As Economic Concerns Rise, Executives Are Reporting Record High Stress and Defaulting To Old Office Habits

Future Forum’s latest report, which surveyed more than 10,000 workers during August, found that overall work satisfaction scores dropped 15% for executives, who also reported work-life balance scores that were 20% worse and work-related stress and anxiety scores that were 40% higher....getty

For months, the pandemic has driven an upswing in burnout among workers, focused attention on employees’ mental health concerns and fueled a wave of departures known as the Great Resignation, most noticeably on the front lines.

But the latest quarterly survey released Thursday from Future Forum, a consortium backed by the messaging platform Slack, finds that now, even senior executives’ sentiments about their jobs are declining—and it appears to be prompting them to fall back on old norms about where and when people work.

Future Forum’s latest report, which surveyed more than 10,000 workers during August, found that overall work satisfaction scores dropped 15% for executives, who also reported work-life balance scores that were 20% worse and work-related stress and anxiety scores that were 40% higher. While the sentiment and experience scores for executives dropped precipitously—particularly among those who work for large companies—those for non-executives remained flat or rose slightly, the report said.

While that might elicit little pity from employees who’ve felt overworked and underpaid over the past two years—and who are also worried about the economic slowdown—the added economic stress for executives can have an impact on the people who work for them, says Slack’s Brian Elliott, the executive leader for Future Forum.

“On top of that set of changes and challenges [from the pandemic], you’re facing a lot of economic pressures too,” says Elliott. “That kind of stress is leading people to go back to what’s familiar and comfortable for them. Executives are saying things like ‘I need my finger on the pulse of the organization’”—otherwise known as monitoring people in the office. “This is the first time we’re seeing this kind of jump and increase in stress in executives.”

Elliott says that whenever he talks to senior leaders—Future Forum does research but also convenes executives to swap ideas—the issues of productivity and culture come up as concerns. But the new data suggests employees work more productively if they have flexibility—and that concerns about culture erosion may be overblown.

Future Forum’s report—released by Slack, which makes tools it hopes will serve as a “digital HQ” for hybrid workers—found that workers who have full flexibility with their schedules say they are 29% more productive and 53% more able to focus than those who have no schedule flexibility.

Meanwhile, remote and hybrid workers were 52% more likely to say company culture has improved over the past two years, compared with those who work onsite daily, even though 25% of executives said “team culture is negatively impacted” by not being together in the office.

“I get why the stress is there on executives, but it’s driving a set of behaviors that are actually contrary to what they want to accomplish,” Elliott says. The report, for instance, also found that 60% of executives surveyed said they are designing policies with little direct input from employees.

He says that could lead organizations to be less competitive when it comes to recruiting talented employees. “If, as a senior leadership team, you’re still basing most of your decisions on the discussions that are happening at this level and not really getting in and understanding it,” Elliott says, “then you’re at risk of going backwards.”

By:

I am a Senior Editor at Forbes, leading our coverage of the workplace, careers and leadership issues. Before joining Forbes, I wrote for the Washington Post for more than a decade covering

Source: As Economic Concerns Rise, Executives Are Reporting Record-High Stress—And Defaulting To Old Office Habits

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How & Why You Should Practice Anti Time Management

How (and why) you should practice ‘anti-time management’[Source Photo: Who’s Denilo/Unsplash]

If you feel overscheduled and overwhelmed, the answer might not be a new productivity hack. You might want to start asking better questions—because how you spend your time is how you show your love, says Richie Norton, author of Anti-Time Management: Reclaim Your Time and Revolutionize Your Results with the Power of Time Tipping.

“We’re all working, but not for work’s sake,” he says. “Ultimately, we’re working for something else.” Norton came to this realization after a string of tragedies. His 21-year-old brother-in-law, Gavin, died in his sleep. His son Gavin, named after his uncle, died at just 10 weeks of age from whooping cough. His wife had a stroke, and his 11-year-old son was hit by a car.

“I was like, ‘Does God hate me?’” he says. “So, I’ve tried to spend my time creating time. How can this job free up space? How can this job support me having more time with my family or more time to travel or more time for the things that really matter, as opposed to endlessly working toward something?”

Norton calls his philosophy Gavin’s Law, which is, “Live to start. Start to live.”

Rethinking Time Management

Norton was a mentee of Stephen Covey, the time management icon and author of The 7 Habits of Highly Effective People. “Stephen said to ‘begin with the end in mind,’” says Norton. “But he never said begin with means in mind. I think, in many ways, we’ve turned goals and habits into ends unto themselves, when in reality, all these things we’re doing are meant for us to live in a different way.”

Traditional time management tools are designed to measure every drop of blood, sweat, and tears from workers, explains Norton. “[They were] never designed for freedom,” he says. “The question is, ‘Who manages my time under time management?’ Traditionally, it is about control. Your employer controls your time. They create your schedule. They tell you what to do when and where. And, if you want to get crazy, they determine that you only have two weeks out of the year for vacation and when you get to retire.”

Norton suggests embracing “anti-time management.” Instead of being the opposite or the reverse, it’s a different level of thinking. “You control your time,” says Norton. “You decide what you want to do, when and where. You decide if you want to create space or not.”

To practice anti-time management, start by identifying “final causes.” “It’s a term from Aristotle,” says Norton. “The idea is [that] an acorn becomes an oak tree. But in real life, a lot of us are planting seeds thinking they’re going to be an oak, when they never will. Why not just plant an oak tree from the start?”

“Final cause” is the sake for which something is done. It’s not the goal; it’s the success that comes from achieving the goal. “Once you realize the final cause, you can change the decision tree around who you want to be and what you really want to do and set up from the dream instead of working endlessly toward it,” says Norton.

For example, you may want to create a table. You might make a design, hire a contractor, and build a table. “That’s great if the goal is to have an heirloom table, but what if the purpose was just to have dinner?” says Norton. “What does success look like after success? Once you understand that, you might realize you could have gotten UberEATS or gone to a food truck. In that process, steps disappear, and you get your time back because the steps weren’t necessary at all.”

“Tip” Time Instead of Managing It

Norton calls the process “time tipping”—rescuing your dream from the end of a timeline and putting it front and center. To tip time and get to the real goal of your goal, you need to get clear on the four Ps of purpose: personal, professional, people, and play.

Your personal purpose relates to the priorities that are just for you, such as health or spirituality. Professional purpose relates to your career, such as promotions or recognition. Your people purpose relates to those around you who are important in your life, such as your family. And your play purpose relates to activities that make you feel energized. Make a list of your Ps, and whenever you have a choice, ask yourself if it fits your purpose priorities.

“They become your North Star,” says Norton. “Does the action bring you closer to or fulfill one of these four goals or not?”

Stop managing time and start prioritizing attention, says Norton. “Pay attention to what you really want, then fast forward the model, going from purpose to priorities to projects,” he says. “The way you’re paid should be in alignment with what you want to be doing. Change the way you work. Change how you’re paid. Change your life. The work you choose determines your lifestyle.”

3 Ways to Reprioritize Your Work Life for a Hybrid World

Credit: Michael Bowles/Getty Images

The world has reopened with a vengeance. Instead of toggling between Zoom, Google Meet, and Teams, we now run among aforementioned platforms and galas, commutes, parent-teacher meetings, conferences, and the block party. If you can’t make something, don’t worry—of course there’s a virtual option. Earbuds must be plentiful in the return to some semblance of normality; excuses are not.

This hybrid juggle appears to be taking a toll. New research from Microsoft finds nearly half of employees and more than half of managers say they’re burned out. A Gallup poll finds that the problem extends far beyond burned-out employees not bringing their best to work — they’re also 63% more likely to call out sick, and more than twice as likely to look elsewhere for a job.

What’s the solution? We need to revamp our approach to three areas of working life in this New World Order: schedules, in-person events, and establishing priorities.

Your calendar isn’t what it used to be.

I have written before about some schedule hacks that can help prevent burnout and overwhelm, including clustering meetings mid-week. That means keeping Monday mornings free to set priorities and Friday afternoons free to wind down.

The last two years democratized meetings in a multitude of ways, as screens leveled “turf” (no your office vs mine, nobody at the head of the table) and opened access (think daily check-ins and more intentional meetings). But you don’t want to feel “prisoner to your calendar,” as Khe Hy often points out in his RadReads blog that covers the intersection of work and productivity, among other topics.

In a Twitter thread earlier this year, Hy confessed distaste for one aspect of calendar management that took off in the pandemic. “Scheduling links never worked for me,” he wrote. “The mix of being self-employed, an active co-parent and wave chaser made my schedule too unpredictable.”

There are other issues with this type of scheduling system. Power dynamics abound when you send someone a link asking them to find time on your calendar. One, you are treating your schedule as sacred and theirs as not, essentially telling them to “get in line.” Two, these requests get weighted the same way with access to the same spots, whether a potential contract is worth $1 million or $500.

In his Twitter thread, Hy called out a product called SavvyCal as a schedule manager that allows for instant booking of meetings between two parties (he’s not paid for the endorsement). Features allows users to prioritize more important meetings, allowing them to override lesser ones.

We are all at a stage, regardless of the software we use, where meetings need such foresight and thought before they occur. The rote and almost-robotic impulse to fill our calendars with talking might even allow us for that other necessity of our jobs: thinking.

Stay present in person.

Scheduling in a hybrid world requires a new awareness of settings, yours and others’, and building in buffer time when needed. If you are attending a conference, for example, running off to make a Zoom right after the panel doesn’t really help create the connections or serendipitous meetings that make in-person gatherings so valuable.

My own practices: I now try to cushion two hours on either side of such gatherings. If I have time to make a quick phone call, I try to prioritize checking in with a colleague or direct report instead of a more formal meeting that requires me to prep or shift modes. I also am trying hard to stop scheduling formal calls in the car, or at the very least be off video and commit to listening versus participating.

Philadelphia-based Tezarah Wilkins, who hosts “Who Taught You How to Drive?!”, a podcast about the culture of cars and driving, doesn’t take meetings while on the road. “I feel like my focus is being split in too many ways. I want to be settled and able to share screens and communicate at a high level in a meeting, and frankly it makes me extremely anxious to even know that people are in their cars driving while we’re on a Zoom,” she says.

“Things have changed quite a bit since the start of the pandemic, but I wish people could leave the urge to multitask to that extent in the past.” Indeed, there’s no place like a car ride to daydream, muse on meetings past, and ponder what’s coming up. We are at a stage where such downtime warrants a schedule override.

We need radical prioritization… of ourselves, too.

The blurry lines between work and home that have characterized the last few years don’t seem to be easing up, even as both seem to be asking more of us. If you’re the parent of school-aged children, you’re likely familiar with the learning loss and mental-health effects the pandemic has wrought. On the work front, we remain in an era of uncertainty over the coming recession, rising prices, and a tight labor market.

A CEO and startup founder I recently met told me he’s all about making his priorities transparent: himself, his family, and only then, his company. Similarly, RadReads’ Hy advocates what he calls “radical prioritization,” a system that acknowledges all outcomes are not equal and thus all inputs should not be either.

How does that work when everything is urgent and important? On his blog, Hy recommended focusing on impact when trying to decide what to do first or what else to take on. An example he offered is between two competing tasks: creating a Twitter thread or a YouTube video. The Tweetstorm will take 30 minutes and will generate 10 new sign-ups,” he wrote. “The YouTube video will take 10 hours and generate 150 sign-ups.” He then calculated, based on the return on effort, that the Tweetstorm should go first. (To be sure, there are additional layers of a calculation based on probability of success.)

Another important part of prioritization, Hy wrote, is knowing the how and why behind every task. “Do you know what you want and why you want it?” he asked. Answering that will help you separate the things that bring you closer to your goals from the things that don’t.

The existential question is critical to this moment as we transition from the pandemic to whatever lies before us. It is the rare person who wants to return to the hamster wheel of pre-pandemic life. As Gallup reported in a recent poll on employee wellbeing, “Wellbeing is often conflated with ‘health,’ but wellbeing isn’t just about the absence of illness or injury, or even the presence of physical fortitude. Wellbeing is about a life well lived; it is about being fulfilled in the aspects of life that matter most.”

That fulfillment rests on knowing where to direct our energy. The antidote to the overwhelm and burnout we know all too well is figuring out what matters most, and why.

By S. Mitra Kalita

Source: 3 Ways to Reprioritize Your Work Life for a Hybrid World | Time

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16 Smart And Effective Uses For Digital Twin Technology

Members of Forbes Technology Council discuss smart and effective uses for digital twin technology. Photos courtesy of the individual members. 

A digital twin is precisely what its name suggests: A digital copy of a physical object or system—even a human being. It may be a simple concept, but the potential applications are anything but. Through the ongoing collection and exchange of data, a digital twin can simulate and even predict the behaviors and reactions of its physical twin in a variety of conditions, providing invaluable insights to industries ranging from manufacturing to healthcare.

Digital twin technology allows businesses and organizations to test products and processes, study and predict how real-world conditions can affect physical objects and beings, and make well-informed, big-impact decisions with minimized financial and human safety risks. Below, 16 members of Forbes Technology Council share some of the fascinating ways industries and organizations are leveraging digital twin technology.

1. Minimizing Manufacturing Waste

We at Cuby use digital twin technology to make sure we produce 1-to-1 kits of the parts needed in our prefab construction process. It’s been estimated that up to 40% of the solid waste in the U.S. is construction and demolition waste. Manufacturing all the parts in advance allows us to reduce waste by up to 90%. – Aleksandr Gampel, Cuby Technologies, Inc.

2. Building Resilient Supply Chains

Businesses are increasingly using digital twin technology to build resilient and responsive supply chains. The digitization of supply chain processes provides businesses the opportunity to increase organizational efficiency by predicting serious problems and deceleration. In fact, it is estimated that by 2025, 80% of participants in industry ecosystems will rely on digital twin technology. – Radhika Krishnan, Hitachi Vantara

3. Mitigating Disruptions Due To Weather And Climate

Businesses are using digital twin technology to mitigate climate-related disruption. By combining data from public sources, such as weather data, with data from suppliers and partners, leaders can see how an unplanned weather event might impact the flow of goods across their supply chain, then use this insight to quickly pivot orders, routes or suppliers to limit waste and meet demand. – Rohit Shrivastava, Anaplan

4. Studying And Refining Processes

Process mining combined with simulation gives reliable visibility into as-executed processes (versus relying on what somebody thinks is happening) and the ability to do “what-if” analyses. This is effective because it allows one to see what’s really happening and simulate changes before making them. Often, changes do nothing or create a bigger problem elsewhere. Simulation and mining prevent that. – Michael Nyman, iGrafx

5. Making Data-Driven Manufacturing Decisions

The utilization of digital twins in the manufacturing industry has seen large growth. Digital twins increase productivity and reduce costs by combining the physical and digital worlds to make data-driven decisions, prolong asset life cycles and minimize unexpected maintenance disruption across assets. This modernizes the sector by moving from the “break and fix” approach to proactive maintenance. – Cindy Jaudon, IFS

6. Testing Health Intervention And Engagement Strategies

Health outcomes improve when patients are confident, connected and engaged. Digital twin technologies provide healthcare organizations the option to test drive new interventions and engagement strategies. This lowers the risks of rolling out new programs by testing hypotheses through a simulated pilot while also enabling cost-conscious innovation. – Trisha Swift, PricewaterhouseCoopers

7. Improving Patient Outcomes

A digital twin enables accurate and continuous monitoring. That data flow can inform data-driven decisions. For example, doctors are using an individual’s genetic makeup to model new organs for transplant. Because these processes can leverage a populationwide data set of digital twins, they can replicate an individual human body’s internal system to improve treatment outcomes for all. – Nicholas Domnisch, EES Health

8. Expanding Professional Services Capabilities

Knowledge-rich professional services firms are building digital twins of accountants, advisors and auditors using graph-based intelligent automation. These are distinct from previous technologies, because the decisions these professionals make are complex, contextual and nonlinear. In a world where there are big skills shortages and raging inflation, this form of IA is closing the gap. – James Duez, Rainbird Technologies

9. Onboarding And Knowledge Sharing

A digital twin use case that is an easy entry point and can provide quick ROI is training or onboarding. In areas where experienced employees are preparing for retirement, where there is high turnover or where there are general labor shortages, having a prerecorded “virtual” expert that can walk you through the instructions in real time can be a game changer and is much more effective than a giant paper manual. – Samantha Williams, Sonoco

10. Providing Safe Training

Today, manufacturing organizations are leveraging digital twin technologies to replicate machinery that would typically put employees in harm’s way. Here, a virtualized version of the original piece of machinery can be used to give employees training experience with the virtual machinery without also putting the employee’s health and safety in peril. – Marc Fischer, Dogtown Media LLC

11. Understanding Multidimensional Problems

Digital twin technology shines the brightest when it helps companies better understand a multidimensional problem—one that is too complex to easily solve. Because it is a way to visualize and make better decisions, the technology has become extremely effective for everything from product design to diagnosing medical issues to better understanding variables that affect business expenses. – Josh Dunham, Reveel

12. Improving Manufacturing Efficiencies

A very interesting field of application is manufacturing. Thanks to a digital twin of a production plant, with all its different lines and machines, we can launch simulations to generate greater efficiency or to detect potential bottlenecks. Simulating the manufacture of new products or variants of existing products is also a very useful application. – Miguel Llorca, Torrent Group

13. Developing And Training Self-Driving Vehicles

Without digital twin technology, it would be impossible to develop self-driving vehicles at the scale and with the reliability we are witnessing nowadays. Billions of simulations on a “virtual road” by a “virtual car” allow for training machine learning models to forecast accidents and plan not just the fastest, but also the safest, routes so that drivers can entrust the actual driving to robots. – Aleks Farseev, SoMin.ai

14. Budgeting And Financial Planning

Financial and operational data is the lifeblood of a company, but it’s difficult to “see all of it” and understand it in real time. Digital twins offer real-time, big-data-enabled simulation modeling that can be particularly useful for budget and financial planning. The technology can streamline tasks such as procurement, case management and capital resiliency and deliver powerful insights for finance leaders. – Nicola Morini Bianzino, EY

15. Managing Traffic

Digital twins are already effectively used by urban planning councils in many U.S. cities for efficient traffic management. They help in simulating real-world congestion at junctions, predicting what may get worse when and where, and they can be used to test multiple mitigation techniques by leveraging the best mix of ML and city know-how. Dashcam-backed digital twins are explored alongside junction twins. – Pramod Konandur Prabhakar, Pelatro PLC

16. Simulating Real-World Conditions

One way businesses are leveraging digital twin technology is by using it to simulate the physical world. For example, a company can use a digital twin to simulate a real-life situation so that they can predict how their product or service will behave in that environment. Another way is by using it to understand how their customers use their services and products. – Leon Gordon, Pomerol Partners

Successful CIOs, CTOs & executives from Forbes Technology Council offer firsthand insights on tech & business.

Source: Council Post: 16 Smart And Effective Uses For Digital Twin Technology

Critics By Carlos Miskinis Digital twin research expert

To explain what Digital Twin means in simple words, it is a digital replica or a representation of a physical object (e.g. aircraft engine, person, vehicle) or an intangible system (e.g. marketing funnel, fulfillment process) that can be examined, altered and tested without interacting with it in the real world and avoiding negative consequences.

Think of it as an online platform for testing, creating and altering objects that are based in reality, without engaging with them in the real world itself. Technologies similar to this one have been used in various industries long before this concept was created, however, this new definition of the technology has much more potential, power, and scalability that can replicate, monitor and test virtually anything you can think of.

The rise of the Internet of Things (IoT) has complimented the adoption of this new technology, as IoT has resulted in its cost-effective implementation. Virtual twins have become imperative to business today, consistently named as a strategic technology trend in recent years. The complexity of technology has led to many questions within the industry. One of the most important ones is how is it changing the way design, planning, manufacturing, operation, simulation, and forecasting is traditionally functioning?

A physical twin that was replicated on a virtual platform is a near real-time digitized copy of a physical object. It is a bridge between the digital world and the physical world. Its core use is to optimize business performance, through the analysis of data and the monitoring of systems to prevent issues before they occur and prevent downtime. The simulations that are produced will help to develop and plan future opportunities and updates within the process or product.

 The benefits of virtual twin technology are astronomical, with industries such as agriculture, government, transportation and retail experiencing rewards from the technology and benefits going forward. Companies must find methods to prevent the risk of potential product defects among their assets and future products. This piece of tech allows production costs to be minimized, as companies will save expenses when products are right the first time.

There is no need for expensive physical tests or updates to the products or process. Research with manufacturers has found that this concept will enable the reduction of development costs of the next generation of machines by well over 50%. The features of the tech also provide added confidence to boost product performance and aid complex decisions, preventing costly downtime to robotics and machinery.

The core benefit of why most companies started twinning their processes, products, and services via simulations is due to their efficiency. Businesses are racing to market their product faster than their competition, and having the ability to virtually simulate scenarios where a product is tested for failure via multiple angles helps the situation immensely. Not mentioning the fact that the development and testing costs are usually reduced hundreds of times.

This technology will be able to anticipate how the product and process will perform through digital simulations and analysis. The accessibility of reliable and consistently updated information provides the assurance needed to make faster decisions and increase the speed of production to overtake competitors. Here is a use case infographic we have presented in our workshop about understanding virtual twins – find event information here.

We can see how a virtual twin simulation is used to replicate and optimize machinery that regulates water flow in a factory. By doing this, developers can see every moving detail on the screen and then make the calculated decision to upgrade, optimize or make positive changes accordingly. Offices that adopt this technology early will attract innovative and leading talent. Offices will be able to incorporate interactive features to improve employee satisfaction and productivity using data-driven simulations.

Employees who will use digital twin technology will be able to expand their engagement with online tools, such as interactive maps to locate colleagues on the floor, book meetings and complete tasks with more diligence and accuracyManagers will also be able to supervise remotely with the tool that will be similar to a 3D map that will be created using virtual online platforms that are based on simulations.

 It is evident that the digital twin concept will benefit many people within the supply chain. Combining this disruptive concept with IoT technology is an incredible opportunity for businesses to improve. Ultimately, it will also allow stakeholders to improve the overall efficiency and cost of their business, and improve many aspects of work for employees….

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Allergic To The World: Can Medicine Help People With Severe Intolerance To Chemicals

Sharon calls herself a universal reactor. In the 1990s, she became allergic to the world, to the mould colonising her home and the paint coating her kitchen walls, but also deodorants, soaps and anything containing plastic. Public spaces rife with artificial fragrances were unbearable. Scented disinfectants and air fresheners in hospitals made visiting doctors torture. The pervasiveness of perfumes and colognes barred her from in-person social gatherings.

Even stepping into her own back garden was complicated by the whiff of pesticides and her neighbour’s laundry detergent sailing through the air. When modern medicine failed to identify the cause of Sharon’s illness, exiting society felt like her only solution. She started asking her husband to strip and shower every time he came home. Grandchildren greeted her through a window. When we met for the first time, Sharon had been housebound for more than six years.

When I started medical school, the formaldehyde-based solutions used to embalm the cadavers in the human anatomy labs would cause my nose to burn and my eyes to well up – representing the mild, mundane end of a chemical sensitivity spectrum. The other extreme of the spectrum is an environmental intolerance of unknown cause (referred to as idiopathic by doctors) or, as it is commonly known, multiple chemical sensitivity (MCS).

An official definition of MCS does not exist because the condition is not recognised as a distinct medical entity by the World Health Organization or the American Medical Association, although it has been recognised as a disability in countries such as Germany and Canada.

Disagreement over the validity of the disease is partially due to the lack of a distinct set of signs and symptoms, or an accepted cause. When Sharon reacts, she experiences symptoms from seemingly every organ system, from brain fog to chest pain, diarrhoea, muscle aches, depression and odd rashes. There are many different triggers for MCS, sometimes extending beyond chemicals to food and even electromagnetic fields. Consistent physical findings and reproducible lab results have not been found and, as a result, people such as Sharon not only endure severe, chronic illness but also scrutiny over whether their condition is “real”.

The first reported case of MCS was published in the Journal of Laboratory and Clinical Medicine in 1952 by the American allergist Theron Randolph. Although he claimed to have previously encountered 40 cases, Randolph chose to focus on the story of one woman, 41-year-old Nora Barnes. She had arrived at Randolph’s office at Northwestern University in Illinois with a diverse and bizarre array of symptoms.

A former cosmetics salesperson, she represented an “extreme case”. She was always tired, her arms and legs were swollen, and headaches and intermittent blackouts ruined her ability to work. A doctor had previously diagnosed her with hypochondria, but Barnes was desperate for a “real” diagnosis.

Randolph noted that the drive into Chicago from Michigan had worsened her symptoms, which spontaneously resolved when she checked into her room on the 23rd floor of a hotel where, Randolph reasoned, she was far away from the noxious motor exhaust filling the streets. In fact, in his report Randolph listed 30 substances that Barnes reacted to when touched (nylon, nail polish), ingested (aspirin, food dye), inhaled (perfume, the “burning of pine in fireplace”) and injected (the synthetic opiate meperidine, and Benadryl).

He posited that Barnes and his 40 other patients were sensitive to petroleum products in ways that defied the classic clinical picture of allergies. That is, rather than an adverse immune response, such as hives or a rash where the body is reacting to a particular antigen, patients with chemical sensitivities were displaying an intolerance. Randolph theorised that, just as people who are lactose-intolerant experience abdominal pain, diarrhoea and gas because of undigested lactose creating excess fluid in their gastrointestinal tract, his patients were vulnerable to toxicity at relatively low concentrations of certain chemicals that they were unable to metabolise.

He even suggested that chemical sensitivity research was being suppressed by “the ubiquitous distribution of petroleum and wood products”. MCS, he believed, was not only a matter of scientific exploration, but also of deep-seated corporate interest. Randolph concludes his report with his recommended treatment: avoidance of exposure.

In that one-page abstract, Randolph cut the ribbon on the completely novel but quickly controversial field of environmental medicine. Nowadays, we hardly question the ties between the environment and wellbeing. The danger of secondhand smoke, the realities of climate change and the endemic nature of respiratory maladies such as asthma are common knowledge. The issue was that Randolph’s patients lacked abnormal test results (specifically, diagnostic levels of immunoglobulin E, a blood marker that is elevated during an immune response). Whatever afflicted them were not conventional allergies, so conventional allergists resisted Randolph’s hypotheses.

Randolph was in the dark. Why was MCS only now rearing its head? He also asked another, more radical question: why did this seem to be a distinctly American phenomenon? After all, the only other mention of chemical sensitivities in medical literature was in the US neurologist George Miller Beard’s 1880 textbook A Practical Treatise on Nervous Exhaustion (Neurasthenia).

Beard argued that sensitivity to foods containing alcohol or caffeine was associated with neurasthenia, a now-defunct term used to describe the exhaustion of the nervous system propagated by the US’s frenetic culture of productivity. Like Beard, Randolph saw chemical sensitivities as a disease of modernity, and conceived the origin as wear-and-tear as opposed to overload.

Randolph proposed that Americans, propelled by the post-second world war boom, had encountered synthetic chemicals more and more in their workplaces and homes, at concentrations considered acceptable for most people. Chronic exposure to these subtoxic dosages, in conjunction with genetic predispositions, strained the body and made patients vulnerable. On the back of this theory, Randolph developed a new branch of medicine and, with colleagues, founded the Society for Clinical Ecology, now known as the American Academy of Environmental Medicine.

As his professional reputation teetered, his popularity soared and patients flocked to his care. Despite this growth in interest, researchers never identified blood markers in MCS patients, and trials found that people with MCS couldn’t differentiate between triggers and placebos. By 2001, a review in the Journal of Internal Medicine found MCS virtually nonexistent outside western industrialised countries, despite the globalisation of chemical use, suggesting that the phenomenon was culturally bound.

MCS subsequently became a diagnosis of exclusion, a leftover label used after every other possibility was eliminated. The empirical uncertainty came to a head in 2021, when Quebec’s public health agency, the INSPQ, published an 840-page report that reviewed more than 4,000 articles in the scientific literature, concluding that MCS is an anxiety disorder.

In medicine, psychiatric disorders are not intrinsically inferior; serious mental illness is, after all, the product of neurological dysfunction. But the MCS patients I spoke to found the language offensive and irresponsible. Reducing what they felt in their eyes, throats, lungs and guts to anxiety was not acceptable at all.

As a woman I will call Judy told me: “I would tell doctors my symptoms, and then they’d run a complete blood count and tell me I looked fine, that it must be stress, so they’d shove a prescription for an antidepressant in my face and tell me to come back in a year.” In fact, because MCS is so stigmatising, such patients may never receive the level of specialised care they need.

In the wake of her “treatment”, Judy was frequently bedbound from crushing fatigue, and no one took her MCS seriously. “I think a lot of doctors fail to understand that we are intelligent,” she said. “A lot of us with chemical sensitivities spend a good amount of our time researching and reading scientific articles and papers. I probably spent more of my free time reading papers than most doctors.”

Judy grew up in Texas, where she developed irritable bowel syndrome and was told by doctors that she was stressed. Her 20s were spent in Washington state where she worked as a consultant before a major health crash left her bedbound for years (again, the doctors said she was stressed). Later, after moving to Massachusetts, a new paint job at her home gave her fatigue and diarrhoea.

She used to browse the local art museum every Saturday, but even fumes from the paintings irritated her symptoms. She visited every primary care doctor in her city, as well as gastroenterologists, cardiologists, neurologists, endocrinologists and even geneticists. Most of them reacted the same way: with a furrowed brow and an antidepressant prescription in hand. “Not one allopathic doctor has ever been able to help me,” Judy said.

Morton Teich is one of the few physicians who diagnoses and treats patients with MCS in New York. The entrance to his integrative medicine private practice is hidden away behind a side door in a grey-brick building on Park Avenue. As I entered the waiting room, the first thing to catch my eye was the monstrous mountain of folders and binders precariously hugging a wall, in lieu of an electronic medical record.

I half-expected Teich’s clinic to resemble the environmental isolation unit used by Randolph in the 1950s, with an airlocked entrance, blocked ventilation shafts and stainless-steel air-filtration devices, books and newspapers in sealed boxes, aluminium walls to prevent electromagnetic pollution, and water in glass bottles instead of a cooler. But there were none of the above. The clinic was like any other family medicine practice I had seen before; it was just very old. The physical examination rooms had brown linoleum floors and green metal chairs and tables. And there were no windows.

Although several of Teich’s patients were chemically sensitive, MCS was rarely the central focus of visits. When he introduced me, as a student writing about MCS, to his first patient of the day, a petrol-intolerant woman whose appointment was over the phone because she was housebound, she admitted to never having heard of the condition. “You have to remember,” Teich told me, “that MCS is a symptom. It’s just one aspect of my patients’ problems. My goal is to get a good history and find the underlying cause.” Later, when I asked him whether he had observed any patterns suggesting an organic cause of MCS, he responded: “Mould. Almost always.”

Many people with MCS I encountered online also cited mould as a probable cause. Sharon told me about her first episode in 1998, when she experienced chest pain after discovering black mould festering in her family’s trailer home. A cardiac examination had produced no remarkable results, and Sharon’s primary care physician declared that she was having a panic attack related to the stress of a recent miscarriage. Sharon recognised that this contributed to her sudden health decline, but also found that her symptoms resolved only once she began sleeping away from home.

She found recognition in medical books such as Toxic (2016) by Neil Nathan, a retired family physician who argued that bodily sensitivities were the product of a hyper-reactive nervous system and a vigilant immune system that fired up in reaction to toxicities, much as Randolph had said. The conditions that Nathan describes are not supported by academic medicine as causes of MCS: mould toxicity and chronic Lyme disease are subject to the same critique.

Sharon went to see William Rea, a former surgeon (and Teich’s best friend). Rea diagnosed her with MCS secondary to mould toxicity. “Mould is everywhere,” Teich told me. “Not just indoors. Mould grows on leaves. That’s why people without seasonal allergies can become chemically sensitive during autumn.” When trees shed their leaves, he told me, mould spores fly into the air. He suspected that American mould is not American at all, but an invasive species that rode wind currents over the Pacific from China. He mentioned in passing that his wife recently died from ovarian cancer. Her disease, he speculated, also had its roots in mould.

In fact, Teich commonly treats patients with nystatin, an antifungal medication used to treat candida yeast infections, which often infect the mouth, skin and vagina. “I have an 80% success rate,” he told me. I was dubious that such a cheap and commonplace drug was able to cure an illness as debilitating as MCS, but I could not sneer at his track record. Every patient I met while shadowing Teich was comfortably in recovery, with smiles and jokes, miles apart from the people I met in online support groups who seemed to be permanently in the throes of their illness.

However, Teich was not practising medicine as I was taught it. This was a man who believed that the recombinant MMR vaccine could trigger “acute autism” – traditionally an anti-science point of view. When one of his patients, a charismatic bookworm I’ll call Mark, arrived at an appointment with severe, purple swelling up to his knees and a clear case of stasis dermatitis (irritation of the skin caused by varicose veins), Teich reflexively blamed mould and wrote a prescription for nystatin instead of urging Mark to see a cardiologist.

When I asked how a fungal infection in Mark’s toes could cause such a bad rash on his legs, he responded: “We have candida everywhere, and its toxins are released into the blood and travel to every part of the body. The thing is, most people don’t notice until it’s too late.” Moulds and fungi are easy scapegoats for inexplicable illnesses because they are so ubiquitous in our indoor and outdoor environments. A great deal of concern over mould toxicity (or, to use the technical term, mycotoxicosis) stems from the concept of “sick-building syndrome”, in which visible black mould is thought to increase sensitivity and make people ill.

This was true of Mark, who could point to the demolition of an old building across the street from his apartment as a source of mould in the atmosphere. Yet in mainstream medicine, diseases caused by moulds are restricted to allergies, hypersensitivity pneumonitis (an immunologic reaction to an inhaled agent, usually organic, within the lungs) and infection.

Disseminated fungal infections occur almost exclusively in patients who are immunocompromised, hospitalised or have an invasive foreign body such as a catheter. Furthermore, if “clinical ecologists” such as Teich are correct that moulds such as candida can damage multiple organs, then it must be spreading through the bloodstream. But I have yet to encounter a patient with MCS who reported fever or other symptoms of sepsis (the traumatic, whole-body reaction to infection) as part of their experience.

Teich himself did not use blood cultures to verify his claims of “systemic candidiasis”, and instead looked to chronic fungal infection of the nails, common in the general population, as sufficient proof.

“I don’t need tests or blood work,” he told me. “I rarely ever order them. I can see with my eyes that he has mould, and that’s enough.” It was Teich’s common practice to ask his patients to remove their socks to reveal the inevitable ridges and splits on their big toenails, and that’s all he needed.

Through Teich, I met a couple who were both chemically sensitive but otherwise just regular people. The wife, an upper-middle-class white woman I will call Cindy, had a long history of allergies and irritable bowel syndrome. She became ill whenever she smelled fumes or fragrances, especially laundry detergent and citrus or floral scents. Teich put both her and her husband on nystatin, and their sensitivities lessened dramatically.

What struck me as different about her case, compared with other patients with MCS, was that Cindy was also on a course of antidepressants and cognitive behavioural therapy, the standard treatment for anxiety and depression. “It really helps to cope with all the stress that my illness causes. You learn to live despite everything,” she said.

In contemporary academic medicine, stress and anxiety cause MCS, but MCS can itself cause psychiatric symptoms. Teich later told me, unexpectedly, that he had no illusions about whether MCS is a partly psychiatric illness: “Stress affects the adrenals, and that makes MCS worse. The mind and the body are not separate. We have to treat the whole person.”

To understand this case, I also spoke to Donald Black, associate chief of staff for mental health at the Iowa City Veterans Administration Health Care. He co-authored a recent article on idiopathic environmental intolerance that took a uniform stance on MCS as a psychosomatic disorder. In 1988, when Black was a new faculty member at the University of Iowa, he interviewed a patient entering a drug trial for obsessive-compulsive disorder.

He asked the woman to list her medications, and watched as she started unloading strange supplements and a book about environmental illness from her bag. The woman had been seeing a psychiatrist in Iowa City – a colleague of Black’s – who had diagnosed her with systemic candidiasis. Black was flummoxed. If that diagnosis was true, then the woman would be very ill, not sitting calmly before him.

Besides, it was not up to a psychiatrist to treat a fungal infection. How did he make the diagnosis? Did he do a physical or run blood tests? No, the patient told him, the psychiatrist just said that her symptoms were compatible with candidiasis. These symptoms included chemical sensitivities. After advising the patient to discard her supplements and find a new psychiatrist, Black made some phone calls and discovered that, indeed, his colleague had fallen in with the clinical ecologists.

Black was intrigued by this amorphous condition that had garnered an endless number of names: environmentally induced illness, toxicant-induced loss of tolerance, chemical hypersensitivity disease, immune dysregulation syndrome, cerebral allergy, 20th-century disease, and mould toxicity. In 1990, he solicited the aid of a medical student to find 26 subjects who had been diagnosed by clinical ecologists with chemical sensitivities and to conduct an “emotional profile”.

Every participant in their study filled out a battery of questions that determined whether they satisfied any of the criteria for psychiatric disorders. Compared with the controls, the chemically sensitive subjects had 6.3 times higher lifetime prevalence of major depression, and 6.8 times higher lifetime prevalence of panic disorder or agoraphobia; 17% of the cases met the criteria for somatisation disorder (an extreme focus on physical symptoms – such as pain or fatigue – that causes major emotional distress and problems functioning).

In my own review of the literature, it was clear that the most compelling evidence for MCS came from case studies of large-scale “initiating events” such as the Gulf war (where soldiers were uniquely exposed to pesticides and pyridostigmine bromide pills to protect against nerve agents) or the terrorist attacks on the US of 11 September 2001 (when toxins from the falling towers caused cancers and respiratory ailments for years).

In both instances, a significant number of victims developed chemical intolerances compared with populations who were not exposed. From a national survey of veterans deployed in the Gulf war, researchers found that up to a third of respondents reported multi-symptom illnesses, including sensitivity to pesticides – twice the rate of veterans who had not deployed.

Given that Gulf war veterans experienced post-traumatic stress disorder at levels similar to those in other military conflicts, the findings have been used to breathe new life into Randolph’s idea of postindustrial toxicities leading to intolerance. The same has been said of the first responders and the World Trade Centre’s nearby residents, who developed pulmonary symptoms when exposed to “cigarette smoke, vehicle exhaust, cleaning solutions, perfume, or other airborne irritants” after 9/11, according to a team at Mount Sinai.

Black, who doubts a real disease, has no current clinical experience with MCS patients. (Apart from the papers he wrote more than 20 years ago, he had seen only a handful of MCS patients over the course of his career.) Despite this, he had not only written the article about MCS, but also a guide in a major online medical manual on how to approach MCS treatment as a psychiatric disease. When I asked him if there was a way for physicians to regain the trust of patients who have been bruised by the medical system, he simply replied:

“No.” For him, there would always be a subset of patients who are searching for answers or treatments that traditional medicine could not satisfy. Those were the people who saw clinical ecologists, or who left society altogether. In a time of limited resources, these were not the patients on which Black thought psychiatry needed to focus. It became clear to me why even the de facto leading professional on MCS had hardly any experience actually treating MCS.

In his 1990 paper, Black – then a young doctor – rightly observed that “traditional medical practitioners are probably insensitive to patients with vague complaints, and need to develop new approaches to keep them within the medical fold.  The study subjects clearly believed that their clinical ecologists had something to offer them that others did not: sympathy, recognition of pain and suffering, a physical explanation for their suffering, and active participation in medical care.”I wondered if Black had given up on these “new approaches” because few CS patients wanted to see a psychiatrist in the first place.

Physicians on either side of the debate agreed that mental illness is a crucial part of treating MCS, with one I spoke to believing that stress causes MCS, and another believing that MCS causes stress. To reconcile the views, I interviewed another physician, Christine Oliver, a doctor of occupational medicine in Toronto, where she has served on the Ontario Task Force on Environmental Health. Oliver believes that both stances are probably valid and true. “No matter what side you’re on,” she told me, “there’s a growing consensus that this is a public health problem.”

Oliver represents a useful third position, one that takes the MCS illness experience seriously while sticking closely to medical science. As one of few “MCS-agnostic” physicians, she believes in a physiological cause for MCS that we cannot know and therefore cannot treat directly due to lack of research. Oliver agrees with Randolph’s original suggestion of avoiding exposures, although she understands that this approach has resulted in traumatising changes in patients’ abilities to function. For her, the priority for MCS patients is a practical one: finding appropriate housing.

Often unable to work and with a limited income, many of her patients occupy public housing or multi-family dwellings. The physician of an MCS patient must act like a social worker. Facilities such as hospitals, she feels, should be made more accessible by reducing scented cleaning products and soaps. Ultimately, finding a non-threatening space with digital access to healthcare providers and social support is the best way to allow the illness to run its course.

Whether organic or psychosomatic or something in between, MCS is a chronic illness. “One of the hardest things about being chronically ill,” wrote the American author Meghan O’Rourke in the New Yorker in 2013 about her battle against Lyme disease, “is that most people find what you’re going through incomprehensible – if they believe you are going through it. In your loneliness, your preoccupation with an enduring new reality, you want to be understood in a way that you can’t be.”

A language for chronic illness does not exist beyond symptomatology, because in the end symptoms are what debilitate “normal” human functioning. In chronic pain, analgesics can at least deaden a patient’s suffering. The same cannot be said for MCS symptoms, which are disorienting in their chaotic variety, inescapability and inexpressibility. There are few established avenues for patients to completely avoid triggering their MCS, and so they learn to orient their lives around mitigating symptoms instead, whether that is a change in diet or moving house, as Sharon did. MCS comes to define their existence.

As a housebound person, Sharon’s ability to build a different life was limited. Outside, the world was moving forward, yet Sharon never felt left behind. What allowed her to live with chronic illness was not medicine or therapy, but the internet. On a typical day, Sharon wakes up and prays in bed. She wolfs down handfuls of pills and listens to upbeat music on YouTube while preparing her meals for the day: blended meats and vegetables, for easier swallowing.

The rest of the day is spent on her laptop computer, checking email and Facebook, watching YouTube videos until her husband returns home in the evening. Then bed. This is how Sharon has lived for the past six years, and she does not expect anything different from the future. When I asked her if being homebound was lonely, I was taken aback at her reply: “No.”

In spite of not having met most of her 15 grandchildren (with two more on the way), Sharon keeps in daily contact with all of them. In fact, Sharon communicates with others on a nearly constant basis. “Some people are very much extroverts,” Sharon wrote. “I certainly am. But there are also people who need physical touch … and I can understand why they might need to see ‘real people’ then … but it’s very possible to be content with online friends. This is my life!”

The friendships that Sharon formed online with other housebound people with chronic illnesses were the longest-lasting and the most alive relationships she had ever known. She had never met her best friend of 20 years – their relationship existed completely through letters and emails, until two years ago, when the friend died. That “was very hard for me”, Sharon wrote.

The pandemic changed very little of Sharon’s life. If anything, Covid-19 improved her situation. Sharon’s local church live-streamed Sunday service, telehealth doctor appointments became the default, YouTube exploded in content, and staying indoors was normalised. Sharon saw her network steadily expand as more older adults became isolated in quarantine.

People within the online MCS community call themselves “canaries”, after the birds historically used as sentinels in coalmines to detect toxic levels of carbon monoxide. With a higher metabolism and respiratory rate, the small birds would theoretically perish before the less-sensitive human miners, providing a signal to escape. The question for people with MCS is: will anyone listen?

“Us canaries,” said a woman named Vera, who was bedbound from MCS for 15 years after a botched orthopaedic surgery, “we struggle and suffer in silence.” Now, in the information age, they have colonised the internet to find people like themselves. For our part, we must reimagine chronic illness – which will become drastically more common in the aftermath of the pandemic – where what matters to the patient is not only a scientific explanation and a cure, but also a way to continue living a meaningful life.

This calls into action the distinction between illness and disease that the psychiatrist and anthropologist Arthur Kleinman made in his 1988 book The Illness Narratives. Whereas a disease is an organic process within the body, illness is the lived experience of bodily processes. “Illness problems,” he writes, “are the principal difficulties that symptoms and disability create in our lives.”

By centring conversations about MCS on whether or not it is real, we alienate the people whose illnesses have deteriorated their ability to function at home and in the world. After all, the fundamental mistrust does not lie in the patient-physician relationship, but between patients and their bodies. Chronic illness is a corporeal betrayal, an all-out assault on the coherent self. Academic medicine cannot yet shed light on the physiological mechanisms that would explain MCS. But practitioners and the rest of society must still meet patients with empathy and acceptance, making space for their narratives, their lives, and their experience in the medical and wider world.

After two years of wrangling, false starts and disappointments, it finally happened: America has passed its first-ever climate legislation, moving the country closer to its goal of a decarbonized future and taking a significant step toward helping the planet avert the worst scenarios of climate catastrophe.

But it’s not a time to rest. We have always held power to account – on climate and  every other major issue – from the fossil fuel companies responsible for heating the planet to the politicians representing their interests. The country responsible for the most greenhouse gas emissions in history has indicated it will change course; we will relentlessly report on what comes next, who will benefit and the remaining obstacles to progress.

With daily reporting and analysis on the climate emergency, we aim to ensure that even more people are made aware of the dangers – and opportunities – of this moment.

By

Source: Allergic to the world: can medicine help people with severe intolerance to chemicals? | Health & wellbeing | The Guardian

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10 Bold Actions In Positive Life & Work                https://jvz3.com/c/202927/383942/
360Apps                https://jvz2.com/c/202927/263380
3D Pal Toons                https://jvz6.com/c/202927/381689/
4brandcommercial        https://jvz1.com/c/202927/375487
7 Minutes Kit                    https://jvz8.com/c/202927/374505/
9 figure Success               https://jvz8.com/c/202927/384653/
Ad Raven                       https://jvz4.com/c/202927/382796/
Ada leadz                           https://jvz8.com/c/202927/376381
ADA Web                        https://jvz3.com/c/202927/383751/
AdRaven                          https://jvz3.com/c/202927/382851/
Adsense Machine                  https://jvz2.com/c/202927/290487
Adtivate Agency                   https://jvz3.com/c/202927/383706/
AdzHero                      https://jvz2.com/c/202927/366972/
AffiliateMatic                 https://jvz3.com/c/202927/381148/
Agency Client Finder             https://jvz3.com/c/202927/384619/
AgencyScale              https://jvz4.com/c/202927/383111/
Agencyscale                      https://jvz1.com/c/202927/383113/
AIWA Commercial              https://jvz2.com/c/202927/365061
AIWA22                           https://jvz6.com/c/202927/377907/
ALL-in-One HD Stock          https://jvz4.com/c/202927/381560
Animaxime                   https://jvz2.com/c/202927/383307/
Appimize                            https://jvz8.com/c/202927/370227
Appoint B Agency            https://jvz1.com/c/202927/384630/
Appointomatic               https://jvz6.com/c/202927/374258
Appowls                     https://jvz4.com/c/202927/381231/
AppOwls                https://jvz4.com/c/202927/381976/ Bundle
Art Of Living                       https://jvz4.com/c/202927/382425/
Audiencetoolkit              https://jvz6.com/c/202927/302715
Aweber Crash Course          https://jvz6.com/c/202927/383057/
Backlinkindexer           https://jvz6.com/c/202927/88118
BevTraders              http://www.bevtraders.com/?ref=arminham
Big Audio Club              https://jvz6.com/c/202927/380087/
BigAudio Club                   https://jvz2.com/c/202927/380877/
Boost Optimism                    https://jvz2.com/c/202927/380692/
BrandElevate                  https://jvzoo.com/c/202927/381812
BrandElevate                https://jvz4.com/c/202927/381807/
Bybit Crypto Trade  https://www.bybit.com/en-US/invite?ref=ALEXP
CanvaKitz                     https://jvz4.com/c/202927/379051/
ChatterPal Commercial                 https://jvz8.com/c/202927/324615
Clientfinda                     https://jvz8.com/c/202927/370806
Clipsreel                             https://jvz3.com/c/202927/372682
Commission smasher          https://jvz3.com/c/202927/376879
Content Gorilla              https://jvz2.com/c/202927/330783
Content Tool Kit                     https://jvz3.com/c/202927/329145/
CourseAlly eLearning                      https://jvz4.com/c/202927/384759/
CourseReel                          https://jvz6.com/c/202927/355256/
CourseReel                        https://jvz2.com/c/202927/355249
Courserious                       https://jvz8.com/c/202927/360397/
Coursova                         https://jvz1.com/c/202927/376527
Creaitecontentcreator          https://jvz1.com/c/202927/376986
Credit Repair                        https://jvz8.com/c/202927/377815/
Crypto Kit                     https://jvz8.com/c/202927/383809/
Crypto Rocket                     https://jvz6.com/c/202927/378113/
Crypto Underworld                           https://jvz8.com/c/202927/374345/
Dealcheck                                  https://dealcheck.io?fp_ref=armin16
Design beast               https://jvz6.com/c/202927/371547
Designa Suite License                  https://jvz2.com/c/202927/297271
Develop Self Empowerment                 https://jvz6.com/c/202927/383094/
DFY Content Club                 https://jvz6.com/c/202927/381337/
DFY Suite                                    https://jvz2.com/c/202927/337292
DFY Suite                      https://jvz2.com/c/202927/381194/
DFY Suite                    https://jvz3.com/c/202927/381194/
Diabetes Guide                       https://jvz2.com/c/202927/358870/
Diddly Pay’s DLCM                  https://jvz2.com/c/202927/315596
Diet fitness diabetes              https://jvz1.com/c/202927/286851
Domainname                  https://jvz6.com/c/202927/377005
Dominate Email             https://jvz4.com/c/202927/386980/
Dropshiply                   https://jvz3.com/c/202927/383483/
DUX Forex Signals                        https://jvz3.com/c/202927/128215/
EBook Agency                        https://jvz2.com/c/202927/384573/
Ejaculation Total                     https://jvz2.com/c/202927/75989/
Email Monetizer                     https://jvz2.com/c/202927/386337/
EngagerMate                         https://jvz8.com/c/202927/328172
EngageYard                     https://jvz2.com/c/202927/383051/
Extreme Adz                 https://jvz8.com/c/202927/379244/
Extreme Coupon                  https://jvz1.com/c/202927/216101/
EZ Local Appointmen                            https://jvz2.com/c/202927/385180/   t
Ezy                https://jvz1.com/c/202927/381935/
Ezy MultiStores               https://jvzoo.com/c/202927/381935
Facebook Cash Machine                 https://jvz4.com/c/202927/382333/
Facedrip                          https://jvz1.com/c/202927/376325/
FaceSwap                 https://jvz4.com/c/202927/381768/
Fade To Black                   https://jvz2.com/c/202927/344541
Fanpage                          https://jvz4.com/c/202927/144349
Fitness Nutrition                    https://jvz4.com/c/202927/353334/
Followup Builder                         https://jvz3.com/c/202927/386313/
Forex Atlatian                        https://jvz8.com/c/202927/25069/
Forex Blizz                             https://jvz8.com/c/202927/144577/
Forex Blue Stark                      https://jvz3.com/c/202927/47481/
Forex expert                   https://jvz1.com/c/202927/376877
Forex Hybrid Scalper                        https://jvz6.com/c/202927/95037/
Forex Joustar                     https://jvz8.com/c/202927/381617/
Forex Joustar                  https://jvz6.com/c/202927/381617/
Forex Mastery                    https://jvz2.com/c/202927/144621/
Forex Scouts                         https://jvz6.com/c/202927/132677/
forrk                                              https://jvz1.com/c/202927/373449
FusionMT4                             https://jvz2.com/c/202927/372523/
FX Goldminer                      https://jvz1.com/c/202927/381439/
Galactic                         https://jvz1.com/c/202927/188236/
Gaming job                    https://jvz2.com/c/202927/184902  s
Genesis Mining                         https://www.genesis-mining.com/a/2535466
Givvy Mobile Lottery             https://givvy-numbers.app.link/qNDZMGGbhsb
Gluten free                              https://jvz4.com/c/202927/296191
GMB Magic                        https://jvz2.com/c/202927/377194
Graphic Alta           https://jvz2.com/c/202927/324492/
Heal Your Emptiness                         https://jvz6.com/c/202927/384848/
High Converting Emails                  https://jvz3.com/c/202927/386305/
HostLegends                       https://jvz4.com/c/202927/384755/
Hostley Domain Creator                        https://jvz1.com/c/202927/379223/
Human Synthesys Studio                      https://jvz8.com/c/202927/367353/
ImageX                      https://jvz6.com/c/202927/363237/
IMSyndicator                   https://jvz1.com/c/202927/370769
Inboxr                            https://jvz2.com/c/202927/312692
Insta Keyword                https://jvz6.com/c/202927/351606/
Instant Website                https://jvz2.com/c/202927/377557
InstantWebsiteBundle          https://jvz6.com/c/202927/377557
iTraffic X                          https://jvz2.com/c/202927/320466
keysearch                                    https://jvz3.com/c/202927/194909
Klippyo Kreators                         https://jvz8.com/c/202927/327447
KoinCart                            https://jvz2.com/c/202927/383555/
Leadvalet                         https://jvz3.com/c/202927/385580/
Levidio Royal Podcasting                        https://jvz6.com/c/202927/384025/
Linkable DFY                       https://jvz6.com/c/202927/385873/
Linkomatic                            https://jvz2.com/c/202927/380937/
LiteTrading                                 https://www.litefinance.com/?uid=929237543
Live Your Truth                       https://jvz6.com/c/202927/379020
Living An Intentional Life              https://jvzoo.com/c/202927/382455
Living an International Life                  https://jvz8.com/c/202927/382455/
Local Leader                   https://jvz4.com/c/202927/383751/
Local Sites                  https://jvz4.com/c/202927/380543/
LocalAgencyBox                 https://jvz2.com/c/202927/359468
LocalCentric                            https://jvz2.com/c/202927/379339/
Marketingblocks             https://jvz6.com/c/202927/374934
MarketPresso                  https://jvz2.com/c/202927/369837
Mat1 Simple Funnel                            https://jvz2.com/c/202927/380197/
Maxslides                         https://jvz8.com/c/202927/376842
Mech Forex Robot                           https://jvz6.com/c/202927/383447/
MediaCloudPro                 https://jvz2.com/c/202927/343635
Megasuite                         https://jvz3.com/c/202927/383953/
Mobi First                          https://jvz2.com/c/202927/353694/
Motion Kingdom Studio                    https://jvz4.com/c/202927/383177/
Movid Animation                     https://jvz6.com/c/202927/380385/
MT4Code System                  https://jvz2.com/c/202927/376925
My Passive Income                  https://jvz1.com/c/202927/384099/
MyMailIt                              https://jvz3.com/c/202927/292919
MyTrafficJacker               https://jvz2.com/c/202927/353558
Next Drive                      https://jvz4.com/c/202927/371095/
NichBox               https://jvz2.com/c/202927/370705/
Organic Life Guide                 https://jvz8.com/c/202927/366872/
Photokit                           https://jvz4.com/c/202927/373207/
PicsAds                         https://jvz2.com/c/202927/385468/
PigMoney Metho                     https://jvz4.com/c/202927/377665/   d
PigMoneyMethod                        https://jvz2.com/c/202927/377665/
Pitchdeck                      https://jvz3.com/c/202927/347847/
Pixal                     https://jvz2.com/c/202927/378775/
Pixivid                           https://jvz6.com/c/202927/385213/
PlanB Muscle Growth              https://jvz1.com/c/202927/36517/
PlayerNeos                 https://jvz2.com/c/202927/376962
Podcast Advantage                        https://jvz8.com/c/202927/379995/
Podcast Advantage              https://jvz1.com/c/202927/379995/
Podcast Masterclass               https://jvz3.com/c/202927/379998/
PodKastr                 https://jvz1.com/c/202927/369500/
Postradamus                              https://jvz6.com/c/202927/108695
Power Reviews                     https://jvz8.com/c/202927/384625/
Powrsuite                       https://jvz1.com/c/202927/376361
PR Rage                        https://jvz4.com/c/202927/343405
prime stocks                              https://jvz8.com/c/202927/369164  prime stocks
Profile mate                           https://jvz4.com/c/202927/358049
Promovidz                      https://jvz8.com/c/202927/375692/
Push Button Traffic         https://jvz2.com/c/202927/301402
QR Verse                      https://jvz3.com/c/202927/383865/
Quintex Capital                         https://quintexcapital.com/?ref=arminham
Quit Smoking                           https://jvz3.com/c/202927/359081/
Reputor                 https://jvz8.com/c/202927/380159/
ReVideo                     https://jvzoo.com/c/202927/381761
ReviewReel                        https://jvz6.com/c/202927/382663/
Rewriter                      https://jvz4.com/c/202927/353373/
RSI SEO                              https://jvz6.com/c/202927/384381/
Scriptdio                       https://jvz4.com/c/202927/385387/
Seniors Income                        https://jvz2.com/c/202927/383888/
Senuke                                  https://jvz6.com/c/202927/279944
ShopABot                           https://jvz2.com/c/202927/291955
ShopFunnels                        https://jvz3.com/c/202927/384069/
SocialAgency360                 https://jvz1.com/c/202927/385357/
SociCake                       https://jvz2.com/c/202927/321987
Socifeed                          https://jvz6.com/c/202927/375706
SociJam                    https://jvz2.com/c/202927/309649
Soronity                                 https://jvz6.com/c/202927/368736
SqribbleEbook                 https://jvz6.com/c/202927/283867
Stackable Picture                        https://jvz1.com/c/202927/385046/
Steven Alvey’s                      https://jvz2.com/c/202927/351754
Stoodaio                                    https://jvz1.com/c/202927/372094
Storymate                         https://jvz3.com/c/202927/320972
StreamPilot                        https://jvz2.com/c/202927/385431/
Studioninja                       https://jvz1.com/c/202927/374965
Sunday Freebie                             https://jvz1.com/c/202927/267113/
Super backdrop                https://jvz8.com/c/202927/376524
Superbackdrop                 https://jvz8.com/c/202927/376524
Survai                      https://jvz8.com/c/202927/380933/
Syndranker                          https://jvz3.com/c/202927/378143/
Talkingfaces                      https://jvz2.com/c/202927/375358
Talkingfaces                    https://jvz3.com/c/202927/375550
The Internet Marketing                https://jvz2.com/c/202927/289944
Tonai Voice Content           https://jvz8.com/c/202927/383119/
Toon Video Maker                   https://jvz2.com/c/202927/357201
TrafficFor                https://jvz8.com/c/202927/381950/
TrafficForU                   https://jvz3.com/c/202927/381950/
Trendio                       https://jvz3.com/c/202927/381003/
TubePal                        https://jvz6.com/c/202927/379863/
Tubeserp                        https://jvz3.com/c/202927/370472
TubeTargeter                   https://jvz6.com/c/202927/377211
TV Boss Fire                https://jvz6.com/c/202927/379480/
Ultrafunnels A.I                 https://jvz2.com/c/202927/381129/
VIADZ Ad Template                    https://jvz4.com/c/202927/379307/
Vidcentric                             https://jvz4.com/c/202927/376095
Viddeyo                                https://jvz6.com/c/202927/382326/
Videevolve                       https://jvz4.com/c/202927/381011/
Video Campaignor      https://jvz4.com/c/202927/387058/
Video Games                            https://jvz3.com/c/202927/184902/
VideoEnginePro                https://jvz2.com/c/202927/372916
VideoGameSuite                     https://jvz3.com/c/202927/366537/
VideoRobot Enterprise                https://jvz8.com/c/202927/291061
VidKreate                        https://jvz6.com/c/202927/386029/
VidMingo                           https://jvz6.com/c/202927/378359/
VidSnatcher                           https://jvz3.com/c/202927/342585
VidVoicer                      https://jvz1.com/c/202927/379983/
Vidzura                       https://jvz4.com/c/202927/385754/
Viral dash                            https://jvz6.com/c/202927/375959
Viral Quotes            https://jvz2.com/c/202927/386984/
VirtualReel                       https://jvz8.com/c/202927/376849
Vocalic                    https://jvz2.com/c/202927/383848/
VoiceBuddy                      https://jvz1.com/c/202927/342854
WebCop                         https://jvz4.com/c/202927/378683/
Webinarkit                       https://jvz3.com/c/202927/383937/
Webprimo                   https://jvz1.com/c/202927/379455/   Website Builder
WordPress Mastery                       https://jvz1.com/c/202927/386249/
WOW Backgrounds                      https://jvz3.com/c/202927/381615/
WowBackgraounds                       https://jvz2.com/c/202927/381556/
WP GDPR                                https://jvz8.com/c/202927/299907
WP Simulator                    https://jvz3.com/c/202927/46987/
Writer Arc           https://jvz1.com/c/202927/386602/
writing job                                  https://jvz8.com/c/202927/213027
XBrain Forex                           https://jvz3.com/c/202927/372305/
XFUNNELS                         https://jvz2.com/c/202927/310335
Xinemax                    https://jvz1.com/c/202927/381749/
YoDrive                    https://jvz2.com/c/202927/384700/
Your 3DPal                https://jvz2.com/c/202927/381685/
YTSuite                       https://jvzoo.com/c/202927/381179
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