Why No Gadget Can Prove How Stoned You Are

If you’ve spent time with marijuana—any time at all, really—you know that the high can be rather unpredictable. It depends on the strain, its level of THC and hundreds of other compounds, and the interaction between all these elements. Oh, and how much you ate that day. And how you took the cannabis. And the position of the North Star at the moment of ingestion.

OK, maybe not that last one. But as medical and recreational marijuana use spreads across the United States, how on Earth can law enforcement tell if someone they’ve pulled over is too high to be driving, given all these factors? Marijuana is such a confounding drug that scientists and law enforcement are struggling to create an objective standard for marijuana intoxication. (Also, I’ll say this early and only once: For the love of Pete, do not under any circumstances drive stoned.)

Sure, the cops can take you back to the station and draw a blood sample and determine exactly how much THC is in your system. “It's not a problem of accurately measuring it,” says Marilyn Huestis, coauthor of a new review paper in Trends in Molecular Medicine about cannabis intoxication. “We can accurately measure cannabinoids in blood and urine and sweat and oral fluid. It's interpretation that is the more difficult problem.”

You see, different people handle marijuana differently. It depends on your genetics, for one. And how often you consume cannabis, because if you take it enough, you can develop a tolerance to it. A dose of cannabis that may knock amateurs on their butts could have zero effect on seasoned users—patients who use marijuana consistently to treat pain, for instance.

The issue is that THC—what’s thought to be the primary psychoactive compound in marijuana—interacts with the human body in a fundamentally different way than alcohol. “Alcohol is a water-loving, hydrophilic compound,” says Huestis, who sits on the advisory board for Cannabix, a company developing a THC breathalyzer.1 “Whereas THC is a very fat-loving compound. It's a hydrophobic compound. It goes and stays in the tissues.” The molecule can linger for up to a month, while alcohol clears out right quick.

But while THC may hang around in tissues, it starts diminishing in the blood quickly—really quickly. “It's 74 percent in the first 30 minutes, and 90 percent by 1.4 hours,” says Huestis. “And the reason that's important is because in the US, the average time to get blood drawn [after arrest] is between 1.4 and 4 hours.” By the time you get to the station to get your blood taken, there may not be much THC left to find. (THC tends to linger longer in the brain because it’s fatty in there. That’s why the effects of marijuana can last longer than THC is detectable in breath or blood.)

So law enforcement can measure THC, sure enough, but not always immediately. And they’re fully aware that marijuana intoxication is an entirely different beast than drunk driving. “How a drug affects someone might depend on the person, how they used the drug, the type of drug (e.g., for cannabis, you can have varying levels of THC between different products), and how often they use the drug,” California Highway Patrol spokesperson Mike Martis writes in an email to WIRED.

Accordingly, in California, where recreational marijuana just became legal, the CHP relies on other observable measurements of intoxication. If an officer does field sobriety tests like the classic walk-and-turn maneuver, and suspects someone may be under the influence of drugs, they can request a specialist called a drug recognition evaluator. The DRE administers additional field sobriety tests—analyzing the suspect’s eyes and blood pressure to try to figure out what drug may be in play.

The CHP says it’s also evaluating the use of oral fluid screening gadgets to assist in these drug investigations. (Which devices exactly, the CHP declines to say.) “However, we want to ensure any technology we use is reliable and accurate before using it out in the field and as evidence in a criminal proceeding,” says Martis.

Another option would be to test a suspect’s breath with a breathalyzer for THC, which startups like Hound Labs are chasing. While THC sticks around in tissues, it’s no longer present in your breath after about two or three hours. So if a breathalyzer picks up THC, that would suggest the stuff isn’t lingering from a joint smoked last night, but one smoked before the driver got in a car.

This could be an objective measurement of the presence of THC, but not much more. “We are not measuring impairment, and I want to be really clear about that,” says Mike Lynn, CEO of Hound Labs. “Our breathalyzer is going to provide objective data that potentially confirms what the officer already thinks.” That is, if the driver was doing 25 in a 40 zone and they blow positive for THC, evidence points to them being stoned.

But you might argue that even using THC to confirm inebriation goes too far. The root of the problem isn’t really about measuring THC, it’s about understanding the galaxy of active compounds in cannabis and their effects on the human body. “If you want to gauge intoxication, pull the driver out and have him drive a simulator on an iPad,” says Kevin McKernan, chief scientific officer at Medicinal Genomics, which does genetic testing of cannabis. “That'll tell ya. The chemistry is too fraught with problems in terms of people's individual genetics and their tolerance levels.”

Scientists are just beginning to understand the dozens of other compounds in cannabis. CBD, for instance, may dampen the psychoactive effects of THC. So what happens if you get dragged into court after testing positive for THC, but the marijuana you consumed was also a high-CBD strain?

“It significantly compounds your argument in court with that one,” says Jeff Raber, CEO of the Werc Shop, a cannabis lab. “I saw this much THC, you're intoxicated. Really, well I also had twice as much CBD, doesn't that cancel it out? I don't know, when did you take that CBD? Did you take it afterwards, did you take it before?

“If you go through all this effort and spend all the time and money and drag people through court and spend taxpayer dollars, we shouldn't be in there with tons of question marks,” Raber says.

But maybe one day marijuana roadside testing won’t really matter. “I really think we're probably going to see automated cars before we're going to see this problem solved in a scientific sense,” says Raber. Don’t hold your breath, then, for a magical device that tells you you’re stoned.

1 UPDATE: 1/29/18, 2:15 pm ET: This story has been updated to disclose Huestis' affiliation with Cannabix.

Read more: https://www.wired.com/story/why-no-gadget-can-prove-how-stoned-you-are/

Weight loss interventions that work: Lifestyle changes

(CNN)Do you have pounds to lose but don’t have a weight loss plan? If you are seriously considering how to go about shedding pounds, there are three proven levels of intervention, depending on your individual needs.

    Our first intervention begins and ends with yourself.
    “If you really want to keep weight off, it requires permanent lifestyle changes. … There are no quick fixes,” said Mascha Davis, a registered dietitian and national spokeswoman for the Academy of Nutrition and Dietetics. “Otherwise, the weight loss is temporary, and you can gain it back when you go back to old habits.”
    To get started on your weight loss journey, Davis recommends looking at three areas of your lifestyle that might require change: food, exercise and sleep. “I call it a trifecta approach, because these three things are essential to keeping weight loss sustainable,” she said.
    For example, in the diet category, you might start eating more fiber-rich vegetables and aim to drink more water. Being more physically active might involve simply getting up every hour if you have a desk job, taking the stairs instead of the elevator and parking your car farther from an entrance.
    Going to the gym regularly is helpful, but don’t expect it to make up for those morning doughnuts. Generally speaking, the amount of exercise required to make up for diet damage is huge (think of walking briskly for nearly two hours to burn off a 500-calorie piece of cake) and explains why diet is generally more crucial than exercise for weight loss.
    Since sleep impacts hunger and satiety hormones, getting enough Zs is another lifestyle factor that can make or break your weight loss efforts.
    “Sleep is essential for weight loss,” Davis said. “I have clients who are doing all these great things with their eating habits and going to the gym, but they don’t realize that a lack of sleep is really wrecking their goals.”
    If you’re constantly tired and drinking coffee all day, you may need to make some adjustments. “Most adults need seven to eight hours of sleep … and some need as many as nine. A lot of people are walking around sleep-deprived — but the less sleep you get, the higher your weight tends to be,” Davis said.
    If you’re not seeing any results after a couple of months, meeting with a professional who is aware of your health history and can personalize a plan based on your habits and food preferences can be extremely helpful. For those with medical conditions, it’s especially important to avoid fad diets or diets that eliminate food groups and seek the expertise of an experienced registered dietitian.
    “Cutting out carbohydrates can be dangerous for someone with diabetes, but they may not even realize the potential harm,” Davis said. Similarly, someone with chronic kidney disease may have to limit the amount of protein they eat and would need to steer clear of diets that promote a high intake of protein.
    Implementing behavior changes and strategies to help you achieve your goals can be very helpful. For example, setting mini-goals that are specific and measured on a weekly basis — such as taking a daily 15-minute walk during a lunch break — can help take a lofty weight loss goal and break it down into something much more achievable.
    Focusing on intuitive eating can be another important behavior change. It involves getting in touch with your body’s hunger and satiety signals and figuring out how to nourish yourself without feeling deprived, Davis explained.

    Factors to consider

    For many, the simple notion of just “eating less and moving more” in order to lose weight might seem oversimplified — and extremely difficult. In fact, there is a physiological basis for why it is so hard. Once we lose even a small amount of weight by cutting back on calories, our body fights to defend our “original” weight, in part by decreasing our metabolism and increasing appetite. This can lead to frustration and the desire to give up, which can cause us to regain the weight we’ve lost, plus more, despite our best intentions.

    See the latest news and share your comments with CNN Health on Facebook and Twitter.

    If you are unable to lose weight or to continue losing after an initial loss despite making changes to your diet, exercise and sleep habits, and you’ve ruled out other possible causes that might prevent weight loss, such as hypothyroidism or Cushing’s syndrome or prescriptions associated with weight gain, it might be time to consider a weight loss medication.

    Read more: http://www.cnn.com/2018/02/07/health/weight-loss-food-exercise-drayer/index.html

    Cuckolding can be positive for some couples, study says

    (CNN)In our current political climate, the term “cuck” — short for “cuckservative” — has become an insult of the so-called alt-right, aimed at men they view as spineless and emasculated. The slur has its roots in the concept of cuckolding, or having an adulterous partner.

    But, according to a recent study by David Ley, Justin Lehmiller and the writer Dan Savage, acting on cuckolding fantasies can be a largely positive experience for many couples, and hardly a sign of weakness.
    References to cuckolding appear in literature as early as the 13th century, usually in the form of male characters who fear that their child has been sired by another man during an act of infidelity. Today, however, cuckolding has become fetishized into a powerful sexual fantasy for some men, who get aroused by the idea of their romantic partner engaging in sexual activity with someone else. Women also share this fantasy, but less so than men.
      “This fantasy has been around as long as marriage and sexuality,” said Ley, whose book “Insatiable Wives” addresses cuckolding in heterosexual couples. “But we’re hearing more and more about it these days, and more people are rejecting the social stigma against this fantasy.”
      Indeed, the numbers suggest that cuckolding, or at least thinking about it, is more common than you might imagine. For his forthcoming book, “Tell Me What You Want: The Science of Sexual Desire and How It Can Help Improve Your Sex Life,” Lehmiller surveyed thousands of Americans and found that 58% of men and about a third of women had fantasized about cuckolding.
      “Men are more likely to fantasize about cuckolding, and they do it more often — but there are a number of women who have these fantasies as well, which points to the need for more research focused on women’s cuckolding desires,” Lehmiller said.
      Initially viewed as a heterosexual phenomenon, it’s increasingly prevalent among gay men, too. “I’d long gotten letters from straight couples into cuckolding (usually initiated by the husband), but none from gay couples until after marriage equality began to gather steam,” explained writer and activist Savage. To learn more, Savage joined with Lehmiller and Ley for a study of cuckolding fantasies and experiences in 580 gay men.
      Their findings suggest that there are similarities between the way gay and straight men view cuckolding, but clear differences, too. Most notably, interracial and BDSM themes don’t appear to be as common in gay men’s cuckolding fantasies as they are among heterosexual men. The motivations behind these fantasies may also be different.
      Part of what makes cuckolding arousing for heterosexual men is that they tend to view it as a taboo act. “In a society or culture that idealizes monogamy, the cuckold fantasy is a current narrative that is available to people to conceptualize their sexual fantasies,” said Ley.
      But that may not be an influence for everyone. “For gay men, cuckolding isn’t quite as taboo because the norm of lifelong monogamy isn’t so strong in the LGBT community; however, it can still be arousing for a number of other reasons,” said Lehmiller. For instance, fantasies about voyeurism and group sex seem to overlap with those about cuckolding in these men. “It’s a sexual desire that can be easily customized to meet a wide range of sexual needs and desires, whether it’s taboo sex, novelty, voyeurism or something else,” he told me.
      And the emotions surrounding seeing your partner with someone else can add to the turn-on, explained Savage. “It’s not cuckolding if there isn’t an element of humiliation, degradation or denial,” he said. “Our erotic imaginations have the ability to turn shame lemons into delicious kink lemonade.”
      As a sex therapist, one of the more intriguing findings from this study involves the impact of cuckolding on relationships.
      “Overall, our research found that for the most part, cuckolding tends to be a positive fantasy and behavior,” said Ley. “It doesn’t appear to be evidence of disturbance, of an unhealthy relationship, or of disregard for one’s partner.” But there’s an important caveat, added Lehmiller. “We found several personality factors that predict more positive experiences acting on cuckolding fantasies. For those who have a lot of relationship anxiety or abandonment issues, who lack intimacy and communication, and who aren’t careful, detail-oriented planners, acting on a consensual non-monogamy fantasy could very well be a negative experience,” he said. “In other words, not everyone who has a cuckolding fantasy should think about acting on it.”

      See the latest news and share your comments with CNN Health on Facebook and Twitter.

      Remember that sometimes just sharing a sexy thought can be arousing enough — you don’t have to follow through. If you are thinking about acting on a cuckolding fantasy, it’s worth stepping back first and making sure your relationship is in a good place and that you have strong sexual communication skills.
      “For men and couples considering the issue of cuckolding, it’s important there be honesty, integrity, communication, mutuality and shared values,” advised Ley. “I’ve seen men who try to trick their wives into cuckolding them, and this never, ever ends up well.”
      For couples who do decide to move forward, it’s important to take things slow. “The reality of watching your spouse have sex with someone else — or knowing they’re doing it, if you’re not there — is often very different than the fantasy. It can dredge up powerful emotions, so take baby steps and keep talking and communicating,” said Savage. “That said, the rewards can be amazing, according to couples who have successfully folded cuckold play into their relationships.”

      Read more: http://www.cnn.com/2018/01/25/health/cuckolding-sex-kerner/index.html

      Lunar trifecta: Rare ‘super blue blood moon’ will light the sky this week

      (CNN)Set your alarms, space fans — if you can drag yourself out of bed on Wednesday, you’re in for a treat.

      To prepare you for the lunar triple whammy, here’s your all-you-need-to-know guide.

      What is a ‘super blue blood moon’?

        It may sound like the apocalypse is nigh, so let’s break it down by its three parts: “super,” “blue” and “blood.”
        So, a “supermoon” is when a full moon occurs at the same time as its perigee, the closest point of the moon’s orbit with Earth. The result: the moon appears larger than normal and NASA is predicting this one will be 14% brighter than usual.
        Chances are you have used the phrase “once in a blue moon” — but have you ever wondered where it came from? The well-known idiom actually refers to the rare instance when there is a second full moon in a calendar month. The first supermoon of 2018 — which took place on New Year’s Day — was previously described by NASA as the “biggest and brightest” one expected for the entire year.
        Then completing this “lunar trifecta” is the “blood” element. Although it does not have a scientific definition, a “blood moon” occurs during a lunar eclipse when faint red sunbeams peek out around the edges of the Earth, giving it a reddish, copper color.

        Where can I see it?

        Eager stargazers living in North America, Alaska or Hawaii will be able to see the eclipse before sunrise on Wednesday, according to NASA. For those in the Middle East, Asia, eastern Russia, Australia and New Zealand, the “super blue blood moon” will be visible during moonrise on the evening of January 31.
        As long as the weather doesn’t try to ruin things, observers in Alaska, Australia, eastern Asia and Hawaii will be experience the whole phenomenon from start to finish.
        For those living in the US, NASA says the best spots to watch the entire celestial show will be in California and western Canada.
        “Weather permitting, the West Coast, Alaska and Hawaii will have a spectacular view of totality from start to finish,” said George Johnston, lunar blogger at NASA, in a press statement. “Unfortunately, eclipse viewing will be more challenging in the eastern time zone. The eclipse begins at 5.51 a.m. ET, as the moon is about to set in the western sky, and the sky is getting lighter in the east.”
        For observers living in New York or Washington D.C., the space agency suggests a 6.45 a.m. ET start for the best viewing.
        “Your best opportunity if you live in the east is to head outside about 6.45 a.m. and get to a high place to watch the start of the eclipse,” Johnston said. “Make sure you have a clear line of sight to the horizon in the west, opposite from where the sun will rise.”
        Where the moon is covered by the Earth’s shadow, known as the period of totality, it will last just over one and a quarter hours, according to EarthSky. And unlike a solar eclipse, a lunar eclipse is perfectly safe to watch in the night with the naked eye.
        Unfortunately, the eclipse will not be visible from the European or African continents as they will already be in daylight during these hours.
        But fear not, Virtual Telescope will be streaming the event live for anyone unable to view the eclipse up close.
        There are usually a couple of lunar eclipses each year so if you do miss it this time around, the next one will happen on July 27 — though it won’t be visible in North America. It’ll be a long wait for skywatchers in the US as Johnston predicts the next visible lunar eclipse will be on January 21, 2019.
        Be sure to take your favorite pictures and tag #CNNSpace for a chance to be featured.

        Read more: http://www.cnn.com/2018/01/26/world/super-blue-blood-moon-guide-2018-intl/index.html

        What should we have the right to know about a president’s health?

        (CNN)On Friday, at the age of 71, President Trump is undergoing his first-known health physical since taking office, and observers are hoping it will shed light on both his physical and mental health.

        Concerns over Trump’s physical health have grown due to reports of his fast-food habits, lack of exercise, age and weight.
        On the issue of mental health, the release of a sensational West Wing tell-all book by journalist Michael Wolff has fueled a growing chorus of critics who believe Trump is mentally unstable and not fully competent to perform as president.
          White House press secretary Sarah Huckabee Sanders has promised a readout of the results as soon as information becomes available. But ultimately, Trump may decide to withhold details from his physical from the public. He can do so because presidents are shielded by the same federal health privacy laws that protect each of us from undue scrutiny.
          The question is, what right do citizens have to know the intimate details ofa president’smedical history, either physical or mental?
          George Annas, chairman of the Department of Health Law, Bioethics and Human Rights at the Boston University School of Public Health, believes the public has “a right to know if the candidate has a reason to believe he might die in office.”
          But short of that, Annas says, he believes that a “president has a right to keep his medical and mental health information private. This helps to ensure that a decision to seek medical care is a personal, medical one and not done for political effect.”
          “It’s a controversial issue, because some illness can be blown out of proportion, and with modern medicine, a person can do well,” said Dr. Jerrold Post, co-author of “When Illness Strikes the Leader” and a George Washington University professor of psychiatry.
          “But if a person is suffering from early Alzheimer’s or another serious disease, it’s quite another story,” Post said. “Even the finest wines can turn to vinegar.”

          Obama’s physicals

          White House physician Dr. Ronny Jackson is on board to perform Trump’s physical on Friday; he performed President Barack Obama’s last several physicals while he was in office.
          The White House has said it will provide some details of the exam after it’s over. If those details are similar to those released for Obama, we will know Trump’s vital statistics, including his weight, body mass index, resting heart rate and blood pressure. We will also learn about past illnesses and surgeries, current medications and immunizations, his cholesterol levels and the specifics of an examination of his eyes, ears, nose, throat, lungs, digestive system, skin and heart.
          Obama’s exam does not specifically describe the former president’s mental or cognitive state. It mentions only a neurological exam that showed “no focal deficits,” meaning his doctor did not find any localized neurological problems, as with speech or gait. Testing for mental or cognitive decline typically requires more extensive examination.
          On Monday, the White House said Trump would not be undergoing a psychiatric evaluation, despite calls from Congress and a group of more than 100 mental health experts for the exam to be done.
          “He is becoming very unstable very quickly,” said Yale psychiatrist Dr. Bandy Lee, who testified in December about Trump’s mental health to both House and Senate lawmakers. “There is a need for neuropsychiatric evaluation that would demonstrate his capacity to serve.”

          Legacy of presidential coverups

          Presidents have long been wary of allowing the public to see them as less than a picture of perfect health, and history reveals an astounding list of hidden truths when it comes to the health of our nation’s commanders in chief.
          One of the most unusual was President Grover Cleveland’s 1893 coverup of his oral cancer surgery. He smuggled a surgeon and his team onto a friend’s yacht to remove a tumor from the roof of his mouth. Cleveland emerged from his “fishing trip” four days later. The surgery was kept largely secret for nearly a quarter-century.
          Woodrow Wilson suffered several strokes while he was serving as president of Princeton, years before he ran for president, but never revealed his medical history to voters.
          In 1919, while campaigning for the Treaty of Versailles, Wilson “suffered a massive stroke, but they concealed it and just said he was under the weather and no one was informed,” George Washington University’s Postsaid. “So we’ve already had the first woman president: his wife, Edith. In fact, she was to have said, ‘I don’t know why you men make such a fus;, I had no trouble running the country while Woody was sick.’ “
          Though the public knew that President Franklin Delano Roosevelt was wheelchair-bound due to polio when he ran for the fourth time, they did not know he had advanced heart disease and hypertension, believed to have contributed to the cerebral hemorrhage that killed him months into his final term.
          Then, and now, Annas said, “the idea of a president dying in office from a disease he knew he had before he ran for election or re-election doesn’t sit quite right with most people.”
          John F. Kennedy, at 43 the youngest man elected president, went to great lengths to be seen as healthy and vibrant during his campaign.
          “We want a leader who is all-wise and all-powerful and in excellent health,” Post said. “If we thought the candidate was ill or failing, it would affect his electability.”
          In reality, Kennedy took office struggling with hypothyroidism, back pain and Addison’s disease and was on a daily dose of steroids as well as a host of other drugs.
          “His pain was so severe that he brought in Dr. Max Jacobson, called ‘Dr. Feelgood’ by the Secret Service, who was giving him frequent methamphetamine injections while in the White House,” Post said. In addition to the possibility that Kennedy was sometimes high from those injections, Post added, “steroids can cause depression and euphoria.”
          “Addison’s disease affects your cortisol levels, your ability to handle stress,” Dr. Connie Mariano, who served as White House physician for Presidents George W. Bush and Bill Clinton, told CNN in 2015. “You wonder, was the Bay of Pigs an issue because he wasn’t adequately treated for Addison’s?
          “There was also some question when George H. W. Bush was diagnosed with hyperthyroidism, or Graves’ disease, around the time of the Gulf War,” Mariano continued. “Did that make Bush more hyper and aggressive? Did it affect his memory or his ability to focus? Can you say Desert Storm was thyroid storm? It’s hard to say.”

          Mental illness and cognitive decline

          A 2006 study by Duke psychiatrists applied today’s diagnostic criteria to historical records of the first 37 presidents and found that 18 of them met the criteria for psychiatric disorders, mostly major depression or anxiety. The study also found that both Teddy Roosevelt and Lyndon Johnson would have been diagnosed with bipolar disorder.
          In fact, the researchers said, 10 of the 18 presidents exhibited enough symptoms of mental illness while in office to have affected their ability to lead the nation.
          Critics questioning Trump’s mental state have suggested a range of possibilities, including cognitive decline. He would not be the first president to face such speculation.
          Ronald Reagan announced in 1994, after his presidency, that he was diagnosed with Alzheimer’s. Whether it affected his ability to function while in office is a subject of debate. Though doctors were in the dark then, today, medical science knows that Alzheimer’s begins in the brain 20 to 30 years before symptoms begin.
          Donald Trump’s father, Fred, developed Alzheimer’s in his 80s. Having a parent or relative with Alzheimer’s greatly increases the risk of developing the disease.

          See the latest news and share your comments with CNN Health on Facebook and Twitter.

          “Can you rely on the politician’s physician to spot these types of issues? Some illnesses are only known by the symptoms the patient complains of,” Post said. “The softening of mental processes that begin in early Alzheimer’s, for example, may only show up if the politician complains about it.”
          Mariano adds that even when there are signs, “you have to remember if there is something wrong with a president that kicks him out of office, everyone who comes with him leaves. So everyone wants to keep him in. They want to silence the doctor.”

          Read more: http://www.cnn.com/2018/01/11/health/trump-health-presidential-history/index.html

          Is everything you think you know about depression wrong?

          In this extract from his new book, Johann Hari, who took antidepressants for 14 years, calls for a new approach

          In the 1970s, a truth was accidentally discovered about depression one that was quickly swept aside, because its implications were too inconvenient, and too explosive. American psychiatrists had produced a book that would lay out, in detail, all the symptoms of different mental illnesses, so they could be identified and treated in the same way across the United States. It was called the Diagnostic and Statistical Manual. In the latest edition, they laid out nine symptoms that a patient has to show to be diagnosed with depression like, for example, decreased interest in pleasure or persistent low mood. For a doctor to conclude you were depressed, you had to show five of these symptoms over several weeks.

          The manual was sent out to doctors across the US and they began to use it to diagnose people. However, after a while they came back to the authors and pointed out something that was bothering them. If they followed this guide, they had to diagnose every grieving person who came to them as depressed and start giving them medical treatment. If you lose someone, it turns out that these symptoms will come to you automatically. So, the doctors wanted to know, are we supposed to start drugging all the bereaved people in America?

          The authors conferred, and they decided that there would be a special clause added to the list of symptoms of depression. None of this applies, they said, if you have lost somebody you love in the past year. In that situation, all these symptoms are natural, and not a disorder. It was called the grief exception, and it seemed to resolve the problem.

          Then, as the years and decades passed, doctors on the frontline started to come back with another question. All over the world, they were being encouraged to tell patients that depression is, in fact, just the result of a spontaneous chemical imbalance in your brain it is produced by low serotonin, or a natural lack of some other chemical. Its not caused by your life its caused by your broken brain. Some of the doctors began to ask how this fitted with the grief exception. If you agree that the symptoms of depression are a logical and understandable response to one set of life circumstances losing a loved one might they not be an understandable response to other situations? What about if you lose your job? What if you are stuck in a job that you hate for the next 40 years? What about if you are alone and friendless?

          The grief exception seemed to have blasted a hole in the claim that the causes of depression are sealed away in your skull. It suggested that there are causes out here, in the world, and they needed to be investigated and solved there. This was a debate that mainstream psychiatry (with some exceptions) did not want to have. So, they responded in a simple way by whittling away the grief exception. With each new edition of the manual they reduced the period of grief that you were allowed before being labelled mentally ill down to a few months and then, finally, to nothing at all. Now, if your baby dies at 10am, your doctor can diagnose you with a mental illness at 10.01am and start drugging you straight away.

          Dr Joanne Cacciatore, of Arizona State University, became a leading expert on the grief exception after her own baby, Cheyenne, died during childbirth. She had seen many grieving people being told that they were mentally ill for showing distress. She told me this debate reveals a key problem with how we talk about depression, anxiety and other forms of suffering: we dont, she said, consider context. We act like human distress can be assessed solely on a checklist that can be separated out from our lives, and labelled as brain diseases. If we started to take peoples actual lives into account when we treat depression and anxiety, Joanne explained, it would require an entire system overhaul. She told me that when you have a person with extreme human distress, [we need to] stop treating the symptoms. The symptoms are a messenger of a deeper problem. Lets get to the deeper problem.

          *****

          I was a teenager when I swallowed my first antidepressant. I was standing in the weak English sunshine, outside a pharmacy in a shopping centre in London. The tablet was white and small, and as I swallowed, it felt like a chemical kiss. That morning I had gone to see my doctor and I had told him crouched, embarrassed that pain was leaking out of me uncontrollably, like a bad smell, and I had felt this way for several years. In reply, he told me a story. There is a chemical called serotonin that makes people feel good, he said, and some people are naturally lacking it in their brains. You are clearly one of those people. There are now, thankfully, new drugs that will restore your serotonin level to that of a normal person. Take them, and you will be well. At last, I understood what had been happening to me, and why.

          However, a few months into my drugging, something odd happened. The pain started to seep through again. Before long, I felt as bad as I had at the start. I went back to my doctor, and he told me that I was clearly on too low a dose. And so, 20 milligrams became 30 milligrams; the white pill became blue. I felt better for several months. And then the pain came back through once more. My dose kept being jacked up, until I was on 80mg, where it stayed for many years, with only a few short breaks. And still the pain broke back through.

          I started to research my book, Lost Connections: Uncovering The Real Causes of Depression and the Unexpected Solutions, because I was puzzled by two mysteries. Why was I still depressed when I was doing everything I had been told to do? I had identified the low serotonin in my brain, and I was boosting my serotonin levels yet I still felt awful. But there was a deeper mystery still. Why were so many other people across the western world feeling like me? Around one in five US adults are taking at least one drug for a psychiatric problem. In Britain, antidepressant prescriptions have doubled in a decade, to the point where now one in 11 of us drug ourselves to deal with these feelings. What has been causing depression and its twin, anxiety, to spiral in this way? I began to ask myself: could it really be that in our separate heads, all of us had brain chemistries that were spontaneously malfunctioning at the same time?

          To find the answers, I ended up going on a 40,000-mile journey across the world and back. I talked to the leading social scientists investigating these questions, and to people who have been overcoming depression in unexpected ways from an Amish village in Indiana, to a Brazilian city that banned advertising and a laboratory in Baltimore conducting a startling wave of experiments. From these people, I learned the best scientific evidence about what really causes depression and anxiety. They taught me that it is not what we have been told it is up to now. I found there is evidence that seven specific factors in the way we are living today are causing depression and anxiety to rise alongside two real biological factors (such as your genes) that can combine with these forces to make it worse.

          Once I learned this, I was able to see that a very different set of solutions to my depression and to our depression had been waiting for me all along.

          To understand this different way of thinking, though, I had to first investigate the old story, the one that had given me so much relief at first. Professor Irving Kirsch at Harvard University is the Sherlock Holmes of chemical antidepressants the man who has scrutinised the evidence about giving drugs to depressed and anxious people most closely in the world. In the 1990s, he prescribed chemical antidepressants to his patients with confidence. He knew the published scientific evidence, and it was clear: it showed that 70% of people who took them got significantly better. He began to investigate this further, and put in a freedom of information request to get the data that the drug companies had been privately gathering into these drugs. He was confident that he would find all sorts of other positive effects but then he bumped into something peculiar.

          Illustration
          Illustration by Michael Driver.

          We all know that when you take selfies, you take 30 pictures, throw away the 29 where you look bleary-eyed or double-chinned, and pick out the best one to be your Tinder profile picture. It turned out that the drug companies who fund almost all the research into these drugs were taking this approach to studying chemical antidepressants. They would fund huge numbers of studies, throw away all the ones that suggested the drugs had very limited effects, and then only release the ones that showed success. To give one example: in one trial, the drug was given to 245 patients, but the drug company published the results for only 27 of them. Those 27 patients happened to be the ones the drug seemed to work for. Suddenly, Professor Kirsch realised that the 70% figure couldnt be right.

          It turns out that between 65 and 80% of people on antidepressants are depressed again within a year. I had thought that I was freakish for remaining depressed while on these drugs. In fact, Kirsch explained to me in Massachusetts, I was totally typical. These drugs are having a positive effect for some people but they clearly cant be the main solution for the majority of us, because were still depressed even when we take them. At the moment, we offer depressed people a menu with only one option on it. I certainly dont want to take anything off the menu but I realised, as I spent time with him, that we would have to expand the menu.

          This led Professor Kirsch to ask a more basic question, one he was surprised to be asking. How do we know depression is even caused by low serotonin at all? When he began to dig, it turned out that the evidence was strikingly shaky. Professor Andrew Scull of Princeton, writing in the Lancet, explained that attributing depression to spontaneously low serotonin is deeply misleading and unscientific. Dr David Healy told me: There was never any basis for it, ever. It was just marketing copy.

          I didnt want to hear this. Once you settle into a story about your pain, you are extremely reluctant to challenge it. It was like a leash I had put on my distress to keep it under some control. I feared that if I messed with the story I had lived with for so long, the pain would run wild, like an unchained animal. Yet the scientific evidence was showing me something clear, and I couldnt ignore it.

          *****

          So, what is really going on? When I interviewed social scientists all over the world from So Paulo to Sydney, from Los Angeles to London I started to see an unexpected picture emerge. We all know that every human being has basic physical needs: for food, for water, for shelter, for clean air. It turns out that, in the same way, all humans have certain basic psychological needs. We need to feel we belong. We need to feel valued. We need to feel were good at something. We need to feel we have a secure future. And there is growing evidence that our culture isnt meeting those psychological needs for many perhaps most people. I kept learning that, in very different ways, we have become disconnected from things we really need, and this deep disconnection is driving this epidemic of depression and anxiety all around us.

          Lets look at one of those causes, and one of the solutions we can begin to see if we understand it differently. There is strong evidence that human beings need to feel their lives are meaningful that they are doing something with purpose that makes a difference. Its a natural psychological need. But between 2011 and 2012, the polling company Gallup conducted the most detailed study ever carried out of how people feel about the thing we spend most of our waking lives doing our paid work. They found that 13% of people say they are engaged in their work they find it meaningful and look forward to it. Some 63% say they are not engaged, which is defined as sleepwalking through their workday. And 24% are actively disengaged: they hate it.

          A
          Antidepressant prescriptions have doubled over the last decade. Photograph: Anthony Devlin/PA

          Most of the depressed and anxious people I know, I realised, are in the 87% who dont like their work. I started to dig around to see if there is any evidence that this might be related to depression. It turned out that a breakthrough had been made in answering this question in the 1970s, by an Australian scientist called Michael Marmot. He wanted to investigate what causes stress in the workplace and believed hed found the perfect lab in which to discover the answer: the British civil service, based in Whitehall. This small army of bureaucrats was divided into 19 different layers, from the permanent secretary at the top, down to the typists. What he wanted to know, at first, was: whos more likely to have a stress-related heart attack the big boss at the top, or somebody below him?

          Everybody told him: youre wasting your time. Obviously, the boss is going to be more stressed because hes got more responsibility. But when Marmot published his results, he revealed the truth to be the exact opposite. The lower an employee ranked in the hierarchy, the higher their stress levels and likelihood of having a heart attack. Now he wanted to know: why?

          And thats when, after two more years studying civil servants, he discovered the biggest factor. It turns out if you have no control over your work, you are far more likely to become stressed and, crucially, depressed. Humans have an innate need to feel that what we are doing, day-to-day, is meaningful. When you are controlled, you cant create meaning out of your work.

          Suddenly, the depression of many of my friends, even those in fancy jobs who spend most of their waking hours feeling controlled and unappreciated started to look not like a problem with their brains, but a problem with their environments. There are, I discovered, many causes of depression like this. However, my journey was not simply about finding the reasons why we feel so bad. The core was about finding out how we can feel better how we can find real and lasting antidepressants that work for most of us, beyond only the packs of pills we have been offered as often the sole item on the menu for the depressed and anxious. I kept thinking about what Dr Cacciatore had taught me we have to deal with the deeper problems that are causing all this distress.

          I found the beginnings of an answer to the epidemic of meaningless work in Baltimore. Meredith Mitchell used to wake up every morning with her heart racing with anxiety. She dreaded her office job. So she took a bold step one that lots of people thought was crazy. Her husband, Josh, and their friends had worked for years in a bike store, where they were ordered around and constantly felt insecure, Most of them were depressed. One day, they decided to set up their own bike store, but they wanted to run it differently. Instead of having one guy at the top giving orders, they would run it as a democratic co-operative. This meant they would make decisions collectively, they would share out the best and worst jobs and they would all, together, be the boss. It would be like a busy democratic tribe. When I went to their store Baltimore Bicycle Works the staff explained how, in this different environment, their persistent depression and anxiety had largely lifted.

          Its not that their individual tasks had changed much. They fixed bikes before; they fix bikes now. But they had dealt with the unmet psychological needs that were making them feel so bad by giving themselves autonomy and control over their work. Josh had seen for himself that depressions are very often, as he put it, rational reactions to the situation, not some kind of biological break. He told me there is no need to run businesses anywhere in the old humiliating, depressing way we could move together, as a culture, to workers controlling their own workplaces.

          *****

          With each of the nine causes of depression and anxiety I learned about, I kept being taught startling facts and arguments like this that forced me to think differently. Professor John Cacioppo of Chicago University taught me that being acutely lonely is as stressful as being punched in the face by a stranger and massively increases your risk of depression. Dr Vincent Felitti in San Diego showed me that surviving severe childhood trauma makes you 3,100% more likely to attempt suicide as an adult. Professor Michael Chandler in Vancouver explained to me that if a community feels it has no control over the big decisions affecting it, the suicide rate will shoot up.

          This new evidence forces us to seek out a very different kind of solution to our despair crisis. One person in particular helped me to unlock how to think about this. In the early days of the 21st century, a South African psychiatrist named Derek Summerfeld went to Cambodia, at a time when antidepressants were first being introduced there. He began to explain the concept to the doctors he met. They listened patiently and then told him they didnt need these new antidepressants, because they already had anti-depressants that work. He assumed they were talking about some kind of herbal remedy.

          He asked them to explain, and they told him about a rice farmer they knew whose left leg was blown off by a landmine. He was fitted with a new limb, but he felt constantly anxious about the future, and was filled with despair. The doctors sat with him, and talked through his troubles. They realised that even with his new artificial limb, his old jobworking in the rice paddieswas leaving him constantly stressed and in physical pain, and that was making him want to just stop living. So they had an idea. They believed that if he became a dairy farmer, he could live differently. So they bought him a cow. In the months and years that followed, his life changed. His depressionwhich had been profoundwent away. You see, doctor, they told him, the cow was an antidepressant.

          To them, finding an antidepressant didnt mean finding a way to change your brain chemistry. It meant finding a way to solve the problem that was causing the depression in the first place. We can do the same. Some of these solutions are things we can do as individuals, in our private lives. Some require bigger social shifts, which we can only achieve together, as citizens. But all of them require us to change our understanding of what depression and anxiety really are.

          This is radical, but it is not, I discovered, a maverick position. In its official statement for World Health Day in 2017, the United Nations reviewed the best evidence and concluded that the dominant biomedical narrative of depression is based on biased and selective use of research outcomes that must be abandoned. We need to move from focusing on chemical imbalances, they said, to focusing more on power imbalances.

          After I learned all this, and what it means for us all, I started to long for the power to go back in time and speak to my teenage self on the day he was told a story about his depression that was going to send him off in the wrong direction for so many years. I wanted to tell him: This pain you are feeling is not a pathology. Its not crazy. It is a signal that your natural psychological needs are not being met. It is a form of grief for yourself, and for the culture you live in going so wrong. I know how much it hurts. I know how deeply it cuts you. But you need to listen to this signal. We all need to listen to the people around us sending out this signal. It is telling you what is going wrong. It is telling you that you need to be connected in so many deep and stirring ways that you arent yet but you can be, one day.

          If you are depressed and anxious, you are not a machine with malfunctioning parts. You are a human being with unmet needs. The only real way out of our epidemic of despair is for all of us, together, to begin to meet those human needs for deep connection, to the things that really matter in life.

          This is an edited extract from Lost Connections: Uncovering the Real Causes of Depression and the Unexpected Solutions by Johann Hari, published by Bloomsbury on 11 January (16.99). To order a copy for 14.44 go to guardianbookshop.com or call 0330 333 6846. Free UK p&p over 10, online orders only. Phone orders min p&p of 1.99. It will be available in audio at audible.co.uk

          Read more: https://www.theguardian.com/society/2018/jan/07/is-everything-you-think-you-know-about-depression-wrong-johann-hari-lost-connections

          Should you try ‘souping’?

          (CNN)When I first heard of “souping,” it brought me back to my clinical days working in a hospital, where pureed soups and other easy to digest foods — also known as “full liquids” — would be prescribed for patients recovering from gastrointestinal surgery, or those who had difficulty chewing or swallowing.

          Then I reflected upon how much I regularly enjoy soup, especially for the comfort it provides on cold, dreary days — even though, thankfull,y I have no health issues that would require such an easily digestible meal. Soup is often my go-to in the winter, especially varieties made with beans or skinless chicken, nutritious veggies, noodles and tasty broth. And I’ve always liked the fact that even though I feel full and satisfied after a bowl of broth, it’s not like the fullness I experience after eating a bowl of pasta.
          Among nutritionists, I’m not alone in my feelings about this comforting, filling, yet not-so-high calorie food. “Soup can be a healthy and delicious way to create balance after a season of heavy meals or even a particularly indulgent weekend,” said Robin Foroutan, a registered dietitian and spokeswoman for the Academy of Nutrition and Dietetics. “It gives your digestive system a chance to reboot and de-bloat.”
            Regularly eating soup might help you shed some unwanted pounds, too. Several studies have shown that when soup is eaten before a meal, it fills you up and helps you eat fewer calories for the entire meal. In one study, when people consumed soup for a snack instead of chips and pretzels, they lost 50% more weight — even though both the soup and snacks, as well as the total day’s diet, had the same amount of calories.
            What’s the slimming secret of soup? Binding water into food slows down gastric emptying, keeping your stomach fuller for longer, according to Barbara Rolls, a professor of nutritional sciences at Pennsylvania State University who has authored studies on soup and its effects on satiety, and wrote “The Ultimate Volumetrics Diet.” Plus, she added, “the water in soup adds weight and volume so that you can have a satisfying amount without too many calories.”

            The ‘souping’ trend

            The weight loss benefits of soup have led to soup cleansing — a trend that has become increasingly popular over the last few years. In fact, according to Pinterest, “souping” is one of the top 10 food trends for 2018.
            And unlike juicing, which removes fiber from fruit, soup can help to stabilize blood sugar for more sustained energy, especially when it includes tons of fiber-rich veggies, protein and healthy fat, according to Foroutan.
            “Soups still contains the whole food, so fiber is still intact, but it’s easier to digest because it’s cooked,” said Foroutan. Juice is high in phytonutrients and antioxidants, but if it’s made from all fruit, it can be very high in sugars (even though they’re natural sugars), and this can cause one’s blood sugar to spike and drop, which can lead to feeling more tired overall, she explained.
            Don’t know how to get started? Companies such as Splendid Spoon, Soupure and Los Angeles-serving Soupelina take the guesswork away by offering consumers various soup-based meal plans which can be delivered directly to your doorstep.
            For example, a single souping cleanse day on Splendid Spoon includes five soups, such as beet balsamic bisque, fennel consommé, cauliflower coconut, butternut turmeric and red lentil dal. After the cleanse, you continue the week-long plan with the company’s breakfasts and lunches for five days, which include smoothies and bowls. Dinner is your choice. Day 7 is a “wander day” to enjoy eating as you typically would.
            The convenience factor of soup delivery is a big draw for those with busy schedules.
            “I choose my order, it comes delivered to my apartment and all I need to do is heat it up. I never have to worry about eating or having a bad meal,” said Morgan Hagney, who was in the throes of grad school and working full time when she started souping with Splendid Spoon about a year ago. “The recipes are delicious. They offer a variety of choices no matter the time of year, my mood or hunger level.”
            Soupure offers soup only packages, like a three-day soup-only cleanse that includes kale minestrone and pumpkin miso, along with chicken or beef broth. But you can also get soups a la carte. “Many of our regulars have made souping part of their regular diet, and they cleanse on a regular basis or they simply incorporate soup into their regular everyday diet as a meal replacement,” said Soupure founder Vivienne Vella.
            Customers of Soupure and Splendid Spoon say the programs have helped them maintain healthier, more nutritious diets, and lose weight, too.

            Calorie check

            Soup cleanses tend to have fewer calories than what you would eat on a typical day, which helps to explain how pounds may drop quickly for some. For example, calories for the cleanse day on Splendid Spoon range from 800 to 950, and breakfasts and lunches on the following five days contain approximately 300 calories per meal. On Soupure, cleanses range from 1,000 to 1,200 calories per day, depending on the type of cleanse you choose. Such a low amount could leave you irritable and hungry.
            “It could be too low in calories for some people, but you can always add more to the soup or have an extra serving,” said Foroutan. “Plus, it’s the quality of the calories that count.” They key, she said, is to include a lot of vegetables, herbs and spices, along with protein such as lentils, beans or tofu for vegetarian options, or chicken, fish and bone broth for omnivores and flexitarians.

            See the latest news and share your comments with CNN Health on Facebook and Twitter.

            Foroutan said having only soup for a few days or only soup for dinner for a week is fine — she even does it herself — as long as you pay attention to your body and listen to its cues.
            She often finds herself souping periodically in the winter, from a variety of soups made in her kitchen.
            “I love homemade miso soup with bok choy, napa cabbage, seaweed and shiitake mushrooms; kale and white bean soup with turmeric, bay leaves, thyme, garlic, onion, crushed tomato, celery and carrots, which I sometimes top with organic spicy chicken sausage; my veggie ‘detox’ soup with kale, daikon radish, celery, bok choy, broccoli and turmeric; and even a simple broth with whichever vegetables are in my fridge simmered in organic bone broth. The options are endless.”

            Read more: http://www.cnn.com/2018/01/26/health/soup-food-drayer/index.html

            Scientists grow new ears for children with defect

            (CNN)Using a combination of 3-D printing and cultured cells, scientists in China have grown new ears for five children born with a defect in one ear called microtia, which impacts the shape and function of the ear.

            In a first-of-its-kind study, researchers describe how they collected cartilage cells called chondrocytes from the children’s microtia ears and used them to grow new ear-shaped cartilage. The new cartilage was based on 3-D-printed models of the children’s healthy ears.
            Then, the researchers transferred the newly engineered ears to the children and performed ear reconstruction, according to a study published this month in the journal EBioMedicine.
              “We were able to successfully design, fabricate, and regenerate patient-specific external ears,” the researchers wrote in their study, which followed each child for up to 2½ years.
              “Nevertheless, further efforts remain necessary to eventually translate this prototype work into routine clinical practices,” they wrote. “In the future, long-term (up to 5 years) follow-up of the cartilage properties and clinical outcomes … will be essential.”

                Growing human bones from fat

              The study involved a 6-year-old girl, a 9-year-old girl, an 8-year-old girl, a 7-year-old boy and a 7-year-old girl, all with unilateral microtia.
              The researchers used CT scanning and 3-D printing to build a biodegradable scaffold that replicated the exact 3-D structure of each patient’s healthy ear. After the researchers derived chondrocytes from the cartilage in each patient’s microtia ear, those cells were seeded onto the scaffold and cultured for three months.
              Next, once the cartilage frameworks were generated with each patient’s specific ear shape, they were implanted to reconstruct ears in the five patients. Each patient was monitored for various amounts of time after implantation, with the longest follow-up being 2½ years.
              Of all of the cases, four showed obvious cartilage formation by six months after the new ear implantation, the researchers found, and among three of the patients, the shape, size and angle of the new ear all matched the other ear, which was healthy.
              The new ears stayed intact as the researchers followed up with the children after surgery, but two of the cases showed slight distortion after surgery, the researchers said.

                Scientists develop new 3D organ printer

              The researchers described their results as “a significant breakthrough” in the clinical application of engineering human ear-shaped cartilage, but the approach comes with several limitations.
              “The part about this work that is dangerous is when you remove cells from someone’s body and you grow them in culture, you have to apply stimulating compounds to the cells to get them to divide,” Hadlock said.
              “When you apply those stimulating compounds, you are running the risk of allowing those cells to go haywire from a division standpoint. It’s another way of saying that you can actually create like a cancerous type of uncontrolled growth,” she said. “In the United States, we have been extremely wary of doing that.”
              Another limitation relates to how the researchers used the children’s own chondrocytes, the cartilage cells within their ears, even though their ears had been diagnosed with microtia, Hadlock added.
              “Because the ear is not normal, they in and of themselves may be diseased. They may be different than a totally healthy chondrocyte,” Hadlock said. “That’s something about which we don’t have enough information.”

              Many challenges remain

              More research is needed before the approach described in the new study could be widely used among microtia patients in a clinical setting.
              Though there has been no recent review of the average medical costs of microtia treatment options, they are expected to be steep since hearing impairment care and multiple surgeries for reconstruction are often needed.
              So the approach described in the new study could come with a hefty price tag as well.
              The researchers noted in their study that they plan to continue to intermittently follow up with the children in the study for up to five years and to continue reporting on their results as data are collected.

              See the latest news and share your comments with CNN Health on Facebook and Twitter.

              “The main challenges for the widespread use of this particular approach for microtia are manufacturing and regulatory surveillance,” said Bonassar, who cofounded 3-D Bio Corp., a company developing tissue-engineered cartilage for multiple applications.
              “The method for making these constructs is quite complicated, involving three distinct biomaterials that are combined into a scaffold, seeded with cells, then cultured for three months before implantation to ensure proper cell distribution throughout the construct,” he said.
              So scaling up that process to help the tens of thousands of patients who need such implants remains a real challenge, Bonassar said.
              “Secondly, the materials that are used for these scaffolds remain in the body for a long time: up to four years,” he said. “Such implants would likely need to be monitored for four or five years before the ultimate fate of these materials in the body is known.”

              Read more: http://www.cnn.com/2018/01/29/health/growing-ears-on-humans-study/index.html

              Apple wants to gather all your medical records in the Health app

              Apple announced a new health effort as part of iOS 11.3. The new Health Records section in the Health app lets you gather and view all your medical records. The company is partnering with hospitals and clinics.

              Apple released the first beta version of iOS 11.3 today. While the new version of iOS is going to remain in beta testing for a couple of months, it should be available as a free download to all iPhone users pretty soon.

              Health Records is going to be a new menu in the Health Data section of the Health app. You’ll be able to add any file to this menu as long as it’s a CDA file (Clinical Document Architecture). Some hospitals already email you those files or make them available on their website. But Apple wants to automate this process.

              Johns Hopkins Medicine, Cedars-Sinai, Penn Medicine and others are already testing the feature with their patients. Health Records is based on FHIR (Fast Healthcare Interoperability Resources), a standard when it comes to data formats and APIs.

              So it means that those hospitals and clinics will be able to push this data to your phone directly. You’ll receive a notification alerting you that you just received a new medical record. Data is encrypted on your phone and protected by your passcode.

              And it looks very thorough based on the screenshot. You’ll be able to list your allergies, medications, immunizations and lab results in the Health app.

              This could be particularly useful for patients who get a lot of lab results to track cholesterol or something else. Newest results appear at the top of the Healthcare Records timeline.

              It’s going to be hard to convince every single hospital and clinic around the U.S. and around the world to adopt the new Health Records feature. But here’s a list of all the institutions participating in the beta test:

              • Johns Hopkins Medicine – Baltimore, Maryland
              • Cedars-Sinai – Los Angeles, California
              • Penn Medicine – Philadelphia, Pennsylvania
              • Geisinger Health System – Danville, Pennsylvania
              • UC San Diego Health – San Diego, California
              • UNC Health Care – Chapel Hill, North Carolina
              • Rush University Medical Center – Chicago, Illinois
              • Dignity Health – Arizona, California and Nevada
              • Ochsner Health System – Jefferson Parish, Louisiana
              • MedStar Health – Washington, D.C., Maryland and Virginia
              • OhioHealth – Columbus, Ohio
              • Cerner Healthe Clinic – Kansas City, Missouri
              1. iPhone_X_Apple_All_Health_Records_Screen_01232018

              2. iPhone_X_Apple_Health_Records_screen_01232018

              Read more: https://techcrunch.com/2018/01/24/apple-wants-to-gather-all-your-medical-records-in-the-health-app/

              Donald Trump’s health: What we know so far

              (CNN)What the world knows about President Donald Trump’s general health is not much as of now — and what the public learns about his health after a medical exam on Friday might not be much, either.

              Trump, 71, is scheduled to undergo his first formal physical exam since taking office.
              “We’ll only learn what he wants us to know,” said Arthur Caplan, a professor and founding head of the Division of Medical Ethics at NYU Langone Health in New York.
                “A physical is forward-looking and almost, really, an examination of your biochemistry. We’re going to look at your blood and your urine, and we’re going to take a look at your heart electronically,” said Caplan, who was one of 75 health professionals who signed a letter urging Trump’s doctor to evaluate his neurological health (PDF).
                Presidents historically will “release general information on things like cholesterol, is there any problem with emerging diabetes or the president’s heart. … It won’t solve or settle any of the controversies about his competence,” he said. “The president has the same right to privacy as you or I would if we went to get a physical. No one has the right to know what the results are. There’s no legislation, there’s no requirement that he tell us anything.”
                Trump’s physical will be performed at the Walter Reed National Military Medical Center in Maryland and conducted by the White House physician, Dr. Ronny Jackson, who also performed President Barack Obama’s last several physicals while he was in office.
                The White House has said it will provide a readout of the exam on Tuesday, but until then, here is what we know about Trump’s health.

                Trump’s weight and cholesterol

                Dr. Harold Bornstein, the president’s personal physician at the time, released a letter in 2016 detailing Trump’s key stats, including his body mass index, blood pressure and even testosterone level.
                The letter noted that at 6-foot-3 and 236 pounds, Trump had a body mass index of 29.5, which made him overweight, according to the National Institutes of Health’s online BMI calculator.
                “Overweight and obesity increase the risk for diabetes, heart disease and high cholesterol,” said Dr. Ranit Mishori, professor of family medicine at Georgetown University School of Medicine who was not involved in the president’s care.
                “I would focus on lifestyle modifications, diet changes and exercise,” she said. “Come up with a plan for incorporating exercise and/or dietary changes into the daily routine, recommend a healthy diet — Mediterranean, lots of fruits, and vegetables, little red meat — and likely perform a blood test for diabetes, in addition to cholesterol levels.”
                Trump had a total cholesterol level of 169, “good” HDL cholesterol of 63, “bad” LDL cholesterol of 94 and blood pressure of 116/70, according to the letter.
                Blood pressure levels less than 120/80 are considered “normal.”

                Trump’s blood and heart health

                The letter also indicated that Trump’s blood sugar level was 99 milligrams per deciliter, and his triglycerides, which are a type of fat found in the blood, were 61 mg/dL. For a fasting blood glucose test, which measures sugar, a level between 70 and 100 mg/dL would be considered “normal.”
                Trump takes a statin, called rosuvastatin, to treat high cholesterol and triglyceride levels, and he takes a low-dose aspirin, according to the doctor’s letter.
                The letter also indicated that Trump was screened for prostate cancer, which resulted in a low score, meaning there was no evidence of cancer. He had a colonoscopy in 2013 and a transthoracic echocardiogram to examine his heart in 2014. Both tests appeared to be normal.
                The letter also mentioned that Trump’s testosterone level was 441.6.
                A testosterone test measures the amount of the male hormone in the blood, and normal measurements for these tests typically are 300 to 1,000 nanograms per deciliter among men and 15 to 70 among women, according to the US National Library of Medicine.
                “From the scientific perspective, it would be interesting to see what kinds of tests he’s had,” Mishori said. “My guess is that he’ll have what’s called a VIP or ‘executive’ physical: a very thorough and lengthy affair with multiple specialists” and manytests, such as EKG, carotid artery ultrasound, urinary test, PSA test and more.

                Trump’s mental health

                That 2016 doctor’s letter noted that “Mr. Trump is in excellent physical health.”
                Yet since taking office, Trump’s mental health has become a topic of public interest.
                A review of the past five presidents’ physical exams shows only brief mentions of mental health, and none included a readout of mental health tests.

                See the latest news and share your comments with CNN Health on Facebook and Twitter.

                “Although cognitive screening is not recommended in every individual older than 65 years because of a current lack of evidence for or against screening, the US Preventive Services Task Force advises clinicians to look for early signs or symptoms of cognitive impairment, such as problems with memory or language,” Mishori said.
                “They are not generally considered routine parts of the physical. The task of recognizing changes in memory, thinking and other cognitive functions and distinguishing whether such symptoms are due to normal aging or are signs of early dementia is not an easy one,” she said.

                Read more: http://www.cnn.com/2018/01/12/health/donald-trump-health-explainer/index.html