How Can Apps Help People with Brain Injury?

How Can Apps Help People with Brain Injury?


Apps are really important for individuals
with traumatic brain injury and PTSD and other kinds of brain conditions. What I found is that they really allow individuals
to apply cognitive skills in a very practical functional way in a way other than often they
get in more traditional kids of therapies. When an individual has a brain injury they
have difficulty with organization and time management and memory and decision making. And one of the interesting things about apps
is that apps allow them to apply strategies to deal with some of those issues that they
might be facing on an everyday life. But the apps give them immediate feedback
that they can then use in order to sort of determine whether or not they’re on the
right track. Whereas if you’re using something like paper
and pencil it’s not so easy to see the results. The other thing about apps is that they’re
with them every day, all day long. And so they’re able to actually use the
applications throughout the day to ben them and to help them with some of the cognitive
struggles that they have.

Knee Pain Relief: Dr. Madhuri Sharma’s Success Story – Dr. Bharti’s Holistic Wellness, Vasant Vihar

Knee Pain Relief: Dr. Madhuri Sharma’s Success Story – Dr. Bharti’s Holistic Wellness, Vasant Vihar


I am Dr. Madhuri Sharma, my age is 77
years. I retired as a Deputy Director General Health Services from Ministry of
Health. I had some problem regarding my knees I had some pain in while
walking and getting up at the morning my knees used to be very stiff so with that
and I heard about Dr. Bharti so I thought that just be going talk to my father a
very pleasant person and he suggested me for some treatment and I had 28 sittings
for that and I feel quite better than what I was and if I continue to do I
think I will be perfect and I can have my normal routine.
I have closely observed Dr. Bharti’s Holistic Program. It is very scientific
and easy and follow and follow it as a that they are focusing upon the
scientific metabolic mechanism and correction of all the deformities
developed due to the Osteo-Arthritis and now I feel that I am quite benefited
with this treatment and I would like to suggest to some of my friends also to go
through this treatment this holistic approach of Dr. Bharti and they can
also be benefited and I am god bless you

Axon regeneration in response to nervous system injury

Axon regeneration in response to nervous system injury


I’m Alex Byrne and I’m an assistant
professor in the Department of Neurobiology I started out being really
interested in genetics with different genetics class in undergrad and that led
me to pursue a graduate degree at the University of Toronto where I studied
genetics again and at the end of my graduate degree I saw a talk on axon
regeneration so it was amazing to me that you could use this tiny worm to
understand how to influence the nervous system to regrow after injury and so we’re looking for genes that
control how an axon can regrow after it’s been injured and so to do that we
study the genetics of this time you little worm called C elegans the beauty
of the system that it has a conserved genome so most of its genes are the same
as ours it also has a really well characterized nervous system and it’s
transparent and so that means that we can take these little worms put them on
a microscope shoot a laser at them to cut one individual neuron and then
manipulate their genome all in a live animal to see how we can get an axon to
regrow or why is it that a maximum doesn’t the ultimate goal of the lab is to not
only understand how the nervous system response to injury but we hope that in
characterizing that process what we find may help develop future strategies for
repair and be injured or the disease nervous system so for example some of
the spinal cord injury or any kind of nervous system disease

Hip Sports Injury | Jaclyn’s Story


Jaclyn:
I ran my first marathon when I was 17 years old. Ever since then,
I was kind of bitten by the distance running bug. About a couple of years ago,
I went for an “easy” 12-mile run and noticed that after the run,
my hip, my right hip, just didn’t feel normal. The pain was so real
that it got to the point that my boyfriend
had to drive me to work because I no longer could walk
a couple blocks to work. So, I went to Penn because I know
how strong they are and how much they really do care
about their patients. – At Penn Medicine,
we’ve developed the Penn Center for the Female Athlete
which is the only truly multidisciplinary center in the region, and it’s one of the few
in the entire country dedicated to the unique needs
of the female athlete. Jaclyn came to us
as a second opinion after having been in pain
for about a year. She had a tear
in the anterior portion of her acetabular labrum. She had worked very diligently with a physical therapist at Penn Medicine. So, while she gained
a lot of core strength and improved her biomechanics, her pain
was still limiting her in terms of
her return to running. We decided that the next best
course of action would be to have a surgical
consultation with Dr. Kamath. – She was an excellent candidate
for the surgery based on the nature
of the severity of the injury but also that she had
really exhausted a lot of the traditional
nonsurgical options that we offer
as a comprehensive approach to treating patients
with hip pain. Surgery went just as planned. We were able to achieve
the repair of the labrum as well as decrease the areas
of impingement within the hip. So, she went through it
with flying colors. Jaclyn:
I’m competitive by nature. I’m going to fight hard
for anything that’s worth fighting for, but the thing is, my doctors
and my therapists at Penn fought right alongside of me. So, we were a team. I didn’t even realize
how limiting the pain was until now that I’m able to
do so much more than I used to be able to do. I just knew in my gut
this is the right thing for me, and I haven’t looked back since.

5 Medical Conditions & illnesses We Can’t Explain


We are all faced with illnesses and ailments at some point in our lives be that a harmless cold or a more serious condition. Although the medical industry is constantly evolving and advancing, We still do not have answers to a surprising amount of problems. For example, there is still no cure for the common cold we do not know what causes cancer and do not even know how anaesthesia works. But there are some interesting conditions like the fact people who undergo organ transplants change personalities And the unknown reason why people who are freezing to death remove their clothing. Here are five disorders, illnesses and conditions that are still, and will most likely remain, unsolved. Sit back and enjoy. We have all heard of hypothermia, the nightmarish condition that occurs when the average person’s body temperature drops below 35 degrees. It all starts with uncontrollable shivering, followed by difficulty walking, poor coordination, and the appearance of being drunk. As breathing and heart rate slows to a dangerous rate, the body stops shaking and eventually the person will fall unconscious and die if not seen to immediately. But right before death it has been known that the sufferer, in a semi comatose state, will instinctively try to hide. This is not a conscious decision to keep warm, because by this stage the person is incoherent, confused, and completely unable to make any kind of rational decison. These actions are purely an effort of the body trying one final effort to keep going. If this thought is quite unnerving, then wait until you hear about the bizarre phenomenon of paradoxical undressing. Paradoxical undressing is when just before losing consciousness a sufferer of hypothermia will get the feeling of extreme warmth. Prompting them to remove all of their clothes, sometimes folding them into a neat pile before passing away. But why would someone dying of cold want to remove the only thing keeping them warm? Well the reason for this is not completely understood although it is thought the dilation of blood vessels in the skin as a result of the cold and of the deterioration of the brain can cause this sensation of extreme heat. Studies show around 30 percent of all people who have passed away from hypothermia have had some or all of their clothes removed. Now I don’t know about you but the thought of someone undressing from a feeling of warmth whilst their body temperature is continuing to drop as they freeze to death is very unnerving. And the fact that we do not know for sure why this happens makes the bizarre phenomenon of paradoxical undressing all the more strange. Oakville Blobs. Now this next one is strange. There is some scepticism about whether it caused ilnesses, but it is however a fascinating incident. At around 3am on the 7th August 1994 rain began to fall over Oakville, Washington. But this was no ordinary rain. What was falling was a strange, jelly like substance. Over the next 3 weeks the area experienced this strange jelly rain a total of 6 times. Local resident Dottie Hearn described the substance as mushy rice sized blobs with a gelatinous texture. And local patrolman David Lacey had to stop his car after the substance smeared over his windscreen making it impossible to see. After it had stopped raining, both Dottie and David along with other resident began to fal ill. They suffered from various symptoms, ranging from difficulty breathing to vertigo, blurred vision and nausea. Several cats and dogs who had come into contact with the goo were said to have died. Dotty’s symptoms were so severe that she was admitted to hospital, and her daughter was convinced that there was a connection to her mother’s sudden illness and the blobs. After examination, it was found that the blobs contained human white blood cells, and were teeming with two types of bacteria, one of which lives in the human digestive system. This lead to the speculation that it was human waste released from an aeroplane, although this was quickly dismissed as waste from planes has to be died blue and is forbidden from being dumped mid flight. However, Dotty was not happy with these findings and over a year after the incident sent some samples she had stored in her freezer to a microbiologist. He discovered a cell which are complex nucleus containing cells present in most living creatures, meaning whatever it was had to be alive at some point in time. This lead to the theory that a military bomb 50 miles away accidentally blew up lots of jellyfish scattering them miles into the sky This theory did not hold up well since the rain came down six times. There was no smell and the distance it would have had to travel seems pretty impossible. The airforce however did confirm that they were doing practice bombing runs over the pacific in 1994. But denied they had anything to do with the blobs. Conspiracy theorists and locals are sceptical about this, and believe that the military were carrying out an experiment possibly a new biological weapon, to see what affects it would have. But it is strange that samples of the substance no longer exist, and the illnesses after remain unsolved. Gulf War Syndrome. Humans are not designed to go to war. At least not the types of war which have been fought in the last hundred years. and this shows with the onset of war related illnesses and mental health problems. Unexplained nerve pain, nausea, headaches, loss of balance, stomach problems, and chronic fatigue These are just a few of the 53 reported symptoms experienced by Gulf War veterans. Who were suffering from an illness that still has not been properly explained or acknowledged. The illness became so widespread that the government set up disease registers but even after assessing over 100,000 soldiers they failed to find a single cause for the condition. Medical experts were stumped. They could see these very real symptoms and sufferings, but could not determine why. One theory is that soldiers returning from the Gulf War had unknowingly been exposed to depleted uranium in tank shells. Or fumes from burning oil wells. Although it did not explain why soldiers who were not exposed to these were also suffering. Other possible explanations are anthrax vaccines, solvents, infectious diseases and chemical age resistant coatings. There was never any evidence of this. But how is this different to PTSD? Well, it’s the sheer extent that has manifested since the gulf war. And the complete lack of research or reasoning for why this war in particular caused this amount of post-war problems. What was also added to this condition is that fact that it took until 2008 before a report was released by the US Advisory Comittee. Stating that Gulf War Syndrome was a disorder tied to chemical exposure. Yet even with all this evidence the government still declared that there was no syndrome. Astonishingly, around 29 percent of soldiers deployed in the Gulf are now considered disabled. And many more are still plagued by a combination of unexplained illnesses, that seem to have no origin apart from the fact that they all started after they were in the war. The Dancing Plague. The Dancing Plague is a condition that you may have heard about before. The name alone draws you in. But what exactly is it? Well, in 1374, hundreds of people living in the medieval towns scattered along the river Rine in central Europe, were suddenly compelled to dance. Not for pleasure, but due to an uncontrollable complusion Although the studies are scarce due to it happening so long ago, and many reports seem to have been glorified, it is said that those who danced literally did so until they died. After the initial outbreak, there were no other incidents of compulsive dancing until the summer of 1518. A woman in France reportedly appeared to dance for 7 days. She was joined by over 100 residents who were affected by the same uncontrollable urges. The authorities of the day left them and hoped they would stop dancing however they started to drop dead, mostly from heart attacks. The dancing plague is always interesting to read about, but due to it being exaggerated it is hard to tell what is true and what isn’t. So what do the records at the time say? It seems that it was a real thing that did happen, and the people of Strasbourg, where the 1518 case started, were convinced that the epidemic was caused by St. Vitus, who unleashed a dancing curse on them. However, nowadays with more advanced medical science, we are able to come up with some interesting theories. The most popular being that the people had unwittingly ingested Ergot, a psychotropic mould which can be found on rye stalks. (A staple diet at the time.) This seems unlikely, as Ergot can give delusions would also cut off blood supply making it hard to move freely. Another theory is mass hysteria, although dancing for days on end with very little food seems unlikely. The most plausible explanation seems to be that those affected were in a disassociate trance, AKA a condition that meant they had lost control of their rational thinking. Nowadays dissociative trance disorder is a recognised category of mental illness, described by psychiatrists as a narrowing of one’s attention so that things like sight and movement are placed outside of one’s reality. So in effect, dancing plague could have been a form of mental illness, possibly bought on by the condition of the time or another unknown reason. But it is said that this unknown illness that caused people to move in a manner that looked like they were dancing took the lives of hundreds of people and it is still a mystery as to why New Organ=New Person. Although organ donation is controversial and divides opinions, there is no denying that many people’s lives have been saved by receiving another person’s organ to replace their failing one. But, with the growing list of transplant patients, it is becoming apparent that some recipients are inheriting the traits of their donors. There are many examples of this. Take Simon, a 29 year old who was born with Cystic Fibrosis, and from a young age knew he would eventually need a new liver. That happened when he received the liver of an 18 year old girl. The operation was a success. However, upon waking, the once polite boy was swearing, something he never did before the operation. Simon believes the reason he started swearing was because of the transplant that must have given him some of the transplantee’s traits. Then there’s the story of Bill, a 52 year old Arizona businessman, who suffered a heart attack and received a new heart from Hollywood stunt man Brady Michaels. After recovering from the operation, Bill, the once overweight and unhealthy man, was drawn towards sport and getting fit. He even became a medal winning swimmer, cyclist, and runner. Traits he linked to his new heart. However it’s not always the good parts of the donor’s personalities which manifest, and one story sticks out in particular. Sonny from Georgia received a heart from a suicide victim, and in the years after receiving his new heart had shown no signs of unhappiness or depression. But in April 2008 he was found in his garage with a self-inflicted shotgun wound to his throat. These were the identical circumstances in which his donor had killed himself 12 years earlier. Incredibly, Sonny’s widow Cheryl was previously married to his donor, they had become friends and Sonny said he felt like he had known her for years. These are just a few of the many bizarre changes in personality in people who have received organ transplants. Scientists who have studied this condition have called it ‘Cell Memory Phenomenon’, and believe that the changed behaviours and emotions experienced by the recepients are due to the memories stored in the neurons of the organ donated. There is now evidence to suggest that up to six percent of organ recipients will experience some change of personality. And in addition to this there was one patient who had a liver transplant acquired the immune system and the blood type of the donor. Due to stem cells transferring over to her bone marrow. Pretty crazy, huh? So that’s five illnesses, conditions and diseases that researchers are still scratching their heads about. I hope you’ve enjoyed, and know that I will be talking about conditions related to the brain in a future video. Because after all, schizophrenia, split personalities and even depression are all conditions that are still unexplained. Thanks for watching, and I’ll see you in the next video.

How To Stop Feeling Overwhelmed As A Parent


Some of our viewers have been asking
about “How to stop feeling overwhelmed as a parent?” There’s a lot to it but there’s
some really clear fixes too. Let’s play with this word for a minute
–Overwhelmed. Kind of presumes that there’s some perfect amount of wellness
and you’ve exceeded that. I’ve heard of people being underwhelmed too which I
guess means you haven’t quite hit the point where you’re perfectly whelmed. What
would that even look like? I think we ought to start a trend here to talk
about feeling perfectly whelmed. And maybe we’ll determine what that looks
like as a parent. Let’s look at some of the causes of feeling overwhelmed. I
think that’s going to lead us into some solutions. One of the roots of feeling
overwhelmed is a sense that you’re not quite doing your job that you’re not
adequate to the task that’s before you and so you feel overwhelmed. What would
be the cure for that particular route? What’s your job? If you’ve been watching
this channel at all in the positive parenting playlist, you’ll know the
answer to that. Your job as a parent is to love them no matter what and even if/
The cure for feeling overwhelmed based on this route that I’m not doing my job
is to get clear about what your job is. Because guess what? You’re doing your job,
aren’t you? If you’re doing your job, you could feel perfectly whelmed that you
already love your kids no matter what and even if. Does that help?
Here’s another root cause of feeling overwhelmed. There’s too much to do,
there’s too much to do. There’s so much to do that there’s no way I could ever
get it all done. Okay. Reality check people: There is too much to do. It’s true.
There is more to do than you could ever possibly get done. I think that’s kind of
a myth anyway when have you ever been done with everything. You’re not.
Other stuff shows up once you finish the stuff you’re working on. This is a true
principle of life. There is too much to do. Except the reality. If you accept that
you can’t possibly do everything. And that’s okay. That’s part of life. Maybe
you could get back to feeling perfectly whelmed. It’s not your job to do all of
the stuff that’s not even possible to get done. What’s your job? Oh, yeah. We
already talked about that. To love them no matter what and even if. Do you see
how that starts to bring a little more whelmedness instead of feeling
overwhelmed? Kind of relieving, isn’t it? Another root cause of feeling
overwhelmed is too many expectations. I’m expected to do this, I’m expected to do
that. I’m not meeting up to all of these expectations. Okay, pause. Whose
expectations? Who says you’re supposed to look this
way or be that way or accomplish this or do that? Who says? Now, maybe you’ve got a
really good answer to that. Oh, well my mother said that I should be this kind
of a mom. Or society expects me to do this or that. Alright. Well, just consider
the source and let’s see if that expectation is something that you really
want to hang on to something that you want to hang your hat on. Most of the
time the expectations that are kicking our trash as a parent come from our own
mind. We’re the ones dreaming up these
expectations. I do this to myself too. Sometimes when I feel overwhelmed in a
project I’ve taken on, it’s because I have set a deadline,
a time line, a limit an expectation for myself. I set it. I set the expectation.
Huh? Well, if I set the expectation, can I change it? “Wait, wait, wait. Dr. Paul, isn’t
that against the rules?” Whose rules? Let’s be clear about where the expectations
are coming from. And I’m betting that if you’re feeling overwhelmed. it’s because
of your own expectations and who’s going to change those? I give you full
permission to change your expectations for yourself. Isn’t that cool? I gave you
permission like you needed permission. Well, maybe you did. And I just gave it to
you. So, if anybody asks you can say, “Hey, Dr. Paul who has a Phd (because that
means something to somebody. I’m sure.) Gave me permission to lighten up on the
expectations.” Wow, that feels a little better too. Are you feeling more perfectly
whelmed as we go through this conversation? You know, I just realized
we’ve talked about this before on the channel. In fact, you can link to another
video watch it right after this one cue it up right there with that card about
how to stop being overwhelmed. You’ll get a double dose that way. I’ve got one more
point for this particular video, though. Sometimes we feel overwhelmed. The root
cause of that overwhelmed for us is feeling that we’re not good enough. I
could probably go off on this one for a while. But here’s the thing, you are
better than you think you are. You are better than you feel that you are. I tell
my clients all the time here at the office, “You’re not as crazy as you feel.”
And they’re like, “Oh, really?” And they feel this relief because we get
it in our head. You know, and it has to do with those expectations and the other
things that we’ve already talked about here today. You’re better than you think
you are. As a parent, you are a benevolent generous loving parent. Will you just
accept that, receive that from me? Because if your own head is telling you
something different, then you’re gonna be all
overwhelmed and then you’re going to start yelling at your kids again and feeling
upset. Pause, just pause for a minute and accept what dr. Paul’s telling you here.
You are a benevolent, generous, loving parent. Embrace that. And I know there’s
improvements you could make. That’s why you’re here. hat’s why we’re doing these
videos. Let’s team up on that. Let’s help each other with that. Setting that aside,
you’re already doing a good job. The fact that you’re here tells me a lot about
you. So, embrace that for a minute. And let go of that destructive pride that has
you hanging on to your own opinion about that in the face of what I just shared
with you. Just trust me enough to go with that for now.
When you accept that, how do you feel? Overwhelmed or perfectly whelmed? Let’s
all work together to be perfectly whelmed. We all get overwhelmed from time
to time. Hopefully now we can all be more perfectly whelmed, right? We’re ready to
help you. Our amazing team of certified coaches is ready to take your call. Sign
up right now. You schedule it, okay? A free break through call with one of our
coaches. We’ve got tons of resources available to you as a parent. Click on
the link down in the description. Dr PaulJenkins.com/
breakthroughcall. It’s free and we’re ready to talk. look at him

Decades of dedication lead to drug trial for rare, fatal illness


So RVCL is a disease that begins in middle-age. The disease then is a relentless and progressive dropout of small blood vessels throughout the body. And then these patients get
progressively more debilitated And lose mental function, lose physical function and become blind. So it’s a progressive relentless disease that leads into death in about five to 10 years. How’s it going? Good to see you. How are you? Kim was one of the original three
patients in the trial. And we follow her now for a number of years. We know how many lesions she has in her eye. We know how many lesions she has in her brain, where they are. And so what we can do then is start her treatment. And we infuse over a five-day period the drug. It’s a chemo therapeutic agent. A cousin of it is used to treat acute leukemia. But here we don’t want to kill the cells. What we want to do is make the cells work better. We’re giving them just enough we hope that will correct or partially correct the defect. We’ve completed the first six months on three patients. The good news is you’re overall stable and in addition the second good news is the toxicity has been minimal if any. We are hoping to stop the disease from progressing. The long-term goal would be using modern genetics to go in and actually correct
the defect in these patients. Go in where we get rid of the mutated gene. That will happen I think in the future, but we’re not there yet. So right now we’ve got to hope that we can prevent it with in-vitro fertilization. And the patients who have it, we’re hoping this drug will slow things down.

The costs of foodborne illness


My name is Piper Burton, I’m from the School of Agricultural Environment. I’m an economist working on issues about food consumption, food demand and for most of 2015 and 2016 I was on leave from working at University of Manchester in the UK on a couple of really quite large projects that were interested in this issue about food safety. So what I am going to do is talk about well, the big picture stuff to start with but then some of the things that came out of that study. Some of the interesting, fun things hopefully, which came out of that study. So go up to the global level, so this is out of work done by the World Health Organization. They did a huge global study trying to look at the impact of foodborne disease and it’s large. One in ten people fall ill, 33 million healthy life years lost, nearly half a million deaths and particularly focused with children and it’s children and the elderly who are the most vulnerable to these types of illnesses. What I’m particularly interested in is, sorry it’s just before your lunch, so this is interesting diarrhoea. Diarrhoea and vomiting are the own seeds of a particularly of concern and interest to these projects we are working on and so these are the
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00:01:22,229 –>00:01:26,729
biggest sector, the biggest element which well for about a half of the global Burden. And there’s a whole variety of different pathogens involved in this. Bacteria, viruses, parasites differs according to which country you’re in, in terms of development as to what actually is going to have the biggest impact. There are concerns that as globalized food trade occurs that if you have a problem in one part of the country because of the globalized networks it can spread really quickly. So this is a problem that if there is a problem somewhere then actually quite quickly it can spread throughout the world. One of the issues about food borne diseases is that they are, really all, very easily preventable and what really is the major way of preventing it is about actually how people handle and cook food. So especially in developed countries. So the burden that’s going to arise and we’re going to talk about is something which actually in some sense could be fixed quite easily and the question is that, the tragedy is that it’s not. So just some numbers for Australia. So gastroenteritis as in diarrhoea and vomiting, DNV as it gets abbreviated to. Large number of cases over 10 years, it’s dropped but there’s still about four million cases of this each year. In terms of looking at which are the main pathogens that are causing this, you’re probably all familiar with Salmonella which is the one sort of most people know but actually the one which causes the greatest number of cases is something called Campylobacter which I

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00:03:10,760 –>00:03:18,579
imagine you may not have heard about. Nobody knows, it’s sort of a, not a hidden but it’s an unfamiliar illness and then there are less, there are other pathogens which have less impact but quite often the ones with less impact actually have in terms of numbers have a higher impact in terms of health consequences. So if Shigella and so on, you can get to serious complications as in kidney failure leading to death. The bottom two are what in the these are the long-term consequences of getting a foodborne illness. This again is something which quite often surprises people. They think you’ve got an upset tummy, that’s true for the vast majority of people but at times those pathogens cause long-run impacts. So William Barr syndrome, that can lead to lead to kidney failure. Irritable bowel syndrome can go from something that is mildly irritating to something which is light which is really debilitating in terms of lifestyle and IBS, they are really quite a large number of cases. And Campylobacter, which we are going to focus on as we go through. You can, cause we are economists we are interested in and think of this in terms of economic costs not just measuring numbers of people. People have tried to put an estimate on actually what the level of the economic, the dollar cost of foodborne illness and it’s about 1.2 billion. That’s almost certainly an underestimate because those numbers when they were generated they were only looking at things like direct cost at in the cost of doctors and hospitals and productivity losses which is your days off work and loss in economic productivity. There’s this thing pain and suffering which actually turns out to be much more important or much more significant in terms of the total burden and we haven’t at the moment got numbers of that for Australia but if you look at the ones for the UK, so the NHS cost is these direct medical costs about 31 million, lost earnings, other expenses that sort of the lost productivity costs, 136 pain and suffering which is just the disruption to people of having from mild to really serious illnesses but it’s that’s of the cognitive impact is a factor where it’s the majority, the vast majority. Ninety percent of the costs are associated with this pain and suffering. So the Australian number of 1.2 is only picking up the first two of those. There’s this sort of hidden impact as well which is out there. So it’s a major issue and people are trying to find out ways of actually trying to control and manage it. So what interventions are possible and one of the, some of the things that we’re doing in the Manchester study was to look at different interventions, at different levels through the food chain producers in the avatars, in supermarkets but essentially most of this could be fixed at the kitchen level as in you can control this by just having good practices in kitchens. Either by professional cooks or by us essentially doing the right stuff. So one of the questions we want to know in this project was well can we start getting some idea and some information about what we’re going to describe as bad practices in kitchens as in people doing things which are actually causing this foodborne illnesses causing that impact. So this is a paper that’s being recently published it’s about restaurant cooking trends and increased risk for campylobacter. That is a really major illness in the UK and something of high importance for the Food Standards Agency and what we are really interested in here was what are the influences essentially of restaurants, celebrity cooks, TV programs, etc. on the way people behave and the way that they perform in kitchens. It’s about campylobacter cause campylobacter is the biggest pathogen in the UK. It also, these are sort of grabs in 2014/15 it also hit the media. Suddenly people became aware of the fact that about 70 to 80 percent of fresh chickens and that were being sold through supermarkets in the UK were infected with this thing called campylobacter which is something to just be known but if it’s been under the radar in terms of public awareness. It came on the radar and basically just had this massive media impact because you can get great headlines. Killer bug in most chickens. Poultry introduced dirty secret. So it has really a huge amount of public traction which is appropriate because it is the biggest impact and so this became, has become and still become a major issue in terms of UK food industry. You may be sitting here thinking well that’s the UK, this is Australia we’re fine. I’m looking up the most recent number for Australia. Australia chickens about 70 to 80 percent of Australian poultry on supermarkets contains Campylobacter. So this is not a small problem in a country far away. This is existing here as well. So what we were interested in? We were interested in this idea, this hypothesis that there was this move to pink but there was this trend in the way that people were consuming food where they were becoming more prone to want to eat meat in a pink state. So beautiful pink state where that’s all fine. That’s fine. Actually it turns out for steak and for red meats the problem comes though with chicken and the reason there’s a problem with chicken is that the pathogens are inside the meat, not on the outsides. So this is a screen grab which is reasonably okay from the British version of MasterChef. That’s a nice little consume and the bit of red that’s floating about at the back there is a chicken liver. And the description of this by the judges was this was perfectly cooked, beautifully pink and perfectly cooked. It’s a major, that’s actually a major problem because the pathogens in chicken are inside the meat. So if you’re eating that and there’s pathogens in the liver then basically, it’s just not being killed by the cooking process and the reason that all these problems could or the problem could be solved in the kitchen is that if you cook things properly i.e. not too pink in terms of chicken then you will kill the pathogen. Serving that is basically, you’re playing Russian roulette with chicken livers. So campylobacter is the food standard agency’s number one priority. They have guidelines about how you should cook chicken 70 degrees C for 2 minutes, should not be pink. If it’s pink you’ve got a problem. So then well Renton just put the culprits up. There may be some faces that you recognize there. Went and looked to see what TV and celebrity chefs were saying in terms of their cooking practices, in terms of recommendations, for how that you should be cooking chicken liver. So along the top now that’s the amount of time that they’re recommending, up to eight minutes, five minutes, there’s been people who’ve done evaluations of this in laboratories as to how long you need to cook chicken livers in order to kill the pathogens inside. It’s five minutes but as you can see there’s a whole series of people who are suggesting 30 seconds each side. Gordon Baxter, Nigel Slater who’s actually good a couple of minutes it’s only to get to Anthony Thompson they actually hit in the level and then some others are really cooking them properly. So this is the concern that there’s recommendations coming out from people who might have influence as to how you should be cooking your food and they’re probably making recommendations which aren’t good in terms of food health safety. So we know that seems to be happening ,we wanted then to follow that through further. So the research question was what the chefs and the public identify as safe cooking standards? Do they understand what is safe and is the divergence between what they think is safe and what they’d like to serve and eat? We had a limited amount of money so we couldn’t actually feed people. What we had to do was basically use this this instrument which is a set of photographs of chicken livers cooked to different levels and those isn’t really clear but number one is really quite pink if you saw it on a normal computer screen or just a photo it’s really quite pink. Number seven is looks like leather basically it’s being cooked really hard. So we’re presenting them with these these different images and just basically ask people well what do you think would be safe and what would you like to serve or eat? And those bottom three are the ones which we know if you ate them there’s a risk that they’re still carrying a high pathogens level. If the pathogen is in the liver, there’s a high probability it’s going to survive being cooked to that degree. There’s still some pink in there. So who do we interview? Well catering students, chefs, and the general public. We are interesting to know, we’re going to talk about here’s the chefs and the public and they’re get their views. So we ask different questions the public. We have had about 900 of these doing it online as in which you think is the first that meets sort of FSA safe food guidelines? Which dish would you prefer to eat at home? Which dish would you prefer to eat out? and this was limited to people who said they ate chicken livers. There’s a group of people who would say no I wouldn’t eat any of it, they would have to be taken out of the survey. The chef was, which is a smaller number, they would have recruited at chef cooking fairs. Which is the first that meets FSA guidelines? Which dish would you prefer to serve? and Which dish your customers prefer? So we’re interested in the guidelines and what they would rather to serve? So these are the public preferences and what’s happening in here is like a cumulative distribution. This is going to just show what proportion of the community proportion of the sample who would say yes that was either going to meet the guidelines or they have their preferences. So the way to read this is that these are quite consistent but about 10 percent are saying that they think that the first one meets guidelines. You’re getting up to about 20% think that either 1 or 2 are, about 25 to 30 % think that 1, 2 or 3 are and so on. So by the time we get to the end of that line we’ve accumulated all of our sample in. But you’ve got quite a proportion of people there who are saying both that they think that the those lower 1,2,3 are safe and it’s their preferences, that meets their Preferences. So what’s quite interesting about this is for the public there’s a consistency between what they think is safe and what willing to eat which is sort of what you’d like to see. It’s still a bit worrying though that are quite a big chunk of the proper the sample are saying that they would be happy to eat those really pink livers. The chefs look quite different. The red dotted line is their perception of what the guide, what the guidelines you know what the FSA’s guidelines are. So you can see they’re actually quite good. There’s only we’re about ten percent of them think that one two or three would meet the guidelines. So they’re aware of what the guidelines are and what they should be presented and as you as you go further up obviously we’re getting more and more saying yes it means the guideline. What’s interesting is the blue one this is the one about what they prefer to serve and what you can see is that most of them wouldn’t want to actually serve the first one but quite quickly fifteen percent would be happy to serve one or two and it’s up to 50 percent would be happy to serve, would prefer to serve not happy prefer to serve liver that’s in the one, two or three range. So here you can see that this divergence. They know what

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the guidelines are but they wanted to diverge from it basically in terms of their preferences and it’s a view of what is good food, what is flavoursome, what has the right mouthfeel and all the rest of it. It’s being driven into those preferences for what should be served and that’s a worry. It’s a worry if people are starting to serve the food in that way. It’s also a worry if this communication of these attitudes and views that are coming from the chef population are feeding through into the way that people are actually behaving in terms of their personal choices, the consumers choices. You can always send your pink livers back if you don’t like them but if you’ve ever been inoculated with the view that will actually pink livers of the way it’s supposed to go then it’s a problem. So they know the guidelines but they would rather serve it pinker. Fifty percent between one and three. We then ask people about influences. What are people’s views on what’s happening in the industry? We ask this about what they think other people do cause there’s always a problem at asking people what do you believe because they might not be prepared to say yes of course I’m influenced but they’re quite happy to say that other people like me are Influenced. So we ask them did they think that other people but we think actually this is about them how they’re eating, are they eating they meat pink because of celebrity chefs. 50 percent thought yes they could detect some impact and about the same portions of chefs think that there’s a trend among chefs recipes and towards cooking increasingly pink. This is a problem because when you get outbreaks of campylobacter based

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poisoning and by outbreaks that means we get large numbers of people being impacted at the same time not just singletons in. Outbreaks,

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quite often, associated with chicken liver and it’s because when people cooking chicken liver and chicken liver pate shows a similar problem they want pink but it actually harbors the pathogens and the reason comes an outbreak is that quite often this happens at catering occasions like weddings which is a great way to finish off your wedding is to have food poisoning. So there’s a major problem here about the way this perception is happening and feeding through. So what we found is that chefs know the FSA guidelines, prefer to serve it pinker. Public actually aren’t quite so good about the guidelines but at least they’re in line with the understanding of their preferences are in line with the guidelines so it would suggest that if we were to get more educated about the guidelines they would presumably change their preferences but the chef’s know there’s a different there’s a problem but still want to push a pink. And we did a test on this so that we’re actually when we were generating those photos at the same time there were chicken livers that were inoculated with Campylobacter, they were cooked for the right times and then we tested expose to see whether campylobacter Survived. The survival rates for those first three levels of cooking range between 98 and 48 percent survival. So if there was campy in the liver it would have survived the cooking process for those first three. It falls really fast when you hit the FSA guidelines not surprisingly because the survival rate disappears or drops. So there’s definitely a problem happening in there. Come back. So another thing we’re interested in was again this idea of bad behaviour, the chicken liver one which is about sort of it’s not illicit it’s not a bad behaviour, it’s just possibly a foolish behaviour, it’s about people’s preferences. There’s another set of behaviour though as well which is basically bad food behaviour as in people who are doing stuff in kitchens which they really shouldn’t be doing and is causing health problems. So another part of the study actually with the same sample of people we wanted to try to find out the prevalence of these illicit quote bad food behaviours. So what’s the questions. Determine the prevalence of bad behaviour among chefs and the public. How to what extent are people doing bad things in the kitchen and see whether or not in terms of the commercial side, whether or not these food bad practices are associated with certain types of establishment or characteristic. So can we predict where bad things are going to be happening? What do we mean by bad things and again I should apologize to you about your lunch but working in a kitchen within 40 hours, eight hours of suffering from diarrhoea and/or vomiting so there’s a recommendation that if as a chef or a food preparer you have had though vomiting an illness a stomach bug you basically even though everything’s cleared up you shouldn’t be working for the next 48 hours because you’re not what are known as shedding as you are still producing the pathogen and putting it out into the environment for 48 hours after you think that you’re fine. So there’s actually a recommendation which says you should not be working 48 hours after for the 48 hours after you have had the symptoms. That’s about behaviour. Have you worked in a kitchen where meat that’s on the turn has been served on the turn means I think it’s obviously not off but it’s on the edge it’s about to go from nice to nasty. So that’s a concern if actually people are serving food in that state. This is a sort of fairly basic one. Not washing hands after handling raw meat, poultry or fish. So one of the issues is cross-contamination with this. So if you’re handling meat chicken that’s been that has the pathogen on it and then you go and start producing salads then the pathogen just gets transferred from the chicken into your hands to the salad. So you should be having good hygiene standards washing, so the fairly basic stuff you thought should be going on. And the last one was serving chickens off barbecue when it’s not we’re not totally sure it’s fully cooked. This was in here because this is chicken it’s a complicated project so we’re interested in that. So we’d like to know both the chef and the public whether or not they undertake these types of
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Behaviours. Are these reasonable things to be worried about? Well there’s a restaurant called the fat duck in the UK. It’s run by Heston Blumenthal, who issue if you’ve been watching TV recently you’ll have seen his face telling up around the place. It’s a very high-end, very well established Restaurant. They had a problem with norovirus which is one of these pathogens. It’s not the more common ones but it is a serious one when it happens. One of the issues here was that apparently it wasn’t reported for a long time but when they went in and actually that the health agencies went in to investigate to find what the cause of this was what they were finding was that staff had been working even though they had been ill and that was all almost certainly the cause of the problem is that they hadn’t actually followed the guidelines as to how they should behave when they’ve been ill. These 240 diners have got Norovirus. So that, it’s a problem its’ out there. Working in a kitchen where meat on the turn has been served you’d hope this wouldn’t happen. This quote comes from a different research project but this is a quote from work from a chef about what they look for when they are employing new staff. Make a meal with chicken that’s on the turn as in didn’t just it’s not really rank but it’s getting there, can they do it? It’s important to do it because you can get another day or two meat out of, you know, economically it’s important and if they can do it then we know that they be experienced in restaurant cooking. So this is like an industry standard. If you can actually cover up the fact that your chicken is going, is about to go off then obviously worked in the kitchens before. Indication that possibly a standard activity that’s going on out there. It’s a bad behaviour, it’s an illicit behaviour. So we’d like to know about this but one of the problems of course is we’re going to be asking chefs do you do bad things and these types of questions are likely to prompt untruthful answers from people who sort of care about their reputation. So you can think of exact other examples of this is as in did you take recreational drugs at the weekends, all this the last weekends. Have you driven over the drink driving limits? Have you fiddled your tax return or you’re about to that’s about to come up. If I were to ask you to have a show of hands amongst you as to who’s performed these bad behaviours I imagine I wouldn’t get a very big response that you would feel yeah I don’t really want to admit I’ve done it but I don’t want to admit it. So how can we trust people if we are asking them to perform these behaviours especially professional people who have it’s a bad behaviour professionally. How can we actually be sure that we’re gonna get a good answer and they’re not just going to to say no of course not even though they do. So this is a problem when you’re trying to do this type of research as to how do you get people to admit they’re behaving badly? So there’s something called the randomize response technique and it’s been used lots of places. Most I think initially for drug use in the American armed forces but what you do is that you have a used dice a randomized process to try to change their answers. The answers that are recorded for people observed by dice rollers. How does this work? You give people two dice, before you answer the question you ask them to roll the two dice. I can’t see it, only you can see it. So the dice is hidden from view. Add the two numbers, up keep it secret don’t tell what your number is and then if the number is two three or four answer yes. Irrespective of what the question is or what the truthful answer is. If you get a two three four just say yes. If it’s an eleven or twelve just say no. Doesn’t matter what the question is nor what your truthful response is, just say no. Five, six, seven, eight, nine or ten, answer truthfully please. So what we’re doing is we’re sort of making bit strange we’re deliberately introducing error into our data. We’re actually getting people to not tell us the truth. We’re asking them to basically say yes or no determine you know just based upon a wrong. Why is this a good thing, well I’ve given you protection. If I ask you a question, Have you filled your taxes and you say yes you can always say it’s only because the dice told me to I’m giving you that answer not because I really did it but you’ve told me. I did the process roll the dice it was a two three or four therefore I’m going to give you the answer yes so I’ve given you some protection for actually revealing because I can’t actually now look you in the eye and say you’re a bad person you can just say I’m a good person, I’ve followed the roll. Even though, actually you truthfully have fiddled the taxes. So this idea of randomized response is a way of trying to actually give people protection so they can reveal the right answers. Does that mean our data is all useless? No, because we can work reverse-engineer this back out and say well we know that to know that a certain proportion of the sample are always going to say yes, a certain proportion are always going to say no and a certain proportion going to behave truthfully so there’s just statistically you can just work back with the say well this is what the true underlying level of behaviour is given that we’ve given this sort of this set up in terms of numerically. So this is quite a nice technique about asking people bad things. If you’re interested, it’s no good in court, it’s good if you want to talk about populations. So what do we do? What came out of this?

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So this is for the public, so this is not this is not the crude results this is the inferred results as to what the underlying rate of prevalence is. Not washing your hands after touching meat about 15 percent. Seems a bit high for the public the 48 hours after D and V that’s quite high that’s heading up to 30 percent but actually for the public that’s quite a difficult one not to do. You’re at home you’ve had you know what you’re going to do not cook for the kids for two days. So you might, may take more care but you probably if anything add balance a bit low almost you might think actually that most people would be forced just because of circumstances they have to cook till it. On the turn getting up beyond 20% and the barbecue chicken about 12% so that’s sort of quite high the on the turn, the barbecues of interest for the chicken so that campylobacter problem because that’s where we think actually a lot of the problems might happen with chicken. So that’s the public ones. What do you think the chef’s did? Not washing hands, thought be the things we drummed into a catering student day one. Okay it’s lower, it’s quite nice in the public one. The 48 hours D&V we’re heading towards 40% of chefs are saying that they’ve done that. So this is something which is actually a recommended practice that shouldn’t be happening. You should actually be out of the workforce for that time period. So that’s a really high level of a problem. Serving on the turn, it’s about the same thing perhaps not surprising given the quote we saw before but they are it’s like almost trained to really work out how to make the best use of their meat which means pushing it to the limits in terms of that whether it’s safe or not and barbecue chicken higher as well upper 20% so this is really quite a concern as in there are bad things happening in kitchens as particular among chefs that are going to be increasing the risks of this foodborne disease and this is increasing risks of things which basically you couldn’t reduce the risk to zero if you just cook the meat properly. Cook chicken so it’s not pink, one’s clear you can actually get rid of you could easily get rid of all of that implications for foodborne disease but there are these bad behaviours happening in the system. We wanted to try to find out whether or not can be explained it’s not everybody was saying it obviously a proportion did. If there’s some characteristics of the chefs and rinsing the chefs around the public as there’s some characteristics of the chefs which might explain whether or not they actually do these bad behaviours and if so that might give you some guidance as to where you might go. In the UK there is this thing called the food hygiene schools or as it’s known locally as the scores on the doors. Local Trading Standards officers go around to every establishment that sells Food, does an assessment of their food Hygiene, scores it between nought and five. If you’re down in the nought level, you’re closed down. One and two, you’re asked to Improve. You should really be hitting a five. Restaurants then get these little stickers they put on the door and they can therefore flag the factors to what that food hygiene rating is. If you’ve got a five you put it on the door flagged to the fact that you’ve got high standards. So this is things you’ve been pushed by the FSA as a way of trying to improve so that gives like to a consumer consumers can now actually influence behaviour by saying I’m not going to go and eat at somewhere that’s got a poor score. So it’s giving people information. So we can try to link, we asked the chef’s well what score does your restaurant have where you work for the school is and then is there any relationship between that score and their probability they behave badly. No. So it’s as likely that somebody in a five school or score of five is behaving badly as one has got to score of two. We asked them about the cost of their meals as in to get some idea of the degree of the cheap. No effect in terms of, no signal in terms of expensive restaurants don’t behave badly. It doesn’t turn up. We asked them, sort of a classification which sort of cost but the type of you know is it a fast Food, is it family dining, is it fine dining? You might hope and think that it’s fine Dining, well what it actually does it increased the likelihood that they’d not wash hand washing. So it’s going the wrong way a team in terms of if you’re trying to think about some sort of indication but only on that one behaviour. We also asked whether they’d won any awards which they won’t be like Michelin stars, these guys these will be like sort of local AA or local tourist awards or whatever for quality. What that was at in if you had been if your restaurant you worked in had won an award it actually increased the probability that you actually worked 48 hours without after D&V i.e. it’s the award-winning restaurants that are actually more likely to actually have the bad behaviours in them. That’s worrying but might be understandable in the same way that didn’t be the problem emerged presumably these guys are committed to the restaurant. Replacing them is probably quite hard because they’re skilled. It’s not like McDonald’s or whatever office of a lower level restaurant chain where you can just churn turnover staff but replace staff quite easily they probably have commitment and so they probably have a motivation to actually turn up as soon as they can and so we’re getting seeing that problem. So in combination, what that suggests is that the challenges for the public in finding outlets or safer food can be considerable and probably if you’re trying to use cues, they might give them to help. I must admit I wouldn’t eat in a restaurant that didn’t have a 4 or 5. The score on the door but this suggests that that might not be a good, necessarily a good predictor of some of these practices. Okay, conclusions. Foodborne illness is a huge issue. Imposes a considerable burden. In principle you could fix it just by cooking things properly. Bad behaviour’s everywhere and it’s actually quite difficult to change as in to make people change their Behaviours. So that’s part of the Challenge. So thank you. I hope I haven’t put you off. You referred to professionals, chefs as being professionals in what way do you define their profession and professionalism? I mean do they have a license to be able to cook our food, does anybody check on them? They have a lot of responsibilities both for the health and economy and should they not have a license like a driver’s license? So for us as in professional was defined in terms of that you are working in a commercial cooking environment. So you are you are cooking food which you’re going to sell to people. I don’t think that there is no requirement, there is no license for them. They will be trained where the standards are imposed will be from the Food Standards guys come in to actually see how they behave. Do they have good hygiene? So in principle, anybody could without any without any formal qualification turn up and cook. The way they are judged is on an assessment of the outcome of that as in they will be looked at again think they have guys outside selling pizzas Subiaco council no doubt will have gone round and inspected and we’ll have spot checks to see if they’ve got good standards. Whether you have a license well ok you could you could have a license but then as you know there are lots of people out there driving who got licenses who aren’t or not very good, who are problematic. So I think that sort of registration process might not actually help and we’ve seen with the people in the highest level as in they main you know into the higher end restaurants where you think there would be some degree of commitment pressures that they are actually places where these things aren’t just automatically fixed. So it’s a worry in terms of changing behaviour, that’s a real, it’s a worry. Probably the best way to do it is that when it turns up, it gets publicized and well-known and then people allow to make their judgments as to whether or not they want to eat in a restaurant. That’s being identified as having a problem. That’s what the schools, the doors is basically trying to do to give consumers information about stuff they can’t see that’s happening in the kitchen but the scores and the doors are actually quite I think if you don’t get a five I can you get everybody really it’s not a particularly rigorous system but now it’s yeah it’s a challenge basically. So you talk a lot of information about chicken and liver. I’m just wondering what do you think of the popular dish and sashimi in Japanese restaurant? So I think it goes to the quality of preparation and control. So you need to have absolute high quality standards and if you’re achieving those then presumably reducing the risks but so the other example is things like beef tartar which is like raw beef and the trend towards rare beef burgers. So and there’s a very clear distinction between those. In the sense that the issue about reason, why the trend to pink in beef isn’t so much of a problem is the pathogens are on the outside so that if you’ve cooked the beef and those steaks you kill the pathogen on the outside the meat in the middle is okay so that’s fine and that sort of trend to pink in terms of steaks whatever it’s in a sense. Fine you’ve got a problem. The problem comes when you

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ship something like burgers where basically what you’re doing is you’re taking the meat pathogens on the Outside, mincing its pathogens now all the way through, cooking it, the burger but only cooking the outside. You’ve basically put the pathogens back in. The pathogen in the middle are basically safe. They’re still existing in there. So this goes to the question about standard. Should you should you eat a rare burger? Well it depends upon preparation. If you prepared the meat to standards that you’ll be prepared to eat it I think it’s steak tartar which means absolutely really strong standards in terms of preparing the food, making sure that actually is time for known as sear and shave. You cook at the outside of the meat very quickly slighted off means the bit inside if you can achieve the standards, hygiene standards then you’re okay. The worry is with anything is that when people try to achieve those standards and fail or don’t bother to achieve the standards. But people still think it’s okay. So okay eating raw fish or chicken, not chicken, but well fish then, as long as your health standards are okay then you’re probably good. But the problem comes when it comes and there may be some people who can absolutely deliver high quality food but you need impeccable standards. The problem is when it becomes more widespread. Can everybody maintain? Can your normal burger joint to a normal chicken joint maintain the same impeccably high standards to ensure you’ve got that and probably the answer that is no. So that’s the worry. It’s about whether they can maintain the standards. You said something like 80% of chickens have the Campylobacter bacteria or disease or whatever it is. Is that related to how the chicken is brought up or is it pretty random. Is it you know your free-range or organic. Is that going to have less chance of having this no Campylobacter than at that tree. No so it doesn’t guarantee it’s not going to. So campy is in the environment. So it’s actually out there in the wild, in the UK it is, then you said cross infections into flocks. There are certain production processes which cause problems there’s something called thinning. Intensive where people go into the battery houses, remove chickens so that they can actually continue to grow and that action of going in and out is cross contaminate. The guys carry in on their boots to the next place. You get this cross contamination. When you get into the advert of our system you’ve got a problem because all the chickens are going through and it’s lots of water and intestines and it just cross contaminates so it gets very hard then to actually control it going through. But there are some production processes which they’re trying to develop which would actually minimize it like and not thinning is seen as being one. There are practice you can do ex-post, after slaughter which can get rid of it so freezing it, freezing chicken kills it but that would mean that every if you implement you would have no fresh chicken in supermarkets. It would all be Frozen, either frozen defrosted so you then can’t refreeze again or just frozen. Irradiation kills it but there’s a version too. So there are practices you can put in place. Now trimming neck skins off chickens, that’s an area where there’s high concentration so we trim the neck skin off the chicken, that reduces it but doesn’t get rid of it completely. So it is really difficult to actually eliminate it completely. They’ve got it down now to 50% of chickens now have got in the UK are down to having the load and they’ve have the number who’ve got the really high level from about nine to about 5% have got really high levels. So there’s some practices you can put in place but it seems to be really quite difficult to eliminate completely. Cook it, it’s a simple recommendation because that does get just get rid of it. But you want that chicken burgers. Thank you.

How Much Can Bicycles Change Communities? | World Bicycle Relief On GCN

How Much Can Bicycles Change Communities? | World Bicycle Relief On GCN


– It’s World Bicycle Relief Week here on GCN, helping to change lives through the power of bicycles. In the second of our
series, we follow Chris, a farmer, as he goes
about his daily routine now with the help of a Buffalo Bike. (Zambians singing) – Today, we are in Zambia on a farm, Christopher’s farm to be exact. He is in the background
somewhere milking cows, which he’s been doing for an hour already. It’s 5:30 a.m. and I think he’s going to give me a go as well. So, let’s go on in. (rooster crows) (milking) Christopher, thank you for
having us at your farm. – No, it’s no problem. – We’re going to follow you
for some of this morning. So first, is that you’re going to let me have a go at milking, briefly. What’s the plan after that? Are we going to load the
bike up with the milk and take it to the distribution centre? – Yes, yes, that’s the plan. That we now start milking,
and we load the bike with the milk on the
bikes, and then we deliver. – Okay, I think we’re going to see if I’m strong enough to load the
milk into the bike, as well. It sounds like it’s
going to be very heavy. – No, no, no, not very heavy. I mean you look strong enough. (laughs) – Not for you, yeah. (laughs) Let’s go and have a go. – (speaks in foreign
language) with milking. – (laughs) He’s laughing. Like, yeah right. – Uh-oh (laughing) – It’s nervous. – Yeah it’s nervous. – Not as nervous as I am,
but he’s still nervous. She, she. – Okay, good to go. (speaks in foreign language) – Okay. – Right. – Okay. So, from the top? – Yeah. Going down. (milking) – All right, we’re off. – Yeah. – Oooh, spray. What am I doing? – Yeah, this is going to be a long one. – (laughs) All right. Come on, I’ve got to least … Oh . Nope. It’s not happening out of any other one. – Oh, yeah? Okay, I think that’s good for- – Yeah, I think that’s enough. We’d better let your man get on with it. (loud milk squirting) (laughing) Right I think all nine
cows how now been milked. A small part by me. So we’re ready to now
put the very heavy urn on to the back of the bike. – Okay, you ready? – I think he’s gonna trust me to do it. – Alone? – Well, we’ll see. How heavy is it? – It is quite heavy. – There we go. – You gonna need some help? – I’m trying not to drop it. – Okay, let me help. – Got it? Yeah, then we’re going to
ride to the collection point. Chris is going to ride
this bike, obviously. His potentially 40 litres of milk could fall all over the place
if I’m on the bike. – I think this should be good enough. – Yeah, look’s solid. Right, let’s go. (uplifting music) Before the Buffalo Bike,
this 4 kilometre journey would be done twice daily on foot. So two people, one on
either side of the urn. Once in the morning, and
again in the afternoon. Or sometimes there’d be
three people around two urns when productivity is particularly high. For other farmers, that journey can be four times the distance. It’d be quite a trick
even without the milk. And you can imagine what it’s like to walk with that extra 40 kilogrammes. The bike has cut the journey time by well over 50%. And that makes a huge
difference in time and energy, but also ensures that
the milk stays fresh. (mosquitoes buzzing) Oh, we’ve arrived. We’ll park the bikes up. I’m gonna help Chris stabilise his bike. (man speaks foreign language) (laughing) His friends are laughing at him. At the collection point,
we have to wait our turn to get the milk tested. If it’s all good, it’s then
poured into a large container, at which point Chris
is paid for the amount that he’s brought in. This is the first of two
trips done each and every day. So I think Chris and
I are just about ready to ride back. We’ll just let you know there
are over 100 small farms here in the small province of Palabana. Over here you can see that there are lots of Buffalo Bikes being used. But here’s somebody doubling
up on the back here. Couple of containers. That must have been very
heavy there on the way in. But this is the difference
these Buffalo Bikes have made to the local community. Because they’re all riding
in instead of walking. (Zambians singing) We’re going to leave, briefly,
our journey with Chris, because I wanted to tell
you about this very cool charity and community. This is called Chikumbuso,
and it’s been around since 2005. It was set up to help people in need. So anyone from young
vulnerable people through to orphans, through to widows,
and grandmothers as well. And for the more senior
people that arrive here, they are taught how to
crochet and how to sew, and how to make some
extremely cool products out of recycled materials. I, for example, have literally
just purchased myself possibly the coolest laptop
case you will ever find. For the younger ones, they
have set up an in-house school, which caters and educates children right the way through from
kindergarten to grade seven. However, what they were
finding was, that when they left here and they went
into the senior schools, they were much further
afield and sometimes they weren’t able to get there on foot. And that is why 10 years ago they started working with World Bicycle Relief, in order to provide those
students with the Buffalo Bikes so they could finish what they’d started. Right, we’re back. So I think Chris, – Yeah? – Time to wash the milk can. – Definitely. – One of your workers is going to do that. We do that over here. – We’ll do it just here. – And then Chris has got
lots of work to do today with his poultry section of the farm. – Yeah. – And also, what is the other
thing you have to do today? – The pigeonry we have to run see. – Pigeonry as well? – Yeah. – He wants to go pigeons as you can see. And then we’ll be back to milking
later on, or they will be. Then back down to the … – To taking, delivering milk. – Yeah? – Yeah. – Yeah, long day. – Right, let’s get this off. Now if you’re wondering why Chris’ bike is bright green or bright
yellow, it is because this is part of a special project called the Conservation Agriculture
Scaling Up Project. Which was done in conjunction
with the European Union, Zambian government, and the
Food Agricultural Organisation. They have provided farms
across Zambia with a total of four and half thousand of these special coloured Buffalo Bikes. Chris, I know, is very
grateful to have this because he has used different
bikes in previous years. But the problem was that
with those huge loads of milk on the back, they broke pretty quickly. Whereas this Buffalo
Bike, which is of course built to withstand loads
of up to 100 kilogrammes plus the rider himself,
this is more than capable of doing multiple years
of journeys to and fro with those loads of milk on the back. We only followed Chris for
the first half of his day. It certainly wasn’t easy just doing that. And of course, farming is
a seven day a week job, arduous in these conditions
then, to say the very least. Even with the bike. Now although Chris was
fortunate enough to be donated his bike, and all
students receive theirs free of charge, most farmers will in fact
pay for them over time with a local employee purchase programme. And that is a really important point, the sustainability of World
Bicycle Relief as a charity. And the farmers are
also finding that their Buffalo Bikes are incredibly
useful for another purpose. And that is to bring their
produce down to local markets like this one is Palabana. The donations that you have
already made for the bikes that have been given to
people here in Zambia have already made a huge difference, but we can do so much more for them. We would love to raise
even more money than we did back in 2016 this time around. There is the incentive that
Matt and Cy are going to ride across London on
a 5 kilometre stretch wearing nothing but swimming costume. But apart from that, the
incentive is right here behind me and with
Christopher, who we’ve been following today. So a very big thank you to him, and to all of you who’ve
already made donations. If you’d like to do so
right now you can just go into the description below, follow link, and all of the details will be right there in front of you. If you would like to
see Lizzie, meanwhile, who we follow as a student
on her daily routine, you can find that video just down there.

What Is a Fragility Fracture?

What Is a Fragility Fracture?


– Fragility fractures are fractures that happen from weak bone. And the general understanding
is that if you have a fall from a standing height or less, that results in a fracture,
it’s a fragile fracture. And that basically means
that the typical person, normal, healthy adult, who just falls from a standing height,
should not break their bones. Now it’s one thing if
you trip, and roll over, and fall down a hill, and tumble. But it’s quite another
if you were to just trip, fall from a low energy
impact, and break something. And the common fragility
fractures are wrist fractures, hip fractures, elbow
fractures, even ankle fractures and tibial plateau knee fractures. Common ones being the wrist and the hip. In those situations, you basically have an underlying weak bone, low energy fall, fall from less than a standing height, and you end up with a fracture that shouldn’t otherwise be
expected to happen, clinically.