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Advancing performance evaluation standards for household water treatment technologies
D. Brown;
D. Brown
1School of Engineering, University of Guelph, Guelph, ON, Canada
C. Farrow;
C. Farrow
E-mail: cfarrow@uoguelph.ca
E. A. McBean;
E. A. McBean
B. Gharabaghi;
B. Gharabaghi
J. Beauchamp
D. Brown, C. Farrow, E. A. McBean, B. Gharabaghi, J. Beauchamp; Advancing performance evaluation standards for household water treatment technologies. J Water Health 1 April 2019; 17 (2): 266–273. doi: https://doi.org/10.2166/wh.2018.266
Diarrheal illnesses and fatalities continue to be major issues in many regions throughout the world. Household water treatment (HWT) technologies (including both point-of-use (POU) and point-of-entry (POE) treatment solutions) have been shown as able to deliver safe water in many low-income communities. However, as shown herein, there are important inconsistencies in protocols employed for validating performance of HWTs. The WHO does not stipulate influent concentration as a parameter that could influence removal efficacy, nor does it indicate an influent concentration range that should be used during technology evaluations. A correlation between influent concentration and removal is evidenced herein (R2 = 0.88) with higher influent concentrations resulting in higher log-removal values (LRVs). The absence of a recommended standard influent concentration of bacteria (as well as for viruses and protozoa) could have negative consequences in intervention efforts. Recommendations are provided that regulatory bodies should specify an influent concentration range for testing and verification of HWT technologies.
ceramic water filters (CWFs), diarrheal disease, drinking water treatment, household water treatment (HWT), point-of-entry (POE), point-of-use (POU)
Ceramic water filter
HWT
Log removal value
Point-of-use
Point-of-entry
USEPA
The current state of water safety
Diarrheal illnesses and fatalities are prominent issues in many regions of the world (Harvey et al. 2015). Among the world's populations where poverty is most severe, diarrheal diseases are the second leading cause of death (WHO 2017). Diarrheal diseases were the cause of an estimated 1.39 million deaths in 2016 (WHO 2017), and are among the leading causes of death among children under five years of age (UNICEF 2012; WHO 2016).
Approximately 90% of diarrheal deaths can be attributed to inadequate drinking water quality, sanitation, and hygiene (Black et al. 2003). Hence, improved delivery of safe water is required for those in the world who rely upon drinking water sources with fecal contamination – currently, about one in four members of the global population (WHO 2014). According to bacterial fecal indicators, more than 1.1 billion people consume water with at least moderate risk of disease (WHO 2014). Bacterial, viral, and protozoan species are the primary sources of diarrheal illness (Gall et al. 2015). It is in this context that researchers, international organizations, governments, and non-governmental organizations strive to develop low-cost water treatment technologies and programs with the goal of providing safe drinking water to low-income populations.
Household water treatment technologies
An effective method to improve drinking water safety for low-income populations is to promote utilization of point-of-use (POU) or point-of-entry (POE) treatment technologies (e.g., Quick et al. 1999; Mintz et al. 2001; Clasen & Mintz 2004; Abebe et al. 2014; Clasen 2015), which are collectively referred to as household water treatment (HWT) technologies. POU treatment is implemented directly before consumption, while POE technologies treat water where it enters the household. These household treatment options are conventionally paired with solutions for safe household water storage.
HWT technologies are considered important as interim and immediate solutions for communities where centralized treatment is difficult, expensive, or infeasible (Mintz et al. 2001; Zwane & Kremer 2007). They can also be effective in households with intermittent water supplies (Bivens et al. 2017), or as temporary solutions in humanitarian crises (Martin-Simpson et al. 2015; Ramesh et al. 2015). There are several household treatment technology interventions that have been proven to significantly reduce the frequency of diarrheal occurrence (Reller et al. 2003; Crump et al. 2005; Enger et al. 2013; Abebe et al. 2014). However, there is a large degree of variation in reported effectiveness of HWT solutions between studies (Hunter 2009).
For HWT technologies to be considered appropriate and potentially effective for low-income and marginalized segments of the world's population, robust technology evaluation standards are needed. The standards must be capable of demonstrating attainment of treatment levels which provide water that sufficiently reduces the risk of waterborne illness. Analysis of HWT interventions has indicated that ceramic water filters (CWFs) are superior to biosand filters, chlorine, and safe water storage, and coagulant-chlorine HWT technologies (Hunter 2009).
Ceramic water filters
CWFs are porous, clay-based filtration devices that retain microbiological pathogens through physical size exclusion and the development of a protective biofilm. CWFs are low cost and are easily manufactured with minimal capital investment. The combination of these factors enables utilization of CWFs in many developing regions (van Halem et al. 2009; Ren et al. 2013; Mellor et al. 2014).
Typical log removal values (LRVs) of Escherichia coli and other bacterial species are reported between two and four (Abebe et al. 2015; Mikelonis et al. 2016), although some publications have reported LRVs between five and seven (van Halem et al. 2007; Rayner et al. 2013; Yakub et al. 2013). Variations in reported CWF bacterial removal efficiencies indicate potential inconsistencies in test protocols between studies. Additionally, concerns have been raised about CWFs' ability to protect end-users from viruses (Farrow et al. 2014) and chemical contaminants such as nitrates (Murphy et al. 2010). Other persistent deficiencies of CWFs include relatively poor performance in the field (in contrast to laboratory studies) (Farrow et al. 2018), and an excessive rate of permanent fouling (van Halem et al. 2009; Salvinelli et al. 2016).
CWF performance has been reported as impacted by variations in design parameters (e.g., pore size, porosity, silver impregnation) (Muhammad et al. 2009; Murphy et al. 2010; Mwabi et al. 2011; Simonis & Basson 2011; Brown et al. 2012; Rayner et al. 2013; Abebe et al. 2015; Rayner et al. 2016; Pérez-Vidal et al. 2016) as well as test methodologies. For example, it is unclear whether silver impregnation significantly improves pathogen removal. Current literature regarding the impact of silver impregnation on CWF bacterial removal efficacy is inconsistent (Fewtrell 2014); some publications suggest that silver impregnation improves performance (Oyanedel-Craver & Smith 2008; Wubbels et al. 2008; Kallman et al. 2011; Mikelonis et al. 2016), while others indicate no significant difference between filters with, and without, silver impregnation (Brown & Sobsey 2010; Clark & Elmore 2011; van Der Laan et al. 2014).
Guidelines for household water treatment (HWT) technologies
Drinking water treatment technologies must be carefully evaluated before they are used as an intervention technology. Governmental and international organizations have provided frameworks by which household treatment technologies should be evaluated. Publications from the World Health Organization (WHO), United States Environmental Protection Agency (USEPA), and NSF International are commonly relied upon.
The WHO Guidelines for Drinking-Water Quality (WHO 2011a) lists factors that may affect microbiological removal efficacy of HWT technologies. These factors include flow rate, pore diameter (for permeable filtration technologies), and the presence or absence of chemical additives. The WHO also published a document entitled Evaluating household water treatment options (WHO 2011b), which recommended baseline log removal values (LRVs) of microbiological contaminants that should be achieved by any HWT solution. Two classes of protectiveness were proposed: 'highly protective,' which requires four log removal of the bacterium Campylobacter jenuni, five log removal of rotavirus, and four log removal of the protozoan Cryptosporidium; and 'protective,' which relaxes the minimum LRVs to two, three, and two, respectively. These target LRVs are based on quantitative microbial risk assessment (QMRA) methods using initial pathogen concentrations that would typically be found in untreated wastewater. In Evaluating household water treatment options, parameters that are described to affect the removal performance of a POU technology include turbidity, temperature, flow rate, and operating and cleaning protocols, among others. Notably, neither of the WHO documents mention influent concentration as a parameter that could influence removal efficacy, nor do they stipulate an influent concentration range that should be utilized during technology evaluations.
NSF International and USEPA
The NSF standard protocol for household treatment technologies (NSF International n.d.) is based on a USEPA report entitled Guide Standard and Protocol for Testing Microbiological Water Purifiers (USEPA 1987). The USEPA report presented more stringent LRVs for each class of microbiological contaminants: six for bacteria (Klebsiella terrigena), four for viruses (poliovirus and rotavirus) and three for protozoa (Giardia). In contrast to the WHO documents, the USEPA stipulated influent concentrations to be used for each contaminant class. The standard influent bacterial concentration for technology verification is 107 CFU/100 mL.
Performance evaluation of ceramic water filters
Across the literature, there is a lack of consistency in the influent E. coli concentrations employed for testing CWFs. A wide range of concentrations has been utilized, ranging from 1.2 × 102 to 9.9 × 108 CFU/100 mL (Bielefeldt et al. 2009; Muhammad et al. 2009; Murphy et al. 2010; Mwabi et al. 2011; Simonis & Basson 2011; Brown et al. 2012; Rayner et al. 2013; Yakub et al. 2013; Abebe et al. 2015; Matthies et al. 2015; Pérez-Vidal et al. 2016). Of 30 publications evaluating CWF removal of E. coli, only 11 included data sufficient to determine both log removal value (LRV) and influent E. coli concentration (Bielefeldt et al. 2009; Muhammad et al. 2009; Murphy et al. 2010; Mwabi et al. 2011; Simonis & Basson 2011; Brown et al. 2012; Rayner et al. 2013; Yakub et al. 2013; Abebe et al. 2015; Matthies et al. 2015; Pérez-Vidal et al. 2016). The data from these publications is plotted in Figure 1. It is of note that the included studies utilized CWFs with different design features, pore diameters, silver content, and challenge water characteristics. Regardless of the significant differences between the CWFs, the data set suggests a log-log relationship between removal value and influent concentration (R2 = 0.75).
Influence of influent concentration on log removal value (LRV): literature data.
Research goals
While a log-log relationship is evident in Figure 1, results are inconclusive due to the variable CWF characteristics and test methods employed in the individual studies. Only one publication that reported influent concentration as a significant factor in the resultant LRV of an HWT could be identified (He et al. 2018), and the authors did not thoroughly discuss the resulting implications. Therefore, a laboratory study using replicate CWFs was conducted to determine whether the log-log relationship could be confirmed.
Laboratory analysis
Column-shaped CWFs (Figure 2) were obtained from an NGO that manufactures and distributes CWFs in rural southeast Asia. The tests using these filters involved soaking in deionized water for 48 hours before testing to ensure the pores were fully saturated, and to prevent airborne contamination. Each filter was flushed with deionized water for 48 hours, after soaking, to remove debris and air that would prevent water from permeating through the internal pore structure. Each filter was flow-tested to ensure factory specified flow-through rates of 1 to 3 L/h (the flow rate range used by the NGO for quality control). Filters with flow-through rates outside of this range were not investigated.
Ceramic column filter apparatus.
E. coli challenge tests at concentrations ranging between 3.4 × 102 and 9.4 × 109 CFU/100 mL were conducted. All samples were analyzed following EPA Method 1603 (Method 1603: Escherichia coli (E. coli) in water by membrane filtration using modified membrane-thermotolerant Escherichia coli agar). For each trial, deionized water was drained from the tank until the water level reached approximately 5 cm above the top of the filters. The bacterial spike was then dropped via pipette into the water at multiple locations to approach an even distribution of bacteria. Deionized water was subsequently added until the desired water level for the trial was reached, with the inlet hose placed at an angle such that it aided in circulating the water and stimulating an even distribution of bacteria throughout the water volume. When the desired water level was obtained, filtration was allowed to occur undisturbed for 2 hours (±15 minutes) to reach equalized conditions. Influent and effluent samples were collected, and flow rates for all filters were measured in triplicate. Each sample dilution was analyzed in triplicate. Method blanks were employed during each bacterial assay (as stipulated in EPA Method 1603).
A correlation between influent concentration and removal is evident (R2 = 0.88) (see Figure 3). As is apparent in Figure 3, higher influent concentrations result in higher LRVs. Lower challenge concentrations yielded LRVs between three and four. The degree of variability observed during laboratory trials is estimated from data at influent concentrations ranging from 5.35 to 5.68 log CFU/100 mL (n = 23). The average influent concentration within this range was 5.54 log CFU/100 mL. The average log removal is observed to be 4.14 LRV (standard deviation = 0.33 LRV) within this range. The log-removal data do not show any evidence of non-normality utilizing the Shapiro–Wilk test (p > 0.05) (McBean 2019). Therefore, the fraction of organisms passing through the filter is log-normally distributed.
Influence of influent concentration on log removal value (LRV): laboratory data.
Literature data and data obtained in this research indicate a similar trend, as illustrated in Figure 4, with a strong correlation between influent concentration and removal efficiency. Therefore, important modifications to the WHO standards for evaluation of household treatment technologies are required.
Influence of influent concentration on log removal value (LRV): comparison of laboratory and literature data.
Implications for CWF regulation
WHO specifications do not provide sufficient guidance for the evaluation of HWT technologies. The absence of a recommended standard influent concentration of bacteria (as well as for viruses and protozoa) could have negative consequences in intervention efforts. To illustrate the potential downfalls, consider a development worker who is not well educated in water science, yet wishes to have a CWF's bacterial removal efficacy evaluated. This evaluator may very well solely consider the WHO standards, without being aware of the NSF or USEPA documents' existence. If this were the case, then the evaluator would operate on the assumption that an LRV should be achieved for the technology to be considered protective, but would not have any basis for choosing a bacterial challenge concentration; the problem is that the evaluator might then select nearby surface water as challenge water. Since surface water typically has low E. coli concentrations (typically less than 104 CFU/100 mL), and thus, from the findings reported herein, LRVs higher than three would not be expected (which is below the WHO's 'highly protective' benchmark for bacteria). Therefore, technology verification using surface water, regardless of the veracity of the CWF in question, would inevitably result in a relatively low LRV and thus not reach the 'highly protective' WHO standard. The same conclusion applies to those who would choose low concentrations for challenge water.
It is evident from Figure 4 that the lack of provision of 'standard' challenge concentrations could lead to misinterpretation of results. Without a recommended concentration to be paired with the required LRVs (as provided in the NSF and USEPA documents), technology evaluators are free to select influent concentrations arbitrarily, meaning resultant LRVs are also arbitrary.
These findings indicate that the WHO testing protocols should be revised to include standard influent concentrations to accompany recommended LRVs.
Implications for ceramic water filters
As evident from Figure 1, there has been a wide range of E. coli challenge concentrations across the literature (with many studies (63% of publications reviewed) not reporting challenge concentrations). In many cases, publications do not include justifications for the challenge concentrations employed in the evaluation. Due to variations in challenge concentrations across the literature, the comparison between publications is difficult.
There are some studies which demonstrate awareness that challenge E. coli concentration influences LRVs. These include: Farrow et al. (2018), who cited low influent concentrations as a potential differentiating factor between laboratory trials and field trials involving CWFs; and van Halem et al. (2007), who reported what was called the 'maximum log removal' of a CWF by using a high influent concentration (which was left unreported). Farrow et al.'s analyses revealed that significantly lower LRVs are consistently found in end-user field evaluation studies as opposed to laboratory studies. This finding has been corroborated by other publications (e.g., Murphy et al. 2010). Typical explanations for the variation in laboratory and field studies include insufficient operator knowledge and lack of access to protective sanitation; the recommendations for improvement, then, relate to improved designs that compensate for lack of operator expertise and adequate sanitation. End-user/field studies exclusively use challenge waters of relatively low concentrations. Therefore, an influential variable and differentiating factor between laboratory and field studies is challenge/source water concentration. In fact, the WHO recommended LRV of four (for bacteria) is difficult to obtain in field studies, irrespective of the technology (where the influent concentration is typically under 1,000 CFU/100 mL).
When evaluating the microbiological removal performance of CWFs, source water concentration has a significant impact on removal efficiency, with higher source water concentrations resulting in higher LRVs. The results presented herein strongly indicate that researchers should henceforth consider influent concentration as an important parameter in HWT bacterial removal studies. A similar log-log relationship (between removal value and influent concentration) would be expected for many microbiological contaminant classes (viruses, bacteria, protozoa) and filtration devices, including CWFs, slow sand filters, and membrane filters.
The WHO's standards for evaluation of household drinking water treatment (HWT) devices need to be modified to include standard challenge microbiological concentrations. Without these clarifications, the potential remains for misinterpretation of results, which poses an avoidable threat to water safety and public health. Further, researchers and policy-makers need to take into account the challenge concentrations employed in previous studies when evaluating/comparing the bacterial removal efficiency of any HWT technology.
The authors would like to thank the Res'Eau National Centre of Excellence, NSERC Discovery, and RBC Blue Water program for the funding that enabled this research.
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With three locations already in business, Ryan and Stephanie Humphrey plan to open another two Papa Murphy's stores in the next two years.
When Ryan and Stephanie Humphrey first came across Papa Murphy's take 'n' bake pizza concept, they weren't sure what to think. While they had consistently heard rave reviews from Ryan's parents—who were loyal customers in Evansville, Indiana—they weren't sure how they felt about baking their own hand-crafted pizza at home. So they set out to try it for themselves.
As soon as the Humphreys took their first bite, they were hooked. Papa Murphy's fresh dough, 100% whole-milk mozzarella, hand-sliced veggies were impossible to beat—the couple knew the brand was on to something special. That's why they decided to take their love for the Papa Murphy's brand a step further by looking into franchising opportunities.
The Humphreys opened their first Papa Murphy's location back in 2010 in Wilmington, North Carolina, and have been growing with the brand ever since. The concept really took off with consumers in the area—Papa Murphy's provides them with a top-quality meal that doesn't break the bank. And its unique take 'n' bake business model is something that helps Ryan and Stephanie manage the costs of owning their own business.
Papa Murphy's has a proven system in place to help set all of its franchisees up for success. The brand offers extensive and ongoing training with support of both the corporate team and local franchisees who are there to guide new and expanding owners through the franchising process.
That broad support makes it easier for franchisees like the Humphreys to expand. Right now, the Humphreys have three Papa Murphy's locations, and they plan to bump that to five by spring of 2018.


The Orthopaedic Research and Education Foundation (OREF), offered 38 grants to fund orthopaedic research by residents, fellows, and practicing orthopaedic surgeons in 2018; only 4 of these grants are available to residents.
The University of Minnesota Department of Orthopaedic Surgery's team of physicians has developed innovative pain reduction techniques, including the use of liposomal bupivacaine (a local anesthetic that prevents pain by blocking signals at nerve endings) for interscalene blocks and intraoperative lidocaine.
Arendt will be honored for her accomplishment with a plaque on the Medical School's Wall of Scholarship featuring the first page of her article, along with an induction ceremony and reception in conjunction with the Medical School Dean's Distinguished Research Lectureship on October 25, 2018.
The University of Minnesota Clinics and Surgery Center, as well as Gillette Children's Specialty Healthcare, have employed an innovative new tool used to create highly precise, low radiation 3-D models of the musculoskeletal system called EOS imaging.


text:
What's Coming / Back Flip / Senate Does It Again
Standing Up for Their Backers / Implosion
Fairness for All? Ha! / Senate Voting Records
What's Coming
NEXT WEEK, we at Life Advocacy Briefing expect to publish our annual US House & Senate Voting Record Index, compiling votes cast by each Member on roll calls we have published during the year. Hoping readers will find it of interest and use, we expect the Index to fill the entire edition next week, closing out our 26th year of publication of timely news you can use in the cause of Life.
A SMALL GROUP OF REPUBLICANS HAVE INTRODUCED a measure by which they may hope to persuade radical feminists and homosexual activists to pick on someone else in next year's election. That is the only motive we can draw from introduction of the so-called "Fairness for All Act," HR-5331, "to prohibit discrimination on the basis of sex, sexual orientation and gender identity," with the incongruous caboose (following a semi-colon in the bill's title): "and to protect the free exercise of religion." Those two objectives are incompatible when one examines the claims of radical feminists and homosexual activists as to what constitutes "discrimination" on their proclivities.
The bill is also incompatible with values which the Republican Party generally – and House Republicans as candidates – seem to advocate when they appeal to voters. And it is particularly ill-timed, while the Trump Administration's regulatory efforts to protect the consciences of pro-life medical personnel are under court challenge by the social Left.
Though we cannot forecast the bill's future, we do think readers of our publication and others who cherish the religiously-based exercise of conscience ought to pay attention to the names of the bill's sponsors. Those who live in their districts – and even others – might wish to contact these nine via the Capitol switchboard at 1-202/224-3121. They might even welcome the invitation to remove their names or at least welcome a phone message on some matter other than the Pelosi/Schiff circus.
Chief sponsor: Utah GOP Rep. Chris Stewart, joined by his Utah GOP colleagues, Representatives Rob Bishop and John Curtis, as well as Representatives Brian Fitzpatrick (PA), Michael Simpson (ID), Fred Upton (MI), Elise Stefanik (NY), Mark Amodei (NV) and David Joyce (OH).
Proposing what is in essence the anti-family, anti-Life, long defunct Equal Rights Amendment – even by mere statute – is not a good way to claim advocacy of fairness in America's laws.
We hope readers who take note of the Life-related voting records in next week's Life Advocacy Briefing will take note, as well, of what we see as a lurch to the Left exhibited by these nine lawmakers in proposing HR-5331.
We publish near the closing of this Life Advocacy Briefing a commentary by John Stonestreet of BreakPoint, analyzing some of the problems with the legislation, problems beyond what we have here touched on. We should note: conservative alert memos we have seen on this bill are not mentioning abortion, but the abortion connection to non-discrimination on the basis of sex has been established by judicial rulings in states such as New Mexico, whose state courts have forced taxpayer-funded abortion based on the state's own "equal rights amendment" outlawing discrimination on the basis of sex.
For now – and possibly forever, given the unwillingness of House Democrats to advance GOP-sponsored legislation – the bill has been referred to the Committees on Judiciary, Education & Labor, Ways & Means, Financial Services, Oversight & Reform and House Administration.
Senate Does It Again
TWO MORE CONSERVATIVE ATTORNEYS HAVE BEEN CONFIRMED for seats on the notoriously Leftish 9th Circuit Court of Appeals. One of them, Lawrence VanDyke, was vigorously opposed by the abortion lobby and its fellow travelers in the Senate.
The first objection raised by the left-wing Alliance for Justice in its letter to Senators was his record on abortion. In that letter, AfJ complained, "As Solicitor General in Montana and Nevada, [Mr. VanDyke] repeatedly attacked the rights of women [sic]. He submitted an amicus brief in support of Arizona's 20-week abortion ban, a position in direct conflict," AfJ charged, "with Supreme Court precedent; in his brief, he asked the Supreme Court to reconsider Roe v. Wade." How shocking! The letter complained further about his challenge to ObamaCare's contraception coverage and his involvement in legal filings opposing the legality of buffer zones, which bar pro-life sidewalk counselors from approaching abortuaries and their customers.
We publish at the conclusion of this Life Advocacy Briefing the Senate roll calls on cloture (closing debate to bring the VanDyke nomination to a vote) and on confirming him to the bench.
Standing Up for Their Backers
U.S. REP. LOIS FRANKEL (D-FL) HAS FILED A RESOLUTION, pending in the House Foreign Affairs Committee, which seeks to undercut the US delegation to the United Nations, reports Elyssa Koren in the Daily Signal, by "recognizing the Nairobi Summit" hosted by the UN Population Fund (UNFPA) "and reaffirming the United States' commitment to 'sexual and reproductive health and rights,' meaning abortion rights."
The US had sent a delegation to Nairobi, notes Ms. Koren, "with the express purpose of rejecting the summit's outcome. Ten other countries," she reports, "joined the US in delivering a joint statement of rejection." Many others refused to participate in the conference, which was, she writes, "a faux UN conference, designed to create the artificial perception of consensus on abortion rights where none exists," and "an attempt to leverage the UN name despite a lack of consensus. It conveniently lacked participation from the full UN body of membership," writes Ms. Koren, "allowing abortion advocates to push through a radical agenda without having to win support from countries that oppose it." This is the stage show which Rep. Frankel and her colleagues are endorsing and celebrating in their resolution as a direct affront to official US policy.
HRes 688 is co-sponsored by 51 House Democrats: Rep. Frankel and Representatives Raul Grijalva/AZ; Judy Chu, Jim Costa, Susan Davis, Ro Khanna, Barbara Lee, Alan Lowenthal, Grace Napolitano, Scott Peters, Adam Schiff, Jackie Speier, Norma Torres/CA; Diana DeGette/CO; Rosa DeLauro/CT; Lisa Blunt-Rochester/DE; Kathy Castor, Theodore Deutch, Alcee Hastings/FL; Hank Johnson/GA; Janice Schakowsky/IL; Andre Carson/IN; Anthony Brown, Jamie Raskin/MD; William Keating, Joseph Kennedy, James McGovern/MA; Brenda Lawrence, Andy Levin & Rashida Tlaib/MI; Betty McCollum/MN; Emanuel Cleaver/MO; Dina Titus/NV; Ann Kuster, Chris Pappas/NH; Bonnie Watson-Coleman/NJ; Debra Haaland/NM; Eliot Engel, Adriano Espaillat, Nita Lowey, Carolyn Maloney, Grace Meng/NY; Earl Blumenauer/OR; Susan Wild/PA; David Cicilline/RI; Steve Cohen/TN; Peter Welch/VT; Gerald Connolly/VA; Pramila Jayapal & Adam Smith/WA; Gwen Moore/WI. Also DC Delegate Eleanor Holmes Norton, whom the House Majority unconstitutionally call a "Representative."
Dec. 3, 2019, Washington Update commentary by Family Research Council president Tony Perkins
Judging by the 2020 debates, the Democratic Party is all-in on abortion. And not just any abortion but taxpayer-funded, expanded and exported killing right past the moment of birth. On stage they're the picture of lock-step radicalism. But behind the curtain, the New York Times warns, there's a lot more disagreement than anyone's letting on.
There's the extremist wing of the party – the national Democrats, full of bravado and cheerleading and "shout your abortion" from the rooftops. But they're only part of the story. The other, the Times points out, is a deeply conflicted base who has serious misgivings about gambling another election on a hard-core abortion strategy.
For the first time in years, liberals are on the defensive about abortion – and at odds with how to handle it. "It's really, really complicated," Rutgers professor Joanna Schoen said, "and somewhat controversial where the pro-choice movement lost." But the basic consensus is this, the Times argues: "The Democratic Party rejected the message that drove its politics since Pres. Bill Clinton's administration – that abortion should be 'safe, legal and rare' – and embraced abortion rights with few stipulations."
There's just one problem. The majority of Americans – including their own grass roots – disagree. "Pro-choice" Democrats think abortion should be legal, sure. But only in certain cases. Like most Americans, they certainly don't side with the field of 2020 abortion zealots, who – with one exception – think infanticide is a "reproductive right." The eight percent who do must either be in Congress or running for President.
Meanwhile, inside the abortion movement, there's at least some recognition of the overreach. Some supporters told the Times that they "worry that establishing abortion rights as a Democratic litmus test is too inflexible for Americans conflicted over abortion. They fear that it could hurt the party in rural areas and the more moderate, suburban districts that may hold the key to regaining the White House, and where many of the remaining vulnerable abortion clinics are."
Considering the Iowa district where Democrat J.D. Scholten is running, they're right. About 60% of the voters there consider themselves "pro-life." "Where I'm from, we have a pretty big tent," he said. "We can't be writing off people."
None of these messages seem to be getting through to national headquarters, where Democrats are doubling down on radical abortion "to shore up a progressive base, boxing in moderate candidates in red states and leaving little room for [the views of average Americans]." But then, misreading the political landscape is nothing new for the Left. When the abortion rate dropped to its lowest level since Roe v. Wade, researchers at the liberal Guttmacher Institute insisted it had nothing to do with the recent wave of pro-life legislation. That's an interesting conclusion, since 40% of the country's pro-life laws were passed in the last 10 years.
In every state but New York, CNSNews's Terry Jeffrey found, abortions dropped an average 24% over the same decade. The reality is simple: "Pro-lifers are winning the argument in the culture," he insisted on [FRC's podcast] Washington Watch. "The Democratic candidates are not. …
"Another tell-tale sign," Terry [Jeffrey] argues, "is what happened in the 2016 Presidential elections." Why did Trump win Pennsylvania, Ohio, Michigan and Wisconsin? Because a lot of voters in those areas, regardless of party, are socially conservative. "They like where Donald Trump was on immigration. They like his foreign policy. They like his views on trade. But they were pro-life. … Now a smart Democratic strategist looking at that would know that if the Democrats nominate a knee-jerk, ideological, 100% pro-abortion candidate to run against Trump in 2020, they're going to have a hard time winning those swing states … . Politically, the pro-abortion position is a disaster for Democrats."
And morally? Well, it's a disaster for everyone. Forty-five years and 60 million lives should have taught us all that.
Fairness for All? Ha!
Dec. 9, 2019, BreakPoint commentary by John Stonestreet
On Friday, Republican Rep. Chris Stewart of Utah introduced the Fairness for All Act, which, as Christianity Today reports, "would prohibit anti-LGBT discrimination in employment, housing and places of public accommodation, including retail stores, banks and healthcare service providers."
In essence, just like the proposed Equality Act supported by House Democrats, the Fairness for All Act would place sexual orientation and gender identity on par with race and religion as protected classes under the Civil Rights Act.
But there's a major difference between Fairness for All and the Equality Act. The Fairness for All Act seeks to exempt religious organizations such as churches and nonprofits. So, for example, "Churches wouldn't be required to host same-sex weddings. Christian schools wouldn't have to hire LGBT people. Adoption agencies could receive federal funding even if they turned away same-sex couples looking to receive children." As such, Rep. Stewart and supporters of the Fairness for All Act see the bill as balancing religious freedom and LGBT rights.
Now I believe Fairness for All is a well-intentioned bill. And I believe that its supporters are truly trying to find ways to compromise with LGBT rights in order to preserve our religious liberties in the end. But this Act is the wrong piece of legislation at the wrong time.
The Act would enshrine into law something that simply is not true, and for Christians that's got to be a non-starter: that sexual orientation and gender identity are equal to race, that they are somehow immutable, something someone is born with. As my colleague Shane Morris discussed with me on BreakPoint This Week, the "born with" idea is a useful fiction created by the early proponents of the gay-rights movement to win public approval for their cause. They succeeded, of course, but it does not make the fiction any more true.
Second, the Act is addressing a non-issue. Back in the 1960s, the Civil Rights Act addressed a very real problem: There were entire swaths of the country where African Americans couldn't find a hotel room, buy gas or get a meal. And so public accommodations were necessary so African Americans could fully participate in society. That most certainly is not the case today with the so-called "sexual minorities." When two men targeted cakeshop owner Jack Phillips to force him to design a cake for their same-sex wedding, they knew full well that there were plenty of cakeshops nearby that would gladly do what they asked.
This raises another problem with the Fairness for All Act: Its exemptions "would not apply to for-profit businesses with 14 or fewer employees." In other words, if you're a Christian business owner and not a church or a religious non-profit, you're on the wrong side of the law – outside of the Act's protections. Meaning Fairness for All isn't really fairness for all.
And as I explained on BreakPoint This Week, this act continues the ghastly idea that people of faith who insist on religious liberty are the bad guys. That they are bigots who need to be "exempted" precisely because they want to deny the rights of others.
The Fairness for All has its roots in what's called the Utah Compromise, which was a state measure largely championed by the LDS church. It hasn't worked in Utah, and it's not a good idea for federal legislation. In fact, these ideas were birthed under a previous Presidential administration openly hostile to religious liberty – and when it looked like the next administration would be as well.
But elections matter. Federal courts and the Supreme Court are growing more conservative and more respectful of religious liberty. Now is simply not the time to give up the rights of individual believers in order to preserve the freedoms of religious institutions alone.
Now, do I think the Fairness for All Act will pass? No. Nor does Rep. Stewart. The Democrats hold the House and see no compromise at all on LGBT rights and religious rights. And while there may be a way to truly balance these rights in the future, the Fairness for All Act isn't it.
Senate Voting Records
Cloture motion on Nomination of Lawrence VanDyke to 9th Circuit Court of Appeals – Dec. 10, 2019 – Adopted 53-40 (Democrats in italics; "Independent" marked with "I")
Voting "yes"/pro-Life: Shelby/AL, Murkowski & Sullivan/AK, McSally/AZ, Boozman & Cotton/AR, Gardner/CO, Rubio & Scott/FL, Isakson & Perdue/GA, Crapo & Risch/ID, Braun & Young/IN, Ernst & Grassley/IA, Moran & Roberts/KS, McConnell & Paul/KY, Cassidy & Kennedy/LA, Collins/ME, Hyde-Smith & Wicker/MS, Blunt & Hawley/MO, Daines/MT, Fischer & Sasse/NE, Burr & Tillis/NC, Cramer & Hoeven/ND, Portman/OH, Inhofe & Lankford/OK, Toomey/PA, Graham & Scott/SC, Rounds & Thune/SD, Alexander & Blackburn/TN, Cornyn & Cruz/TX, Lee & Romney/UT, Capito/WV, Johnson/WI, Barrasso & Enzi/WY.
Voting "no"/anti-Life: Jones/AL, Sinema/AZ, Feinstein/CA, Blumenthal & Murphy/CT, Carper & Coons/DE, Hirono & Schatz/HI, Duckworth & Durbin/IL, King(I)/ME, Cardin & VanHollen/MD, Markey/MA, Peters & Stabenow/MI, Smith/MN, Tester/MT, Cortez-Masto & Rosen/NV, Hassan & Shaheen/NH, Menendez/NJ, Heinrich & Udall/NM, Gillibrand & Schumer/NY, Brown/OH, Merkley & Wyden/OR, Casey/PA, Reed & Whitehouse/RI, Leahy/VT, Kaine/VA, Cantwell & Murray/WA, Manchin/WV, Baldwin/WI.
Not voting: Harris/CA, Bennet/CO, Warren/MA, Klobuchar/MN, Booker/NJ, Sanders/VT, Warner/VA.
Nomination of Lawrence VanDyke to 9th Circuit Court of Appeals – Dec. 11, 2019 – Confirmed 51-44 (Democrats in italics; "Independent" marked with "I")
Voting "yes"/pro-Life: Shelby/AL, Murkowski & Sullivan/AK, McSally/AZ, Boozman & Cotton/AR, Gardner/CO, Rubio & Scott/FL, Isakson & Perdue/GA, Crapo & Risch/ID, Braun & Young/IN, Ernst & Grassley/IA, Moran & Roberts/KS, McConnell/KY, Cassidy & Kennedy/LA, Hyde-Smith & Wicker/MS, Blunt & Hawley/MO, Daines/MT, Fischer & Sasse/NE, Burr & Tillis/NC, Cramer & Hoeven/ND, Portman/OH, Inhofe & Lankford/OK, Toomey/PA, Graham & Scott/SC, Rounds & Thune/SD, Alexander & Blackburn/TN, Cornyn & Cruz/TX, Lee & Romney/UT, Capito/WV, Johnson/WI, Barrasso & Enzi/WY.
Voting "no"/anti-Life: Jones/AL, Sinema/AZ, Feinstein & Harris/CA, Blumenthal & Murphy/CT, Carper & Coons/DE, Hirono & Schatz/HI, Duckworth & Durbin/IL, Collins & King(I)/ME, Cardin & VanHollen/MD, Markey/MA, Peters & Stabenow/MI, Klobuchar & Smith/MN, Tester/MT, Cortez-Masto & Rosen/NV, Hassan & Shaheen/NH, Menendez/NJ, Heinrich & Udall/NM, Gillibrand & Schumer/NY, Brown/OH, Merkley & Wyden/OR, Casey/PA, Reed & Whitehouse/RI, Leahy/VT, Kaine & Warner/VA, Cantwell & Murray/WA, Manchin/WV, Baldwin/WI.
Not voting: Bennet/CO, Paul/KY, Warren/MA, Booker/NJ, Sanders/VT.


Physiologist, psychologist, SCENAR therapist. Medical researcher of OKB RITM from 1998. Scientific referent of Deutchen Gesellshaft für Adaptive Terapien e.V. Dr. Boris Kulizhsky started applying SCENAR in 1996 working at the emergency ambulance. In 1998 he was invited to work at OKB RITM by Yury Gorfinkel as medical researcher. He participated in the development of SCENAR devices. He was also engaged in methodological maintenance of SCENAR Expert devices. He is a co-author of user"s manual to SCENAR devices. He conducted researches on the electrophysiology of SCENAR. He has written academic papers. He is a co-author of the training method of physiotherapists of DeGAT e.V.
Dr Peta Zafir was born in Brisbane and is the Head Therapist and Owner of Coolum Therapy Clinic. She has a Doctorate in Education, Masters in Educational Studies, Bachelor in Arts majoring in Psychology and Sociology and a Diploma in Teaching; she then proceeded to pursue her studies in Complementary Medicine. Peta spent 23 years nursing family members suffering from heart attack, stroke, bowel cancer, diverticulitis, lewy body dementia, multiple myeloma, acoustic neuroma, lung embolism and thrombosis, most ending in palliative care. And her 50 year passion in Natural Medicine lead first her to SCENAR; she is a Professional SCENAR Therapist, completing all speciality areas and proceeding to becoming one of the Australasian trainers. She furthered her studies by qualifying as a Nutri Energetic System Specialist, Counsellor, Reflexologist and Naturopath. Peta specialises in Complex Multifaceted Health Conditions, in a professional and informative environment. Her ongoing study and research, has kept her current with cutting edge technology and scientific information. She has an armoury of expertise and skills that she continues to develop through conferences, workshops and seminars. In 2014 she worked in a clinic in Germany, loves languages, speaks Italian, travels extensively and has clients in London and Italy. Her aim is to teach, support, assist and change people's focus, life and energy- leading them to an active, healthy and fulfilling life. In her spare time, she writes books, speaks publicly and has a YouTube channel.
Michael has always been actively involved in health, fitness and sport. He is an athlete, specializing in distance running, having begun his athletics career at the age of eleven. He still trains daily and has competed at international level. When Michael started coaching other athletes he soon recognized the need to undertake formal study to equip him to treat the injuries and other physical problems presented to him by these athletes. After completing his clinical studies and gaining accreditation with professional health practitioner organizations and health funds, he opened his own clinic in 1999. The patients who come to see Michael range from elite international athletes, to those who follow more leisurely pursuits. Patient ages range from tiny babies up to over one hundred. Michael has used SCENAR therapy in his clinic for twelve years. By integrating SCENAR with other modalities and bioregulatory medicine protocols, (including musculoskeletal practice, massage, Dorn spinal therapy, Bowen, Emmett technique, homoeopathy, homotoxicology, and nutrition) Michael is able to attain the best outcomes for his patients. Michael has completed all levels of SCENAR training and accreditation available in Australia. He has studied with Russian and other world-leading international health practice experts and, in addition to his own extensive clinic work, Michael teaches SCENAR and other remedial and bioregulatory medicine therapies to other practitioners.
Manuela graduated in 2010 as a Remedial Massage Therapist in Perth, WA. Since then she has extended her knowledge to offer professional help for people who have a history of cancer. Manuela did her postgraduate training in Oncology Massage through the nationally accredited 'Oncology Massage Training' which led her further into studying Manual Lymphatic Drainage with the internationally accredited 'Dr Vodder Akademie' where she graduated in Austria in 2014. Manuela became a professional Scenar Therapist in 2016 and is very passionate about incorporating Scenar Therapy into her practice.