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Tag: Now Magazine

  • Study Says Jetliner Air Quality Poses Health Risks: CUPE Takes On Airline Industry With Findings Of Survey

    Study Says Jetliner Air Quality Poses Health Risks: CUPE Takes On Airline Industry With Findings Of Survey

    By David South

    Now Magazine (Toronto, Canada), March 11-17, 1993

    Canada’s troubled airline industry is about to face some more turbulence, as the union representing more than 6,000 flight attendents presses its concern that many of its members’ health problems are related to poor air quality in jets.

    The Canadian Union of Public Employees (CUPE) says its locals have compiled data that paints a fairly stale profile of in-flight air quality and its relationship to altitude, passenger load and length of flight. As part of the survey, the union recorded flight crews’ complaints of chest pains and lack of oxygen, as well as other work-related problems like back injuries, hearing loss and high incidence of colds and flu.

    Of more interest to frequent fliers might be the opinion of some experts that even the more common jet lag may be caused by excess carbon dioxide, ozone and radiation. More than half the air in many aircraft is recirculated, “stale” air that is high in carbon dioxide and may be carrying bacteria and viruses, according to some experts.

    CUPE health and safety chair Tracy Angles says the union now has enough evidence to at least pressure the carriers to undertake more comprehensive air quality studies. CUPE represents workers at Air Canada, Canadian, Nationair, Air Transat and some smaller feeder carriers.

    While the union’s study is the first of its kind in Canada, a survey by the US department of industrial relations found, among other things, that flight attendents had 20 times the expected frequency of respiratory illness.

    Flying mines

    “Flight attendants have been equated with coal miners in terms of the bad air they have to breathe,” says Angles. “But this is not something the companies want to study.”

    However, spokespeople for Air Canada and Canadian Airlines say they have not heard of such health problems. Jerry Goodrich of Canadian simply says, “It’s not an issue.”

    However, while earlier-model jets supplied the cabin with 100 per cent fresh air, increasing fuel costs led to some modification. Modern jets mix fresh air – expensive to produce – with stale air from inside the cabin, which is passed through filters. The percentage of recirculated air in some aircraft, such as the popular Boeing 747-400, could be as high as 52 per cent, Boeing’s figures show.

    Boeing’s Tom Cole says air circulation in Boeing’s jets is better than in an average office building, and that the passengers are “washed” with air to eliminate carbon dioxide and other hazards.

    Critics like Georgia doctor William Campbell Douglass, publisher of the health newsletter Second Opinion, charge that the high rates of recirculated air, and the reliance on passengers’ own breath and perspiration to humidify the dry air, provide a perfect environment for bacteria and viruses. Douglass even speculates that planes could transmit serious diseases like tuberculosis. He suggests jet leg could be “nothing more than CO2 intoxification and oxygen starvation.”

    “There is no doubt if you are in a confined space, you are at greater risk,” says University of Toronto microbiologist Eleanor Fish. “Aircraft filter systems aren’t sophisticated enough to filter out all the bacteria and viruses. But I’d be hard pressed to believe that you are at greater risk traveling on airplanes than on elevators.”

    It is difficult for public health authorities to pin down the health risks of airplane travel because passengers disperse immediately after a flight. However, medical journals have documented two cases where virus transmission could be established because the passengers were easily traceable.

    In 1977, 38 of the 54 passengers on a plane grounded in Alaska for a four and a half hours came down with the same strain of flu.

    “We consistently hear complaints about certain aircraft,” says Angles. “The Airbus 320 is one of the worst.”

    Angles says many airlines exacerbate the problem by over-crowding planes and flying them longer and farther than they were designed for.

    Cut corners

    “With deregulation, they have more people in there than was ever planned on. Nationair is a good example. A normal class Air Canada 747 carries about 420 people. In the all-economy configuration the load is upwards of 496.”

    Angles also says airlines have been known to cut corners by turning down air flow to save money. In their 1990 book The Aircraft Cabin: Managing the Human Factors, Mary and Elwin Edwards cite a study indicating a 1 per cent saving on a fuel bill can be achieved by reducing the ventilation rate in a McDonnel-Douglas DC-10.

    More resources: 

    April 2021

    Airqualitynews.com Terror at 20,000 feet

    “A new global campaign and film asks whether the air we breathe on commercial flights is as safe as we think it is. …

    Another issue, which frequently gets overlooked, is the quality of the air passengers breathe onboard

    In February, a global campaign was launched by the Global Cabin Air QualityExecutive (GCAQE), which called for the mandatory introduction of effective filtration and warning systems, to be installed on all commercial passenger jet aircraft.

    According to the GCAQE, there have been 50 recommendations and findings made by 12 air accident departments globally over the last 20 years, directly related to contaminated air exposures on passenger jet aircraft.

    However, commercial aircraft continue to fly, with no contaminated air warning systems to inform passengers and crews when the air they are breathing is contaminated.”

    Jetliner Cabins Are Quickly Cleared of Virus, Pentagon Says

    “Particles the size of the new coronavirus are quickly purged from a commercial aircraft cabin, according to a U.S. Defense Department study touted by United Airlines Holdings Inc. in its effort to reassure wary travelers.

    Filtration systems and rapid air-exchange rates mean that only about 0.003% of infected particles entered a masked passenger’s breathing zone, said the report, released Thursday.”

    Aircraft Air Quality – Protecting Against Contaminants, Association of Flight Attendants

    “On October 5, 2018, a 5-year FAA bill became law. Included in the bill is a study on technologies to combat contaminated bleed air. This is significant progress!”

    ‘Contaminated air’ on planes linked to health problems, 21 June 2017

    AEROTOXIC SYNDROME: A NEW OCCUPATIONAL DISEASE?, Public Health Panorama, Volume 3, Issue 2, June 2017

    Influenza Air Transmission, Influenza A (H1N1) Blog, September 28, 2009

    “What does this tell us? Aerosols, very small particles of saliva containing the virus we exhale when we sneeze or even when we breathe if we have the flu, probably have an important role in the transmission of influenza. In addition to that we have public transportation, with a great number of people circulating in a place that may be closed and badly ventilated at times and we may have a notion of the importance of public campaigns that promote education and awareness of contaminated people to avoid leaving their homes when they have the flu and that they cover their mouth and nose with a disposable tissue when they sneeze and discard it right after that.”

    2006

    Tuberculosis and Air Travel: Guidelines for Prevention and Control

    “The revised International Health Regulations, adopted in 2005, provide a legal framework for a more effective coordinated international response to emergencies caused by outbreaks of infectious diseases. A number of provisions are relevant to the detection and control of TB during air travel, strengthening the authority of WHO and of national public health authorities in this domain. Because of these important developments since the original guidelines were issued in 1998, WHO has prepared this revised version to take account of current public health risks that may arise during air travel and new approaches to international collaboration in dealing with them. The guidelines were developed with the collaboration of international experts in air travel medicine and other authorities. Implementing the recommendations will help to reduce the spread of dangerous pathogens across the globe and decrease the risk of infection among individual travellers.“

    An outbreak of influenza aboard a commercial airliner, American Journal of Epidemiology, Volume 110, Issue 1, July 1979

    “A Jet airliner with 54 persons aboard was delayed on the ground for three hours because of engine failure during a takeoff attempt. Most passengers stayed on the airplane during the delay. Within 72 hours, 72 per cent of the passengers became III with symptoms of cough, fever, fatigue, headache, sore throat and myalgia. One passenger, the apparent Index case, was III on the airplane, and the clinical attack rate among the others varied with the amount of time spent aboard. Virus antigenlcally similar to A/Texas/1/ (H3N2) was Isolated from 8 of 31 passengers cultured, and 20 of 22 ill persons tested had serologic evidence of infection with this virus. The airplane ventilation system was inoperative during the delay and this may account for the high attack rate.”

    The Airliner Cabin Environment and the Health of Passengers and Crew.

    “At the end of its review of health data in the 1986 report The Airliner Cabin Environment: Air Quality and Safety, the National Research Council (NRC) committee concluded that “available information on the health of crews and passengers stems largely from ad hoc epidemiologic studies or case reports of specific health outcomes [and] conclusions that can be drawn from the available data are limited to a great extent by self-selection…and lack of exposure information” (NRC 1986). This chapter reviews data on possible health effects of exposure to aircraft cabin air that have emerged since the 1986 report and the emergence of data resources (e.g., surveillance systems) and studies that have particular relevance for the evaluation of potential health effects related to aircraft cabin air quality. Selected earlier sources are also reviewed. The decision to ban tobacco-smoking on domestic airline flights in 1987 and on flights into and out of the United States in 1999 reduces the relevance of some studies of exposures and reported signs and symptoms that clearly could have been related to the products of tobacco smoke.” 

    ORCID iD: https://orcid.org/0000-0001-5311-1052.

    © David South Consulting 2021

  • US Health Care Businesses Chasing Profits Into Canada

    US Health Care Businesses Chasing Profits Into Canada

    Some fear corporate health care will kill equality of treatment

    By David South

    Now Magazine (Toronto, Canada), April 8-14, 1993

    American-style private health care is slipping across the Canadian border under the noses of three provincial NDP governments, say researchers representing an association of health care workers.

    Jackie Henwood and Colleen Fuller of the 7,500-member Health Sciences Association of British Columbia charge in a recent report that a combination of free trade and tightfisted government spending is undermining the universality of medicare and ushering in the beginnings of a two-tier system.

    While the health care industry created more jobs than any other sector of the economy between 1984 and 1991, they point out, things have changed dramatically since the Canada-US free trade agreement came into effect in 1989. Now much of this growth is clustering in the private sector.

    And they expect that this trend will continue under the forthcoming North American free trade agreement.

    “NAFTA will accelerate trends towards a privatized, nonunion and corporate dominated system of health care in Canada,” says the report.

    Binding provisions

    Chapter 14 of the Canada-US free trade agreement opened competition for health-care facilities management services to US companies. Certain NAFTA provisions will bind all levels of government to consider for-profit health care companies on equal footing with public providers when bidding for services, and entitles them to compensation if they can prove to an arbitration board that they’ve been wronged.

    “That represents a substantial encroachment on the democratic right of local, provincial and federal governments to make decisions,” says Cathleen Connors, who chairs the Canadian Health Coalition, which includes labour activists, nurses, doctors and other health-care workers.

    This, in combination with health care cutbacks – both federal and provincial – is resulting in service and job cuts, bed closures, increased drug costs and an increase in privatization, the report says.

    In the area of home care, for example – visiting nurses, physiotherapists, homemakers and other services – private firms now take in close to half of all OHIP billings. Many of their clients pay out of their own pockets for services.

    The Ontario ministry of health doesn’t keep statistics on the private home health care sector in the province, but the Ontario Home Health Care Providers’ Association, a trade group, estimates that private firms in the industry now employ 20,000 people.

    The industry is dominated by a small number of large firms, including Paramed, Comcare and Med+Care.

    “It’s a market situation,” says Henwood. “If the services aren’t available to people within the public sector, they will go outside of it.

    “We’ve seen this in other countries like England, where they had a public system and now have a parallel private system. If you erode a system enough that people get pissed off, they are going to start to look for alternatives, and the people with the greatest liberty are those with money.”

    Connors says that because the Canada Health Act only covers the provision of hospital and physician services, the prinicples of universality and comprehensiveness don’t extend down to community-based services like home care.

    The study also found that giant US private health insurers are positioning themselves to reap profits in the fertile Canadian market.

    Last week, Wisconsin-based American Medical Security Inc. announced it will begin offering American hospital insurance to Ontario residents this month, citing a demand in Canada to bypass lengthening waiting lists for medical treatment.

    Giant US west-coast insurer Kaiser Permanente declared in the March 1992 issue of Fortune magazine that they have targeted Canada as the next growth market. And American Express membership now offers the privilege of health insurance.

    With private health care services sprouting up like spring weeds, says Henwood, provinces are placing yearly limits on the number of private services covered under provincial health plans, thus preventing people shopping around for services, no matter what their income.

    Sheila Corriveau, corporate relations coordinator at Toronto-based Dynacare, Canada’s largest full-range private health care company – which operates labs, retirement homes, homecare services and consulting services – is enthusiastic about expansion plans, and says that removing patients from hospitals into their homes has been a boon for private health-care services.

    “I think the health system will benefit, because what you are really doing is off-loading the cost from the public sector and from the treasury to private enterprise,” says Harry Shapiro of Dynacare. “Private enterprise depends on its own ingenuity for survival and its own levels of efficiency.”

    But advocates of the public system say the free-market option now looming is being ushered in by the very parties that Canadians have come to rely on to defend medicare.

    Medicare stance

    Ontario’s new health minister, Ruth Grier, however, denies her government is jeopardizing medicare.

    “I want to disagree with that as profoundly as I can,” she says, fidgeting with an ashtray during a recent interview. “Our government has reaffirmed its commitment to medicare. Over the last decade, under conservative and liberal governments, health care costs have increased in double-digit figures. The system would have collapsed at that rate of growth.

    “I guess I haven’t found a way of blaming free trade for failures of the health care system at this point,” she says.

    But critics say in the last year alone, Ontario’s ministry of health has capped health coverage for travellers abroad, removed coverage for physical exams requested by employers, chopped hospital beds and cut back the number of drugs covered on the provincial drug plan.

    Grier says that the government’s vision relies on a new view of medical care seekers as consumers who are going to take more responsibility for their own health care

    “Government can’t do it all,” she says.

    Now Magazine (Toronto, Canada), April 8-14, 1993.

    More investigative journalism by David South for Toronto’s Now Magazine:

    Now Magazine (Toronto, Canada), November 12-18, 1992.

    More healthcare reporting by David South from Canada’s Today’s Seniors: 

    Feds Call For AIDS, Blood System Inquiry: Some Seniors Infected

    Government Urged To Limit Free Drugs For Seniors

    Health Care On The Cutting Block: Ministry Hopes For Efficiency With Search And Destroy Tactics

    New Seniors’ Group Boosts ‘Grey Power’: Grey Panthers Chapter Opens With A Canadian Touch

    Seniors Falling Through The Health Care Cost Cracks

    ORCID iD: https://orcid.org/0000-0001-5311-1052.

    © David South Consulting 2021

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    ORCID iD: https://orcid.org/0000-0001-5311-1052.

    © David South Consulting 2022

  • Aid Organization Gives Overseas Hungry Diet Food: Diet Giant Slim-Fast Gets Tax Write-Off For Donating Products

    Aid Organization Gives Overseas Hungry Diet Food: Diet Giant Slim-Fast Gets Tax Write-Off For Donating Products

    By David South

    Now Magazine (Toronto, Canada), December 2-8, 1993

    Doling out diet supplements to recipients of food aid may sound bizarre, but that’s what US diet giant Slim-Fast has been doing.

    The company’s cans of powder have been distributed to the conflict-ridden former Soviet republic of Georgia and other parts of the collapsed Soviet Union by the aid agency Americares.

    Critics say Slim-Fast is far from appropriate and is, at best, in bad taste. New York-based food-aid critic and writer Michael Maren says such contributions are simply the result of agencies being used as dumping grounds for tax write-offs.

    As an example, he cites Somalia, where he recenly spent time researching an upcoming book critical of aid programs. Pharmaceutical firms, he charges, are dumping unnecessary drugs in that country.

    “If you want to help people, give them what they need, not the crap we have around here. That a so-called aid agency would bring over Slim-Fast is absurd.

    “The attitude that they should take any shit we give them – it’s arrogance,” says Maren, who believes many donors have a beggars-can’t-be-choosers attitude to people in need of help.

    At Slim-Fast’s corporate headquarters in New York, Adena Pruzansky acknowledges that the donations are tax write-offs, but insists that their product is very nutritious. No one, she says, has complained about their contribution.

    Powdered cure

    “If you look at our powdered products, there is a lot of nutrition in there. Certainly for people who don’t have food, this is something that could be useful to them.”

    A spokesperson for Connecticut-based Americares, which directs surpluses donated by 1,100 firms to relief operations in 80 countries, praises Slim-Fast.

    “They are a fine group of humanitarians,” says Elizabeth Close.

    “Americares was just written up in Money magazine as the most cost-effective nonprofit agency,” she says of the organization, whose donations consist of overstocked, discontinued or obsolete items.

    “We only accept a product for donation when we know we have a home for it. So we are not giving something inappropriate,” she says.

    Close provides no details, however, about Slim-Fast’s participation. “Without their permission, I’m not really supposed to go into any further description of what they donated,” she says.

    But those who see the devastating effects of eating disorders on women say Americares exercises poor judgement when it accepts such diet supplements.

    “I think it’s quite bizarre,” says Merryl Bear of the National Eating Disorder Information Centre. “Many of these diet plans are starvation diets. In many of the diets, the caloric intake is less than or equivalent to what the Nazi concentration camps delivered.”

    Slim-Fast’s chocolate drink powder, for instance, is made of skim milk powder, sugar, whey powder, cocoa, fibre, calcium caseinate, corn oil, fructose, lecithin, salt and carrageenan. It relies on mixing with milk to gets its nutrition.

    Lynne Martin of the Toronto Hospital’s eating disorder clinic says Americares is encouraging dieting among starving people who need calories first.

    “Women need a minimum of 1,800 to 2,100 calories per day – to meet that requirement with Slim-Fast, you would need eight glasses per day,” she says.

    Low calories

    Martin says the low calories available in the supplement become even lower if recipients don’t have access to milk and try to mix it with water.

    “The protein level isn’t given without the milk, so you don’t know how much is in the powder, but certainly the calories would change if one were to mix it with water.”

    At food relief agency CARE in Ottawa, program officer Ivan Connoir says what “the hungry need isn’t Slim-Fast but what is called a human daily ration (HDR).

    “It is prepared in the United States especially for emergencies. It has no pork, so it can go to any country,” he says. “It is a kind of lentil stew and vegetable soup – just add water and it’s ready to eat. You even find bread in it. It can last for years.

    “Of course the best thing is family food parcels that last one month.”

    Now Magazine (Toronto, Canada), December 2-8, 1993.
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    Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License. 

    ORCID iD: https://orcid.org/0000-0001-5311-1052.

    © David South Consulting 2022

  • Counter Accusations Split Bathurst Quay Complex: Issues Of Sexual Assault, Racism At Centre Of Local Dispute

    Counter Accusations Split Bathurst Quay Complex: Issues Of Sexual Assault, Racism At Centre Of Local Dispute

    By David South

    Now Magazine (Toronto, Canada), August 26-September 1, 1993

    At the foot of Bathurst where the street disappears into the blue shimmer of Lake Ontario, a complex of apartment dwellers is bitterly divided over issues of public safety in a contest fraught with the tensions of race, class and gender.

    Here in the seven-year-old neighbourhood of four co-ops and two municipally funded Cityhome buildings, activist opinion has hardened into factions with widely divergent views on one question – how safe is the Bathurst Quay community?

    One group, an ad hoc collection of residents and concerned others is calling for an inquiry to investigate a list of alleged instances of sexual assault and harassment against women going back more than three years. Some of these say they cannot speak publicly for fear of retaliation by a coterie of violence-prone youth in the area.

    And they say that they will not release the names of the alleged victims until confidentiality is assured by an independent inquiry.

    But neighbourhood youth workers and some residents say this group hasn’t come forward with enough evidence to back their allegations, and that they are playing judge and jury. This collection of individuals, they say, are at best insensitive to the problems of Cityhome youth – many of whom are black – and at worst racist.

    Forgotten youth

    A year ago, Cityhome management commissioned a consultants report after residents reported the alleged gang rape of an 11-year-old girl, the presence of youth gangs with guns and drugs, and the sexual assault of young girls in the community centre.

    The document, concluded in February, argued that the gang had disappeared, but admitted that it couldn’t come to any conclusion as to the validity of the accusations.

    Some argue that the list of allegations is an over-reaction to the energies of under-class youth, and that what is essential is keeping communications with them open. Calling the police every time there is a problem, they say, only exacerbates tensions.

    “My analysis of the situation is that there are a bunch of adults who have forgotten what it’s like to be youth,” says a community leader who prefers to remain nameless.

    “There are youth who are angry, have done stuff, I see a lot of threatening happening, and it’s not by young black youth. It’s by articulate, middle-class white women. It’s sexist, ageist and racist.”

    But members of the pro-inquiry group – many of whom belong to the safety committee of the Bathurst Quay Neighbourhood Association (BQNA) – say this point of view, which looks so politically correct, in reality favours young men over young women.

    One resident who has been mintoring the situation and who fears physical assault if identified, says it’s important to link racial discrimination and sexual harassment, but women’s fears, she says, shouldn’t be sacrificed to make links with troubled youth.

    “Community workers have made choices to privilege male youth,” the resident says. “Racial oppression and sexual oppression are bumping heads, but when young males engage in acts of crime they have to account for their actions. The safety group went many times to the community centre board about abuse in the neighbourhood, but the discussion was repressed. The racism charge is a silencing tool, preventing people from speaking out.”

    Three arrested

    Another resident of one of the Cityhomes, whose daughter was assaulted in the laundry room over two years ago, says she and other women have to deal constantly with taunting by local youth.

    “We are known as the broad squad,” she says. “Three or four of us will defend each other in the courtyard. A lot are afraid to walk at night.”

    Three of the youths accused of harassing tenants were arrested Sunday (August 22) for a hat-trick of armed robberies on Bathurst, according to Keith Cowling of 14 Division. Two are residents of Bathurst Quay, while a third, from nearby Maple Leaf Quay, regularly visits the area.

    Pro-inquiry forces say they are stung by charges of racial unfairness, and say they want prominent womens’ and black community groups as investigators to ensure, as their pamphlet explains, an “anti-racist, anti-sexist and anti-classist” resolution.

    “It seems to me that whenever you say something, you are called a ‘racist’,” says Marlene Irwin, chair of BQNA and contact person for the pro-inquiry group.

    “I feel we are doing male youth more of a favour (by calling for charges to be laid) than those protecting them for assault, harassment and break and enter,” she says.

    Much of the attention of the ad hoc group focuses on the Harbourfront Community Centre (HCC) – a small, portable building, clean, unvandalized and decorated with posters depicting African-Canadian history.

    Last month, a former youth worker who left the HCC circulated a hard-hitting document summarizing her experience at the centre. She says in it that there is an “apparent ‘normalizing’ of violence within the youth community that has been supported by various adults living and working in the community.”

    She was, she says “physically assaulted at work. There was a general environment of abusiveness that frequently resulted in forceful behaviour.” There was, she says, daily physical, sexual and verbal bullying and manipulation by the young men towards the young women.

    Washrooms and the office, she says, were dangerous places for young girls.

    But HCC executive director, Leona Rodall, sitting in her office – a small janitor’s closet – with tears rolling down her face, denies that she allowed young women to be abused.

    “The BQNA safety committee refused to meet with us,” she says. “We have nothing to hide, but what can we do if we don’t know what the incident is and when? Children’s Aid said there is nothing they can do without names and dates. If safety committee members have information of assaults by minors, they are liable to inform the CAS.”

    The problems faced by youth in the community involve racism and poverty, and this means some aren’t Sunday-school types, she says.

    Rodall supports an inquiry if it clears the air and investigates the validity of the alleged assaults.

    HCC staff believe they are being singled out for blame for the community’s social problems because they are the only service there, and that some residents don’t like the mandate and approach of the HCC, where youth take priority and those charged with criminal acts are not excommunicated.

    Youth worker Robin Ulster says some of the residents insult the youth. She argues that the conflict is a two-way street. She says the issue of public safety is being defined much too narrowly by those arguing for an inquiry.

    “It should take into consideration the safety of youths who experience racism and poverty,” she says.

    “All these incidents of young women being touched, or pushed into the washrooms, I haven’t seen it,” she says.

    One black youth worker at the HCC who helps with the girl’s club, Tamara (she prefers not to use her last name), says rather than being harassed, the young women are very independent and confident.

    Yuppie attitude

    Residents are causing a self-fulfilling prophecy, by backing troubled black male youth against the wall. People who think the easy solution is to rely on police are expressing a “yuppie WASP attitude”, she says.

    Black and white youth interviewed at the HCC say they don’t recognize the scenario the complainants paint. One of them, David, a 12-year-old who has lived in the community since its beginning seven years ago, says it is far safer than other Cityhomes he’s lived in, but “Some of them are prejudiced, nosy people.”

    Toronto Councillor Liz Amer, who sits on the board of the HCC, says while she has helped women transfer out of the neighbourhood, the numbers have been no worse than in other Cityhomes.

    “I know from time to time people do run into problems with neighbours,” says Amer. “The centre is trying to provide recreation services, not police.”

    But Francis Gardner, chair of the tenant association at the Bishop Tutu Cityhome says many people are underestimating the menacing impact, particularly for women, of local teenage boys clustered outside the entrance.

    “It’s easy to trivialize the loitering. But you have to step over their feet, and this lurking – they give young women the once over.”

    Creative Commons License

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    Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License. 

    ORCID iD: https://orcid.org/0000-0001-5311-1052.

    © David South Consulting 2022