Theresa May signs 100m fighter jet deal with Turkey’s Erdoan

Prime minister also uses last leg of diplomatic tour to issue warning to Turkish president to respect human rights obligations

Theresa May issued a stern warning to Turkish president Recep Tayyip Erdoan about respecting human rights yesterday as she prepared to sign a 100m fighter jet deal that Downing Street hopes will lead to Britain becoming Turkeys main defence partner.

May was in Ankara on the final leg of a diplomatic tour that had taken her to Washington to meet Donald Trump and underlined the compromises inherent in seeking closer trade and diplomatic links outside the European Union in the build-up to Brexit.

Turkey is a fellow member of Nato and has cooperated with Europe in tackling the refugee crisis, but Erdoans government has locked up thousands of political dissidents and protesters in the wake of an attempted coup last year.

Speaking alongside a stony-faced Erdoan in his opulent office, May said: Turkey is one of the UKs oldest friends our relations stretch back over 400 years but there is much that we can do in the future to build on that relationship together. Im proud that the UK stood with you on 15 July last year in defence of democracy, and now it is important that Turkey sustains that democracy by maintaining the rule of law and upholding its international human rights obligations as the government has undertaken to do.

Erdoan said the two countries would press ahead with talks aimed at boosting business ties, adding that he hoped that trade between the two countries, now worth $15bn, could soon reach $20bn. The pair also discussed security and counter-terrorism cooperation and the conflict in Syria.

Downing Street insisted that there was no contradiction between having concerns about a countrys human rights record and signing trade deals. The PMs approach is quite clear: she thinks it is important and in the UKs interests to engage with Turkey.

But May faced criticism from some politicians for doing business with Turkey at all. The Liberal Democrat leader Tim Farron said: As Theresa May seeks trade deals with ever more unsavoury leaders, she ignores the simple point that the most successful countries around the world respect human rights. Economies flourish in free societies.

The prime minister, who had earlier laid a wreath at the mausoleum of Kemal Atatrk, the founder of modern Turkey, said: This agreement underlines once again that Britain is a great, global trading nation and that we are open for business.

Andrew Smith, of Campaign Against Arms Trade, said the deal signed with Turkey confirmed that the UK was prepared to sell weapons to countries that flouted international human rights laws. There is a hypocrisy at the heart of UK foreign policy, and the message this sends to those being repressed or locked up for their beliefs is that their human rights dont matter. The fawning images and uncritical support are not just a propaganda victory for Erdoan; theyre a slap in the face for human rights campaigners and political prisoners across Turkey.

Speaking before the prime ministers arrival in Turkey, Amnesty Internationals UK director, Kate Allen, said the visit was a vital opportunity for May to ask probing questions about allegations of excessive use of force and ill-treatment of detainees by Erdoans security forces. The human rights situation in Turkey had deteriorated markedly during the state of emergency imposed after last Julys botched coup, said Amnesty.

Separately Downing Street announced that, as a result of her talks with Trump, May had agreed to set up a preliminary trade negotiation agreement with Washington, aimed at smoothing the way to a bilateral trade deal when Britain leaves the EU.

Britain must tread carefully in laying the groundwork for future trading relations, because it is not allowed to open formal negotiations with other countries while still inside the EU. However, No 10 sources suggested there were a series of steps that could be taken, short of drawing up a deal, that could smooth the path to the post-Brexit world. That could include lowering so-called non-tariff barriers, such as bans on particular products, and cutting down on regulations.

Liam Fox, the international trade secretary, has been travelling around the globe seeking to lay the groundwork for future trade talks.

The Turkish defence deal will see BAE Systems collaborate with Turkish companies to build a bespoke fighter jet, the TF-X. It is worth 100m small in economic terms, but Britain hopes it will kick off a long relationship and open the door to becoming Turkeys main defence provider. We would expect this to unlock further deals, a spokeswoman said.

May and Erdoan also agreed to form a joint working group to begin talking about a bilateral trade deal that could be signed after Brexit. Britain currently trades with Turkey through Ankaras trade deal with the EU, which will no longer be valid when Britain leaves. The working group will be the 13th Britain has established to scope out potential agreements.

The Turkish prime minister, Binali Yldrm, said that, as well as signing the so-called heads of agreement for the jet aircraft deal, May and Erdoan discussed security cooperation and counter-terrorism.

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WH: No mention of Jews on Holocaust Remembrance Day because others were killed too

Washington (CNN)The White House statement on International Holocaust Remembrance Day didn’t mention Jews or anti-Semitism because “despite what the media reports, we are an incredibly inclusive group and we took into account all of those who suffered,” administration spokeswoman Hope Hicks told CNN on Saturday.

Hicks provided a link to a Huffington Post UK story noting that while 6 million Jews were killed by the Nazis, 5 million others were also slaughtered during Adolf Hitler’s genocide, including “priests, gypsies, people with mental or physical disabilities, communists, trade unionists, Jehovah’s Witnesses, anarchists, Poles and other Slavic peoples, and resistance fighters.”
    Asked if the White House was suggesting President Donald Trump didn’t mention Jews as victims of the Holocaust because he didn’t want to offend the other people the Nazis targeted and killed, Hicks replied, “it was our honor to issue a statement in remembrance of this important day.”
      The presidential reference to the “innocent people” victimized by the Nazis without a mention of Jews or anti-Semitism by the White House on International Holocaust Remembrance Day was a stark contrast to statements by former Presidents George W. Bush and Barack Obama.
      Anti-Defamation League Director Jonathan Greenblatt tweeted that the “@WhiteHouse statement on #HolocaustMemorialDay, misses that it was six million Jews who perished, not just ‘innocent people'” and “Puzzling and troubling @WhiteHouse #HolocaustMemorialDay stmt has no mention of Jews. GOP and Dem. presidents have done so in the past.”
      Asked about the White House explanation that the President didn’t want to exclude any of the other groups Nazis killed by specifically mentioning Jews, Greenblatt told CNN that the United Nations established International Holocaust Remembrance Day not only because of Holocaust denial but also because so many countries — Iran, Russia, Poland, and Hungary, for example — specifically refuse to acknowledge Hitler’s attempt to exterminate Jews, “opting instead to talk about generic suffering rather than recognizing this catastrophic incident for what is was: the intended genocide of the Jewish people.”
      Downplaying or disregarding the degree to which Jews were targeted for elimination during the Holocaust is a common theme of nationalist movements like those seen in Russia and Eastern Europe, Greenblatt said.
      Initially, after being asked about the ADL criticism and the omission of any mention of Jews or anti-Semitism, Hicks provided a statement from Ronald Lauder of the World Jewish Congress that seemed to criticize Greenblatt and the ADL.
      “It does no honor to the millions of Jews murdered in the Holocaust to play politics with their memory,” the Lauder statement read in part. “Any fair reading of the White House statement today on the International Holocaust Memorial Day will see it appropriately commemorates the suffering and the heroism that mark that dark chapter in modern history.”

      Read more:

      Categories CNN

      Uber: the app that changed how the world hails a taxi

      How James Bond, an abusive Parisian cabbie, and one mans frustration with going out in San Francisco led to a transport revolution

      The whole thing might not have happened without Bond James Bond. It was mid-2008, the Canadian entrepreneur Garrett Camp had just sold his first company, the website discovery engine StumbleUpon, to eBay for $75m. Now he was living large, enjoying San Franciscos nightlife, and when relaxing at his apartment in the citys South Park neighbourhood, he occasionally popped in the DVD of Daniel Craigs first Bond movie, Casino Royale.

      Camp loved the movie, but something specific in it got him thinking. Thirty minutes into the film, Bond is driving his silver Ford Mondeo in the Bahamas on the trail of his adversary, Le Chiffre, when he glances down at his Sony Ericsson phone. Its brazen product placement and by todays standards the phone seems comically outdated. But at the time, what Bond saw on his phone startled Camp: a graphical icon of the Mondeo moving on a map toward his destination. The image stuck in his head and to understand why, you need to know more about the restless, inventive mind of Garrett Camp.

      Camp was born in Calgary, Canada, and spent his early childhood playing sports, learning the electric guitar and asking lots of questions. Eventually, his curiosity settled on the world of personal computers. An uncle gave the family an early model Macintosh, from the days of floppy disks and point-and-click adventure games, and Camp spent hours on it during the frigid winters, toying with early computer graphics and writing basic programs.

      By the time Camp graduated from high school, his parents had a three-storey home that included a comfortable office and a computer room in the basement. There wasnt much reason to leave, he says. He enrolled at the nearby University of Calgary, saved money by living at home and spent the next few years there (aside from one year in Montreal, interning at a company called Nortel Networks). He got his undergraduate degree in 2001 and stayed at the university to pursue a master of science, finally leaving his comfortable nest after he turned 22 to move into a campus apartment with classmates.

      Camp met Geoff Smith, who would become his StumbleUpon co-founder, through one of his childhood friends and they started the site as a way for users to share and find interesting things on the internet without having to search for them on Google. By the time Camp finished his degree in 2005, StumbleUpon was starting to show promise. Camp and Smith met an angel investor that year who convinced them to move to San Francisco to raise capital. Over the next 12 months, the number of users on StumbleUpon grew from 500,000 to 2 million.

      With the trauma of the first dot-com bust fading and the scent of opportunity again wafting across Silicon Valley, offers for StumbleUpon started pouring in. In May 2007, eBay bought StumbleUpon for $75m, turning it into one of the early successes of what became known as Web 2.0, the movement in which companies such as Flickr and Facebook mined the social connections among internet users. For Camp, it seemed the highest possible level of success in Silicon Valley and it was, by any reasonable standard until the one that he achieved next.

      Uber co-founder Garrett Camp. Photograph: Rob Kim/Getty Images

      Camp continued to work at eBay after the sale and he was now young, wealthy and single, with a taste for getting out of the house. This is when he ran headlong into San Franciscos feeble taxi industry.

      For decades, San Francisco had kept the number of taxi licences capped at about 1,500. Licences in the city were relatively inexpensive and couldnt be resold and owners could keep the permit as long as they liked if they logged a minimum number of hours on the road every year. So new permits usually became available only when drivers died and anyone who applied for one had to wait years to receive it. Stories abounded about a driver waiting for three decades to get a licence, only to die soon after.

      The system guaranteed a healthy availability of passengers for the taxi companies even during slow times and ensured that full-time drivers could earn a living wage. But demand for cars greatly exceeded supply and so taxi service in San Francisco famously sucked. Trying to hail a cab in the outer neighbourhoods near the ocean, or even downtown on a weekend night, was an exercise in futility. Getting a cab to take you to the airport was a stomach-churning gamble that could easily result in a missed flight.

      Attempts to improve the situation were fruitless, since the fleets and their drivers were adamant about limiting competition. Over the years, whenever the mayor or the citys board of supervisors tried to increase the number of permits, angry drivers would fill city council chambers or surround city hall, causing havoc.

      After the eBay acquisition, Camp splurged out on a red Mercedes-Benz C-Class sports car, but the vehicle sat in his garage. He hadnt driven much in Calgary and at college he preferred to take public transport. Driving in San Francisco was too stressful, he says. I didnt want to park the car on the street and I didnt want people to break into it. Just logistically, it was much harder to drive.

      So the citys sad taxi situation seriously cramped his new lifestyle. Since he couldnt reliably hail a cab on the street, he began putting the yellow cab dispatch numbers in his phones speed dial. Even that was frustrating. I would call and they wouldnt show up and while I was waiting on the street, two or three other cabs would go by, he says. Then Id call them back and they wouldnt even remember that I called before. I remember being late for first or second dates. I could start getting ready 20 minutes early and still Id end up being 30 minutes late.

      The sparkling city by the bay beckoned, but Camp had no reliable way to answer its call. Habitually restless and frustrated by inefficiencies, he came up with his first attempt at a solution: he would call all the yellow taxi companies when he needed a cab. Then he would take the first one that arrived.

      Not surprisingly, the cab fleets didnt like that tactic. Though impossible to confirm, Camp believes his mobile phone was blacklisted by the San Francisco taxi companies. They wouldnt take my calls, he says. I was banned from the cab system.

      Then Camp got a girlfriend: a smart, beautiful television producer named Melody McCloskey. The relationship posed a new set of transport hurdles: McCloskey lived a few miles away from Camp, in Pacific Heights. Meeting anywhere was a hassle and Camp often wanted to get together somewhere out at night.

      To solve these challenges, Camp started to experiment with the citys gypsy cab fleet the unmarked black sedans that would approach prospective passengers on the street and flash their headlights to solicit a fare. Most San Franciscans, particularly women, would stay away from these unmarked cars, fearing for their safety or worried by the ambiguity of a cab without a running meter. But Camp found that a majority of the cars were clean and that many of the drivers were friendly. The biggest problem for these drivers was filling in the dead time between rides, when they tended to wait outside hotels. So Camp started collecting the phone numbers of town-car drivers. At one point, I had 10 to 15 numbers in my phone of the best black-car drivers in San Francisco, he says.

      Then he started gaming the system further: texting a favourite driver hours before he needed him and telling him to meet him at a restaurant or bar at an appointed time. On another night, he rented a town car and driver for himself and a group of friends for an entire evening. It was an indulgence that cost $1,000 and zooming around the city at the end of the night dropping everyone off was a pain.

      And that is when the futuristic image from Casino Royale popped into Camps head. Suddenly, he was obsessed with a new notion. He frequently talked with McCloskey about the idea of an on-demand car service and vehicles that passengers could track via a map on their phones. At one point that year, Camp scrawled the word ber into a Moleskine notebook that he kept to jot down new ideas and logos for companies and brands. Isnt that pronounced Yoober? she asked him.

      I dont care. It looks cool, he said.

      McCloskey recalls that Camp wanted it to be one word and a description of excellence and that his musings on the word, its sound and meaning, were incessant. What an uber coffee that was, hed say randomly after drinking a cup. It means great things! It means greatness!

      Cab drivers wait to be processed at Ubers London driver service centre. Photograph: Felix Clay for the Guardian

      Camp says he contemplated calling this new service berCab or BestCab and finally settled on just UberCab, losing the umlaut. (He registered the domain name in August 2008.) McCloskey loved Camps endless examination of new ideas but wasnt so sure she believed in this particular one. Sure, cabs are terrible, she said. But you are only in the cab for eight minutes! Why does itmatter?

      But Camp was certain that he wanted such a service. He also knew that the iPhone and its new app store, which Apple introduced over the summer of 2008, were going to finally make the futuristic vision in Casino Royale practical. Not only could you chart the location of an object on a map, but since the earliest models of the phone had an accelerometer, you could also tell if the car was moving or not. That meant that an iPhone could function like a taximeter and be used to charge passengers by the minute or the mile.

      He talked it over that year with many of his friends. The author and investor Tim Ferriss first brainstormed with Camp about the then-unnamed Uber at a bar in the Mission District. He thought it was a great idea, then forgot all about it. A month or two later, he got a call from Camp and when they started talking about Uber again, Ferriss was shocked. Camp, he says, had done an incredibly deep dive into the flaws of black cars and a kind of lost utility, the downtime of black cars and taxis. It was clear that he was probably already in the top 1% of market analysts who have looked at the space.

      The idea behind Uber was crystallising in Camps mind.

      Both the passenger and the driver could have an app on their phones. The passenger could have a credit card on file and wouldnt have to travel with any pesky cash. I bounced the idea off of everyone, Camp says. All these ideas kept building and building.

      The original idea was to buy cars, then share the fleet among his friends who were using the app. But Camp says that was only a starting point and that even back then he was considering the potential to use such a system to co-ordinate not just black taxis but eco-friendly Priuses and even yellow cabs.

      I always thought it could become a more efficient cab system, particularly in San Francisco, he says. He wasnt sure it would work outside the city, though. If he could get it to work in just 100 cities, he reasoned, it could be big enough for a company that generated about $100m a year in service fees.

      By the autumn, Camp had more free time to work on Uber, since he and McCloskey had broken up, though they remained friends, and he was going less frequently into StumbleUpon. He recalls spending his weekends getting coffee, cruising the web and doing research into the transport industry and then going out with friends at night.

      On 17 November 2008, he registered UberCab as a limited liability company in California. Soon after, hungry for some basic market research, he sent an email to Ferriss, saying: My goal is to be at a go or no-go decision by 1 December and to be live with five cars in January.

      In December, on the way to LeWeb, a high-profile annual technology conference in Paris, Camp stopped in New York. There he met Oscar Salazar, a friend and fellow graduate student from the University of Calgary. Salazar was a skilled engineer from Colima, Mexico. He got his masters in electrical engineering in Canada and his PhD in France, then moved to New York.

      During this time, he kept in touch with Camp and they reunited that December at a delicatessen in lower Manhattan. Camp pitched UberCab to Salazar and asked him to lead the development of the prototype.

      I have this idea. In San Francisco its hard to get a taxi. I want to buy five Mercedes, Camp said, taking out his phone and showing him a picture of a Mercedes-Benz S550, a high-end coupe that sold for about 80,000. Im going to buy the cars with some friends and were going to share drivers and the cost of parking. He showed mock-ups of iPhone screens demonstrating how cars would move on maps and how passengers might see a town car coming toward them.

      Salazar had experienced his own troubles hailing cabs in Mexico, Canada and France and remembers telling Camp: I dont know if this is a billion-dollar company, but its definitely a billion-dollar idea. Since Salazar was in the US on a student visa, he couldnt receive payment in cash for the job. Instead, he received equity in the fledgling startup. His stake is now worth hundreds of millions of dollars.

      Its way more than I deserved. Its more than any human deserves, he told me over breakfast at a New York cafe in 2015. UberCab was officially in development, and so Camp left for Paris and the LeWeb conference, where he was meeting McCloskey and a close friend and fellow entrepreneur Travis Kalanick.

      Every company creates its own origin myth. Its a useful tool for expressing the companys values to employees and the world and for simplifying and massaging history to give due credit to the people who made the most important contributions when it all started. Ubers official story begins here in Paris, when Camp and Kalanick famously visited the Eiffel Tower on a night after LeWeb and, looking out over the city of light, decided to take on an entrenched taxi industry that they felt was more interested in blocking competition than serving customers.

      We actually came up with the idea at LeWeb in 2008, Kalanick would say five years later at the same conference, citing the challenges of getting a cab in Paris. We went back to San Francisco and we created a very simple, straightforward [way] to us at the time, to push a button and get a ride. We wanted it to be a classy ride.

      Uber instruction video

      Like all mythologies, it is not really true. The story gets misrepresented a lot, Camp sighs. The whole LeWeb thing. Im OK with it, as long as its directionally correct.

      Camp had previously discussed the Uber idea with Kalanick, as he had with other friends. At the time, Kalanick was enthusiastic about Camps notion for a smartphone-based town-car-sharing service but only mildly interested in getting involved. He had just sold a previous startup, the streaming-video company Red Swoosh, to a much larger competitor, Akamai, and was in the middle of what he later called his burnout phase, travelling through Europe, Thailand, Argentina and Brazil, and sizing up different career options. Travis thought it was interesting but he was in this mode, Camp says. He had just left Akamai and was travelling a lot and angel investing. He wasnt ready to go back in.

      In Paris, they all stayed at a lavish apartment that Kalanick had found on the website VRBO. Camp was talking endlessly that week about Uber, but Kalanick had his own startup idea, which, considering everything that subsequently happened, was ironic: he was envisioning a company that would operate a global network of luxurious lodgings, identically furnished and separated into different classes, which could be leased via the internet. Frequent business travellers could subscribe to this network, rent places and pay for them seamlessly. He called this business idea Pad Pass. It was sort of a cross between a home experience and a hotel experience, Kalanick later told me. I was trying to bring those two together. Camp recalled it too. Travis had hacked out a whole Airbnb-like system that we were considering starting, he said. Uber was my idea; that was his idea.

      McCloskey remembers that Kalanick had reached the same conclusions as the founders of Airbnb. The internet could allow travellers to find luxurious yet cheap accommodations while also offering a far more interesting travelling experience.

      Nevertheless, the conversation that week in Paris gradually came to focus more on Uber than Pad Pass. Camp was convinced that the right way to start the business was to buy those top-line Mercedes. Kalanick strongly disagreed, arguing that it was folly to own the cars and more efficient just to distributethemobile app to drivers.

      McCloskey remembers one dinner at a restaurant in Paris where the debate raged over the best way to run an on-demand network of town cars. The restaurant was elegant, with expensive wine, light music and a sophisticated French clientele. Apparently there was also paper over the tablecloth because Camp and Kalanick spent the entire meal scrawling their estimates for things such as fixed costs and maximum vehicle utility rates.

      On a separate night in Paris, the group went for drinks in the Champs-lyses and then to an elegant late-night dinner that included wine and foie gras. At 2am, somewhat intoxicated after a night of revelry, they hailed a cab on the street.

      Apparently they were speaking too boisterously, because halfway through the ride home, the driver started yelling at them. McCloskey was sitting in the middle of the backseat and, at 5ft 10in tall, shed had to prop her high heels on the cushion between the two front seats.

      The driver cursed at them in French and threatened to kick them out of the car if they didnt quieten down and if McCloskey didnt move her feet. She spoke French and translated; Kalanick reacted furiously and suggested they get out of the car.

      The experience seemed to harden their resolve. It definitely lit a fire, McCloskey says. When you are put in a situation where you feel like theres an injustice, that pisses Travis off more than anything. He couldnt get over it. People shouldnt have to sit in urine-filled cabs after a wonderful night and be yelled at.

      That cantankerous Paris cab driver may have left an indelible mark on transport history. By the time they got back to San Francisco, Kalanick was ready to get more involved, at least as an adviser, and Camp was ready to listen to him. A few weeks into 2009, after a trip to Washington DC to see Barack Obamas first inauguration as president, Camp called Kalanick. He was about to lease parking spaces in a garage near his home in San Francisco for the fleet of Mercedes he was still determined to buy. Kalanick counselled him against it one last time: Dude, dude! You dont want to dothat!

      Camp finally gave in and ended the ongoing debate; he never signed the lease and never purchased the cars. Instead of buying a dozen flashy Mercedes, Camp, along with Kalanick, would pitch the app to owners and drivers of limousines.

      Kalanick would brag a few years later, in one of our first interviews: Garrett brought the classy and I brought the efficiency. We dont own cars and we dont hire drivers. We work with companies and individuals who do that. Its very straightforward. I want to push a button and get a ride. Thats what its about.

      Edited extract from The Upstarts by Brad Stone published by Bantam Press (20)

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      ‘I was murdered in Auschwitz’: victims of Holocaust remembered on Twitter

      One report tweets in regards to the St Louis, a boat taking Jews fleeing Nazi Germany that was turned from the United States

      Twitter users have enlisted the social networking platform to help bring to light private narratives of the victims of the Nazi regime on Holocaust Remembrance Day.

      Within the length of the day, the St Louis Manifest report told the stories of the passengers of the German transatlantic liner that has been turned from the United States in 1939. There were 937 folks onboard, nearly all were Jews fleeing from the Third Reich.

      Following the boat was denied permission to dock in Florida and sent back across the Atlantic, 532 passengers were immobilized when Western Europe was seized by Germany. Just over half survived the Holocaust.

      The report was set up by Jewish teacher and activist Russel Neiss.

      St. Louis Manifest (@Stl_Evident)

      My name is Lore Dublon. The US turned me away in the boundary in 1939. I used to be killed in Golleschau

      January 28, 2017

      St. Louis Manifest (@Stl_Evident)

      My name is Joachim Hirsch. The US turned me away in the boundary in 1939. I used to be killed in Auschwitz

      January 27, 2017

      St. Louis Manifest (@Stl_Evident)

      My name is Werner Stein. The US turned me away in the boundary in 1939. I used to be killed in Auschwitz

      January 28, 2017

      St. Louis Manifest (@Stl_Evident)

      My name is Irmgard Kppel. The US turned me away in the boundary in 1939. I used to be killed in Auschwitz

      January 27, 2017

      Other moving posts on Twitter marking Holocaust Remembrance Day featured men, girls and kids who perished in Nazi death camps across Europe through the 2nd world war.

      Robert Popper (@robertpopper)

      Little Uzhu might have grown up to be my cousin. Instead, slain, aged 6, in the Holocaust. #HolocaustMemorialDay

      January 27, 2017

      Shulem Stern (@ShulemStern)

      In 1944 my grandpa’s family hid out where they were gassed before they were taken off to Marianka subsequently Auschwitz. #HolocaustMemorialDay

      January 27, 2017

      To mark the 72nd anniversary of the liberation of Auschwitz, photographer Marina Maral recoloured a picture shot in Auschwitz of 14-year old Polish Catholic Czeslawa Kwoka. Czeslawa was killed in 1943.

      Stig Abell (@StigAbell)

      I can not quit staring at this: 14-yearold Czeslawa Kwoka, killed in Auschwitz. Picture recoloured by @marinamaral2. #HolocaustMemorialDay

      January 27, 2017

      Writer Leah Bobet used Twitter to tell the story of her grandfather, who survived a Nazi concentration camp.

      Leah Bobet (@leahbobet)

      Today’s the anniversary of the liberation of Auschwitz Birkenau. Going to tell my grandpa’s story about that to you. #HolocaustMemorialDay

      January 27, 2017

      Leah Bobet (@leahbobet)

      When he expired, it was quite slow: diabetes-associated dementia. Essentially, he was got by the camps only on a sixty-year delay.

      January 27, 2017

      Leah Bobet (@leahbobet)

      The effects on my family of that one survivor grandparent are observable. Everyone hoards food. There’s definitely an excessive amount of food in the home.

      January 27, 2017

      Leah Bobet (@leahbobet)

      Injury ripples through families. It ripples through cultures. It’s the work of centuries when there’s coming back from genocide.

      January 27, 2017

      Saint Louis Manifest was still tweeting as news of Donald Trumps executive order prohibiting Syrian refugees in the US issued.

      Benjamin Pauker (@benpauker)

      Noticed for history: A Trump management executive order from entering the United States on Holocaust Remembrance Day, prohibited refugees.

      January 27, 2017

      Elisabeth Malkin (@ElisabethMalkin)

      When you yourself have forgotten when it means to turn away refugees, please follow @Stl_Evident. They killed and were turned away in 1939.

      January 28, 2017

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      Donald Trump and Theresa May: Another ‘special relationship’?

      (CNN)Reagan and Thatcher. Bush and Blair. Obama and Cameron. And now? Trump and May.

      The close relationship between US and British leaders goes back to Winston Churchill and Franklin D. Roosevelt, but how the longstanding “special relationship” will do under US President Donald Trump’s isolationist government and UK Prime Minister Theresa May’s Brexit Britain is still in question.
      May will function as the first foreign leader to fulfill with President Trump on Friday. Here is a look at the world is seen by every one of these.


      Trump’s view:
        Trump campaigned on protectionist trade policies throughout his candidacy and he is spent the first day or two as president signing executive orders that strengthen his vow to set “America first.”
        On his first day in office, he signed a executive actions to remove in the negotiating procedure for the Trans-Pacific Partnership — a deal he formerly described as a “disaster done and pushed by special interests who want to rape our country.” He is also said he really wants to renegotiate the North American Free Trade Agreement (NAFTA), using the probability of left everything together.
        Trump has expressed openness to carry out a fresh trade handle the UK, but has said he’ll prioritize American occupations.
        May’s view:
        May is a proponent of free trade and globalization — branding her vision of a “Global Britain” that’s “open for company” in her Brexit strategies.
          But May’s international vision may not reach as far as she trusts.
          When the UK leaves the single market, which ensures the free movement of services, products and individuals inside the 28 member bloc, it’s going to have to negotiate a fresh trade deal featuring all participant states.
            The UK mightn’t get the deals it needs as the EU will give preference first. This can be among the reasons May might look to get a fresh free trade handle the US.
            May has said she’ll seek free trade deals with individual nations in and out of Europe and will use her meeting with Trump to begin preliminary discussions. But even if Trump is open into a UK commerce venture that is new, the UK will not be able to sign any deals until it formally leaves the EU, a procedure which has not formally began and is likely to take at least two years.


            Trump’s view:
            Trump has sent mixed messages on NATO. He is repeatedly known as the organization dated and committed campaign air time to rally against members of the 28-nation coalition for not bringing to the recommended defense spending amounts of around 2% of GDP.
              However, now that James Mattis has been confirmed as Defense Secretary, the new government could continue its dedication to the decades-old military alliance.
              Mattis, a solid supporter of NATO, talked with Secretary General Jens Stoltenberg and three coalition partners such as the UK this week and reaffirmed that the US had an “unshakeable commitment to NATO.”
              Mattis and Stoltenberg said they “looked forward to working together to strengthen the Alliance, including by increasing defense spending and doing even more to fight terrorism,” according to your statement released by NATO.
              May’s view:
              May lately reaffirmed her commitment to the coalition, saying that NATO has helped to “defend Europe and its Allies.” After discussing with Stoltenberg last week, she stated that she’d reiterate to Trump the coalition’s value inside their assemblies.
              As stated by the British Ministry of Defence, the UK spends 2.1% of their yearly GDP on NATO.


                Trump’s view:
                He campaigned hard on developing a border wall with Mexico, making a Muslim registry and getting tough on illegal immigration.
                On Wednesday, Trump signed two executive orders on immigration and border security, which contained strategies to construct the wall and add increased spending to immigration enforcement and deportations.
                  An executive actions ban refugees, mainly from Muslim nations, is additionally expected.
                  Trump’s refugee prohibition would last for four months if enacted. After 120 days, the US would then prioritize entries of refugees who are fleeing religious persecution from Iraq, Syria, Iran, Sudan, Libya, Somalia or Yemen, “provided that the religion of the individual is a minority religion in the individual’s country of nationality,” according to the draft order got by CNN.
                  Entries for Syrian refugees could be frozen indefinitely before an overhaul is seen by the checking procedure. The strategy would limit the total variety of refugees accepted to the United States in half throughout the 2017 fiscal year.
                  May’s view:
                  In her address to the 2015 Conservative Party Conference, May, then Home Secretary, laid out her position on immigration — repeating precisely the same hardline stand she is taken as Prime Minister. Inside it, she indicated the fury and bitterness felt by Brits out of work was spurred by immigration, she also maintained a considerable variety of asylum seekers were “foreign criminals” and asserted immigrants made society less “cohesive.”
                  How immigration will appear under Brexit is still uncertain, even though the Prime Minister has said she needed to ensure the rights of EU citizens already in Britain and British citizens in other EU states “as early as we can.”
                  Seeing future immigration from European nations, May said: “Brexit must mean charge of the amount of people that come to Britain from Europe. And that’s that which we’ll deliver.”
                  The Home Office in addition has assured to resettle 20,000 Syrian refugees by 2020, but last year only 2,102 were resettled in the UK.
                  A year ago, May fought the Minister for Syrian Refugees post and has been critical of Angela Merkel’s open-door policy strategy.


                  Trump’s view:
                  Trump has referenced that he desires to find a significant shift in US-Russia relations during his presidency. He recently said: “If Putin likes Donald Trump, I consider that an asset.”
                  Trump has expressed an openness to work with Putin, and has said that Russia could be a partner in the struggle against ISIS. While President elect, he also indicated he was amenable to the chance for lifting sanctions on Russia — using the caveat the state helps the US in its continuing fight against terrorism. Both states are trying to improve their atomic capacities, increasing the prospect of a new arms race involving Russia and the United States.
                  For the present time, Trump said he intends to keep sanctions for “at least a period of time.”
                  He also recently admitted that Russia was behind the hacking of the Democratic National Convention through the campaign — but added they “were totally open to be hacked.” Russia has denied any participation in america election campaign.
                  May’s view:
                  May appears less inclined to open up relationships with Russia.
                  She joined other world leaders in denouncing Russia’s participation in the Syrian battle and supports Britain’s continued sanctions in response to Russia’s part in “destabilizing Eastern Ukraine”.

                  CLIMATE CHANGE

                  Trump’s view:
                  Trump has splendidly called climate change a “hoax,” saying that environmentalism is “out of control.”
                  Although his pick to head the Environmental Protection Agency, Scott Pruitt will not consider climate change is a hoax, the former Oklahoma attorney general is a long time EPA skeptic and has sued the bureau many times.
                  Trump’s stated that the US will “cancel” the Paris deal, a landmark climate change deal that commits states to lessen their greenhouse gas emissions with all the purpose of keeping a rise in worldwide temperatures to within 1.5 degrees Celsius.
                  On Tuesday, Trump signed executive activities to improve the acceptance of the Dakota Access and Keystone XL pipelines — contentious undertakings which could see water pollution, a rise in greenhouse gas emissions, as well as the destruction of Native American property and burial sites.
                  May’s view:
                  May vowed to ratify the Paris deal to slow climate change during her first address to the UN General assembly this past year.
                  But May’s dedication to the environment is not clear.
                  Among her first acts as Prime Minister shut down the Department of Energy and Climate Change — folding its into the Department for Energy Business & Industrial Strategy.
                  She is also supported hydraulic fracturing (fracking), a contentious approach that raises oil and gas generation that also includes devastating environmental threats, a few of including human induced quakes as well as the pollution of water sources.

                  Read more:

                  Categories CNN

                  Canadian scientists lend support to muzzled US counterparts

                  For nine years under Canadas preceding authorities, science endured severe limitations. Now US scientists might be facing the same destiny

                  Canadian scientists who have been muzzled for almost a decade from the preceding Conservative authorities that was countrys happen to be making contact by making use of their counterparts in america to provide solidarity and their support amid mounting fears that Donald Trumps presidency will seek to curb climate science.

                  For nine years, scientists with Canadas federal government grappled with what many described as a all out assault on science.

                  Scientific libraries were shut, programmes endured severe cutbacks while national scientists were prohibited from speaking to media on subjects that ranged from snowflakes to salmon and even a 13,000-year old flooding.

                  It turned out to be a dramatic departure from previous practices, said Robert MacDonald, that has worked for almost 30 years as a government scientist.

                  In 2015, the Justin Trudeau-headed Liberals swept into a majority government, buoyed in part by guarantees to reverse the draconian limitations the preceding authorities had demanded on its scientists.

                  MacDonald pointed to an 2013 survey of authorities scientists in which 24% said they’d been directly requested to exclude or change advice for non-scientific reasons. Thats something you’d be prepared to listen to in the 1950s from eastern Europe, not a thing you expect to listen to in 2013 from a democracy like Canada, he explained. And I believe, by all sign, thats what brothers and our sisters will be faced with down in the United States.

                  Recent days have found the Trump government apparently contemplate scrubbing all references of climate change from the Environmental Protection Agency site, while the Associated Press reported that EPA scientists could be subject to some short-term hold, pending review by political appointees.

                  The reports have triggered concern north of the boundary. Were already reaching out to our counterparts in the US as well as in the international science community, said Debi Daviau, head of the Professional Institute of the Public Service of Canada, a union that represents more than 15,000 authorities scientists, engineers and research workers.

                  On Thursday, her organisation released a statement calling the activities of the Trump management a chilling reminder of the years under Stephen Harpers premiership. We thus stand in solidarity with our co-workers and fellow government scientists in the United States by once again declaring science shouldn’t be quieted, and by expressing our hope the present limitations on US government scientists will shortly be revoked , nor indicate an enduring change in US policy on science, like the one we fought so long to overturn in Canada.

                  In 2013, hundreds of individuals clad in white lab coats collected on Parliament Hill in Ottawa for what became among the very observable actions of opposition from the repression of Canadian government scientists. A mock funeral procession was held on the passing of scientific evidence, whole with eulogies that took aim in the years of escalating from your Conservative authorities. Similar demonstrations were held throughout the nation.

                  Signs for Democracy, the group behind the Canadian demonstrations, has been in touch using the organisers of the March for Science in the US. Why opposition has galvanised so rapidly in america, the Americans pointed to the Canadian experience to spell out, said Katie Gibbs of Evidence for Democracy. They saw what occurred under Harper and so theyve seen so theyre not taking a wait and where it leads -and-see strategy, theyre acting now.

                  Gibbs described the reports this week in regards to the activities of Trumps team torwards climate science shocking. It certainly harks back to what we saw in the States under George Bush and what we saw under Harper, except its so much speedier than that which we saw under Harper and much more brazen, she said. But in precisely the same time theres been a tremendous opposition coming from thats been heartening to find out and the scientific community.

                  The Canadian expertise offers myriad lessons for the US government scientists, said Kristi Miller-Saunders who was one of Canadas first authorities scientists to be prohibited from talking to the media above a newspaper investigating the 2009 fall of the sockeye salmon population in British Columbia.

                  Chief among these lessons is the trustworthiness said the molecular geneticist and also the connection involving treating scientists.

                  She said, in the event the authorities can suppress info coming from a programme that info isn’t in the public eye anymore. When the advice just isn’t in the public eye, the people believes theyre actually not doing much for the reason that place, there hasnt been any inroads. And its much more easy for the authorities to subsequently gently cut on the plan.

                  Science is manufactured inside a community, that community stands willing to fight for US authorities scientists and said MacDonald.

                  Among the amazing things that happened during our darkest days for us using the Harper government was from our brothers and sisters down in the States and the support we’d received from international scientists, he explained. Were there to stand with them shoulder to shoulder. Well be there for them.

                  Read more:

                  Britain’s navy keeps eye on Russia’s ‘ship of shame’

                  (CNN)Britain’s defense secretary had some extreme words for the Russian armed force on Wednesday as UK warplanes and warships tracked Russia’s only carrier through the English Channel.

                  “We are keeping a close eye on the Admiral Kuznetsov as it skulks back to Russia; a ship of pity whose objective has actually just extended the suffering of the Syrian individuals,” Defense Secretary Sir Michael Fallon stated.
                  The provider and its escort are on their method back to Russia after taking part in airstrikes in Syria. They left the Mediterranean Sea previously this month .


                      MUST WATCH

                      At the time, Russia stated the Kuzentsov’s trip was “to guarantee marine existence in the essential locations of the world ocean. Unique focus will be made on securing security of maritime traffic and other kinds of Russian maritime financial activity as well as reacting to brand-new sort of modern-day risks such as piracy and global terrorism.”
                      But others took a various view.
                      “It’s a program of force and a program of abilities,” Peter Felstead, editor of Jane’s Defence Weekly, informed CNN in October. “In regards to strike objectives, they (the Russians) might simply as quickly have actually performed them with the land-based airplane they currently have in Syria.”

                      Read more:

                      Trump’s new idea? Walls have lined national borders for thousands of years

                      (CNN)Walls in between nations are absolutely nothing brand-new. The Romans constructed Hadrian’s Wall about 120 years after the birth of Christ to safeguard the Roman province of Britain from the heathens who resided in exactly what is now Scotland– individuals the Romans described as “barbarians.”

                      And let’s not even speak about the Great Wall of China, the building which started centuries prior to that.

                        Sickening, gruelling or frightful: how doctors measure pain | John Walsh

                        The Long Read: Suffering is difficult to describe and impossible to see. So how can doctors tell how much it hurts?

                        One night in May, my wife sat up in bed and said, Ive got this awful pain just here. She prodded her abdomen and made a face. It feels like somethings really wrong. Woozily noting that it was 2am, I asked what kind of pain it was. Like somethings biting into me and wont stop, she said.

                        Hold on, I said blearily, help is at hand. I brought her a couple of ibuprofen with some water, which she downed, clutching my hand and waiting for the ache to subside.

                        An hour later, she was sitting up in bed again, in real distress. Its worse now, she said, really nasty. Can you phone the doctor? Miraculously, the family doctor answered the phone at 3am, listened to her recital of symptoms and concluded, It might be your appendix. Have you had yours taken out? No, she hadnt. It could be appendicitis, he surmised, but if it was dangerous youd be in much worse pain than youre in. Go to the hospital in the morning, but for now, take some paracetamol and try to sleep.

                        Barely half an hour later, the balloon went up. She was awakened for the third time, but now with a pain so savage and uncontainable it made her howl. The time for murmured assurances and spousal procrastination was over. I rang a local minicab, struggled into my clothes, bundled her into a dressing gown, and we sped to St Marys Paddington at just before 4am.

                        The flurry of action made the pain subside, if only through distraction, and we sat for hours while doctors brought forms to be filled, took her blood pressure and ran tests. A registrar poked a needle into my wifes wrist and said, Does that hurt? Does that? How about that? before concluding: Impressive. You have a very high pain threshold.

                        The pain was from pancreatitis, brought on by rogue gallstones that had escaped from her gall bladder and made their way, like fleeing convicts, to a refuge in her pancreas, causing agony. She was given a course of antibiotics and, a month later, had an operation to remove her gall bladder.

                        Its keyhole surgery, said the surgeon breezily, so youll be back to normal very soon. Some people feel well enough to take the bus home after the operation. His optimism was misplaced. My wife came home the following day filled with painkillers. When they wore off, she writhed with suffering. After three days she rang the specialist, only to be told: Its not the operation thats causing discomfort its the air that was pumped inside you to separate the organs before surgery. Once the operation had proved a success, the surgeons had apparently lost interest in the fallout.

                        During that period of convalescence, as I watched her grimace and clench her teeth and let slip little cries of anguish until a long regimen of combined ibuprofen and codeine finally conquered the pain, several questions came into my head. Chief among them was: Can anyone in the medical profession talk about pain with any authority? From the family doctor to the surgeon, their remarks and suggestions seemed tentative, generalised, unknowing and potentially dangerous: Was it right for the doctor to tell my wife that her level of pain didnt sound like appendicitis when the doctor didnt know whether she had a high or low pain threshold? Should he have advised her to stay in bed and risk her appendix exploding into peritonitis? How could surgeons predict that patients would feel only discomfort after such an operation when she felt agony an agony that was aggravated by fear that the operation had been a failure?

                        I also wondered if there were any agreed words that would help a doctor understand the pain felt by a patient. I thought of my father, a GP in the 1960s with an NHS practice in south London, who used to marvel at the colourful pain symptoms he heard: Its like Ive been attacked with a stapler; Like having rabbits running up and down my spine; Its like someones opened a cocktail umbrella in my penis Few of them, he told me, corresponded to the symptoms listed in a medical textbook. So how should he proceed? By guesswork and aspirin?

                        There seemed to be a chasm of understanding in human discussions of pain. I wanted to find out how the medical profession apprehends pain the language it uses for something thats invisible to the naked eye, that cant be measured except by asking for the sufferers subjective description, and that can be treated only by the use of opium derivatives that go back to the middle ages.

                        When investigating pain, the basic procedure for clinics everywhere is to give a patient the McGill pain questionnaire. Developed in the 1970s by two scientists, Dr Ronald Melzack and Dr Warren Torgerson, both of McGill University in Montreal, it is still the main tool for measuring pain in clinics worldwide.

                        Melzack and his colleague Dr Patrick Wall of St Thomas Hospital in London had already galvanised the field of pain research in 1965 with their seminal gate control theory, a ground-breaking explanation of how psychology can affect the bodys perception of pain. In 1984, the pair went on to write Wall and Melzacks Textbook of Pain, the most comprehensive reference work in pain medicine. It has gone through five editions and is currently more than 1,000 pages long.

                        In the early 1970s, Melzack began to list the words patients used to describe their pain and classified them into three categories: sensory (which included heat, pressure, throbbing or pounding sensations), affective (which related to emotional effects, such as tiring, sickening, gruelling or frightful) and lastly evaluative (evocative of an experience from annoying and troublesome to horrible, unbearable and excruciating).

                        You dont have to be a linguistic genius to see there are shortcomings in this range of terms. For one thing, some words in the affective and evaluative categories seem interchangeable theres no difference between frightful in the former and horrible in the latter, or between tiring and annoying and all the words share an unfortunate quality of sounding like a duchess complaining about a ball that didnt meet her standards.

                        But Melzacks grid of suffering formed the basis of what became the McGill pain questionnaire. The patient listens as a list of pain descriptors is read out and has to say whether each word describes their pain and, if so, to rate the intensity of the feeling. The clinicians then look at the questionnaire and put check marks in the appropriate places. This gives the clinician a number, or a percentage figure, to work with in assessing, later, whether a treatment has brought the patients pain down (or up).

                        A more recent variant is the National Initiative on Pain Controls pain quality assessment scale (PQAS), in which patients are asked to indicate, on a scale of 1 to 10, how intense or sharp, hot, dull, cold, sensitive, tender, itchy, etc their pain has been over the past week.

                        The trouble with this approach is the imprecision of that scale of 1 to 10, where a 10 would be the most intense pain sensation imaginable. How does a patient imagine the worst pain ever and give their own pain a number? Some men may find it hard to imagine anything more agonising than toothache or a tennis injury. Women who have experienced childbirth may, after that experience, rate everything else as a 3 or 4.

                        I asked some friends what they thought the worst physical pain might be. Inevitably, they just described nasty things that had happened to them. One man nominated gout. He recalled lying on a sofa, with his gouty foot resting on a pillow, when a visiting aunt passed by; the chiffon scarf she was wearing slipped from her neck and lightly touched his foot. It was unbearable agony.

                        A brother-in-law nominated post-root-canal toothache unlike muscular or back pain, he said, it couldnt be alleviated by shifting your posture. It was relentless. A male friend confided that a haemorrhoidectomy had left him with irritable bowel syndrome, in which a daily spasm made him feel as if somebody had shoved a stirrup pump up my arse and was pumping furiously. The pain was, he said, boundless, as if it wouldnt stop until I exploded. A woman friend recalled the moment the hem of her husbands trouser leg snagged on her big toe, ripping the nail clean off. She used a musical analogy to explain the effect: Id been through childbirth, Id broken my leg and I recalled them both as low moaning noises, like cellos; the ripped-off nail was excruciating, a great, high, deafening shriek of psychopathic violins, like nothing Id heard or felt before.

                        It seems a shame that these eloquent descriptions are reduced by the McGill questionnaire to words like throbbing or sharp, but its function is simply to give pain a number a number that will, with luck, be decreased after treatment, when the patient is reassessed.

                        This procedure doesnt impress Professor Stephen McMahon of the London Pain Consortium, an organisation formed in 2002 to promote internationally competitive research into pain. There are lots of problems that come with trying to measure pain, he says. I think the obsession with numbers is an oversimplification. Pain is not unidimensional. It doesnt just come with scale a lot or a little it comes with other baggage: how threatening it is, how emotionally disturbing, how it affects your ability to concentrate. The measuring obsession probably comes from the regulators who think that, to understand drugs, you have to show efficacy. And the American Food and Drug Administration dont like quality-of-life assessments; they like hard numbers. So were thrown back on giving it a number and scoring it. Its a bit of a wasted exercise because its only one dimension of pain that were capturing.

                        Illustration: Matthew Richardson

                        Pain can be either acute or chronic, and the words do not (as some people think) mean bad and very bad. Acute pain means a temporary or one-off feeling of discomfort, which is usually treated with drugs; chronic pain persists over time and has to be lived with as a malevolent everyday companion. But because patients build up a resistance to drugs, other forms of treatment must be found for it.

                        The Pain Management and Neuromodulation Centre at Guys and St Thomas Hospital in central London is the biggest pain centre in Europe. Heading the team there is Dr Adnan Al-Kaisy, who studied medicine at the University of Basrah, Iraq, and later worked in anaesthetics at specialist centres in England, the US and Canada.

                        Id say that 55 to 60% of our patients suffer from lower back pain, he says. The reason is, simply, that we dont pay attention to the demands life makes on us, the way we sit, stand, walk and so on. We sit for hours in front of a computer, with the body putting heavy pressure on small joints in the back. Al-Kaisy reckons that in the UK the incidence of chronic lower back pain has increased substantially in the last 15 to 20 years, and that the cost in lost working days is about 6 to 7 billion.

                        Elsewhere the clinic treats those suffering from severe chronic headaches and injuries from accidents that affect the nervous system.

                        Do they still use the McGill questionnaire? Unfortunately yes, says Al-Kaisy. Its a subjective measurement. But pain can be magnified by a domestic argument or trouble at work, so we try to find out about the patients life their sleeping patterns, their ability to walk and stand, their appetite. Its not just the patients condition, its also their environment.

                        The challenge is to transform this information into scientific data. Were working with Professor Raymond Lee, chair of Biomechanics at the South Bank University, to see if there can be objective measurement of a patients disability due to pain, he says. Theyre trying to develop a tool, rather like an accelerometer, which will give an accurate impression of how active or disabled they are, and tell us the cause of their pain from the way they sit or stand. Were really keen to get away from just asking the patient how bad their pain is.

                        Some patients arrive with pains that are far worse than backache and require special treatment. Al-Kaisy describes one patient let us call him Carter who suffered from a terrible condition called ilioinguinal neuralgia, a disorder that produces a severe burning and stabbing pain in the groin. Hed had an operation in the testicular area, and the inguinal nerve had been cut. The pain was excruciating: when he came to us, he was on four or five different medications, opiates with very high dosages, anticonvulsive medication, opioid patches, paracetamol and ibuprofen on top of that. His life was turned upside down, his job was on the line. The utterly stricken Carter was to become one of Al-Kaisys big successes.

                        Since 2010, Guys and St Thomas has offered a residential programme for adults whose chronic pain hasnt responded to treatment at other clinics. The patients come in for four weeks, away from their normal environment, and are seen by a motley crew of psychologists, physiotherapists, occupational health specialists and nursing physicians who between them devise a programme to teach them strategies for managing their pain.

                        Many of these strategies come under the heading of neuromodulation, a term you hear a lot in pain management circles. In simple terms, it means distracting the brain from constantly brooding on the pain signals it is getting from the bodys periphery. Sometimes the distraction is a cunningly deployed electric shock.

                        We were the first centre in the world to pioneer spinal cord stimulation, says Al-Kaisy. In pain occasions, overactive nerves send impulses from the periphery to the spinal cord and from there to the brain, which starts to register pain. We try to send small bolts of electricity to the spinal cord by inserting a wire in the epidural area. Its only one or two volts, so the patient feels just a tingling sensation over where the pain is, instead of feeling the actual pain. After two weeks, we give the patient an internal power battery with a remote control, so he can switch it on whenever he feels pain and carry on with his life. Its essentially a pacemaker that suppresses the hyperexcitability of nerves by delivering subthreshold stimulation. The patient feels nothing except his pain going down. Its not invasive we usually send patients home the same day.

                        When Carter, suffering from agonising pain in the groin, had failed to respond to any other treatments, Al-Kaisy tried his new combination of therapies. We gave him something called a dorsal root ganglion stimulation. Its like a small junction-box, placed just underneath one of the bones of the spine. It makes the spine hyperexcited, and sends impulses to the spinal cord and the brain. I pioneered a new technique to put a small wire into the ganglion, connected to an external power battery. Over 10 days the intensity of pain went down by 70% by the patients own assessment. He wrote me a very nice email saying I had changed his life, that the pain had just stopped completely, and that he was coming back to normality. He said his job was saved, as was his marriage, and he wanted to go back to playing sport. I told him, Take it easy. You mustnt start climbing the Himalayas just yet. Al-Kaisy beams. This is a remarkable outcome. You cannot get it from any other therapies.

                        The greatest recent breakthrough in assessing pain, according to Professor Irene Tracey, head of the University of Oxfords Nuffield Department of Clinical Neurosciences, has been the understanding that chronic pain is a thing in its own right. She explains: We always thought of it as acute pain that just goes on and on and if chronic pain is just a continuation of acute pain, lets fix the thing that caused the acute and the chronic should go away. That has spectacularly failed. Now we think of chronic pain as a shift to another place, with different mechanisms, such as changes in genetic expression, chemical release, neurophysiology and wiring. Weve got all these completely new ways of thinking about chronic pain. Thats the paradigm shift in the pain field.

                        Tracey has been called the Queen of Pain by some media commentators. She was, until recently, the Nuffield Professor of anaesthetic science and is an expert in neuroimaging techniques that explore the brains responses to pain. Despite her nickname, in person she is far from alarming: a bright-eyed, enthusiastic, welcoming and hectically fluent woman of 50, she talks about pain at a personal level. She has no problem defining the ultimate pain that scores 10 on the McGill questionnaire: Ive been through childbirth three times, and my 10 is a very different 10 from before I had kids. Ive got a whole new calibration on that scale. But how does she explain the ultimate pain to people who havent experienced childbirth? I say, Imagine youve slammed your hand in a car door thats 10.

                        She uses a personal example to explain the way perception and circumstance can alter the way we experience pain, as well as the phenomenon of hedonic flipping, which can convert pain from an unpleasant sensation into something you dont mind. I did the London Marathon this year. It needs a lot of training and running and your muscles ache, and next day youre really in pain, but its a nice pain. Im no masochist, but I associate the muscle pain with thoughts like, I did something healthy with my body, Im training, and Its all going well.

                        I ask her why there seems to be a gap between doctors and patients apprehension of pain. Its very hard to understand, because the system goes wrong from the point of injury, along the nerve thats taken the signal into the spinal cord, which sends signals to the brain, which sends signals back, and it all unravels with terrible consequential changes. So my patient may be saying, Ive got this excruciating pain here, and Im trying to see where its coming from, and theres a mismatch here because you cant see any damage or any oozing blood. So we say, Oh come now, youre obviously exaggerating, it cant be as bad as that. Thats wrong its a cultural bias we grew up with, without realising.

                        Recently, she says, there has been a breakthrough in understanding about how the brain is involved in pain. Neuroimaging, she explains, helps to connect the subjective pain with the objective perception of it. It fills that space between what you can see and whats being reported. We can plug that gap and explain why the patient is in pain even though you cant see it on your x-ray or whatever. Youre helping to bring truth and validity to these poor people who are in pain but not believed.

                        But you cant simply see pain glowing and throbbing on the screen in front of you. Brain imaging has taught us about the networks of the brain and how they work, she says. Its not a pain-measuring device. Its a tool that gives you fantastic insight into the anatomy, the physiology and the neurochemistry of your body and can tell us why you have pain, and where we should go in and try to fix it.

                        Some of the ways in, she says, are remarkably direct and mechanical like Al-Kaisys spinal cord stimulation wire. There are now devices you can attach to your head and allow you to manipulate bits of the brain. You can wear them like bathing caps. Theyre portable, ethically allowed brain-simulation devices. Theyre easy for patients to use and evidence is coming, in clinical trials, that they are good for strokes and rehabilitation. Theres a parallel with the games industry, where theyre making devices you can put on your head so kids can use thought to move balls around. The games industry is, for fun, driving this idea that when you use your brain, you generate electrical activities. Theyre developing the technology really fast, and we can use it in medical applications.

                        Illustration: Matthew Richardson

                        Pain has become a huge area of medical research in the US, for a simple reason. Chronic pain affects over 100 million Americans and costs the country more than half a trillion dollars a year in lost working hours, which is why it has become a magnet for funding by big business and government.

                        Researchers at the Human Pain Research Laboratory at Stanford University, California, are working to gain a better understanding of individual responses to pain so that treatments can be more targeted. The laboratory has several study initiatives on the go into migraine, fibromyalgia, facial pain and other conditions but its largest is into back pain. It has been endowed with a $10m grant from the National Institutes of Health to study non-drug alternative treatments for lower back pain. The specific treatments are mindfulness, acupuncture, cognitive behavioural therapy and real-time neural feedback.

                        They plan to inspect the pain tolerance of 400 people over five years of study, ranging from pain-free volunteers to the most wretched chronic sufferers who have been to other specialists but found no relief. The idea is to find peoples mid-range tolerance (theyre asked to rate their pain while they are experiencing it), to establish a usable baseline. They then are given the non-invasive treatments such as mindfulness and acupuncture and are subjected afterwards to the same pain stimuli, to see how their pain tolerance has changed from their baseline reading. MRI scanning is used on the patients in both laboratory sessions, so that clinicians can see and draw inferences from the visible differences in blood flow to different parts of the brain.

                        A remarkable feature of the assessment process is that patients are also given scores for psychological states: a scale measures their level of depression, anxiety, anger, physical functioning, pain behaviour and how much pain interferes with their lives. This should allow physicians to use the information to target specific treatments. All these findings are stored in an informatics platform called Choir, which stands for the Collaborative Health Outcomes Information Registry. It has files on 15,000 patients, 54,000 unique clinic visits and 40,000 follow-up meetings.

                        The big chief at the Human Pain Research Laboratory is Dr Sean Mackey, Redlich professor of anaesthesiology, perioperative and pain medicine, neurosciences and neurology at Stanford. His background is in bioengineering, and under his governance the Stanford Pain Management Center has twice been designated a centre of excellence by the American Pain Society. A tall, genial, easy-going man, he is sometimes approached by legal firms who want him to appear in court to state definitively whether their client is or is not in chronic pain (and therefore justified in claiming absentee benefit). His response is surprising.

                        In 2008, I was asked by a law firm to speak in an industrial injury case in Arizona. This poor guy got hot burning asphalt sprayed on his arm at work; he had a claim of burning neuropathic pain. The plaintiffs side brought in a cognitive scientist, who scanned his brain and said there was conclusive evidence that he had chronic pain. The defence asked me to comment, and I said, Thats hogwash, we cannot use this technology for that purpose.

                        Shortly afterwards, I gave a talk on pain, neuroimaging and the law, explaining why you cant do this because theres too much individual variability in pain, and the technology isnt sensor-specific enough. But I concluded by saying, If you were to do this, youd use modern machine-learning approaches, like those used for satellite reconnaissance to determine whether a satellite is seeing a tank or a civilian truck. Some of my students said, Can you give us some money to try this? I said, Yes, but it cant be done. But they designed the experiment and discovered that, using brain imagery, they could predict with 80% accuracy whether someone was feeling heat pain or not.

                        Mackey finally published a paper about the experiment. So did his findings influence any court decisions? No. I get asked by attorneys, and I always say, There is no place for this in the courtroom in 2016 and there wont be in 2020. People want to push us into saying this is an objective biomarker for detecting that someones in pain. But the research is in carefully controlled laboratory conditions. You cannot generalise about the population as a whole. I told the attorneys, This is too much of a leap. I dont think theres a lot of clinical utility in having a pain-o-meter in a court or in most clinical situations.

                        Mackey explains the latest thinking about what pain actually is. Now we understand that pain is a balance between ascending information coming from our bodies and descending inhibitory systems from our brains. We call the ascending information nociception from the Latin nocere, to harm or hurt meaning the response of the sensory nervous system to potentially harmful stimuli coming from our periphery, sending signals to the spinal cord and hitting the brain with the perception of pain. The descending systems are inhibitory, or filtering, neurons, which exist to filter out information thats not important, to turn down the ascending signals of hurt. The main purpose of pain is to be the great motivator, to tell you to pay attention, to focus. When the pain lab was started, we had no way of addressing these two dynamic systems, and now we can.

                        Mackey is immensely proud of his massive CHOIR database which records peoples pain tolerance levels and how they are affected by treatment and has made it freely available to other pain clinics as a community source platform, collaborating with academic medical centres nationwide so that a rising tide elevates all boats. But he is also humble enough to admit that science cannot tell us which are the sites of the bodys worst pains.

                        Back pain is the most reported pain at 28%, but I know theres a higher density of nerve fibres in the hands, face, genitals and feet than in other areas, Mackey says, and there are conditions where the sufferer has committed suicide to get away from the pain. Things like post-herpetic neuralgia, that burning nerve pain that occurs after an outbreak of shingles and is horrific; another is cluster headaches some patients have thought about taking a drill to their heads to make it stop.

                        Like Irene Tracey, Mackey is enthusiastic about the rise of transcranial magnetic stimulation (Imagine hooking a nine-volt battery across your scalp) but, when asked about his particular successes, he talks about simple solutions. Early on in my career, I used to be very focused on the peripheral, the apparent site of the pain. I was doing interventions, and some people would get better but a lot wouldnt. So I started listening to their fears and anxieties and working on those, and became very brain-focused. I noticed that if you have a nerve trapped in your knee, your whole leg could be on fire, but if you apply a local anaesthetic there, it could abolish it.

                        This young woman came to me with a terrible burning sensation in her hand. It was always swollen; she couldnt stand anyone touching it because it felt like a blowtorch. Mackey noticed that she had a post-operative scar from prior surgery for carpal-tunnel syndrome. Speculating that this was at the root of her problem, he injected botulinum toxin, a muscle relaxant, at the site of the scar. A week later, she came up and gave me this huge hug and said, I was able to pick up my child for the first time in two years. I havent been able to since she was born. All the swelling was gone. It taught me that its not all about the body part, and not all about the brain. Its about both.

                        Main illustration by Matthew Richardson

                        This is an edited version of an article that appears on Mosaic. It is republished here under a Creative Commons licence.

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                        The hottest food trends for 2017 from the hottest chefs

                        (CNN)Two of 2016’s most significant food patterns from leading chefs consisted of boundary-pushing meals that blurred the lines in between science, cooking and art, and going “locavore”– eating in your area produced foods.

                        It was likewise the year that supergrains and veggies discovered their method into the cooking areas of virtually every dining establishment in the world.

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                          Stories on a plate: Virgilio Martinez

                          Diners will look for easy fruit and vegetables so that they can experience the culture, history and taste of a food in one bite, anticipates Virgilio Martinez of Peru’s Central Restaurant.
                          ” Single origin produce with a story and custom will return with more worth to reveal quality and feeling,” stated Martinez.
                          Examples of this: a roasted lamb in the Patagonia, a plate filled with potatoes from the Andes, an entire grilled fish in Galicia, or fruits from the Amazon.
                          Central Restaurant, Santa Isabel 376, Lima, Peru; +5112428515

                          Homecomings: Andre Chiang

                          Many excellent young Asian chefs trained in leading dining establishments in Europe and the United States will return the home of begin their own food, states Andre Chiang of Singapore’s 2 Michelin-starred Restaurant Andre .
                          They’ll bring with them a”European soul”to a brand-new Asian taste which will utilize regional components.
                          This Europe-meets-Asia pattern will spread out all over Asia– consisting of Japan, China, Korea, Taiwan, Thailand and the Philippines, inning accordance with Chiang.
                          Restaurant Andre , 41 Bukit Pasoh Road, Singapore; +6565348880
                          MORE: World’s 23 finest cities for street food

                          Hospitality: Daniel Humm

                          Hospitality is king for 2017, states chef Daniel Humm of Eleven Madison Park, a routine finest dining establishment of the year heavy player.
                          Now more than ever, Humm states individuals desire real hospitality when they go out for a meal.
                          “Whether that comes at a great dining restaurant, or counter-service area, it’s still appropriate, due to the fact that it’s exactly what makes the experience unique,”he stated, including that he’s delighted to see restauranteurs and chefs handle the obstacle.
                          Eleven Madison Park, 11 Madison Ave, New York; +1 2128890905

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