover and share the latest news and developments, guidelines and stories of interest.

CARCINOMA PROSTATE--1

Active Surveillance
• Localized prostate cancer patients who elect active surveillance should have accurate disease staging including systematic biopsy with ultrasound or MRI guided imaging (Clinical Principle) 
• Localized prostate cancer patients undergoing active surveillance should have routine surveillance PSA (prostate specific antigen) testing and DRE (digital rectal examination) (Strong Recommendation; Evidence Level: Grade B) 
• Localized prostate cancer patients undergoing active surveillance should be encouraged to have a confirmatory biopsy within the initial two years and surveillance biopsies thereafter (Clinical Principle) 
• Clinicians may consider multiparametric prostate MRI as a component of active surveillance for localized prostate cancer patients (Expert Opinion)
• Tissue based genomic biomarkers have not shown a clear role in active surveillance for localized prostate cancer and are not necessary for follow-up (Expert Opinion) 
• Clinicians should offer definitive treatment to localized prostate cancer patients undergoing active surveillance who develop adverse reclassification (Moderate Recommendation; Evidence Level: Grade B)
Prostatectomy
• Clinicians should inform localized prostate cancer patients that younger or healthier men (e.g., 10 year life expectancy) are more likely to experience cancer control benefits from prostatectomy than older men (Strong Recommendation; Evidence Level: Grade B) 
• Clinicians should inform localized prostate cancer patients that open and robot-assisted radical prostatectomy offer similar cancer control, continence recovery, and sexual recovery outcomes (Moderate Recommendation; Evidence Level: Grade C) 
• Clinicians should inform localized prostate cancer patients that robotic/laparoscopic or perineal techniques are associated with less blood loss than retropupic prostatectomy (Strong Recommendation; Evidence Level: Grade B) 
• Clinicians should counsel localized prostate cancer patients that nerve sparing is associated with better erectile function recovery than non-nerve sparing (Strong Recommendation; Evidence Level: Grade A) 
• Clinicians should not treat localized prostate cancer patients who have elected to undergo radical prostatectomy with neoadjuvant androgen deprivation therapy (ADT) or other systemic therapy outside of clinical trials (Strong Recommendation; Evidence Level: Grade A) 
• Clinicians should inform localized prostate cancer patients considering prostatectomy, that older men experience higher rates of permanent erectile dysfunction and urinary incontinence after prostatectomy compared to younger men (Strong Recommendation; Evidence Level: Grade B)
• PLND (pelvic lymphadenectomy) can be considered for any localized prostate cancer patients undergoing radical prostatectomy and is recommended for those with unfavorable intermediate risk or high risk disease. Patients should be counseled regarding the common complications of lymphadenectomy, including lymphocele development and its treatment (Expert Opinion) 
• Clinicians should inform localized prostate cancer patients with unfavorable intermediate risk or high risk prostate cancer about benefits and risks related to the potential option of adjuvant radiotherapy when locally extensive prostate cancer is found at prostatectomy (Moderate Recommendation; Evidence Level: Grade B)
Read about the guidlines in detail here

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