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CNN —This essay contains some spoilers for “Baby Reindeer.”The Netflix hit “Baby Reindeer” has taken the world by storm with its nuanced, painfully honest portrayal of one man’s experience of stalking and abuse. According to the US Centers for Disease Control and Prevention (CDC), “nearly a quarter of men reported some form of contact sexual violence in their lifetime. “There is a hidden epidemic of sexual violence within the queer community that is rarely visible in the media. A man some viewers mistakenly identified as the older television writer in “Baby Reindeer” has gone to the police after receiving threatening messages on social media. Whatever the legacy of “Baby Reindeer” may be, it stands as one of the boldest and most forthright explorations of male victims of stalking and sexual assault.
Persons: Sara Stewart, Sara Stewart Todd Thompson, Richard Gadd, Gadd, Donny, ” Gadd, GQ, , , ’ ”, he’d, hadn’t, , who’s, ” Jeffrey Ingold, ” Ingold, stalkers, Jessica Gunning, Martha, , he’s, it’s, Teri, she’s Organizations: CNN, Netflix, US Centers for Disease Control, Prevention, Guardian, Independent, Twitter, Facebook Locations: Pennsylvania
Today is World Maternal Mental Health Day, and it’s time to recognize the importance of maternal mental health. She previously served as Baltimore’s health commissioner and as chair of Behavioral Health Systems Baltimore, a regional nonprofit advancing mental health and substance use disorder treatment. Dr. Leana Wen: Mental health is an essential part of overall health. Those with preexisting mental health conditions such as depression and bipolar disorder have a much higher rate of experiencing mental health issues in the postpartum period. That said, it’s also very important to recognize that postpartum depression and other mental health diagnoses in pregnancy and postpartum can occur in people who have not had mental health conditions in the past.
Persons: Leana Wen, Wen, It’s, , it’s Organizations: CNN, Lifeline, George Washington University, Behavioral Health Systems, US Centers for Disease Control, World Health Organization, US Food and Drug Administration Locations: United States
CNN —Even if your genetics put you at greater risk for early death, a healthy lifestyle could help you significantly combat it, according to a new study. Individuals with genetic risk could extend their lifespan by up to 5.5 years with a healthy lifestyle, the data showed. “Adherence to a healthy lifestyle could substantially attenuate the lifespan reduction for individuals with genetic susceptibility to a shorter lifespan,” Li said. But researchers were able to identify four factors that were associated with the biggest impact on risk of early death. Making lifestyle changesBuilding a healthier lifestyle may sound like a major undertaking, but manageable steps can help you get there.
Persons: Xue Li, Dr, Aladdin Shadyab, Shadyab, Li, ” Li, , Rosamund Dean, , you’ve Organizations: CNN, School of Public Health, Zhejian Univeristy, of Medicine, University of California, National Institute for Data Science, Health, Medicine, Zhejiang University, US Centers for Disease Control, CDC, of Locations: China, University of California San Diego, of Columbia, Guam, Puerto Rico
These are all clinically documented cases of sleep sex, or sexsomnia, part of a family of sleep disorders called parasomnias that include sleepwalking, sleep talking, sleep eating and sleep terrors. “There certainly can be legal consequences from the sexual behaviors, particularly with minors, and also with aggressive behaviors during sleep,” Schenck said. Also called OSA, obstructive sleep apnea is a serious sleep malady in which breathing stops for 10 seconds to two minutes many times per hour each night. “It’s the breath holding or apnea from the obstructive sleep apnea that triggers the arousal, typically in men, which then triggers the sexual behaviors in sleep,” Schenck said. “It’s so interesting, because a lot of people with stress become hyposexual, not interested in sex,” Schenck said.
Persons: rouses, Carlos Schenck, , Schenck, ” Schenck, Jennifer Mundt, moan, “ You’re, , Yuliya Kirayonak, , Northwestern’s Mundt, it’s, Mundt, ” Mundt, you’re Organizations: CNN, Hennepin County Medical, University of Minnesota, Northwestern University’s Feinberg School of Medicine, sexsomnia, , US Centers for Disease Control Locations: Hennepin, Norway, Chicago
CNN —The number of measles cases around the world nearly doubled from 2022 to 2023, researchers say, presenting a challenge to efforts to achieve and maintain elimination status in many countries. The US has had 128 measles cases reported in 20 jurisdictions this year, as of Friday, according to the US Centers for Disease Control and Prevention. Measles was declared eliminated in the US in 2000, “meaning there is no measles spreading within the country and new cases are only found when someone contracts measles abroad and returns,” the CDC says. However, the rapid rise in cases this year poses a threat to that disease elimination status, the agency says. Get CNN Health's weekly newsletter Sign up here to get The Results Are In with Dr. Sanjay Gupta every Tuesday from the CNN Health team.
Persons: Patrick O’Connor, O’Connor, Dr, Sanjay Gupta, ” O’Connor, Organizations: CNN, World Health Organization, ESCMID Global, US Centers for Disease Control, CDC, CNN Health, US Locations: Barcelona, Azerbaijan, Kyrgyzstan, Yemen, kindergarteners
CNN —Disease detectives in Chicago say they have been seeing a worrisome trend: Patients complaining of unusual symptoms like vision and eye problems, headaches and hearing loss or dizziness caused by the sexually transmitted infection syphilis. More than two-thirds of these patients (68%) lacked typical syphilis symptoms, like a rash or chancre sore, that might tip doctors off to the infection. Syphilis cases are surging across the US. In 2022, there were more than 207,000 syphilis cases reported, the highest number since the 1950s, according to the US Centers for Disease Control and Prevention. “There could just be an increase in untreated or inadequately treated patients, which is leading to more severe outcomes of syphilis,” Nham said.
Persons: , Amy Nham, Nham, “ They’re, , Dr, Sanjay Gupta, ” Nham Organizations: CNN —, Intelligence Service Conference, Chicago Department of Public Health, US Centers for Disease Control, CNN, CNN Health, CDC Locations: Chicago, Atlanta
Sleep supplements: Can they help me sleep?
  + stars: | 2024-04-25 | by ( Katia Hetter | ) edition.cnn.com   time to read: +8 min
Some 18% of American adults take a form of medication to help them sleep, including over-the-counter pills and prescription medications, according to a 2023 US Centers for Disease Control and Prevention report. Some 6.3% said that they take sleep medications every day and 2.1% took medication most days. While medical treatments can help with sleep, are some forms more effective than others? Melatonin supplements are lab-made versions of this hormone. There is some evidence that melatonin supplements can help with jet lag.
Persons: CNN —, Leana Wen, Wen, There’s Organizations: CNN, for Disease Control, George Washington University, Food and Drug Administration, FDA
In recent months the highly pathogenic H5N1 virus has been spreading through US cattle herds for the first time ever. The cow-to-cow transmission is the latest escalation in a global outbreak that began when the virus reemerged in Europe in 2020. Bill Powers with his flock of white turkeys, kept under shelter to prevent exposure to bird flu, in Townsend, Delaware. Nathan Howard/Getty ImagesDr. Jerome Adams, a former surgeon general and the director of health equity at Purdue University, is getting deja vu. AdvertisementOnly testing the sickSo far, the USDA has only been testing cattle herds when an animal appears sick.
Persons: , Jeremy Farrar, Nathan Frandino, Farrar, Bill Powers, Nathan Howard, Jerome Adams, they've, Adams, Donald Trump, hasn't, Terry Chea, they're, Zeynep Tufekci, Jean Carroll, Alexi J . Rosenfeld, President Trump, Trump, Biden Organizations: Service, Business, World Health Organization, Washington Post, Food and Drug Administration, New York Times, FDA, Johann, Reuters, US Centers for Disease Control, Purdue University, CDC, US Department of Agriculture, White, USDA Locations: Europe, South America, Fresno , California, Texas, Townsend , Delaware, COVID, Sonoma County , California
CNN —The fertility rate in the United States has been trending down for decades, and a new report shows that another drop in births in 2023 brought the rate down to the lowest it’s been in more than century. But the 3% drop between 2022 and 2023 brought the rate just below the previous low from 2020, which was 56 births for every 1,000 women of reproductive age. The birth rate fell among most age groups between 2022 and 2023, the new report shows. For older women, the option of waiting is not as viable.”Meanwhile, births continued to shift to older mothers. Provisional births data is based on birth records received and processed by the National Center for Health Statistics as of January 25.
Persons: “ We’ve, , Brady Hamilton, ” Hamilton, Court’s Dobbs, Dr, Sanjay Gupta, Hamilton Organizations: CNN, US Centers for Disease Control, Prevention’s National Center for Health Statistics, National Center for Health Statistics, CNN Health, CDC Locations: United States
Opinion: Why memes about Mommy and wine are no joke
  + stars: | 2024-04-24 | by ( Kara Alaimo | ) edition.cnn.com   time to read: +6 min
Editor’s note: Kara Alaimo, an associate professor of communication at Fairleigh Dickinson University, writes about issues affecting women and social media. At work, women on average earn just 84 cents for every dollar earned by men and are up against endless stereotypes about why they’re not leadership material. “Anyone who’s been on social media in the last ten years has seen the memes: ‘Mommy needs wine.’ ‘I wine because my kids whine.’ You can buy infant onesies that say ‘I’m the reason mommy drinks’ on Amazon,” Yvonne points out. It requires social structures such as an adequate childcare system and resources for women who need to leave abusive homes. We all also need to stop sharing jokes and memes that suggest it’s humorous for people of any gender to deal with the stresses they’re up against by imbibing carcinogens.
Persons: Kara Alaimo, Kara, Celeste Yvonne, it’s, Yvonne, they’re, who’s, ” Yvonne, , I’ve, Holly Whitaker, Carol Lee Flinders, ” Whitaker Organizations: Fairleigh Dickinson University, Women, Press, Facebook, CNN, JAMA, Pew Research Center, US Centers for Disease Control Locations: United States
CNN —It’s 420 or “weed day,” and people around the world will be paying homage to their favorite guilty pleasure: marijuana. “I worry when people are in an enclosed space because new data is beginning to show that secondhand marijuana smoke may be just as dangerous as the primary smoke,” Page said. “Approximately 3 in 10 people who use marijuana have marijuana use disorder,” according to the US Centers for Disease Control and Prevention. In fact, some parents told doctors they believed vaping marijuana was safer than tobacco, Boyd told CNN earlier via email. A cloud of marijuana smoke rises as a clock hits 4:20 p.m. during the Mile High 420 Festival in Denver on "weed day" in 2022.
Persons: CNN —, Dr, Beth Cohen, Cohen, , , Robert Page II, ” Page, Weed, It’s, ’ ” Carol Boyd, Ann Arbor, Peter Grinspoon, ” Young, Sam Wang, Boyd, Grinspoon, Patrick T, Fallon, Nixon, ” Boyd, ” Grinspoon, ’ ”, Page Organizations: CNN, District of Columbia, University of California, University of Colorado Skaggs School of Pharmacy, Pharmaceutical Sciences, Center, Drugs, University of Michigan, US Centers for Disease Control, Prevention, CDC, Massachusetts General Hospital, Marijuana, Children’s Hospital, Yale Medicine, Drug, University of Colorado’s, Getty, University of Mississippi, US Drug, Administration Locations: United States, San Francisco, Colorado, Aurora, Ann, Boston, Children’s Hospital Colorado, Denver, AFP
CNN —Dengue cases are surging in the Americas, with cases reported topping 5.2 million as of this week, surpassing a yearly record set in 2023, according to the Pan American Health Organization (PAHO). PAHO spokesperson Ashley Baldwin told CNN Thursday that 5,214,480 cases of dengue have been reported in the Americas as of Wednesday. In all of 2023, the total number of cases reported in the region was 4,572,765. “We are in an emergency situation because of dengue,” PAHO Director Jarbas Barbosa said in a news briefing Thursday. Early detection and access to proper medical care will reduce the probability of dying due to severe dengue,” Baldwin added.
Persons: PAHO, Ashley Baldwin, , Jarbas Barbosa, ” Baldwin, Barbosa, Agustin Marcarian, Eraldo Peres, Baldwin Organizations: CNN, Pan American Health Organization, Reuters Public, AP, US Centers for Disease Control, Prevention, World Health Organization, Virgin Islands Locations: Americas, Brazil, Rio de Janeiro, Peru, Buenos Aires, Argentina, Ceilandia, Brasilia, Puerto Rico, Virgin, American Samoa
CNN —The bird flu spreading through cattle in the United States is an “enormous concern” the chief scientist of the World Health Organization said Thursday as he called for more tracking and preparation for the virus. So far, there is no evidence that the highly pathogenic H5N1 flu virus can spread from person to person. Though H5N1 doesn’t spread from person to person, humans can catch it when they’re exposed to infected animals. They are only the second documented case of human H5N1 in the United States. The US Centers for Disease Control and Prevention says that while the current risk to public health from H5N1 is low, it is monitoring the situation carefully.
Persons: Dr, Jeremy Farrar, , Richard Webby, , hasn’t, Sanjay Gupta Organizations: CNN, World Health Organization, WHO, Research, Get CNN, CNN Health, US Department of Agriculture’s, Plant Health, Services, US Centers for Disease Control, CDC Locations: United States, British, Geneva, Texas, Colorado, St, — Texas, New Mexico , Kansas, South Dakota , Idaho , Michigan , Ohio, North Carolina
Well, so far US officials are saying they believe there is minimal risk to the public from the latest iteration of bird flu. According to the Global Health Security Index, there are significant gaps in countries’ pandemic preparedness capabilities. Given the impact of Covid, it is deeply disappointing that national governments are not investing the necessary resources to build life-saving pandemic preparedness capacity. Making matters worse, Congress has made major cuts to pandemic preparedness funding, as part of the ongoing appropriations process. Playing the long game also means supporting the World Bank Pandemic Fund, which is designed to invest in long-term pandemic preparedness capacity of low- and middle-income countries.
Persons: Jaime M, Yassif, , , we’ve, US Department of Agriculture —, It’s, Biden, Covid Organizations: Global Biological Policy, Nuclear Threat Initiative, CNN, Yassif Nuclear, US Centers for Disease Control, Prevention, US Department of Health, Human Services, CDC, US Department of Agriculture, Global Health, Brown, Pandemic Center, Gates Foundation, NTI, Johns Hopkins Center for Health Security, Global Health Security, Bank, Fund, pandemics Locations: Texas , Kansas, Texas, Colorado, Covid, United States
CNN —The US Food and Drug Administration is warning that dangerous counterfeit versions of Botox have been identified in multiple states, putting the safety of consumers at risk. The incidents of counterfeit Botox being administered to consumers appear to be connected to products that have been purchased from unlicensed sources and then administered by either unlicensed or licensed providers. The counterfeit Botox products may be identified by the lot number C3709C3 found on the outer carton and vial, the FDA said. Counterfeit botox has been found in several states. Most often, when counterfeit Botox is sold, “the injector knows they’re purchasing something counterfeit,” Sung said.
Persons: Washington –, Botox, Lavanya Krishnan, Arya Derm, ” Krishnan, Krishnan, Allergan, , , Jimmy Sung, you’re, can’t, ” Sung, Michael Cameron, Cameron, ” Cameron, Sung, “ I’m, I’ve, Steven Williams, ” Williams, Dr, Sanjay Gupta, Cynthia Elliott, ” Elliott Organizations: CNN, Food and Drug Administration, FDA, US Centers for Disease Control, CDC, American Board of Cosmetic, Revance Therapeutics, Merz Aesthetics, Tribeca Aesthetics, Cameron Dermatology, Mount Sinai Health, American Society of Plastic Surgeons, , CNN Health Locations: – Colorado, Florida , Illinois , Kentucky , Nebraska , New Jersey , New York , Tennessee, San Francisco, United States, New York City, New York, Florida
As a dietary supplement, melatonin is not approved by the US Food and Drug Administration for safety, effectiveness or labeling before it is sold to the public. The council’s action follows recent reports of a massive rise in accidental ingestions of melatonin by children and an April 2023 study that found 25 products labeled as melatonin gummies contained dangerous levels of the hormone. Melatonin gummies were involved in nearly 5,000 of those cases. While the vast majority of unsupervised melatonin ingestions did not result in hospitalization, the number of accidental ingestions by children 5 and under may be underestimated, the report said. New and improved labelsThe council guidelines call for new labels that warn consumers about the danger of drowsiness after taking a melatonin supplement.
Persons: , , Pieter Cohen, ” Cohen, it’s “, Cohen, Catherine McQueen, ” Dr, Cora Collette Breuner, “ It’s, Breuner, Amanda Musa Organizations: CNN, Council for Responsible Nutrition, US Food and Drug Administration, Cambridge Health Alliance, US Centers for Disease Control, Prevention, CDC, Food and Drug Administration, Getty, Seattle Children’s Hospital, University of Washington Locations: Somerville , Massachusetts, Seattle
Dr. Leana Wen: Bird flu, also called avian flu or avian influenza, refers to infections caused by the avian influenza Type A viruses. Avian influenza A viruses are divided into two categories: low pathogenicity avian influenza (LPAI) A viruses and high pathogenic avian influenza (HPAI) A viruses. The H5N1 avian flu virus has been causing outbreaks among poultry in the US, with 48 states and over 85 million poultry now affected. The seasonal flu vaccine does not protect people against infection from the avian flu. CNN: Can my pet bird get bird flu?
Persons: Leana Wen, Wen Organizations: CNN, US Centers for Disease Control, Prevention, George Washington University, CDC Locations: Texas, United States, Colorado
“I didn’t really know what was happening. Romero has her own experience with head injuries, after sustaining a TBI snowboarding while she was in high school. It was a pretty serious brain injury,” she told CNN Sport. Romero and co-director Anna Wilder Burns wanted to use Speak’s story to raise awareness of the impact of brain injuries. Throughout her treatment, Speak realized she had been living with the effects of her untreated head injuries for most of her adult life.
Persons: Becca Speak, ’ …, , she’s, Jordyn Romero, Romero, , , Anna Wilder Burns, Burns, ’ ” Burns, I’ve, ” “ Organizations: CNN, Billabong, CNN Sport, US Centers for Disease Control, CDC, Nature
But a new report from Consumer Reports said it recently compared the nutritional profiles of two Lunchables kits served in schools and found they have even higher levels of sodium than the Lunchables kits consumers can buy in stores. The non-profit consumer group said it has petitioned the US Department of Agriculture, which oversees the federally assisted school meal program, to remove Lunchables food kits from school cafeterias, as a result. The introduction of Lunchables in schools came amid proposed changes to school food guidelines by the USDA, which oversees the federally assisted school meal program. The proposed changes aimed to reduce added sugars and sodium levels in school-provided lunches. Food additives are considered “generally recognized as safe” (GRAS) by the US Food and Drug Administration, but not everyone agrees.
Persons: Lunchables, Armour LunchMakers, Oscar Mayer, can’t, , Brian Ronholm, Kraft Heinz, ” Kraft Heinz, Carlos Monteiro, Monteiro, ” Monteiro, Heinz “ Organizations: New, New York CNN, Consumer, Natural Meat, World Health Organization, US Centers for Disease Control, US Department of Agriculture, CNN, USDA, University of Sao, NOVA, US Food and Drug Administration, Center for Science, Environmental, Kraft Locations: New York, University of Sao Paulo, Brazil
Research shows that Black women and women of lower socioeconomic status are more likely to die from breast cancer. The earlier breast cancer is caught, the easier it is to treat, according to the National Breast Cancer Foundation. Routine screening mammograms have been shown to reduce breast cancer deaths by 22%, Houry said in a news conference. However, these new findings show that other health-related social needs also play a role, Miller said. “Health care providers can now assess whether women have health-related social needs and help women get the services they need.
Persons: Dr, Debra Houry, Houry, Jacqueline Miller, Miller, ” Miller, Sanjay Gupta, Lisa C, Richardson, ” Houry, , Organizations: CNN, Centers for Disease Control, Health, Research, CDC, National Breast Cancer Foundation, US Preventive Services Task Force, Medicare, Services, CNN Health, CDC’s Division of Cancer Prevention Locations: United States, Rhode Island, Wyoming, CDC’s
Could decaf coffee cause cancer? Experts weigh in
  + stars: | 2024-04-04 | by ( Kristen Rogers | ) edition.cnn.com   time to read: +8 min
Here’s what experts and the FDA say about this clause in the modern context, and what you should know about the safety of decaf coffee. “There is more information on the toxicity of methylene chloride and the levels at which it causes this toxicity,” she added. Then there is the Swiss Water Process, which decaffeinates the beans by soaking them in warm water. The Clean Label Project, an organization that tests consumer products for hidden industrial and environmental contaminants, has detected methylene chloride in several brands of coffee. What you can do nowWhether or not the FDA eventually bans methylene chloride is a decision that could take years.
Persons: Maria, Monique Richard, , Richard, wasn’t, ” Richard, Richard said, Dunkin Organizations: CNN, Food and Drug Administration, Occupational Safety, Health Administration, National Institutes of Health’s, Toxicology Program, Environmental Protection Agency, World Health Organization, Environmental Defense Fund, FDA, US Centers for Disease Control, EPA, Federal Food, Nutrition, maté Locations: California, Tennessee
Are nicotine pouches better than vaping? Zyn, among other brands of nicotine pouches such as Rogue, On! However, FDA officials have allowed the nontobacco nicotine product to stay on the market while the application is under review. Nicotine pouches have varying degrees of nicotine strength; 3 or 6 milligrams per pouch is most common, but some brands have pouches that contain upward of 28 milligrams. What’s more, the Zyn nicotine pouches come in a variety of flavors, including cool mint, wintergreen, coffee and cinnamon, that could be appealing to younger people.
Persons: Philip Morris, Chuck Schumer, , Kecia Christensen, , ’ ”, Christensen, Philip Morris International’s, ” Philip Morris, Meghan Moran, ” Moran, Brian King, Yanfang Ren, ” Ren, Moran Organizations: CNN, Philip Morris International, Facebook, Federal Trade Commission, Food and Drug Administration, American Cancer Society, Nebraska Medicine, FDA, National Cancer Institute, CDC, Centers for Disease Control, ” Philip Morris International, Swedish, Johns Hopkins Bloomberg School of Public Health, Tobacco Survey, FDA’s Center for Tobacco Products, University of Rochester Eastman Institute for Oral Health, Philip Locations: United States, , Baltimore, New York, Mayo
CNN —Flame retardants added for decades to thousands of consumer products in the United States may raise the risk of dying from cancer, according to new research. “The new study links PBDEs to deaths from cancer, building a case for the association between flame retardants and cancer mortality being real,” said Trasande, who researches the impact of plastics, flame retardants and other chemicals on children. Flame retardant chemicals also can pass to developing fetuses via the placenta and to newborns through breast milk, past research has found. In some cases, the industry has replaced these chemicals with newer phosphorus-based flame retardants, Trasande said, adding that researchers are now concerned these chemicals may be linked to cancer as well. When reupholstering older couches or chairs, be sure to replace the old foam with flame retardant-free foam.
Persons: Leonardo Trasande, , Trasande, ” Trasande, Tasha Stoiber, EWG Organizations: CNN, National Health, JAMA, NYU Langone Health, US Centers for Disease Control, Manufacturers, US Environmental Protection Agency, CDC, Environmental Locations: United States, PBDEs, New York City
Dr. Mikhail Varshavski is known as Dr. Mike on social media. “Zoom out of just thinking about, ‘What I can take or what I can eat?’ and understand that there’s a lot of other things that impact your weight,” Dr. Mike said. “(Make) sure that you get help when it comes to mental health issues and concerns,” Dr. Mike said. For example, Dr. Mike said he recently had a guest on his podcast who tried to equate a chocolate kiss to a grape. While you may compare them based on their sugar content, that’s one way to categorize them,” Dr. Mike said.
Persons: Sanjay Gupta, what’s, Mikhail Varshavski, Mike, , Ponce de León, we’re, ” Dr, Dr, , ” “, edu ”, , That’s, “ It’s, You’re, Skip, you’re, Jennifer Lai Organizations: CNN, Facebook, YouTube, TED, Inc, US Centers for Disease Control, Harvard Medical Locations: Chatham , New Jersey, Ponce, “ .
Yet despite the popularity of various 10-minute plank challenges, planking is actually one of the most dreaded core exercises, according to many fitness experts. But it’s not because a strong core equates to a sexy six-pack — a strong core is central to your overall health. Also, as time goes on, a strong core helps with hernia prevention and incontinence issues.”A strong core is also an important means of combating back pain, especially in the lumbar region. The breath is the key to successBefore performing any core exercise, you first need to think about your breathing. Core exercises that don’t require plankingReady to strengthen your core without planking?
Persons: , Samira Shuruk, Jessica Chellsen, Chellsen, Prasert, ” Shuruk, , ” Chellsen, Shuruk, Melanie Radzicki McManus Organizations: CNN, Yoga Center of Columbia, US Centers for Disease Control, National Institutes of Health, Therapy, Wellness, Getty, CNN’s Locations: Maryland, San Luis Obispo , California
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