Billionaire Bloomberg to fund $5m public health projects in 40 cities worldwide

Exclusive: Melbourne, Accra and Ulaanbaatar among cities to benefit from funding pledged by former New York mayor to tackle issues from air pollution to obesity

Michael Bloomberg, the billionaire bte noire of both the sugar industry and the tobacco industry, famously fought for a ban on the sale of large-sized colas and other sweet drinks when he was mayor of New York and lost. Although that is not how he sees it.

We actually won that battle, he says. I have always thought if we had not been stopped by the court, it would have died as an issue. Nobody would have known about it. But the fact that it kept coming back to the newspapers was a gift in disguise because people started to think, Holy God, maybe full-sugar drinks are bad for me.

So what happened was consumption of full-sugar drinks around the world has gone down dramatically. If we had won the thing, I think it would have been less.

Bloomberg did plenty more for public health while mayor of New York, including imposing one of the first bans on smoking in bars and restaurants in 2003. Since then he has widened his sphere of influence, funding successful campaigns through his philanthropic foundation for sugar taxes in Mexico and Philadelphia and for curbs on smoking all over the world.

Now, appointed last year as the World Health Organisations global ambassador for non-communicable diseases meaning anything that can harm or kill you that is not infectious the eighth richest person in the world, worth an estimated $47.5bn, is taking his philosophy and his cash to 40 cities around the globe.

His offer, taken up by about 40 cities so far and officially launched on Tuesday, is $5m in assistance from Bloomberg Philanthropies as well as technical support for cities that choose to focus on one of 10 healthy lifestyle issues, including curbing sugary drink consumption, air pollution, promoting exercise and and bans on smoking. They range from affluent Melbourne in Australia to Cali and Medellin in Colombia, Accra in Ghana, Ulaanbaatar in Mongolia, Khatmandu in Nepal and Kampala in Uganda.

National and state governments collect taxes, but it is city governments that make things happen. 50% of people currently live in cities and that is projected to rise to 70% in the next decade or so. Cities are where the rubber meets the road, Bloomberg told the Guardian. The problems are in the cities and the solutions are in the cities.

Bloomberg is upbeat, indomitable and an independent thinker. He made his money in global financial services and has been a Democrat, a Republican and an independent at various times. He says he believes the war on sugar and tobacco, of which his foundation must be seen as the main global financial backer, is being won.

In parts of the world, clearly yes, and particularly on smoking, he said. In Europe nobody would have thought people wouldnt insist on smoking in an Irish bar or pub or an Italian restaurant, but the smoking campaign has really worked, reducing consumption in all of western Europe, north and south America and even in China.

But there are places where poor people live and they are still smoking and really damaging their lungs and they are going to die young. It is up to us to keep the battle going. Sugar is a little bit less developed but still working.

His attention is on non-communicable diseases more broadly now that includes air pollution and road traffic accidents as well as cigarettes, alcohol and bad food. Cities in poor countries may argue that they have too many other problems to spend time on sugary drinks, but, says Bloomberg, poverty, ill-health and poor education are all interlinked.

It will be harder to get the public behind you because they less understand the damage being done to their own health. But thats the challenge. The cities where its easy have probably already addressed the issue, he said.

Michael
Michael Bloomberg and WHO director-general Dr Margaret Chan Photograph: Bloomberg Phlilantropies

Bloomberg would not suggest it is easy to make the sort of changes he has pushed for in all these years.

I dont remember anybody objecting to the smoking ban when we put it in, although a lot of people wanted to take my picture and a lot of people gave me one finger waves, he said. If there was an easy solution to a complex problem, we wouldnt have the problem. If you want to make things better, youre going to be doing things that are tough.

The cities that commit to the Partnership for Healthy Cities can choose between curbing sugary drink consumption, passing laws to make public places smoke-free or banning cigarette advertising, cutting salt in food, using cleaner fuels, encouraging cycling and walking, reducing speeding, increasing seatbelt and helmet use, curbing drink driving or carrying out a survey to collect data on the lifestyle risks the city population runs.

Cape Town in South Africa was one of the earliest cities to commit and will focus on reducing the intake of sugary drinks. Its mayor, Patricia de Lille, says they are facing an epidemic of type 2 diabetes, caused by obesity. Diabetes is a silent killer, she said. We dont have the luxury to work by trial and error. Unfortunately we have to get it right first time.

London has also said it wants to be involved, although which issue will be the focus has not yet been revealed. It is a city with which Bloomberg says he has a complex relationship his former wife is British and his daughters hold dual nationality. He has an honorary knighthood from the Queen. He also has an honour from the City of London that he intends one day to cash in.

I do have the right to drive sheep across London Bridge and before I die, I want to do it one day at rush hour, just to see what happens, he said.

Read more: https://www.theguardian.com/society/2017/may/16/billionaire-bloomberg-to-fund-5m-public-health-projects-in-40-cities-worldwide

Are smartphones really making our children sad?

US psychologist Jean Twenge, who has claimed that social media is having a malign affect on the young, answers critics who accuse her of crying wolf

Last week, the childrens commissioner, Anne Longfield, launched a campaign to help parents regulate internet and smartphone use at home. She suggested that the overconsumption of social media was a problem akin to that of junk-food diets. None of us, as parents, would want our children to eat junk food all the time double cheeseburger, chips, every day, every meal, she said. For those same reasons, we shouldnt want our children to do the same with their online time.

A few days later, former GCHQ spy agency chief Robert Hannigan responded to the campaign. The assumption that time online or in front of a screen is life wasted needs challenging. It is driven by fear, he said. The best thing we can do is to focus less on the time they spend on screens at home and more on the nature of the activity.

This exchange is just one more example of how childrens screentime has become an emotive, contested issue. Last December, more than 40 educationalists, psychologists and scientists signed a letter in the Guardian calling for action on childrens screen-based lifestyles. A few days later, another 40-odd academics described the fears as moral panic and said that any guidelines needed to build on evidence rather than scaremongering.

Faced with these conflicting expert views, how should concerned parents proceed? Into this maelstrom comes the American psychologist Jean Twenge, who has written a book entitled iGen: Why Todays Super-Connected Kids Are Growing Up Less Rebellious, More Tolerant, Less Happy and Completely Unprepared for Adulthood and What That Means for the Rest of Us.

If the books title didnt make her view clear enough, last weekend an excerpt was published in the American magazine the Atlantic with the emotive headline Have smartphones destroyed a generation? It quickly generated differing reactions that were played out on social media these could be broadly characterised as praise from parents and criticism from scientists. In a phone interview and follow-up emails, Twenge explained her conclusions about the downsides of the connected world for teens, and answered some of her critics.

The Atlantic excerpt from your book was headlined Have smartphones destroyed a generation? Is that an accurate reflection of what you think?
Well, keep in mind that I didnt write the headline. Its obviously much more nuanced than that.

So why did you write this book?
Ive been researching generations for a long time now, since I was an undergraduate, almost 25 years. The databases I draw from are large national surveys of high school and college students, and one of adults. In 2013-14 I started to see some really sudden changes and at first I thought maybe these were just blips, but the trends kept going.

Id never seen anything like it in all my years of looking at differences among generations. So I wondered what was going on.

What were these sudden changes for teens?
Loneliness and depressive symptoms started to go up, while happiness and life satisfaction started to go down. The other thing that I really noticed was the accelerated decline in seeing friends in person it falls off a cliff. Its an absolutely stunning pattern Id never seen anything like that. I really started to wonder, what is going on here? What happened around 2011-2012 [the survey data is a year or two behind] that would cause such sudden changes?

And you concluded these changes were being brought about by increased time spent online?
The high-school data detailed how much time teens spend online on social media and games and I noticed how that correlated with some of these indicators in terms of happiness, depression and so on.

I was curious not just what the correlations were between these screen activities, mental health and wellbeing, but what were the links with non-screen activities, like spending time with friends in person, playing sports, going to religious services, doing homework, all these other things that teens do?

And for happiness in particular, the pattern was so stark. Of the non-screen activities that were measured, they all correlated with greater happiness. All the screen activities correlated with lower happiness.

Youve called these post-millennials the iGeneration. What are their characteristics?
Im defining iGen as those born between 1995 and 2012 that latter date could change based on future data. Im reasonably certain about 1995, given the sudden changes in the trends. It also happens that 1995 was the year the internet was commercialised [Amazon launched that year, Yahoo in 1994 and Google in 1996], so if you were born in that year you have not known a time without the internet.

But the introduction of the smartphone, exemplified by the iPhone, which was launched in 2007, is key?
There are a lot of differences some are large, some are subtle, some are sudden and some had been building for a while but if I had to identify what really characterises them, the first influence is the smartphone.

iGen is the first generation to spend their entire adolescence with the smartphone. This has led to many ripple effects for their wellbeing, their social interactions and the way they think about the world.

Psychology
Psychology professor Jean Twenge. Photograph: Gregory Bull/AP

Why are you convinced they are unhappy because of social media, rather than it being a case of the unhappy kids being heavier users of social media?
That is very unlikely to be true because of very good research on that very question. There is one experiment and two longitudinal studies that show the arrow goes from social media to lower wellbeing and not the other way around. For example, an experiment where people
gave up Facebook for a week and had better wellbeing than those who had not.

The other thing to keep in mind is that if you are spending eight hours a day with a screen you have less time to spend interacting with friends and family in person and we know definitively from decades of research that spending time with other people is one of the keys to emotional wellbeing; if youre doing that less, thats a very bad sign.

A professor at Oxford University tweeted that your work is a non-systematic review of sloppy social science as a tool for lazy intergenerational shaming how do you respond?
It is odd to equate documenting teens mental health issues with intergenerational shaming. Im not shaming anyone and the data I analyse is from teens, not older people criticising them.

This comment is especially strange because this researchers best-known paper, about what he calls the Goldilocks theory, shows the same thing I find lower wellbeing after more hours of screen time. Were basically replicating each others research across two different countries, which is usually considered a good thing. So I am confused.

Your arguments also seem to have been drawn on by the conservative right as ammunition for claims that technology is leading to the moral degradation of the young. Are you comfortable about that?
My analyses look at what young people are saying about themselves and how they are feeling, so I dont think this idea of older people love to whine about the young is relevant. I didnt look at what older people have to say about young people. I looked at what young people are saying about their own experiences and their own lives, compared to young people 10, 20, or 30 years ago.

Nor is it fair or accurate to characterise this as youth-bashing. Teens are saying they are suffering and documenting that should help them, not hurt them. I wrote the book because I wanted to give a voice to iGen and their experiences, through the 11 million who filled out national surveys, to the 200 plus who answered open-ended questions for me, to the 23 I talked to for up to two hours. It had absolutely nothing to do with older people and their complaints about youth.

Many of us have a nagging feeling that social media is bad for our wellbeing, but we all suffer from a fear of missing out.
Teens feel that very intensely, which is one reason why they are so addicted to their phones. Yet, ironically, the teens who spend more time on social media are actually more likely to report feeling left out.

But is this confined to iGeners? One could go to a childs birthday party where the parents are glued to their smartphones and not talking to each other too.
It is important to consider that while this trend also affects adults, it is particularly worrisome for teens because their brain development is ongoing and adolescence is a crucial time for developing social skills.

You say teens might know the right emoji but in real life might not know the right facial expression.
There is very little research on that question. There is one study that looked at the effects of screens on social skills among 11- to 12-year-olds, half of whom used screens at their normal level and half went to a five-day screen-free camp.

Those who attended the camp improved their social skills reading emotions on faces was what they measured. That makes sense thats the social skill you would expect to suffer if you werent getting much in-person social interaction.

So is it up to regulators or parents to improve the situation? Leaving this problem for parents to fix is a big challenge.
Yes it is. I have three kids and my oldest is 10, but in her class about half have a phone, so many of them are on social media already. Parents have a tough job, because there are temptations on the screen constantly.

What advice would you give parents?
Put off getting your child a phone for as long as possible and, when you do, start with one that doesnt have internet access so they dont have the internet in their pocket all the time.

But when your child says, but all my friends have got one, how do you reply?
Maybe with my parents line If your friends all jumped in the lake, would you do it too? Although at that age the answer is usually yes, which I understand. But you can do social media on a desktop computer for a limited time each day. When we looked at the data, we found that an hour a day of electronic device use doesnt have any negative effects on mental health two hours a day or more is when you get the problems.

The majority of teens are on screens a lot more than that. So if they want to use Instagram, Snapchat or Facebook to keep up with their friends activities, they can do that from a desktop computer.

That sounds hard to enforce.
We need to be more understanding of the effects of smartphones. In many ways, parents are worried about the wrong things theyre worried about their kids driving and going out. They dont worry about their kids sitting by themselves in a room with their phone and they should.

Lots of social media features such as notifications or Snapchats Snapstreak feature are engineered to keep us glued to our phones. Should these types of features be outlawed?
Oh man. Parents can put an app [such as Kidslox or Screentime] on their kids phone to limit the amount of time they spend on it. Do that right away. In terms of the bigger solutions, I think thats above my pay grade to figure out.

Youve been accused by another psychologist of cherry-picking your data. Of ignoring, say, studies that suggest active social media use is associated with positive outcomes such as resilience. Did you collect data to fit a theory?
Its impossible to judge that claim she does not provide citations to these studies. I found a few studies finding no effects or positive effects, but they were all older, before smartphones were on the scene. She says in order to prove smartphones are responsible for these trends we need a large study randomly assigning teens to not use smartphones or use them. If we wait for this kind of study, we will wait for ever that type of study is just about impossible to conduct.

She concludes by saying: My suspicion is that the kids are gonna be OK. However, it is not OK that 50% more teens suffer from major depression now versus just six years ago and three times as many girls aged 12 to 14 take their own lives. It is not OK that more teens say that they are lonely and feel hopeless. It is not OK that teens arent seeing their friends in person as much. If we twiddle our thumbs waiting for the perfect experiment, we are taking a big risk and I for one am not willing to do that.

Are you expecting anyone from Silicon Valley to say: How can we help?
No, but what I think is interesting is many tech-connected people in Silicon Valley restrict their own childrens screen use, so they know. Theyre living off of it but they know its effects. It indicates that pointing out the effects of smartphones doesnt make you a luddite.

iGen: Why Todays Super-Connected Kids Are Growing Up Less Rebellious, More Tolerant, Less Happy and Completely Unprepared for Adulthood and What That Means for the Rest of Us by Jean Twenge is published by Simon & Schuster US ($27) on 22 August

Read more: https://www.theguardian.com/technology/2017/aug/13/are-smartphones-really-making-our-children-sad

Ohio doughnut shop closes during norovirus investigation

(CNN)An Ohio doughnut shop has voluntarily closed as public health workers investigate a norovirus outbreak affecting 266 people, according to county health officials.

The health department said it had been alerted to reports of several customers who had gotten sick after eating doughnuts from Mama C’s between August 4 and August 7. According to Greg Moore, program coordinator with the county health department, “specimens” were sent to the Ohio Department of Health for norovirus testing and three came back positive for the virus.
“Mama C’s is being extremely cooperative,” the health department said. “The health department has been in contact with the professional cleaning company that Mama C’s is using to ensure the food establishment is properly cleaned,” the statement says.
    Calls to Mama C’s Donuts and Coffee were not returned Thursday.
    According to Moore, the doughnut shop will remain closed until after the cleaning and after it is reinspected by the health department.
    Norovirus causes around 20 million cases of gastrointestinal illness in the United States each year, according to the Centers for Disease Control and Prevention, and it spreads easily in any area of close contact.
    The virus causes inflammation in the stomach and intestines, leading to stomach pain, nausea and diarrhea. These symptoms typically last one to three days. Other symptoms include a fever, headache and body aches, according to the CDC.

    Read more: http://www.cnn.com/2017/08/10/health/ohio-doughnuts-norovirus-outbreak/index.html

    Study finds 1 in 8 Americans struggles with alcohol abuse

    (CNN)Americans are drinking more. A lot more. According to a new study published in JAMA Psychiatry, an estimated one out of every eight Americans struggles with an alcohol disorder.

    The study tracked drinking patterns among 40,000 people between the years of 2002 and 2003, and then again from 2012 to 2013 to create a long-term picture of their habits. The results are chilling, especially in light of other substance abuse crises plaguing the country.

    Women, minorities, older people among most affected

      Overall, alcohol use disorders rose by almost 50%, affecting a projected 8.5% of the population during the first research period, and 12.7% during the second. That’s almost 30 million Americans actively struggling with alcohol abuse.
      The numbers are even more grim for certain groups. According to the research, alcohol use disorders have almost doubled (92.8%) among the African American population, and increased nearly 84% among women.
      However, the group that saw the highest increase in alcohol abuse disorders actually wasn’t women or minorities. It was senior citizens. Individuals 65 and older saw a staggering 106.7% increase in alcohol use disorders from 2002/2003 to 2012/2013. For 45- to 65-year-olds, that increase was also high at 81.5%.

      For the JAMA Psychiatry study, researchers used the DSM-IVdefinition laid out by the American Psychiatric Association in 1994. This definition combines factors of alcohol abuse and alcohol dependence like:

      • Drinking interfering with home, family, or job responsibilities
      • Drinking increasing chances of danger or injury
      • Withdrawal symptoms when coming down from intoxication
      • An inability to stop drinking

      Of 11 criteria given, the presence of two or more indicates an alcohol use disorder. Six or more indicates a severe alcohol use disorder.

      It’s not just alcohol abuse

      The study didn’t just track alcohol abuse. It also tracked other patterns like “high risk” drinking, which the study defines as four or more drinks a day for women and five for men, plus a day that exceeds those limits at least once a week.
      “High risk” drinking has increased on pace with alcohol abuse, swelling from 9.7 percent of the population in 2002-2003 to 13.7 percent of the population in 2012-2013.

      A chilling echo

      The study was conducted by researchers from the National Institute on Alcohol and Alcoholism, the New York State Psychiatric Institute and Columbia University, and relied on rigorously controlled self-reporting of drinking habits. While there was no clear reason as to the increases, researchers claimed it constitutes a “public health crisis” on par with the current national opioid crisis.

        It’s ‘chemical warfare’ on our children

      “Most important, the findings…highlight the urgency of educating the public, policymakers, and health care professionals about high-risk drinking and [alcohol use disorders], destigmatizing these conditions and encouraging those who cannot reduce their alcohol consumption on their own..to seek treatment,” the study posits.
      The findings come as President Trump said the ongoing opioid crisis is a national public health emergency. Last week a White House panel, stating that 142 Americans die from drug overdoses every day, urged President Trump to make such a declaration.
      Dr. Marc Schuckit, a professor of psychiatry at the University of California, San Diego, wrote an editorial published with the new study and said the results are an extension of the same crisis.
      “[This study] reminds us that the chilling increases in opioid-related deaths reflect a broader issue regarding additional substance-related problems,” he wrote.
      The Distilled Spirits Council, the trade association of producers and marketers of distilled spirits, issued a response to the study, noting that an annual nationwide survey of about 70,000 people ages 12 and older showed a decline in alcohol use disorders in 2015. That year, the survey found, about 15.7 million people had an alcohol use disorder in the past year, and 7.7million people had an illicit drug use disorder.
      “While any amount of alcohol abuse is too much, the claims published in JAMA Psychiatry do not comport with findings of the National Survey on Drug Use and Health, the federal government’s leading survey that tracks substance use disorders,” Sam Zakhari, the Distilled Spirits Council senior vice president of science, said in a statement.”The NSDUH shows a decline in alcohol use disorders among all age groups.”

      Read more: http://www.cnn.com/2017/08/10/health/drinking-alcoholism-study-trnd/index.html

      Couple fosters 13 children left by addicted parents

      Dayton, Ohio (CNN)When Cyndi and Jesse Swafford were certified to become foster parents 10 years ago, they were told to expect to wait for a baby up to two or three years. Fast forward to today — with a foster license, a new baby can be placed with them within a week.

      “It blows my mind,” Cyndi says. “There are babies in the hospital waiting because of this heroin epidemic for a family that will be able to take care of them.”
      Walk into the Swafford home and you’ll find it filled with baby bottles, cribs and framed family portraits. In the last decade, Cyndi and Jesse have taken in 15 foster children.
        “We’re a temporary gap between their parents getting clean and sober, and then, if we can reunify them, we will,” Cyndi says.
        Foster care systems in many states are struggling to manage children whose parents are addicted to opioids. Nationally, 32% of children were removed from their homes due to drug abuse by a parent as of September 30, 2015, the most recent data available, according to the US Department of Health and Human Services foster care reporting system.
        In Ohio, where the Swaffords live, that percentage is even higher. Fifty percent of children taken into custody in 2015 faced parental drug use when they were removed, and 28% of children removed that year had parents using opioids, according to Public Children Services Association of Ohio. “Nearly a third of children in custody are there because of the epidemic, and that number doesn’t count many children who continue to be served in their homes or who are placed with kin,” the association noted.
        Ohio has become the crossroads of the crisis, as the intersection of interstates 70 and 75 has been dubbed by law enforcement the “distribution hub of America,” according to Montgomery County Sheriff Phil Plummer. And children of parents addicted to opioids are the “invisible victims of the epidemic,” according to the Children Services Association.
        Of the 15 foster children Cyndi and Jesse have taken in over the last decade, 13 were there because one or both of their birth parents struggled with drug addiction.
        “I’m confident that if we opened another bed in our home, it would be filled with another baby with an opiate issue,” Cyndi says, “It’s hard to hold a baby as they are withdrawing from heroin.”
        Between 2000 and 2013, the rate of babies born addicted to drugs increased five times in the United States.
        These babies are frequently born early and have low birth weights. As they withdraw, they tremble, have difficulty feeding and regulating their temperatures. They’re best known for their wailing, piercing cries as their bodies detox from the drugs. For some babies, these symptoms can last as long as four to six months, depending on how long they were exposed and the amount they were exposed to.While some studies have found these children are more likely to have behavioral issues when they are older, the data on long term effects are limited.
        Helen Jones-Kelley, who runs the addiction services and mental health programs in Montgomery County, says foster parents aren’t rushing into the system to help the way they have in the past.
        “There’s a fearfulness and it’s an understandable fearfulness because some of the children are grappling with their own addiction,” Jones-Kelley tells CNN. “It’s hard to understand that as a foster parent, you have to watch out for things going missing or the potential of a child dying from an overdose while in your care.”
        But Jesse Swafford feels they have a responsibility to help young children of addicts.
        “I hate to say it this way, but we clean up a little bit of the mess, so we need more people to help clean up the messes with us, but it’s just normal for us,” Jesse says. “People think we’re crazy and they don’t understand why we do it, or how we do it.”
        Jewell Good, director of Children and Family Services in Montgomery County, says it’s increasingly a challenge to find placement for children of addicts.
        “We’ve suffered a 25% reduction in foster families over the last year,” Good says, “We’re investing more this year in recruiting and training foster families.”
        Children of addicts often need special care and counseling, and data shows they are staying in foster care longer because it can take months or years for their parents to get clean. Some never do.
        The Swafford family has legally adopted two children, and is in the process of adopting a third.
        Twelve-year-old Kalib and 10-year-old Brandon are biological brothers removed from their birth family in 2008 because of addiction issues. After 18 months in foster care, Cyndi and Jesse Swafford finalized their adoption.
        The Swaffords havehelped Kalib and Brandon deal with the long-term cognitive effects that Cyndi and Jesse believe stem from opioids they were exposed to and the trauma of separation from their birth parents.
        “It’s just been a lot better than I would’ve done with my other parents,” Kalib says, “These parents, Mom and Dad, never kept anything from me.”
        But after 10 years, Kalib was ready to reunite with his birth father, James Fuller, who says he has been clean for the last 18 months.
        “It’s his choice if he wants to go back on them, but I feel I can help in some way to motivate him to not use it again,” says Kalib.
        Fuller says he was addicted to heroin for more than a decade. It cost him his family, his job, and even his home.

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

        “It took my whole life from me,” Fuller tells CNN anchor Poppy Harlow, “All my children, my job at one time, I was homeless out here for three years. Not knowing where my next meal was coming from. I was out here shoplifting to support my habit. It got bad. Many, many jail stays.”
        Fuller says a recent overdose that nearly killed him is what forced him to get clean.
        At a park in Dayton, Kalib and his adopted family invited CNN as he reunited with Fuller.
        “God, I’ve missed you so much. Ain’t a day went by I haven’t thought about you,” Fuller says to Kalib. “We were going through so much when you was that age, man. I didn’t have no means to get you guys where you guys needed to be. I let you guys just stay where you was. I knew you were well took care of.”
        “Glad you’re feeling better so I can see you,” Kalib told Fuller. “I’m glad now that you are able to be clean.”
        That night, before he went to bed, Kalib told his adopted mother, Cyndi, that reuniting with his birth father, James, was the best day of his life.
        It’s moments like these, Cyndi says, that encourage her and Jesse to continue fostering children of addicts, but she says “the realization that more kids for us means that someone else is hurting in a rough spot … whether the heroin epidemic comes to an end or not, there’s still going to be babies out there.”

        Read more: http://www.cnn.com/2017/08/06/health/opioid-crisis-ohio-foster-family-son-father-reunion/index.html

        Here, heroin spares no one, not even the sheriff’s wife

        (CNN)Robert Leahy was sitting on his couch, watching TV, when his wife, Gretchen, walked through the front door.

        It was about 10 p.m. She’d left for the grocery store hours earlier. Now, she “bumbled” about the room, Leahy says, incoherent and vacant. He’d seen her like this before.
        “What the f**k are you doing?” he asked. “You’re high.”
          After the initial shock wore off, Leahy was angry and embarrassed. He worried about his reputation and what his colleagues at the Clermont County Sheriff’s Office would think. He’d been a law enforcement officer for more than a decade, and now he was married to a heroin addict.
          He needed to save himself and their young son. He had done all he could to save her.
          Just weeks earlier, Gretchen had returned home to Madeira, Ohio, from Crossroads Centre Antigua, an addiction treatment facility founded by musician Eric Clapton. It was one of a handful of times she’d received treatment for opiate addiction in the past five years. Leahy says he spent more than $16,000 — nearly all of their life savings — to cover the cost.
          And now she was high again.
          On September 7, 2005, Leahy filed for divorce and a temporary restraining order. At the time, the US opioid epidemic was in its early stages. Abuse of prescription painkillers was a growing, if hidden, problem, and heroin addiction had yet to ravage rural and suburban America. That would soon change. Nearly 15,000 Americans — 500 from Ohio alone — died of an opioid overdose in 2005. In 2015, those numbers soared to 33,000 and 2,700 deaths, respectively.
          At first, Leahy could not understand why his wife had let herself become an addict, why she had made that choice. But as he watched her struggle for years to stay clean, his knowledge of addiction matured. He began to see it as a disease in need of treatment and compassion.
          More than a decade later, as Ohio grapples with one of the deadliest drug epidemics in American history, the state’s criminal justice system has undergone a similar transformation. Local officers and judges know that they can no longer treat all addicts like criminals. To stop an epidemic, they have to think like medical professionals.

          ‘This is a mass fatality crisis’

          On July 31, the White House’s Commission on Combating Drug Addiction and the Opioid Crisis released an interim report asking President Donald Trump to declare the opioid epidemic a national health emergency.
          Ohio has been one of the states hit hardest by the crisis. Last year, 86% of overdose deaths in the state involved an opioid. In Montgomery County, the situation is particularly dire. Local officials say that more than 800 people will probably die from an opiate overdose there this year, more than double last year’s record of 349 opioid deaths.
          Law enforcement officials say the county’s location has made it an ideal distribution hub for Mexican drug cartels. Interstates 70 and 75, two major arteries that crisscross the nation, intersect in the northeast corner of the region. Officials say the cartels ship their product directly to Dayton, less than a 10-minute drive from the intersection. Then, local dealers hop onto one of the “heroin highways” and circulate opioids throughout the country.
          Most nights, the freezer in Montgomery County’s morgue is stacked floor-to-ceiling with bodies. Dr. Kent Harshbarger, the coroner whose office services more than 30 counties, estimates that 60% to 70% of these corpses are the result of an opioid overdose.
          “What’s most challenging is seeing the same story repeated over and over again,” he said. “It seems, from my perspective, inevitable.”
          Since last year, to deal with the surge in overdose deaths, Harshbarger has hired six part-time coroners, two autopsy technicians and three field investigators. He also extended some of the staff’s workday by three hours so they had time to perform more autopsies and remodeled the morgue freezer to fit more bodies.
          Several times in 2015 and 2016, the office was overwhelmed, and he had to house some of the corpses in mobile morgues — trucks with refrigerated trailers. The state purchased the trucks in the mid-2000s with a grant from the Department of Homeland Security. They were intended to be used in the field to store bodies after a mass-casualty event like a plane crash or a terrorist attack. Harshbarger says the current crisis is not so different.
          “Staff is overwhelmed,” he said. “This is a mass fatality crisis.”
          What started as a heroin epidemic quickly turned even deadlier. Experts say the spike in overdose deaths in Montgomery, and in many places across the country, is largely due to heroin’s opiate cousins: fentanyl and its more potent analogues like carfentanil. Fentanyl is a synthetic opioid 50 to 100 times stronger than heroin. Carfentanil, originally designed as a large-animal tranquilizer, is 5,000 times more potent than heroin.
          Montgomery County Sheriff Phil Plummer says that when addicts think they’re purchasing heroin, they’re more likely buying one of these synthetic opioids.
          “We need to quit calling it a heroin epidemic; this is fentanyl.” he said. “It’s really not a heroin issue anymore.”
          The numbers back him up. In 2016, 251 of the 349 opioid-related overdose deaths in the county involved only fentanyl or carfentanil, with no heroin present, and an additional 34 involved heroin laced with fentanyl.
          To stem the tide of overdose deaths, the sheriff’s office is spearheading a new program called Get Recovery Options Working, or GROW. As part of the initiative, a sheriff’s deputy, a social worker, a medic and a member of the clergy visit a home where an overdose occurred within the past week. Together, they provide literature about Cornerstone Project, a local drug treatment facility, and talk to family members about how to best help their loved one, and if the individual is willing, the deputy will drive him or her to treatment that day.
          “We just stop and tell them, ‘We love you and we care for you, we want to seek help for you,'” Sheriff Plummer said. “And we’re having tremendous success with that.”
          Since the program started on January 1, GROW has reached out to 162 people who have overdosed, 57 of whom have entered treatment at Cornerstone Project, Plummer says. More than half of those who entered Cornerstone because of the initiative are still in treatment, says Cornerstone Project Community Outreach Manager Wendie Jackson.

          A stopgap

          By 2014, Leahy had climbed the ranks to chief deputy in the Clermont County Sheriff’s Office. That year, drug overdose deaths were also steadily climbing in the county, from 56 in 2013 to 68 by year’s end. It was the sixth year in a row the number of overdose deaths had risen.
          Leahy recognized the trend and had an idea. He’d heard about law enforcement agencies in other parts of the country equipping their officers with a drug called naloxone, also known by the brand name Narcan. Administered as a nasal spray, the drug could reverse the effects of an opioid overdose and was easy to use. Leahy lobbied Sheriff A.J. “Tim” Rodenberg and volunteered to lead the initiative.
          Rodenberg, Leahy says, was receptive but not convinced. He needed more information. The topic would be controversial, he told Leahy. Some in the community would, of course, think it’s a good idea, but others would consider it a waste of taxpayer money.
          Leahy called other sheriff’s offices in the north of the state that were using Narcan and learned about the success they were having in saving lives.
          He told Rodenberg what he’d heard and laid out the pros and cons of buying Narcan. Then, Leahy decided to speak from personal experience. He didn’t bring up Gretchen by name, but “I think he realized some of the decisions that I made, or the things I pushed along, were related to that.”
          Leahy and Gretchen still shared custody of their son, but he says she was rarely around. She would stay clean for a few weeks — periods he calls “flashes of brilliance.” Each time, he hoped she’d turned a corner. But really, he was just waiting for her to relapse. If she overdosed, he would want the responding officer to have all the tools available to revive her, so she’d have the chance to fight another day.
          “How can you get people into recovery if you can’t save their lives?” Leahy asked Rodenberg. Within months, the deputies were equipped with Narcan.

          ‘The challenge is to keep them alive’

          In Montgomery County, the average opioid user is a 38-year-old white man, according to data collected by the sheriff’s office. But officials say the number of young addicts in the area has increased exponentially over the past five years.
          County Juvenile Court Judge Anthony Capizzi estimates that nearly a quarter of the young defendants in his courtroom are addicted to either opiate painkillers or heroin.
          “I have jurisdiction over children until they reach 21,” Capizzi said. “The challenge for me right now is to keep them alive that long.”
          Capizzi presides over the county’s Juvenile Treatment Court. The young people in his courtroom have substance abuse issues and often, as a result, lengthy criminal histories. Capizzi puts the vast majority into some kind of treatment program; detention centers are the last resort.
          Three and a half years ago, Rachel Chaffin walked into Capizzi’s courtroom. She was one of the first young defendants addicted to heroin that he’d seen in his 13 years behind the bench in Montgomery.
          Chaffin was 15 years old. She had been captain of the JV cheerleading squad in high school and dreamed of one day cheering on the sidelines for the Dallas Cowboys. But growing up, her life was chaotic and unstable. Her family often teetered on the edge of homelessness. In December 2013, Chaffin got pregnant.
          “I was 14. I was freaking out,” she said. “I ended up having a miscarriage.”
          A drug dealer in her neighborhood later asked her whether she wanted to be a “tester” for his product and check the quality of the dope. She was scared but took the leap, fueled by a depression that consumed her after her miscarriage.
          “Once I started doing it,” she said, “I didn’t want to stop.”
          She landed in front of Capizzi after multiple felony and misdemeanor charges. Eventually, the judge removed her from her mother’s custody because she continued to use and put her in foster care. For the next three years, she bounced from group home to foster home, sometimes clean, sometimes not. She overdosed, and was revived by Narcan, three times.
          Now 18, Chaffin eventually found a good foster home and graduated high school with a 4.0 GPA. She says she’s been clean since March, when she relapsed after another miscarriage. She says she struggles every day to stay clean, but when she feels weak, she remembers what a counselor told her during a recent stay in rehab.
          “My counselor said, ‘I want you to picture your mom coming to the morgue to identify your body,'” she said. “That just broke me. I can’t picture putting my mom through so much.”

          Before there’s no hopera

          In 2013, the Clermont County Sheriff’s Office collaborated with local mental health officials to open the Community Alternative Sentencing Center inside the local jail. The voluntary program offers people who have been convicted of a misdemeanor and have a substance abuse issue the opportunity to serve their sentences in a wing of the jail that is separated from the general population. Nearly 40% of the participants at any given time were once addicted to opioids.
          The center is operated by Greater Cincinnati Behavior Health Services. The participants — or “clients,” as staff refer to them — receive group therapy and drug rehabilitation treatment, such as participating in Narcotics Anonymous.
          In 2016, the voters of Clermont County elected Leahy sheriff. He says he never had aspirations for the position, but in 2015, Rodenberg told Leahy he was retiring and wanted Leahy to be his successor. Leahy ran unopposed. Now, he was in charge of a program he’d help shepherd for years.
          Alternative Sentencing Center clients technically are not inmates, and there are no correctional officers in that wing of the jail. The clients are on probation, and as part of that, they’ve agreed to complete their treatment. But if a client leaves the program early, he is in violation of his probation.
          Leahy says these programs can help people before they’re burglarizing homes or robbing people to feed their habit — before they’re burdened with a rap sheet full of felonies. Once a person reaches that point, they often believe there’s no hope. Leahy saw Gretchen fall into a similar abyss, and it took her years to claw her way out.
          “If you can catch people in the early stages, where their life is starting to go south but it’s not totally out of control,” he said, “there’s a chance for them.”
          He doesn’t want people to mistake his compassion for weakness. Those who commit felonies, he says, deserve to be in jail. But most people with substance abuse issues are better served in treatment, he says.
          So far, the program has helped men exclusively, but in the fall, Leahy and GCBHS will open a women’s version in another wing of the jail. The Clermont jail now houses between 90 and 100 female inmates, nearly double the number a decade ago, Leahy says. Virtually the entire increase in population, he says, can be attributed to the crisis. Opioid overdoses have increased 2000% in Clermont County since 2007.
          Both the Narcan and Alternative Sentencing Center programs seem to be paying off. Overdose deaths in Clermont County decreased from 94 in 2015 to 83 in 2016.
          “Is it too early to tell? Well, I think by the end of 2017, if we can get two or three years in a row with those numbers trending down,” Leahy said, “I think people will realize and say, ‘I think somebody’s doing something that’s working.’ “
          Leahy says he speaks with Gretchen only occasionally now. There’s no ill will, but since their son has grown, there’s also no need. Gretchen says she’s been sober for three years, and Leahy gives her the benefit of the doubt. Not that he would ever ask. She doesn’t owe him any explanation, he says.
          In some ways, he has a more clear-eyed view of her disease than even she does. Gretchen is still wracked with guilt from the years lost with their son and for driving her husband away.
          “I think that was half of my issue. Every time I would get clean, I couldn’t let go of that guilt, shame,” she said. “And I still struggle with that to this day.”
          But Leahy sees it differently. He says that the programs weren’t in place to save her, that law enforcement didn’t understand what they were dealing with yet. He’s learned that the addiction chose her, not the other way around.
          “There is no rhyme or reason,” he says. “This is one of those deals, it’s kind of like fighting cancer. Your first heaviest, hardest hit is going to give you the best opportunity.”

          Read more: http://www.cnn.com/2017/08/06/health/ohio-heroin-opioid-crisis-morgue-full/index.html

          The Mediterranean diet doesn’t benefit everyone, study says

          (CNN)The Mediterranean diet can reduce the risk of cardiovascular disease, yet only people with higher incomes or more education, or a combination of the two, experience this benefit, found a study published Monday in the International Journal of Epidemiology.

          The Mediterranean diet emphasizes eating plant-based foods, including vegetables, nuts, fruits and whole grains, in addition to fish and poultry. The diet also recommends that you limit red meat, replace butter with olive oil, and exercise.Red wine in moderation is optional on the diet, which past scientific research proves to be heart-healthy.
          Marialaura Bonaccio, lead author of the new study and a researcher at IRCCS Istituto Neurologico Mediterraneo Neuromed, an Italian Clinical Research Institute, said in an email that this same problem — in which people from different income levels get different results from the same diet — may also be true for other diets.
            The reason? Diets “focus on quantity, rather than on quality” of the food, she said.

            Diet data

            Bonaccio and her co-authors randomly recruited over 18,000 people living in the Molise region of southern Italy between March 2005 and April 2010. The Pfizer Foundation, which helped fund enrollment costs, did not influence the analysis or interpretation of results, Bonaccio noted.
            She and her team calculated total physical activity, body mass index (BMI), smoking status and health history, including cardiovascular disease, diabetes and cancer. The data available for each participant also included education, household income and marital status.
            Using the Mediterranean Diet Score, Bonaccio and her colleagues assessed participants’ food intake, examining the variety of fruits and vegetables, meat and fish consumed. They scored participants’ cooking methods, detailing whether they’re using healthy methods such as boiling and stewing or less healthy methods such as frying, roasting and grilling. Vegetables were categorized as organic or not, bread as whole-grain or not.
            Over an average followup period of about four years, participants experienced a total of 5,256 cardiovascular disease events, including incidents of heart failure, diagnoses of coronary heart disease (a buildup of plaque in the arteries) and strokes.
            Analyzing the data, the researchers found that a Mediterranean diet effectively reduced cardiovascular disease risk, but only among a select group of participants: those with higher income or more education.
            “We found heart advantages were limited to high socioeconomic status groups, even if groups showed the same adherence to the Mediterranean diet,” Bonaccio wrote. No benefits occurred for participants in the low income and low education group.

            Differences in food quality

            Surprised by this result, the researchers dug into the data more deeply and unearthed a possible reason for the difference: The same Mediterranean diet adherence score still included slight differences in food consumption.
            “For example, as compared to less advantaged counterparts, people with high socioeconomic status tended to consume fish more frequently,” Bonaccio wrote. She added that, beyond diet adherence, participants in the most advantaged category reported a higher quality diet, which included higher consumption of organic products and whole grain foods.
            “Let’s give that two persons follow the same diet, that is equal amounts of vegetables, fruits, fish, olive oil etc. every day so that they report the same adherence score to Mediterranean diet,” Bonaccio said. “It might be that, beyond quantity, differences in quality may exist. For example, in olive oil.”
            She said it’s unlikely that a bottle of extra virgin olive oil with a price tag of 2 to 3 euros has the same nutritional properties as one costing 10 euros. Given that it is reasonable to assume higher-income participants are more likely to buy the 10-euro bottle compared with lower-income participants, “our hypothesis is that differences in the price may yield differences in healthy components and future health outcomes,” Bonaccio said.
            How the food is cooked or prepared might also contribute to differences in results, according to Bonaccio, though she said the differences in cooking procedures — “a kind of marker of the numerous differences still persisting across socioeconomic groups” — probably did not “substantially account” for the disparities in cardiovascular risk.

            Similar results in US?

            Mercedes Sotos-Prieto, an assistant professor and visiting scientist at Harvard Chan School of Public Health, said evidence, including from her own research, shows that a Mediterranean diet is “one of the best choices to improve health.”
            Sotos-Prieto, who was not involved in the new research, wrote in an email that the new study, which relied on self-reported data, does not prove that socioeconomic status caused the health benefits seen; it shows only a relationship between income and/or education and health outcomes.
            “Previous studies have already showed a socioeconomic gradient regarding adherence to diet quality,” Sotos-Prieto wrote. Because of this, a similar difference in health results depending on socioeconomic status may also be occurring in the United States among those who follow a Mediterranean diet, she said.
            Dr. Barbara Berkeley, who specializes in weight management and practices medicine in Beachwood, Ohio, said “one caveat in interpreting studies like this is that they are based on diet recall. It is generally very difficult for people to keep accurate food records and there is a tendency for participants to record their diets in the best possible light.”
            Berkeley, who was not involved in this research, agreed with the hypothesis of the authors.
            “A good diet is undoubtedly more than just a shopping list,” she said. “Quality, freshness, variety and purity of production may truly differentiate diets even when they appear to be the same.”
            Berkeley noted that “food deserts” in lower-income areas means both quality and variety of fresh foods may be limited, while organic produce may be unavailable or too expensive.
            “A healthy diet is likely not the sum of its parts but the quality of its elements,” Berkeley said.
            Maria Korre, a research fellow at Harvard Chan School of Public Health, noted that “among the most important perceived barriers to healthy eating are the time and cost of shopping.” Korre, who did not contribute to the new study, added that “we need to work toward identifying ways … to overcome these barriers.”
            “As a result of the worldwide epidemics of obesity and diabetes, we witness a strong and renewed interest in the traditional Mediterranean diet,” Korre said. Yet the appeal of this diet extends well beyond proven health benefits.
            With its wide range of colorful foods, the diet provides “delicious meals” and “because of its emphasis on limited consumption, rather than abstention from red meat and sweets” plus its inclusion of moderate drinking of alcoholic beverages, “the Mediterranean diet represents a healthy yet indulgent and appealing lifestyle that can be sustained over long periods of time,” Korre said.

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            According to the study authors, people of high socioeconomic status may actually be selecting foods that are higher in both polyphenols (plant-based micronutrients) and antioxidants (a nutrient found in fruits and vegetables that helps repair damage in our bodies). Such daily choices could result in health advantages unseen by those who make different selections.
            “This hypothesis could be only tested by a direct measure of such natural compounds in biological samples, e.g., blood levels or urinary polyphenol excretion,” Bonaccio said. She said her groups’ future research and analysis will test this theory.

            Read more: http://www.cnn.com/2017/07/31/health/mediterranean-diet-heart-benefits-socioeconomic-study/index.html

            Let this fitness tracker motivate you to get moving

            Just to let you know, if you buy something featured here, Mashable might earn an affiliate commission.

            Theres nothing better than being in shape. It prolongs your life, it makes you feel better, and it can even boost your mood. Unfortunately, its really hard to get in shape, and even harder to maintain it.

            Luckily, there are some great fitness trackers that can help you achieve your goals like the Moov Now Personal Coach & Workout Tracker. This award-winning tracker actively monitors your bodys motion to ensure that you get the most out of every workout. It even gives you personalized feedback to correct your form and help minimize your risk of injury.

            But what really separates Moov Now from the competition is its coaching. Moov Now features a real-time audio coach that gives you positive feedback throughout your workout so youre always pumped to conquer that next hill or set a new personal record. Its the perfect training tool for high-intensity workouts like circuit training, running, cycling, swimming, and cardio boxing.

            Moov Now also shows you how to work in proper intervals so you can recover safely, gain results faster, and gradually level up to more intensive workouts. Plus, it constantly changes your workouts so you stay motivated and dont plateau.

            With a tracker like this, its much more likely that you’ll actually get your butt off the couch.Moov Now normally costs $79.95, but you can get it for just $49.95, a savings of 37 percent. Buy it here.

            Read more: http://mashable.com/2017/07/29/a-fitness-tracker-thats-also-a-personal-trainer/

            Doctor delivers a baby right before she gives birth to her own

            A big day.
            Image: Shutterstock / Angyalosi Beata

            A doctor in Kentucky and her patient will always remember their babies’ birthdays.

            Amanda Hess, an OB/GYN in Frankfort, Kentucky, was in the hospital as she prepared to give birth to her daughter. While she waited, Hess heard another expectant mother who was closer to giving birth.

            The doctor went to the room, where a woman who happened to be one of her patients was fully dilated. The doctor on call was on his way to the hospital, but the baby was coming. So Hess stepped in and handled the delivery right before she went back to her own room to give birth.

            I just put on another gown to cover up my backside and put on some boots over my shoes, to keep from getting any fluid and all that stuff on me, and went down to her room and I knew her,” Hess told WKYT.

            “She was just glad to be able to get to push and have the baby out and not have to wait any longer,” she added.

            Then, Hess gave birth to her own daughter, Ellen Joyce.

            Congratulations to the two mothers! Now time for maternity leave.

            Read more: http://mashable.com/2017/07/29/doctor-delivers-baby-gives-birth/

            Fight your nightmares for a better night’s sleep

            (CNN)A bomb rips through the Humvee in the road ahead, sending it flying into the air. The pop of gunfire is everywhere.

            The man next to you — your best pal in this godforsaken place — suddenly slumps over. Screams and dense smoke fill the air.
            It’s the stuff nightmares are made of, and all too real most nights for many returning veterans.
              “Six to eight months after I got home, the nightmares really started to come in,” said Army Reserve veteran Aaron. “Middle of the night, all of a sudden I’m back in Iraq, full battle mentality, running, chasing people down.”
              Aaron is one of many soldiers identified by their first names who shared their stories on video on Make the Connection, a US Department of Veterans Affairs website devoted to returning veterans.
              “I was having to sleep on the front porch, I couldn’t even sleep in my wife’s bed,” added Mike, who served in Iraq for the Army Reserve and National Guard. “When I slept in her bed, I’d wake up every 30 minutes with nightmares that someone had come into the house and were harming my family, my kids.”
              “Over half all veterans have nightmares,” said psychologist David Cooper, who works with traumatized veterans at the Department of Defense National Center for Telehealth and Technology. “It’s a common symptom that comes along with PTSD, or post-traumatic stress syndrome.”
              But it’s not just veterans who struggle with nightmares. The American Sleep Association estimates between 80% and 90% of us have disturbing dreams at night.

              The dark side of nightmares

              For most of us, nightmares occur when we are stressed and worried, or when we’ve experienced an upsetting event. Nightmares tend to stay with us longer if they are fear-based, but studies show confusion, guilt, disgust and sadness are the most common triggers.
              It’s not just feelings. Late-night snacks, some medications, and even the withdrawal of medications or alcohol can trigger repugnant dreams.
              Science says these types of dreams may actually be good for our psyche. Instead of living with vague feelings of unease, the brain, usually during the REM stage of sleep, consolidates our bad feelings into a concrete memory that we can then process, file away, and forget.
              But for the unlucky among us, nightmares can become chronic, and turn into a disorder that rips apart sleep and destroys productive lives.
              “I started having a lot of trouble sleeping, sleeping for two, three hours a week,” said US Army veteran Bryan in a Make the Connection video. Bryan served several tours in Iraq. “I just couldn’t sleep through the whole night.”
              “They start avoiding sleep for fear of the nightmares,” said neuropsychologist William Kerst. He worked with soldiers with PTSD and nightmares while in the Air Force and now counsels vets in his private practice in Alaska.
              “And chronic sleep deprivation is associated with lots of bad things,” Kerst continued. “Obviously their attention, concentration and memory are going to suffer … depression risk, it goes way up … there’s even lots of studies to show a really clear link between chronic sleep deprivation and suicidal thoughts.”

              It can happen to any of us

              You don’t have to be a veteran to have PTSD and the accompanying nightmares. Anyone who has suffered or witnessed major trauma, such as natural disasters, domestic violence, rape, terrorism, even a terrifying car accident, can develop ongoing, frightening memories of the event. The National Center for PTSD estimates 10 out of every 100 women and four of every 100 men will develop PTSD at some point in their lives, and as a result, may suffer nightmares.
              And here’s the really nightmarish thing. Even if the PTSD is addressed and overcome, studies show the gut-wrenching dreams may not go away.
              “The tendency for these individuals to have trauma related nightmares and then sleep disruption and sleep disturbances continued well after successful PTSD treatment was complete,” said Kerst.
              The reason why may lie in how PTSD and nightmares are treated.
              “When I’m working with a patient with PTSD one of the things I want them to do is expose themselves to those traumatic feelings over and over again so that their body learns to calm down and not react as much,” said Cooper. “But traumatic nightmares are not treated the same way as other PTSD symptoms. Instead we give something new for the brain to focus on which eventually reduces the overall frequency of the nightmares.”
              The approach is called Imagery rehearsal therapy or IRT. The goal of this type of therapy isn’t to relieve or process the trauma in your nightmare. Instead you want to change it — tweak it, really — so the nightmare loses its power over your mind and your sleep.
              “Let’s say I’m working with someone who has a nightmare about going on patrol in Afghanistan where their Humvee was blown up by an IED,” said Cooper. “I may want to have them change that explosion to confetti, or a balloon popping.”
              “Or instead of an IED on the road,” Cooper continued, “maybe it’s a grocery bag that the Humvee hits, something that is not going to elicit the same emotional response, but still remains true to a majority of the dream.”
              Developed in the 1990s by Dr. Barry Krakow at the University of New Mexico School of Medicine, Imagery rehearsal therapy has shown some impressive results in studies. Besides limiting chronic nightmares and improving sleep quality in over 70% of the subjects, IRT has been shown to decrease PTSD severity, as well as reducing symptoms of anxiety and depression.
              Other research found the effects of IRT on nightmares can be long lasting, especially if the rewritten dream removes violent details.

              How IRT works

              Imagery rehearsal therapy works by having the patient write down specifics about the nightmare, creating almost a movie-like script of the disturbing dream. Then, in conjunction with a therapist, the patient rewrites the nightmare to make it less disturbing. Then they are told to practice the re-scripted dream during the day.
              The good news is that it doesn’t take long for the positive benefits of IRT to take place, for both those with PTSD and more common nightmares.
              “It’s usually only a couple of sessions, maybe four,” said Cooper, “and we ask that folks rehearse the new dream one or two times throughout the day for 20, 30 minutes. That’s really all the actual work that it takes.”
              In fact, one of the most time-consuming parts of the process, said Kerst, is the writing process. That’s why he was excited to partner with Cooper and the National Center for Telehealth and Technology to develop an app called Dream Ez. While it can be used on its own, Kerst and Cooper say it will be most effective with an IRT-trained therapist.
              “You wake up, you grab your phone, you record your nightmare,” said Kerst. “Then you rate how distressing or disturbing the nightmare was, and with the help of your therapist turn the dream away from the distressing turn of events.”
              The app allows users to audio record the re-scripting of the dream, and then encourages them to practice the reworked dream, while also providing some relaxation tools to foster better quality sleep.
              The app is currently being evaluated by various sleep clinicians.

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

              “We know IRT works, so we’re not studying that,” explained Cooper. “But we want to know if making the process more user friendly will help people stick with it longer, so they get the full effect of something that we already know works.”
              One of the biggest pluses for IRT is the avoidance of prescription sleep aids, which often cause drowsiness, lethargy, and in some cases, are dangerously addictive. It’s also helpful for veterans or others who refuse to be treated for PSTD or other disorders, perhaps because of stigma or personal pride.
              “A lot of people are willing to say I want to get rid of my nightmares and sleep better,” Kerst explains. “So even when people don’t want to talk about their trauma specifically, they’re willing to say that and they begin to get the help they need.”

              Read more: http://www.cnn.com/2017/07/27/health/treatment-for-nightmares/index.html