San Franciscos Air Quality Matches Beijings

Air quality in San Francisco sank to the level of smog-choked Beijing this week, as soot from more than a dozen wildfires in California’s wine country blanketed the Bay Area.

As San Francisco residents woke up to a hazy sky for the fifth day in a row, the concentration of dangerous particulate matter was forecast to be 158 on the air-quality index, according to the Bay Area Air Quality Management District. That’s roughly on par with notoriously smoggy Beijing, which clocked in at 165.

The gauge, known as PM2.5, refers to particles with a diameter of less than 2.5 micrometers, which can be inhaled and penetrate deep into the lungs. While long-term exposure is correlated with lung and heart disease, Bay Area residents should only experience temporary discomfort with no permanent effects, said John Balmes, a professor of medicine at the University of California, San Francisco.

Lenard Lesser, a doctor at primary care group One Medical, said he has seen several patients with smoke-related complaints, including sore throat and difficulty breathing, at his San Francisco office this week. Children, older adults and people with lung disease such as asthma should stay indoors while the air quality is bad, and wear an "N95"-rated mask when outdoors, Lesser said in an email.

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    The psychology of gold and why it has that allure

    (CNN)When you think of the color gold, images of grandeur and extravagance are likely to come to mind.

    For millennia, the metal has adorned crowns and hilts of swords. It has been used to enhance paintings and ornaments to increase their value.
    That led to the metal being associated with a shining, otherworldly character attributed to the gods in the religions of many different cultures. “Some of these were bodily associations,” the authors write.
    The Aztecs described gold as the “excrement of the gods,” while the Incas thought of it as the “sweat of the sun.” In ancient Egypt, gold was considered the “flesh of the gods.” Across cultures, it was a sacred material.
    The book goes on to illustrate the importance of gold in health and medicine. Chinese alchemists believed that drinking potable gold in the form of elixirs, eating from gold plates and using gold utensils helped attain longevity.
    “Before the 20th century, gold was used to treat conditions as varied as syphilis, heart disease, smallpox and melancholia,” the book notes.
    Today, gold compounds are still thought to have some anti-inflammatory effects.

    Attracting the eye

    The incorruptible nature of gold has an otherworldly allure to it and the reflective quality of the metal gives the impression that it glows from the inside, said Oakley.
    When viewed by candlelight, gilded medieval manuscripts, statues and icons in the Eastern Orthodox Church exuded a transcendental quality, glowing as if they were illuminated from the inside.
    Human vision can discriminate millions of colors, but it can discriminate trillions of chromatures — colored textures, said Donald Hoffman, professor of cognitive science at University of California, Irvine.
    “It is the chromature that targets the human emotions more specifically than uniform color patches,” he said.
    Hoffman believes the reason chromatures can target human emotions more specifically than uniform color patches is that they contain far more information than color patches.
    He demonstrated the concept with two pictures — a section of brown grizzly bear fur and the same brown color in plain background. When looking at the chromature, our mind can immediately grasp that we are looking at a bear, he explained.
    “Evolution would have more success training the emotional system to be wary of the bear fur chromature than to be wary of the uniform color patch of the same average color.”
    Similarly, when we look at a gold ring versus a standard patch of uniform color, we see interesting highlights on the ring because the metal is highly reflective.
    “Companies are using genetic algorithms to evolve chromatures and target specific emotions they want people to experience with respect to their product or brand. It turns out to be quite powerful,” he adds. For example, “A company might, for instance, want to convey the idea that their product is soft and warm. Then we would start with closeup images of patches of soft things, such as the fur of a rabbit and the down of a goose, and warm things, such as glowing embers of charcoal or a warm sunset,” Hoffman explained.
    The same could be applied to evoke emotions linked to gold — how does it make you feel?

    A sign of success

    In ancient Rome and medieval Europe, sumptuary laws prohibited people from wearing too much gold — or not wearing it at all unless they were from a noble family.
    Gold leaf has been used liberally in artwork which hinted at the status of the patron who commissioned it.
    All societies value gold and investing in gold has survived for centuries through marketing — even glorified.
    “(Gold) carries with it the messaging that you should own it. It is a learned, conditioned response,” said Eiseman — but not so much that it becomes tacky, she adds.
    In popular culture, musicians flaunt their gold bling. The underlying message being that they are good at what they do and have amassed a lot of wealth. “In a lot of cultures, the word for money derives from the word for gold. In China, the ideogram for money is the ideogram for gold,” Oakley said.

    Tell us your story
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    Gold continues to be featured heavily in religion and religious rituals alike. It decorates the papal regalia, spires, domes and minarets of temples, churches, monasteries and mosques worldwide.
    Golden trophies like Olympic medals, the Nobel Prize, Oscars and Emmys are presented to people who display a unique talent. “The idea is the prize made of a rare material is given to people with display talent as rare as the material,” said Sally Augustin, an environmental and design psychologist.
    Psychologically, this results in gold being a color of motivation.
    Are you motivated?

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    NHS future precarious, says regulator

    The Care Quality Commission (CQC) says the health system is “straining at the seams” and faces a “precarious” future.

    The England’s regulator’s annual report raised concerns about staff shortages, rising demand and the number of patients with preventable illnesses.

    It said so far the quality of NHS and council care has been maintained but warned standards were likely to drop.

    Health Minister Philip Dunne suggested that extra money for social care, mental health and A&E was enough.

    “With record funding and more doctors and nurses, the NHS was recently judged the best healthcare system in the world, despite the pressures from increasing demand,” he said.

    In its report, the CQC highlighted:

    • Staffing shortages with vacancy rates in the NHS rising by 16% over the last two years despite an increase in staff of 4%
    • Bed shortages in hospitals with occupancy levels being consistently above recommended levels since April 2012
    • Falling numbers of nursing homes beds – down by 4,000 in two years at a time when more are needed
    • Rising numbers of people not getting support for their social care needs with the numbers hitting 1.2m, up 18% in a year
    • Number of detentions under the Mental Health Act up by a fifth in two years to more than 63,000 last year

    The CQC’s report – its yearly round-up on the state of the sector – comes after it completed its new inspection regime of hospitals, mental health units and care services.

    ‘Quality will fall’

    CQC chief executive Sir David Behan said that while the quality of care was being maintained currently thanks to the efforts of staff, that resilience was not inexhaustible given the rising pressures.

    “We are going to see a fall in the quality of services that are offered to people and that may mean that the safety of some people is compromised,” he added.

    He said the NHS is “struggling to cope with 21st century problems” including increasing numbers of people with illnesses linked to unhealthy lifestyle choices like obesity, diabetes, dementia and heart disease.

    “We are living longer but are not living healthier so I think what we are signalling is that the system now and into the future has got to deal with those increased numbers of older people who are going to have more than one condition.”

    He said one of the immediate priorities was finding a solution to funding social care – ministers have promised a Green Paper by the end of the year after providing an extra £2bn of funding over the next three years to keep services going.

    Image copyright Science Photo Library

    Caroline Abrahams, of Age UK, said the findings made worrying reading.

    “Really this tells you everything you need to know about the state of care today – it’s like a rubber band that’s been stretched as far as it will go and can’t stretch any further.”

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    Arthur Janov, psychologist behind ‘primal scream’ therapy, dies aged 93

    Janov achieved celebrity with the idea that repressed childhood trauma leads to mood disorders, addiction and even epilepsy

    Arthur Janov, a psychotherapist whose primal therapy had celebrities screaming to release their childhood traumas and spawned a bestselling book in the 1970s, has died. He was 93.

    Janov died on 1 October at his Malibu home from respiratory arrest following a stroke, said his wife, France Janov.

    Janov, a clinical psychologist, became an international celebrity with his idea that adults repressed childhood traumas, making them neurotic and leading to problems such as mood disorders, drug addiction and even epilepsy.

    He believed that what he termed primal pain could extend as far as birth.

    Coming close to death at birth or feeling unloved as a child are examples of such pain, he wrote.

    When the pain is too much, it is repressed and stored away. When enough unresolved pain has occurred, we lose access to your feelings and become neurotic, he wrote. The number one killer in the world today is not cancer or heart disease, it is repression.

    His therapy method involved having people relive their traumatic memories by regressing to infancy or childhood in order to confront and exorcise their demons.

    His southern California centre provided props such as cribs and stuffed animals. Patients, who might pay thousands of dollars, would scream or shout as their supposedly pent-up traumas were revealed.

    Once you feel it, people just become themselves, his wife said. People dont need the drugs, the smoking, the acting out … not to feel that pain.

    Janov contended the therapy contended the therapy could cure everything from stuttering to drug addiction to epilepsy, and might even lead to an end to war.

    He included homosexuality as a curable condition, although the American Psychiatric Association took it off the list of psychiatric disorders in 1973.

    His 1970 book The Primal Scream made him an international celebrity. His patients included John Lennon, Yoko Ono and actor James Earl Jones.

    In a 1975 book, Janov called his therapy the only hope if mankind is to survive and suggested that what he called primal consciousness certainly means an end to war.

    As with many other emotional-release therapies of its time, primal therapy is today widely rejected by mental health professionals as unscientific and ineffectual.

    However, Janovs widow said it is still practised around the world.

    It changed so many peoples lives, she said.

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    Benefits of water: Are you getting enough fluids to stay healthy?

    (CNN)Water is known as the elixir of life, with good reason. Every system in your body needs it to survive.

    This feature is part of CNN Parallels, an interactive series exploring ways you can improve your health by making small changes to your daily habits.
    “Water regulates our body temperature, keeps our joints lubricated, helps prevent infections and delivers nutrients to our cells,” said registered US dietitian and CNN contributor Lisa Drayer. “Additionally, our kidneys and liver work hard to get rid of toxins in our bodies, and they depend on water to do their job.”
    Water makes up about 60% of your body’s weight, and although you can survive without food for weeks, dehydration can kill you within days or even hours, depending on the temperature and your environment.
      Dehydration means more water is moving out of your body’s cells than into them. And as this happens, it’s not just water that you lose. Small amounts of electrolytes critical to cell function and energy, such as sodium and potassium, are lost along with the water.
      You’re constantly losing water and electrolytes throughout the day via breath, sweat, urine and bowel movements, so even mild dehydration can exhaust you and affect many of your body’s daily functions.

      Hydration and your health

      You could quickly become constipated as your colon steals water from your stool to keep your digestive system moving. Urine will become darker; prolonged dehydration can also crystallize salts and minerals in urine, possibly leading to the formation of painful kidney stones.
      Because dehydration can often be mistaken for hunger, you might gain weight as you try to satisfy your body’s needs. Fortunately, the opposite is also true if you’re hydrated.
      “If you are looking to lose weight, water can help you shed pounds,” Drayer said. “Drinking a glass of water before a meal can fill you up a bit and help you eat fewer calories at a meal.”
      If you suffer from migraines, studies show that a lack of fluids might easily trigger an episode. Headaches are also likely to last longer if you’re low on fluids. In addition, dehydration can leave you unable to concentrate, cause short-term memory problems and leave you feeling moody and anxious.
      “When you’re well-hydrated, your sleep quality is better, your cognition is better, you function better, your mood is better, the list goes on,” said Douglas Casa, CEO of the University of Connecticut’s Korey Stringer Institute, which studies athletic performance — another area that benefits from drinking enough fluids.
      “We did a study on people who were mildly dehydrated, which can happen within just 30 minutes of exercise,” Casa said, “and we found mood was compromised in both men and women.”

      Signs of dehydration

      The signs of dehydration differ by age group. Infants and young children may not be able to recognize their need for fluids, so it’s critical to provide frequent fluid intake and keep an eye out for symptoms of dehydration: irritability or lethargy, no tears when crying, no wet diapers for as little as three hours, a dry mouth and tongue, sunken eyes and cheeks, and a shrinking of the soft spot on top of head.
      Adults show much different signs of dehydration, including fatigue, dizziness, confusion, less-frequent urination and extreme thirst, but the latter has one exception: the elderly. Older adults may not feel thirsty but can still be dehydrated.
      That’s why one of the best ways to tell whether you’re lacking fluids is by the color of your urine.
      “The morning is the best time to get a global sense of your hydration status,” Casa advised. “If your urine looks more like apple juice instead of lemonade, then you’re dehydrated. On the flip side, the need to urinate throughout the day is a sign that you’re well-hydrated.”

      Additional causes of dehydration

      A lack of fluids is not the only cause of dehydration. Certain blood pressure and diuretic medications can increase urination, as can diabetes that has not been diagnosed or isn’t well controlled.
      A sudden and extreme episode of diarrhea or vomiting can remove a large amount of fluids in a short amount of time. Add a high fever, and you could be in trouble quickly. Upping fluid intake, preferably fluids fortified with electrolytes, is critical.
      Sweating due to hot, humid conditions or extreme physical activity is another sure way to become quickly dehydrated. Athletes and those who work outside have to be especially careful to avoid heat injuries including muscle cramps, heat exhaustion and seizures.
      Hypovolemic shock, in which low blood volume causes a drop in oxygen and blood pressure, is the most serious form of dehydration and can be life threatening.

      The many sources of water

      What’s the best way to stay hydrated? Drinking plain water, of course, can’t be beat. It’s readily available and has zero calories.
      But what if, like many Americans, you don’t like the taste of water? Drayer suggests adding fruit or vegetables, such as lemons, berries and orange or cucumber slices, to enhance the flavor.
      The National Academies of Medicine recommends a little over 11 cups (2.7 liters) of fluids a day for the average woman and 15 1/2 cups (3.7 liters) for men. Though that may sound difficult to achieve, the fluids can come from many sources besides water, including food.
      “I often remind people that broth-based soup, as well as other beverages including tea, coffee and milk, count towards your daily fluid intake,” Drayer added. “Also vegetables including cucumbers, lettuce, celery and tomatoes and fruits including watermelon, cantaloupe and strawberries.”
      “Why don’t Americans like to drink water? Because we are conditioned to expect high levels of sweetness in everything,” said renowned nutritionist Dr. Walter Willett, professor of nutrition and epidemiology at Harvard T.H. Chan School of Public Health.
      “And that has led to a lot of problems,” he added. “High levels of sugar have adverse metabolic effects, and the amounts we get in beverages today is so huge that it is one of our major health issues.”
      Willett, who is also a professor of medicine at Harvard Medical School, has published over 1,700 research papers and reviews on lifestyle risk factors for chronic disease.
      “You might say we are malhydrated, because we drink so much soda and fruit juice and other sugar-sweetened beverages, and by that I mean we drink beverages that harm our health,” he said. “Even energy drinks and vitamin waters, most are loaded with sugar and not worth the use.”

      Calculate your fluids

      To help people make better choices about their fluid intake, the American Society for Clinical Nutrition’s Beverage Guidance Counsel created a “pitcher” of liquids to illustrate at a glance how much of each fluid is considered best for optimal health. Though it was created in 2006, Willett, who served on the council, said the guidance holds true today.

      The vast majority of your daily fluid intake should come from water. In this illustration, a person on a 2,200-calorie diet would drink about 50 fluid ounces of water a day, which is just over 6 cups (1.4 liters). Another 28 fluid ounces, which is 3½ cups or just over 700 milliliters, could come from coffee or tea.
      “There are health benefits to coffee. Studies show it can help with diabetes and has some modest cardiovascular benefits,” Willett said. “It’s a mild antidepressant. In fact, studies show about a 50% lower risk of suicide of with three to four cups of coffee a day.
      “Tea has about a third the amount of caffeine as coffee, so you’re much less likely to have sleep problems,” he added, “but we don’t see as many health benefits for tea as coffee.”
      The next choice in the fluid pyramid is skim milk, also sold as 1% milk, as well as soy or other unsweetened alternatives such as almond milk. For adults who wish to add that beverage to their diet, the maximum amount per day would be two cups (almost 500 milliliters).
      “Milk is really complicated area because it comes along with saturated fat,” Willett said, “and even low-fat milk is high in calories. Up to two servings a day is fine, but going beyond that is excessive.”
      Level four in the diagram includes diet sodas, teas and other beverages with non-calorie artificial or natural sweeteners such as aspartame, sucralose and stevia. Because there is growing evidence that these drinks might contribute to weight gain, Willett says they should be seen as an “occasional treat.” They are listed in the pitcher as no more than 16 ounces a day (2 cups or almost 500 milliliters); keep in mind that a typical can of soda is 12 ounces.
      Then come alcohol, whole fat milk, sports drinks, vitamin enhanced waters and fruit and vegetable juices. Yes, even fruit and veggie drinks are capped at 4 ounces a day.
      “Fruit juices are cautionary because they contain about the same amount of sugar as soda,” Willett said. “Orange juice has nutritional value, apple juice much less, so we recommend choosing orange over apple juice.”
      Alcoholic beverages are complicated, he added. “There are definite protective health benefits against heart disease for both sexes, but for women, even a half a drink a day can raise the risk of breast cancer. So if you’re not at risk for heart disease, there’s no benefit in preventing it, so there’s no reason to drink,” he said. That’s why alcohol is listed on Willet’s diagram as zero fluid ounces toward your daily amount.
      The last category is reserved for sugar- or high fructose corn syrup sweetened beverages such as regular soda, lemonade and fruit drinks. Willett says those get a ‘”thumbs down” because they provide no nutritional value and plenty of calories.

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      Taken as a whole, Willett said, the pitcher recommendations should come as a wake up call for anyone looking to quench their thirst.
      “The most important message is the source of the hydration,” he said. “Beverages can cause real harm. People are not dying of dehydration in America, so choosing beverages other than water and other healthy sources has major health implications.”

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      Blood clot risk — and other problems — might be tied to how tall you are

      (CNN)How tall you are might hold clues to your risk of various health problems, such as blood clots, according to a new study.

      Height can be an independent predictor of your risk for venous thromboembolism, or VTE, also known as blood clots, according to the study, published Tuesday in the journal Circulation: Cardiovascular Genetics.
      That blood clot risk was lowest among the shortest women and men and appeared to increase with height, the research showed.
        “Height is not something we can do anything about,” lead study author Dr. Bengt Zöller, associate professor at Lund University and Malmö University Hospital in Sweden, said in a news release.
        “However, the height in the population has increased, and continues increasing, which could be contributing to the fact that the incidence of thrombosis has increased,” he said. “I think we should start to include height in risk assessment just as overweight, although formal studies are needed to determine exactly how height interacts with inherited blood disorders and other conditions.”
        In the United States, blood clots are thought to kill about 60,000 to 100,000 people annually, according to the US Centers for Disease Control and Prevention.
        Across Europe, there are an estimated 500,000 deaths related to blood clots each year, according to a 2014 review paper in the journal Thrombosis Research.
        The risk of blood clots isn’t the only health concern that has been tied to height: Cancer, heart problems, gestational diabetes and even longevity have been linked with stature.

        ‘Body size in general is an important factor’

        The new blood clot study involved data on more than 1.6 million Swedish men who enlisted in the military and were born between 1951 and 1992, and data on more than 1 million Swedish women who had a first pregnancy between 1982 and 2012. Pregnancy can increase the risk of blood clots, which is among the leading causes of maternal death in the developed world.

          How dangerous are blood clots?

        Using the Swedish Multi-generation Register, the researchers identified siblings of different heights. They also used the national Swedish Hospital Register to track hospital inpatient and outpatient diagnoses of blood clots between 1969 and 2012.
        The researchers found that the risk for blood clots decreased 69% for women shorter than about 5-foot-1, compared with women about 6 feet and taller. The risk dropped 65% for men shorter than about 5-foot-3, compared with men about 6-foot-2 and taller, the researchers found.
        Among men, an association with height was found for risk of blood clots in the lungs, called pulmonary embolism, as well as in the legs and other locations. Among women, only the risk of blood clots in the legs was significantly associated with height.
        Still, “these clots are deadly because they can break free from the vein and travel to the lung,” said Dr. Mary Cushman, professor of medicine and pathology and director of the Thrombosis and Hemostasis Program at the Larner College of Medicine at the University of Vermont, who was not involved the new study.
        “If the clot is big enough, that can cause death, which is sometimes sudden,” she said.
        The researchers also found that the strong association between blood clot risk and height remained among the siblings.
        The strengths of the new study are its large sample sizes and its utilization of siblings, said Dr. Nesochi Okeke-Igbokwe, an attending physician of internal medicine at NYU Langone Health in New York, who was not involved in the new study.
        “Overall, it is a solid study with good research methodology used,” Okeke-Igbokwe said.
        “The bottom line regarding this recent study, whether you are a taller or shorter individual, you must be aware of all the additional lifestyle factors that may increase your risk for blood clots, such as smoking or a sedentary lifestyle,” she said. “We have no control over our height, but we certainly can all take the appropriate measures in making healthy lifestyle choices to reduce the risk of various conditions.”
        One limitation of the study was that the researchers did not have information on the participants’ childhoods, home environments and diets. However, they used educational level as a measure of lifestyle factors.
        All in all, “this study adds to growing evidence that body size in general is an important factor to consider in determining the risk of VTE. It also gives us information about why VTE occurs in the legs more often than elsewhere, like the arms,” said Cushman, who also serves as editor-in-chief of the journal Research and Practice in Thrombosis and Haemostasis.
        “Basically, the blood has to travel up a vein against gravity, and when there is a longer distance to travel, there is more opportunity for the blood to clot abnormally,” she said. “This is not the case in the arms, for example, where arm movement allows blood to more easily flow out of the limb with the help of gravity.”
        When it comes to the new study, the “robust” design could be replicated to determine whether height correlates with other health problems, said Ulhas Naik, professor of medicine and director of the Cardeza Center for Vascular Biology Research at the Sidney Kimmel Medical College at Thomas Jefferson University, who was not involved in the new study.
        “Being tall, there are benefits in some ways in some diseases, (and) there is the opposite in some other diseases,” he said. “This kind of a study is a good starting point to now look at other diseases.”

        Cancer risk goes up with height?

        Epidemiological studies have suggested that taller people are at an increased risk of cancer.
        A systematic review paper published in the journal Plos Medicine last year, in which 63 studies on the association of height with cancer risk were analyzed, provided evidence for a potential link between adult height and the risk of colorectal and lung cancers.
        The paper also suggested that certain genetic factors and biological pathways affecting adult height may affect the risk of those cancers.
        A separate study published in the Journal of the National Cancer Institute in 2015 provided strong evidence that adult height can be a risk factor for breast cancer in women.
        As with the Plos Medicine study, the researchers behind the 2015 study pointed to certain genetic factors and biological pathways affecting height as having an important role in the development of breast cancer.

        Is short stature tied to gestational diabetes risk?

        Height also has been linked to gestational diabetes, which occurs when high blood sugar starts or is first diagnosed during pregnancy.

          Gestational diabetes affects mom, baby

        A study of 135,861 pregnancies in women of various races in the US, of whom 5,567 were diagnosed with gestational diabetes, found that taller height was significantly associated with a lower risk of gestational diabetes.
        Overall, women in the highest height quartile in that study had more than 60% lower risk of gestational diabetes compared with women in the lowest quartile, even after accounting for maternal age, weight, race, insurance and education, according to the findings.
        The study was published in the journal Diabetic Medicine in 2013.

        Are your height and heart risk connected?

        Researchers have long suspected that being shorter might be tied to an increased risk for certain heart problems, such as heart disease and heart attacks.
        On the other hand, atrial fibrillation, a problem with the speed or rhythm of your heart rate, has been observed to be more prevalent among taller individuals.
        Overall, a meta-analysis research paper on height and health risks, published in the International Journal of Epidemiology in 2012, found that “height was negatively associated with death from coronary disease, stroke subtypes, heart failure, stomach and oral cancers, chronic obstructive pulmonary disease, mental disorders, liver disease and external causes,” according to the abstract.
        “In contrast, height was positively associated with death from ruptured aortic aneurysm, pulmonary embolism, melanoma and cancers of the pancreas, endocrine and nervous systems, ovary, breast, prostate, colorectum, blood and lung,” the abstract said. That study involved an analysis of 121 prospective studies including about 1 million people.

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        NYU Langone’s Okeke-Igbokwe said that with all of these height-related correlations — from cancer to heart diseases — the exact underlying mechanisms still need to be fleshed out.
        “Undoubtedly, an increased number of large-scale studies will still be required to really examine the correlation between height and these other medical conditions,” she said.

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        Curvy swimsuit model cyberbullied over revealing Instagram photo

        Plus size model Alexa Phelece routinely uses her Instagram to post body positive shots of herself in swimsuits and curve-hugging fashions.

        Through her posts and uplifting messages, Phelece has grown her following to nearly 80K. However, her largely supportive fans weren’t as encouraging when the model posted a picture of herself and a much thinner woman wearing the same swimsuit – a $40 khaki monokini from Fashion Nova.

        “So here we have two girls in the same swimsuit. Let me just point out a few things,” Phelece captioned the splitscreen photo.


        “One girl is in size Sm (I looked online) and one is in 3x- different skin colors,” she continued. “– one may be considered privileged- one is more commonly seen as healthy based on size – one is more commonly recognized as beautiful on tv or media,” Phelece said.

        However, it was the similarities the Instagram influencer listed that whipped her followers into a frenzy.

        “Both [women] are models – both are wearing the same swimsuit,” Phelece said. “LETS NOT FORGET: BOTH are beauty – BOTH should be treated equally – both should be able to love their bodies – BOTH should be judged on the content of their character NOT their skin color and definitely NOT their size – Both women are equally capable and worthy.”

        Her empowering speech is in line with other captions the Every Body Deserves Love founder has posted. This time, though, her fans were not feeling the love.

        “At first I was getting a lot of love and encouragement to continue my self love journey but it quickly got very negative,” she told Yahoo Style. “I received a lot of comments mentioning the status of my health and how I am promoting obesity.”

        On the photo, which received over 8,000 likes, one woman commented, “Girl from the right picture represents- laziness, obesity, and this type of post is just an excuse for fat persons, to continue leaving unhealthy life.”


        And another person wrote, “’Fat but Fit’ is a myth. There are a myriad of studies out there that all come to the same conclusion. Being overweight, especially obese (yes, she IS obese), increases your risk of heart disease. Love yourself all you want, but you can’t deny reality that your weight puts you at risk for an early death. Period.”

        Phelece, who told Yahoo Style that she was “heartbroken” to see the amount of hate her photo received, feels that women need to build each other up more rather than attack each other over physical differences.

        Still, she is addressing the hate head on in her follow-up posts calling out those who have “fat shamed” and accused her of “promoting obesity,” and posting the ways she stays healthy like exercising and embracing her curves.

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        A Cup Of Coffee Before The Gym Can Make Your Workout More Enjoyable, But There’s A Catch

        If you’re a frequent gym-goer, I’m willing to bet that you’ve probably seen that chick who strolls into the weight room with her giant Starbucks cup in hand, or the dude with the hefty coffee mug sitting alongside him as he slays on the rowing machine. While we can all agree that coffee is, indeed, a serious blessing that shouldn’t just be limited to a morning wake-up call, is it really all that safe to drink coffee before a workout?

        Anyone who’s looking for a little extra pep in their step before hitting the gym will likely opt for something like a pre-workout energy drink or supplement. But if you’ve ever tried that stuff, you know damn well just how expensive it is, not to mention the fact that it’s not exactly healthy for you and your hard-working bod

        Of course, this only makes a quality cup of glorious java that much more tempting to indulge in before a tough sweat sesh.

        If you’re out here dreaming of a nice cup of joe before the gym, science says you, my friend, are in luck.

        A cup of coffee before your ab circuit can reap results such as an increased metabolism, improved circulation, muscle preservation, and extra endurance.

        Plus, in a study from Coventry University, sports scientists found that caffeine helps fight decreased muscle strength that often occurs as the body ages.

        I’m sure you didn’t need me to tell you how amazing coffee is in general, but who knew it could do so much good for the body when it comes to exercising?

        But on the real, before you start ordering five cups of your favorite caffeinated beverage at Dunkin’ Donuts on your way to the gym, there’s a bit of a catch that you should know about.

        Despite some of these reported benefits, some personal trainers say drinking coffee before a workout has a few downsides.

        For example, while personal trainer Greer Rothermel loves her caffeine as much as the next girl, she knows what to avoid when it comes to her own energizing cup of pre-workout joe.

        In terms of the benefits, Rothermel tells Elite Daily,

        I have coffee before almost every workout.

        It has many benefits which could help you during your next workout, including increasing your alertness, improving focus, and enhancing performance.

        Though a couple shots of espresso can help you push through a rough workout and make it easier to exercise at a greater intensity, the catch you need to know about is what you put into your coffee: the creamer, the sugar, the artificial flavors — all that stuff.

        Rothermel reveals,

        Coffee can become unhealthy quickly, so make sure your coffee is good for you.

        Make sure you skip out on the artificial sweeteners, artificial flavoring, and highly processed creamers.

        If you’re just not about that black coffee lifestyle, though, personal trainer Rebecca Kennedy has you covered.

        Kennedy uses healthy additives in her java to replace the processed crap that hinders the #gains, and your health.

        Here’s what you can find in Kennedy’s cup of brew:

        I start every day with a Moka (stove-top espresso) with three pumps of Promix medium chain triglyceride (MCT) oil, and two scoops of collagen peptides.

        The MCT breaks down fast like a carb and is great to help sustain energy levels without experiencing spikes.

        Additionally, the collagen peptides I add have a banging 20 grams of protein.

        Kennedy stresses the fact that she never adds sugar to her coffee anymore because of its detrimental negative health effects. However, she says the MCT she adds to her coffee give the drink a smooth, butter-like quality that she used to turn to milk and creams for.

        So, yes, you can totally mix your coffee with your cardio — just take it easy on the sugary artificial crap you pour into it to make it taste good. Try reaching for a banana to wash down some black coffee, or sprinkle some cinnamon in your cup when you’re craving that sweet little something.

        Read more:

        Dallas preps ‘mega-shelter’ as Texas braces for more rain

        Houston (CNN)Harvey is no longer a hurricane, but life-threatening flooding continued in and around Houston on Sunday night as citizens with boats assisted authorities in search and rescue efforts.

        Flooding from Tropical Storm Harvey is overburdening resources in the country’s fourth-largest city, prompting authorities to call on volunteers with watercraft for help in rescuing those trapped in homes and buildings.
        An immediate respite from Harvey’s wrath seems unlikely to come. The National Weather Service calls the flooding “unprecedented,” and warns things may become more dire if a forecasted record-breaking 50 inches of rain does fall on parts of Texas in coming days. In anticipation of a worsening situation, Dallas is turning its main convention center into a “mega-shelter” that can host 5,000 evacuees.
          The rainfall threatens to exacerbate an already dangerous situation, as Harvey’s rains have left many east Texas rivers and bayous swollen to their banks or beyond.
          “The breadth and intensity of this rainfall are beyond anything experienced before,” the weather service said. “Catastrophic flooding is now underway and expected to continue for days.”
          The storm killed two people in Texas, authorities said, and the death toll will likely rise. More than 1,000 people were rescued overnight, and Houston Mayor Sylvester Turner warned that some 911 calls are going unanswered as operators “give preference to life-threatening calls.”
          Here are the latest developments:
          • A woman who drove her vehicle into high water in Houston was killed, and fire killed a man in Rockport.
          • Several states and the US military are sending emergency workers and equipment to Texas. In Harris County, though, authorities are having issues mobilizing those resources. “We’ve requested boats, all the things that would normally happen in a well-planned response to an event like this, but they can’t get here,” Harris County Judge Ed Emmett said.
          • Dallas announced its plans to open a “mega-shelter” capable of accommodating 5,000 evacuees at the Kay Bailey Hutchison Convention Center. County officials, charitable groups and local hospitals are working to open the shelter by Tuesday morning.
          • While Turner warned the rain could exacerbate flooding for “four to five days,” Federal Emergency Management Agency Director Brock Long said he expects his agency “is going to be there for years.”
          • The Houston Independent School District has canceled school for the week.
          • Houston’s George Bush Intercontinental and William P. Hobby airports are closed until further notice, officials said. Corpus Christi International reopened at 4 p.m. Sunday, officials said. Jack Brooks Regional Airport in Beaumont, Ellington Airport in Houston, Mustang Beach Airport in Port Aransas and McCampbell-Porter Airport in Aransas Pass are also temporarily closed, the Federal Aviation Administration says.
          • Ben Taub Hospital, which houses a Level I trauma center, is being evacuated after flooding in the basement “disrupted the power source,” Emmet said.
          • 316,000 customers have lost electricity, Gov. Greg Abbott said.
          • The Red Cross is serving about 130,000 meals a day, the governor said.
          • President Donald Trump will travel to Texas on Tuesday, press secretary Sarah Huckabee Sanders said.


            Woman trapped in home: 911 told us not to call

          Among those stranded by the storm is Ify Echetebu, 30, who spoke to CNN from her aunt’s house in Dickinson, not far from Galveston Bay. Along with her fiancé, grandparents, a friend and several teenagers, Echetebu is trapped on the second floor of the house as floodwaters creep up the staircase. She can see the rooftops of submerged cars in driveways, she said.
          On the first floor, the water is up to her waist, she said. Emergency services know she and 10 others are holed up in the home, she said, but because emergencies take priority, she doesn’t expect to be rescued until tomorrow, Echetebu said.

          The severity of the situation just hit me. I’m overcome with grief due to how helpless I feel in all of this. This is truly devestating. #PrayForTexas #PrayForGalvestonCounty #TropicalStormHarvey #HurricaneHarvey

          A post shared by Lotenné I. E. (@1whitenigerian) on

          “We’re nervous to stay here, but we are sleeping in shifts,” she said. “Now we’re having to deal with sewage in the water, river water, bayou water, water moccasins, snakes, gators.”
          Not far away, a rescue operation saved 20 to 25 residents of La Vita Bella assisted-living facility in Dickinson.
          “They were up to their waist,” Galveston County Commissioner Ken Clark said. “If they were in a wheelchair, they could have been up to their neck.”
          After a record 22 inches fell on the county in one day, rescuers set out before dawn Sunday to save those who braved the storm. Officials quickly realized they did not have enough boats for the rescue operations and asked private boat owners to help, said County Judge Mark Henry, responsible for disaster response in the county.
          As of Sunday evening, between 800 and 1,200 people had been rescued from their homes in Galveston County, Henry said.
          As authorities warned people not to take shelter in attics, unless they have axes handy to break through their roofs, several residents provided CNN with their accounts of riding out the storm.
          “We are still stranded in our home with little kids and the water keeps rising,” Houston resident Janet Castillo said Sunday morning. “We have (tried calling several numbers), but their lines are all busy or they don’t answer.”
          Jake Lewis of New Braunfels, Texas, said he woke up to ankle-deep water in the Houston hotel where he is staying.
          “We have nowhere to go,” he said. “I have a 2016 Chevy Silverado and the water is up to the door panels. The water keeps rising.”
          One of two confirmed fatalities happened in Houston when a woman drove her vehicle into high water and couldn’t make it across, city police said. She got out of her vehicle, was overtaken by floodwaters and drowned.

          Many roads impassable

          In a Sunday news conference, Abbott said, “We want to stress when there is heavy rainfall and flooding, the importance of staying off the road. If you drive into water, you’re taking your life into your own hands.”
          Portions of major highways, including Interstates 10, 45 and 610, were submerged and unnavigable. Houston resident Dion Laurent said the White Oak Bayou flooded I-10 and I-45.

          White Oak Bayou flooding I-10 and I-45 #Harvey from Quitman St. Bridge

          A post shared by dion laurent (@dionrlaurent) on

          Harris County Sheriff Ed Gonzalez said he understands the compulsion to find safer ground, but urged people to think twice before venturing out into high water and to consider unforeseen dangers, such as manhole covers being lifted from their holes.
          Lt. Craig Cummings of the Texas Department of Public Safety said attempts to drive to safety may be futile anyway, as it took him two and a half hours to drive 20 miles in Houston on Sunday.
          “There’s 60 barricaded locations as of midnight. Most thoroughfares are impassable. Several hundred structures are flooded, and we are expecting that number to rise,” he said.
          In Brazoria County, south of Houston, officials set up an evacuation route for all residents living west of State Highway 288 and south of State Highway 6, ordering them to “LEAVE NOW!” under a mandatory evacuation order. Those in need of shelter can take refuge in the Bell County Expo Center in Belton, officials said.
          The 911 dispatchers in the nation’s fourth-most populous city have received 2,000 requests for rescue, Mayor Turner said. Houston Fire Chief Samuel Peña said his department had responded to 2,500 calls and have about 1,000 more waiting to be serviced.
          Gonzalez tweeted that many high-water rescues were performed overnight in Houston, some involving children or residents with medical issues, including one person suffering from cardiac arrest. Stranded residents were saved from vehicles on the highway. Airboats were employed in some instances, he said.
          People are taking to social media to announce their locations and ask for help.
          One person, whose mom is diabetic and dad has heart disease, tweeted, “We need help!! My house is flooded.”

          24 inches of rain in 24 hours

            Slow moving storm Harvey drenching Texas

          Harvey blasted ashore as a Category 4 hurricane just north of Corpus Christi. It brought with it 132-mph winds but was quickly downgraded to a tropical storm. Still, it continued to spawn tornadoes and lightning.
          A flash flood emergency was declared for sections of Houston, where more than 24 inches of rain fell in 24 hours, the National Weather Service said.
          The weather service said maximum sustained winds Sunday would be near 45 mph. While Harvey could become a tropical depression by Sunday night, residents are warned to remain vigilant.
          The slow-moving storm is expected to drop 15 to 25 inches of rain over the Texas coast through Thursday. Isolated storms could drop up to 50 inches of rain, the weather service said.
          “What is unique in Harvey is that as the storm moved inland, a large high pressure built in to the north and, basically, the steering currents, which guide Harvey, collapsed,” said CNN senior meterologist Dave Hennen. “This has caused the extremely slow movement of the storm, moving only around 60 miles, less than 2 miles per hour. This has allowed the bands of storms to move over the same areas over and over.”
          The weather service says rainfall of this magnitude “will cause catastrophic and life-threatening flooding.”
          Some residents are comparing Harvey to Allison, a storm that struck the Texas coast in 2001 and killed 23 people.
          “Allison was bad — really, really bad,” Houston resident Pat Napolio said, “but if (the water) creeps up anymore, Harvey will surpass (Allison).”

          Rockport hit hard

          Another fatality was reported in the battered coastal city of Rockport. A person died in a house fire during the storm, Aransas County Judge Burt Mills said Saturday.
          Warnings of tornadoes, torrential downpours and potentially historic flooding means extra bad news for broad swaths of southeast Texas, already littered with uprooted trees, toppled signs, flagpoles snapped like toothpicks and homes missing rooftops and patches of brick walls.
          Additional fatalities were feared in Rockport, where an estimated 5,000 residents rode out the storm, Aransas County Sheriff Bill Mills said.
          Brock Long, director of the Federal Emergency Management Agency, said that Harvey would leave areas “uninhabitable for weeks or months,” echoing language last heard ahead of Hurricane Katrina in 2005.
          “FEMA is going to be there for years,” Long said.

          Read more:

          Read the Fine Print on the $475,000 Price of a Cancer Breakthrough

          It's been an historic week for cancer treatment. 

          Kicking it off, Gilead Sciences Inc. bought Kite Pharma Inc., a pioneer in "CAR-T" cell therapy, which uses a patient's immune cells to potentially eradicate blood cancers with just one treatment. And on Wednesday, Novartis AG's entry in this field, Kymriah, became the first such treatment to get FDA approval — a month ahead of schedule, to boot. 

          Making this even more interesting, Novartis priced the drug at $475,000 for one treatment. That is eye-popping, but well below even higher expectations of up to $700,000. And Novartis said it would offer ways to make the price even lower for some patients.  

          Kymriah will still be one of the most-expensive drugs ever, and its list price doesn't include the other costs of administering a complicated treatment with major side effects. But if CAR-T drugs are to become more than just niche medicines, then drugmakers will have to be flexible on pricing. It is encouraging that Novartis is building such flexibility in from the start. 

          Novartis hopes to use "indication-based" pricing, meaning it would charge patients differently depending on what sort of cancer they have. Kymriah's initial FDA approval is for a narrow group of patients: children and young adults with a specific blood cancer. These patients will likely be charged the highest prices. Not only is this a niche population, but the drug works particularly well in this group, with remissions achieved in 83 percent of patients within 3 months.

          But in clinical trials for older patients with a different cancer, Kymriah hasn't worked as well. So Novartis will likely charge that larger group less for the drug, if it is approved for those patients in the future. This would not be an entirely altruistic move on the drugmaker's part. A discount may be necessary to get doctors to prescribe, and payers to pay for, a drug in a larger population that will see less benefit. If Kymriah is to meet Wall Street's sales expectations, then it will need to move well beyond its initial approved use. Variable pricing may help.  

          Novartis is also working with the Centers for Medicare and Medicaid Services on a novel plan where it won't charge for Kymriah if it isn't working after a month. There's room for the drugmaker to do much more here. In the narrow group of patients for which Kymriah has initial approval, the response rate after a month is very high. Relapses tend to occur later. That means discounts tied to long-term success would be more meaningful. But Novartis will end up eating the cost for some treatments — and that's a big deal for a drug that is expensively manufactured for each individual patient rather than in large batches. 

          Novartis may still take some heat for its price tag, but it could have been much worse. A U.K cost-benefit analysis of CAR-T drugs suggested a $750,000 price could be justified. Novartis is notably scrapping the typical pharma playbook, which is to start high and privately give discounts to insurers. That would have been the wrong approach in this case, optically and strategically, inviting a fiercer backlash and slowing uptake of the drug.

          Novartis knows how that movie goes. It thought its heart drug Entresto, approved in 2015, could be a blockbuster with $5 billion in annual sales. But pharmacy benefit managers and insurers afraid of such spending threw up roadblocks to the drug's broader use — it only costs about $4,500 a year, but heart disease is a huge market — that have badly hurt sales growth and expectations. Analysts once expected Entresto to hit $1 billion in sales this year; now they expect that milestone to come in 2018, and just barely. By adding extra pricing levers for Kymriah, Novartis will be better at adapting to an even more complicated market than Entresto's. 

          The fact that a $475,000 price looks something like restraint says a lot about the state of drug pricing in the U.S. But in this case, the fine print matters. 

          This column does not necessarily reflect the opinion of Bloomberg LP and its owners.

            Read more: