Plastic fibres found in tap water around the world, study reveals

Exclusive: Tests show billions of people globally are drinking water contaminated by plastic particles, with 83% of samples found to be polluted

Microplastic contamination has been found in tap water in countries around the world, leading to calls from scientists for urgent research on the implications for health.

Scores of tap water samples from more than a dozen nations were analysed by scientists for an investigation by Orb Media, who shared the findings with the Guardian. Overall, 83% of the samples were contaminated with plastic fibres.

The US had the highest contamination rate, at 94%, with plastic fibres found in tap water sampled at sites including Congress buildings, the US Environmental Protection Agencys headquarters, and Trump Tower in New York. Lebanon and India had the next highest rates.

European nations including the UK, Germany and France had the lowest contamination rate, but this was still 72%. The average number of fibres found in each 500ml sample ranged from 4.8 in the US to 1.9 in Europe.

The new analyses indicate the ubiquitous extent of microplastic contamination in the global environment. Previous work has been largely focused on plastic pollution in the oceans, which suggests people are eating microplastics via contaminated seafood.

We have enough data from looking at wildlife, and the impacts that its having on wildlife, to be concerned, said Dr Sherri Mason, a microplastic expert at the State University of New York in Fredonia, who supervised the analyses for Orb. If its impacting [wildlife], then how do we think that its not going to somehow impact us?

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A magnified image of clothing microfibres from washing machine effluent. One study found that a fleece jacket can shed as many as 250,000 fibres per wash. Photograph: Courtesy of Rozalia Project

A separate small study in the Republic of Ireland released in June also found microplastic contamination in a handful of tap water and well samples. We dont know what the [health] impact is and for that reason we should follow the precautionary principle and put enough effort into it now, immediately, so we can find out what the real risks are, said Dr Anne Marie Mahon at the Galway-Mayo Institute of Technology, who conducted the research.

Mahon said there were two principal concerns: very small plastic particles and the chemicals or pathogens that microplastics can harbour. If the fibres are there, it is possible that the nanoparticles are there too that we cant measure, she said. Once they are in the nanometre range they can really penetrate a cell and that means they can penetrate organs, and that would be worrying. The Orb analyses caught particles of more than 2.5 microns in size, 2,500 times bigger than a nanometre.

Microplastics can attract bacteria found in sewage, Mahon said: Some studies have shown there are more harmful pathogens on microplastics downstream of wastewater treatment plants.

Plastic fibres found in tap water across the world

Microplastics are also known to contain and absorb toxic chemicals and research on wild animals shows they are released in the body. Prof Richard Thompson, at Plymouth University, UK, told Orb: It became clear very early on that the plastic would release those chemicals and that actually, the conditions in the gut would facilitate really quite rapid release. His research has shown microplastics are found in a third of fish caught in the UK.

The scale of global microplastic contamination is only starting to become clear, with studies in Germany finding fibres and fragments in all of the 24 beer brands they tested, as well as in honey and sugar. In Paris in 2015, researchers discovered microplastic falling from the air, which they estimated deposits three to 10 tonnes of fibres on the city each year, and that it was also present in the air in peoples homes.

This research led Frank Kelly, professor of environmental health at Kings College London, to tell a UK parliamentary inquiry in 2016: If we breathe them in they could potentially deliver chemicals to the lower parts of our lungs and maybe even across into our circulation. Having seen the Orb data, Kelly told the Guardian that research is urgently needed to determine whether ingesting plastic particles is a health risk.

The new research tested 159 samples using a standard technique to eliminate contamination from other sources and was performed at the University of Minnesota School of Public Health. The samples came from across the world, including from Uganda, Ecuador and Indonesia.

How microplastics end up in drinking water is for now a mystery, but the atmosphere is one obvious source, with fibres shed by the everyday wear and tear of clothes and carpets. Tumble dryers are another potential source, with almost 80% of US households having dryers that usually vent to the open air.

We really think that the lakes [and other water bodies] can be contaminated by cumulative atmospheric inputs, said Johnny Gasperi, at the University Paris-Est Creteil, who did the Paris studies. What we observed in Paris tends to demonstrate that a huge amount of fibres are present in atmospheric fallout.

Plastic fibres may also be flushed into water systems, with a recent study finding that each cycle of a washing machine could release 700,000 fibres into the environment. Rains could also sweep up microplastic pollution, which could explain why the household wells used in Indonesia were found to be contaminated.

In Beirut, Lebanon, the water supply comes from natural springs but 94% of the samples were contaminated. This research only scratches the surface, but it seems to be a very itchy one, said Hussam Hawwa, at the environmental consultancy Difaf, which collected samples for Orb.

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This planktonic arrow worm, Sagitta setosa, has eaten a blue plastic fibre about 3mm long. Plankton support the entire marine food chain. Photograph: Richard Kirby/Courtesy of Orb Media

Current standard water treatment systems do not filter out all of the microplastics, Mahon said: There is nowhere really where you can say these are being trapped 100%. In terms of fibres, the diameter is 10 microns across and it would be very unusual to find that level of filtration in our drinking water systems.

Bottled water may not provide a microplastic-free alternative to tapwater, as the they were also found in a few samples of commercial bottled water tested in the US for Orb.

Almost 300m tonnes of plastic is produced each year and, with just 20% recycled or incinerated, much of it ends up littering the air, land and sea. A report in July found 8.3bn tonnes of plastic has been produced since the 1950s, with the researchers warning that plastic waste has become ubiquitous in the environment.

We are increasingly smothering ecosystems in plastic and I am very worried that there may be all kinds of unintended, adverse consequences that we will only find out about once it is too late, said Prof Roland Geyer, from the University of California and Santa Barbara, who led the study.

Mahon said the new tap water analyses raise a red flag, but that more work is needed to replicate the results, find the sources of contamination and evaluate the possible health impacts.

She said plastics are very useful, but that management of the waste must be drastically improved: We need plastics in our lives, but it is us that is doing the damage by discarding them in very careless ways.

Read more: https://www.theguardian.com/environment/2017/sep/06/plastic-fibres-found-tap-water-around-world-study-reveals

Apple reportedly in talks with Aetna to bring the Apple Watch to millions of customers

Apple and Aetna have held several secret meetings to discuss offering the Apple Watch to Aetnas 23 million customers, according to CNBC.

These meetings, held on Thursday and Friday of last week in Southern California,reportedly involved top executives from both companies, including Myoung Cha, who is in charge of Apples special health projects, and hospital chief medical information officers from across the country.

Aetna could roll out the plan as early as next year, according to a CNBC source.

Weve reached out to both Apple and Aetna and will be sure to update you if and when we hear more. So far Aetna has declined to comment.

This is not the first time Apple has joined up with the health insurance company. Aetna already offers the Apple Watch to its 50,000 employees. Aetna also announced last September it would be offering the Apple Watch to select large employers and these talks could be an extension of that announcement.

Aetna now reportedly has ambitions to offer it to a wider field adding large swaths of new health data to pull from and giving the health insurance company insight into the activities of its customers.

The deal also would be beneficial to Apple, which heavily promotes the Apple Watch for health and fitness and briefly became the top wearable vendor this year, beating out Fitbit before Xiaomi took the top spot in Q2.

Apple also has been secretly hiring biomedical engineers and beefing up work on sensors for tracking blood sugar levels and detection of other diseases, which would come in handy for any health insurer wanting data-driven insights into its customer base.

Of course, whether customers will be willing to give up that information in exchange for the Apple Watch remains to be seen.

Read more: https://techcrunch.com/2017/08/14/apple-reportedly-in-talks-with-aetna-to-bring-the-apple-watch-to-millions-of-customers/

Terry Pratchett’s unfinished novels destroyed by steamroller

Unpublished works are lost for ever with crushing of computer hard drive as the late fantasy novelist had instructed

The unfinished books of Sir Terry Pratchett have been destroyed by a steamroller, following the late fantasy novelists wishes.

Pratchetts hard drive was crushed by a vintage John Fowler & Co steamroller named Lord Jericho at the Great Dorset Steam Fair, ahead of the opening of a new exhibition about the authors life and work.

Pratchett, famous for his colourful and satirical Discworld series, died in March 2015 after a long battle with Alzheimers disease.

After his death, fellow fantasy author Neil Gaiman, Pratchetts close friend and collaborator , told the Times that Pratchett had wanted whatever he was working on at the time of his death to be taken out along with his computers, to be put in the middle of a road and for a steamroller to steamroll over them all.

On Friday, Rob Wilkins, who manages the Pratchett estate, tweeted from an official Twitter account that he was about to fulfil my obligation to Terry along with a picture of an intact computer hard drive following up with a tweet that showed the hard drive in pieces.

The symbolism of the moment, which captured something of Pratchetts unique sense of humour, was not lost on fans, who responded on Twitter with a wry melancholy, though some people expressed surprise that the author who had previously discussed churning through computer hardware at a rapid rate would have stored his unfinished work on an apparently older model of hard drive.

The hard drive will go on display as part of a major exhibition about the authors life and work, Terry Pratchett: HisWorld, which opens at the Salisbury museum in September.

The author of over 70 novels, Pratchett was diagnosed with Alzheimers disease in 2007.

He became an advocate for assisted dying, giving a moving lecture on the subject, Shaking Hands With Death, in 2010, and presenting a documentary for the BBC called Terry Pratchett: Choosing to Die.

He continued to write and publish, increasingly with the assistance of others, until his death in 2015. Two novels were published posthumously: The Long Utopia (a collaboration with Stephen Baxter) and The Shepherds Crown, the final Discworld novel.

The Salisbury museum exhibition will run from 16 September until 13 January 2018.

Read more: https://www.theguardian.com/books/2017/aug/30/terry-pratchett-unfinished-novels-destroyed-streamroller

Heroin laced with elephant tranquilizer hits the streets

(CNN)The American heroin epidemic has become more dangerous, as reports of heroin laced with carfentanil are being reported throughout the country.

Carfentanil is the most potent opioid used commercially, 10,000 times stronger than morphine. It is a version or analogue of fentanyl, the painkiller that most recently made headlines with its role in the death of pop star Prince.
    It is not clear whether the Indiana and Ohio overdoses are connected, but officials are investigating the possibility.
    This month, a seizure of carfentanil in Manatee County, Florida, coincided with an increase in overdose deathsthere.

    Little data to track the drug

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

    The Drug Enforcement Administration does not track carfentanil cases separately. Most states flag a handful of fentanyl analogues in postmortem testing, but very few labs across the country are equipped to test for it or have any reference materials to help identify it. The University of Florida Forensic Toxicology Lab is currently developing a new test to identify the drug.
    Like fentanyl, carfentanil is dangerous not just to users but to anyone who comes into contact with it. Grains of it can be absorbed through the skin or inhaled.
    According to the DEA, most fentanyl analogues in the United States are being manufactured in China and transported through Mexico.

    Read more: http://www.cnn.com/2016/08/24/health/elephant-tranquilizer-carfentanil-heroin/index.html

    Girl, 2, defends her choice of doll to cashier

    (CNN)When 2-year-old Sophia was told she could pick out a prize for finishing her potty training, she knew just what she wanted.

    She and her mother, Brandi Benner, visited a Target near their South Carolina home, where Sophia spent 20 minutes looking at all the dolls in the toy aisle.
    “She kept going back to the doctor doll, because in her mind, she is already a doctor,” Benner said. “She loves giving checkups, and if you come in the house, she’ll tell you that’s the first thing you need.”
      Sophia, who will be 3 in July,was so excited by her choice that she wouldn’t let go of her new doll until they reached the register to check out.
      Did we mention that the doll is black and Sophia is white?
      The issue came up right away, when a store cashier asked Sophia: Wouldn’t she rather have a doll that looked like her?
      According to her mother, Sophia had a ready answer.
      “She does (look like me)!” the toddler responded. “She’s a doctor; I’m a doctor. She is a pretty girl; I am a pretty girl. See her pretty hair? See her stethoscope?”
      Benner credits the TV cartoon “Doc McStuffins” with teaching Sophia the word “stethoscope.” But she credits Sophia for knowing what is important: The doll’s skin tone didn’t matter. To Sophia, she and the doll share the same aspirations.
      Benner was relieved she didn’t have to defend her daughter’s choice and glad that Sophia wasn’t fazed by the cashier’s question.
      “If she was another child, that could have discouraged her,” Benner said.

      Nick and I told Sophia that after 1 whole month of going poop on the potty, she could pick out a special prize at Target. She, of course, picked a new doll. The obsession is real. While we were checking out, the cashier asked Sophia if she was going to a birthday party. We both gave her a blank stare. She then pointed to the doll and asked Sophia if she picked her out for a friend. Sophia continued to stare blankly and I let the cashier know that she was a prize for Sophia being fully potty trained. The woman gave me a puzzled look and turned to Sophia and asked, "Are you sure this is the doll you want, honey?" Sophia finally found her voice and said, "Yes, please!" The cashier replied, "But she doesn't look like you. We have lots of other dolls that look more like you." I immediately became angry, but before I could say anything, Sophia responded with, "Yes, she does. She's a doctor like I'm a doctor. And I'm a pretty girl and she's a pretty girl. See her pretty hair? And see her stethoscope?" Thankfully the cashier decided to drop the issue and just answer, "Oh, that's nice." This experience just confirmed my belief that we aren't born with the idea that color matters. Skin comes in different colors just like hair and eyes and every shade is beautiful. #itswhatsontheinsidethatcounts #allskinisbeautiful #teachlove #teachdiversity #thenextgenerationiswatching

      A post shared by Brandi Benner (@leilani324) on

      Benner posted an account of their experience Friday to her personal Facebook page. It’s been shared more than 140,000 times and attracted more than 19,000 comments. Most of them have been supportive messages from other mothers or people with similar experiences.
      The few negative ones don’t bother her.
      “I just want to teach my kids love, and that’s included in my own actions,” Benner said, explaining why she doesn’t engage with negative commenters.
      Research suggests that kids aren’t born with biases about race and gender.
      But Sophia doesn’t know about all that. She just knows that everywhere she goes, she wants her doctor doll to come along.

      Read more: http://www.cnn.com/2017/04/03/health/potty-training-doll-trnd/index.html

      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

      Trust me, I’m a fake doctor: how medical imposters thrive in the real world

      Versions of Jodie Whittakers bogus TV medic do exist. But fantasists and charlatans tend to operate outside the hospital, where victims have been assaulted, misdiagnosed or offered false hope

      Within the first half-hour of the BBCs psychological thriller Trust Me, Cath (a former nurse) had stolen her doctor friends identity, picked up some suturing skills from YouTube, and was handling a stethoscope like a pro. Before you could say: Adrenaline, STAT!, Cath (played by Jodie Whittaker) was a fake doctor at an Edinburgh hospital, yanking twisted ankles into place and shoving chest drains where they belonged.

      It couldnt happen in real life, though, could it? It already has. Others with medical backgrounds have posed as fully fledged doctors before. Take Levon Mkhitarian who encountered 3,363 patients in two years, working across seven NHS trusts on oncology, cardiology, transplant and surgical wards as well as in A&E. Mkhitarian, originally from Georgia, had graduated from medical school in the Caribbean island of Grenada and received provisional registration from the General Medical Council (GMC) to work specifically under supervision here. But he failed to complete the year. He went on to fraudulently secure a job anyway, was caught, and then promptly struck off. Undeterred, he forged a host of documents including a medical degree and energy bills, stealing the identity of a genuine doctor. The IT department of the William Harvey hospital in Ashford, Kent, finally rumbled Mkhitarian when he applied for a security pass in the name of another doctor. He pleaded guilty to fraud charges and in July 2015 was sentenced to six years in prison.

      Levon
      Levon Mkhitarian worked as a locum, never staying in one hospital or one speciality too long. Photograph: Kent Police/PA

      These sorts of hospital cases are uncommon the subterfuge required is substantial and most medical impostors thrive in the community (more of which later) or apply for non-clinical roles. Anecdotally, the GMC receives about half a dozen cases a year where details of a registered doctor (their name or GMC number) have been used illegally. According to the Crown Prosecution Service, 13 people were charged with pretending to be registered as a doctor since 2004 (under the Medical Act 1983) prosecution figures are unavailable and this omits those charged more broadly under the Fraud Act 2006.

      How did Mkhitarian get away with it? He certainly capitalised on medicine generally being a team sport. There are (or always should be) senior decision-makers around medical training is an apprenticeship and so asking for assistance wouldnt necessarily raise a red flag. He may have had enough experience to coast at times, just as Caths nursing background helped in the first episode of Trust Me she quickly diagnosed a boxers fracture and deftly administered intravenous drugs. And Mkhitarian later worked as a locum, never staying in one hospital or one speciality too long.

      He earned 85,000 during the two years, but undoubtedly sought more than financial gain. Steven Jay Lynn, professor of psychology at the State University of New York at Binghamton, believes a variety of motivations drive medical impostors: a grandiose fantasy of power, respect, authority and the social rewards of being a doctor.

      Lynn also thinks that many are old-fashioned charlatans. Theyre likely not much different from conmen and women of different stripes who try to pull off scams in the business world, law and psychology, he says. Many could probably be described as callous, lacking in empathy, narcissistic, antisocial and even psychopathic, such that they can exploit people and treat them as objects without guilt or remorse.

      Their hunting ground is often outside the hospital, away from the scrutiny of regulators or eagle-eyed IT departments. They prey upon impressionable, suggestible and vulnerable victims, perhaps not explicitly stating they are doctors, but professing medical knowledge all the same. Recently, 48-year-old Joseph Valadakis from Tottenham, north London, convinced his victims that he had treated the royal family, Barack Obama, Banksy, Robbie Williams, Theresa May and Russell Brand. One Hertford couple fell for Valadakiss claim of running a government laboratory he assured them he was allowed to treat commoners, too. Meanwhile, his website stated that he possessed a biophysics PhD: It gave him the credibility we were looking for at the time, one of the defrauded couple said. She and her husband received wrap treatments costing 1,600 each (made from the excrement of snails fed on lemongrass) and 2,000 massages with whale sperm. These treatments would prevent otherwise inevitable strokes, heart attacks and blindness, Valadakis insisted. He (incorrectly) diagnosed the husband with pancreatic cancer, cautioning him against obtaining a second opinion. The couple were ultimately conned out of 97,000. In 2015, Valadakis, who had no medical qualifications, was jailed on fraud charges for four years.

      Other victims of medical impostors pay a different price. Sheffield civil servant Stewart Edwards posed as a GP for 34 years, targeting Asian families (initially following them home and looking up names on the electoral roll). He arrived at their doorsteps carrying a briefcase and stethoscope, claiming he had been sent from a local health centre. Unsuspecting families let him in; one treated him as their family GP for a decade. In 2011, Edwards pleaded guilty to 13 offences five indecent assaults, two sexual assaults on a child, three counts of sexual activity with a child and three sexual assaults on two women and a man, between 2000 and 2010. He was jailed for four years. But Edwards admitted to impersonating a GP since 1976, in London and Sheffield. His actual number of victims remains unknown.

      The
      The family of Angela Murray say medical deception hastened her death. Photograph: Collect/BNPS

      Some victims forgo effective treatments or receive unnecessary ones. An ongoing Ohio lawsuit claims that dozens were given a false diagnosis of dementia by Sherry-Ann Jenkins who had no medical qualifications. The Associated Press reported that her patients had been planning their final years, preparing their children for the inevitable, quitting their jobs and selling their possessions. Attorney David Zoll tells me that many of his 65 clients are devastated; they had placed absolute faith in Jenkins. One developed depression after his diagnosis and took his own life. An autopsy showed no evidence of Alzheimers, his wife says. She, too, was mistakenly diagnosed with dementia by Jenkins.

      Back in Britain, the family of Angela Murray say medical deception hastened her death. The lack of a transplant was going to kill Angie anyway, her brother said, but I am totally convinced her death was due to this. It took away her will to live.

      She met Julie Higgins at Inspire beauty salon in Poole, Dorset. Higgins was a regular there, or at least visited whenever her hectic schedule allowed, she said. She claimed to be an oncologist at Great Ormond Street childrens hospital and a humanitarian aid worker. Occasionally she arrived in medical garb, apparently fresh from a volunteer shift at the local health centre, happy to dispense medical advice to other customers. Sometimes, she had her head shaved, too, later, saying it put her young cancer patients at ease.

      Murray, a 59-year-old sales manager, was terminally ill with lung fibrosis and pulmonary hypertension. But Higgins carried hope when there was barely any to find she would source transplant organs, she assured Murray, on one occasion telling her to fast overnight as organs were in transit from Germany. Later, she sent texts from a supposed aid mission to Aleppo, promising to donate Murray her organs if she died. None of it was true.

      Murrays family did become suspicious, but her brother, Dave Drummond, explained: Even when it was at its most unbelievable, I didnt want to say to Angie I think shes a conwoman. It would have just taken all the hope away from her.

      Angelas husband, Gregory, told a local newspaper about how the eventual exposure of Higgins, in September last year, affected her: [Angelas] health deteriorated rapidly. Before then, she had said she was going to fight, but she lost hope. A month later she died in my arms.

      Higgins claimed dissociative identity disorder and post-traumatic stress disorder were responsible for her actions. Earlier this year, she received a 12-month community order and was instructed to pay a 140 victim surcharge. Judge Donald Tait concluded that the Medical Act 1983 did not allow him to impose a prison sentence.

      There was no real financial motive Higgins received free haircuts valued at 80. But she envisaged herself as Murrays saviour. I rang her twice a week to keep her going and support her, she told the Bournemouth Echo. She relied on me and said I was her sanity.

      Murrays husband sees Higgins as anything but: To put my wife through what she put her through, Ive never met someone so evil. You see things on TV and you think how can people be so stupid. But if someone gives you that little bit of hope you grasp at it.

      Criminals such as Edwards, Higgins and Valadakis who act outside hospitals never register with the authorities in the first place that is one of the secrets of their success.

      But in case Trust Me has you worried about encountering a bogus hospital doctor, the GMC insists that it now conducts face-to-face identity checks for registration and cites a robust data-security system. Employers must take responsibility, they insist, for checking identification and qualifications. Abdul Pirzada became a locum GP in Birmingham after employers failed to challenge his misleading CV or confirm he had registered with the GMC (he hadnt).

      You cant be worse than Brigitte! was how one character greeted Cath in Trust Me. Dan Sefton, doctor and writer of the series, said: For me, theres a delicious irony in the idea that the impostor doctor is better than the real thing, both clinically and with patients. Im still hoping Cath wont get away with it. That might be just the reassurance we all need.

      • Jules Montague is a consultant neurologist and writer.
      • Trust Me continues on BBC1 on Tuesday at 9pm.

      Read more: https://www.theguardian.com/global/2017/aug/14/trust-me-im-a-fake-doctor-how-medical-imposters-thrive-in-the-real-world

      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

      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