NHS patients dying in hospital corridors, A&E doctors tell Theresa May

Doctors running 68 A&E departments tell PM patients are dying prematurely because staff are too busy to treat them

Patients are dying in hospital corridors during the ongoing winter crisis because the NHS is so underfunded and short-staffed that it cannot cope, senior doctors have warned Theresa May.

A&E units are under such intense strain that patients are at intolerable risk of being harmed by receiving poor care, specialists in emergency medicine from 68 hospitals have told the prime minister in a letter of unprecedented alarm.

In recent weeks some hospitals have become so overloaded that they have been looking after as many as 120 patients a day in corridors, with some dying prematurely as a result, the letter says.

The doctors, consultants who work in or run A&E units in England and Wales, have written to May to highlight the very serious concerns we have for the safety of our patients. This current level of safety compromise is at times intolerable, despite the best efforts of staff.

Conditions in many A&E units are so appalling that they could kill patients, claim the signatories, who work at both major teaching hospitals and smaller district general hospitals. They include Frimley health trust in Surrey, which May visited last week in an attempt to reassure the public that the NHS was coping well this winter.

As you will know a number of scientific publications have shown that crowded emergency departments are dangerous for patients. The longer that the patients stay in [the] emergency department after their treatment has been completed, the greater is their morbidity and associated morbidity, they write.

Their intervention came as new NHS figures showed that the percentage of patients being treated within four hours at hospital-based A&E units in England fell last month to its lowest-ever level 77.3%. The performance of all types of settings offering A&E-type care taken together, including walk-in centres and urgent care centres, was better but still the joint worst ever at 85.1% far below the politically important target of 95%.

Graph

Only three of the NHSs 137 acute trusts hit the 95% target, while 32 were at or below 70%. Blackpool teaching hospitals trust had by far the lowest performance, at 40.1%. The figures reinforced the warning to ministers on Thursday from NHS Providers that it would be impossible to deliver on their pledge that all hospitals would be achieving 95% by March.

Our emergency departments are not just under pressure, but in a state of emergency, said Dr Taj Hassan, the president of the Royal College of Emergency Medicine, which represents A&E doctors.

The NHS undertook unprecedented planning to help services cope with the annual spike in demand in December and January. Despite that, hospitals had a record number of emergency admissions last month 520,163, a 4.5% rise on the numbers admitted in December 2016.

A drive to free up 2,000-3,000 beds by 1 September, to avoid hospitals becoming dangerously full, appears to have failed. Separate NHS figures for last week show that 19 trusts were on 99% or 100% bed occupancy between 1 and 7 January. Three were completely full.

Average bed occupancy shot up last week to 95%, far higher than the 85% that experts say, and the NHS accepts, hospitals need to maintain in order to stop patients getting hospital-acquired infections such as MRSA or Clostridium difficile, or experiencing poor care.

Bed occupancy as high as 95% is a danger to patient safety, with around 7,000 fewer beds open than in the same period last year, said Hassan.

Drawing on their own experiences in recent weeks ,the doctors who signed the letter painted a stark picture of conditions inside A&E units. Common situations include over 50 patients at a time waiting beds in the emergency department [and] patients sleeping in clinics as makeshift wards.

A Department of Health and Social Care spokeswoman said in response to the letter: There has been a 68.7% increase in the number of A&E consultants since 2010, and the NHS was given top priority in the recent budget with an extra 2.8bn allocated over the next two years.

But we know there is a great deal of pressure in A&E departments, and we are grateful to all NHS staff for their incredible work in challenging circumstances. Thats why we recently announced the largest single increase in doctor training places in the history of the NHS a 25% expansion.

May stressed on Thursday that flu was a key factor in the intense strain that NHS services were facing. We have seen the extra pressures that the NHS has come under this year. One of the issues that determines the extent of that pressure is flu and we have seen in recent days an increase in the number of people presenting at A&E from flu, she said.

Q&A

Why is the NHS winter crisis so bad in 2017-18?

A combination of factors are at play. Hospitals have fewer beds than last year, so they are less able to deal with the recent, ongoing surge in illness. Last week, for example, the bed occupancy rate at 17 of Englands 153 acute hospital trusts was 98% or more, with the fullest Walsall healthcare trust 99.9% occupied.

NHS England admits that the service has been under sustained pressure [recently because of] high levels of respiratory illness, bed occupancy levels giving limited capacity to deal with demand surges, early indications of increasing flu prevalence and some reports suggesting a rise in the severity of illness among patients arriving at A&Es.

Many NHS bosses and senior doctors say that the pressure the NHS is under now is the heaviest it has ever been. We are seeing conditions that people have not experienced in their working lives, says Dr Taj Hassan, the president of the Royal College of Emergency Medicine.

The unprecedented nature of the measures that NHS bosses have told hospitals to take including cancelling tens of thousands of operations and outpatient appointments until at least the end of January underlines the seriousness of the situation facing NHS services, including ambulance crews and GP surgeries.

Read a full Q&A on the NHS winter crisis

Hours after she spoke, new figures from Public Health England confirmed that flu was putting a sharply increased burden on GP surgeries as well as hospitals.

Last week 758 peple around the UK were hospialised because of flu, up from 421 the week before. Of those, 240 were so sick they had to be admitted to an intensive care or a high dependency unit, up from 114. The number of people consulting a GP with flu-like symptoms almost doubled.

A further 27 people died of flu-related symptoms last week, three more than the week before, taking the toll of deaths this winter to 85.

Read more: https://www.theguardian.com/society/2018/jan/11/nhs-patients-dying-in-hospital-corridors-doctors-tell-theresa-may

Damian Green sacked as first secretary of state after porn allegations

Green admits he made misleading statements after pornography was found on Commons computer in 2008

Damian Green has been sacked as first secretary of state after admitting he lied about the presence of pornographic images on his House of Commons computer.

An investigation by the cabinet secretary, Sir Jeremy Heywood, found that Greens vehement denials after a Sunday newspaper reported that porn had been found on his computer were inaccurate and misleading.

His departure is a personal blow for Theresa May, who brought him into Downing Street after her majority was wiped out in Junes general election to help shore up her authority.

He is the third cabinet minister to step aside since early November, following the departures of Michael Fallon and Priti Patel.

In a letter responding to his resignation, the prime minister said she was extremely sad about losing Green from government. May said it was with deep regret and enduring gratitude for the contribution you have made over many years that I asked you to resign from the government and have accepted your resignation.

In his resignation letter, Green continued to maintain that he did not download or view the pornography, but added that he should have been clear in my press statements, that his lawyers were informed about its presence in 2008 and that he discussed it with the police in 2013.

Heywood found Green had twice breached the ministerial code, because his misleading comments had fallen short of the seven principles of public life, one of which is honesty.

He was unable to reach a definitive conclusion on separate allegations, made by the Tory activist Kate Maltby, that Green had behaved improperly towards her.

The cabinet secretarys report found that Maltbys account of a disputed meeting was plausible, but with competing and contradictory accounts of what were private meetings, it is not possible to reach a definitive conclusion.

Sir
The investigation was led by cabinet secretary Sir Jeremy Heywood. Photograph: Press Association

In his letter, Green said: I deeply regret the distress caused to Kate Maltby following her article and the reaction to it. I do not recognise the events she described in her article, but I clearly made her feel uncomfortable and I apologise.

Maltby did not comment publicly on Wednesday evening, but her parents, Colin and Victoria Maltby, released a statement: We are pleased that the Cabinet Office has concluded its inquiry into the conduct of Damian Green. We are not surprised to find that the inquiry found Mr Green to have been untruthful as a minister, nor that they found our daughter to be a plausible witness.

We have received many supportive messages from people near and far who appreciate Kates courage and the importance of speaking out about the abuse of authority. We join with them in admiring her fortitude and serenity throughout the length of the investigation and despite the attempted campaign in certain sections of the media to denigrate and intimidate her and other witnesses. We are proud of her.

In her letter to Green, May welcomed the fact that he had apologised to Maltby.

Speaking on Thursday morning, the health secretary, Jeremy Hunt, acknowledged that Green had been sacked for lying, adding: I think lots of people who understand the context would appreciate why that might have happened. But that doesnt make it any more acceptable.

He told BBC Radio 4s Today programme the episode showed that cabinet ministers were held to the very highest standard of conduct. But, he said: I think we should probably remember that those are standards that would probably not apply in other countries.

Labours Jess Phillips told the same programme the decision had taken too long and that the allegations made by Maltby were still hanging over Green.

The investigation said that Kate Maltby was credible and plausible and what they found that they couldnt prove was the sexual harassment charge.

However, Im not convinced by that. Ive seen all of the evidence thats in the public domain: text messages between Damian Green and Kate Maltby, text messages between Kate Maltby and her friends at the time, saying how uncomfortable shed felt, whether she felt she had to report it.

She said that, although it was not officially acknowledged, she believed those allegations had contributed to Mays decision to sack Green.

The prime minister also used her letter to criticise the conduct of police officers who carried out the raid on Greens parliamentary office in 2008, when the pornography was discovered, and revealed aspects of the case to the media in recent weeks.

I shared the concerns raised from across the political spectrum when your parliamentary office was raided in 2008 when you were a shadow minister holding the Labour government to account, she said. Greens office was raided as police investigated a series of leaks from inside the Home Office.

The allegations about porn being found on his computer were the latest chapter in a long-running feud between Green and Bob Quick, the former assistant commissioner of the Metropolitan police, who oversaw the raid almost a decade ago.

Following a Sunday Times report last month claiming there was extreme pornography on his parliamentary computer, which quoted Quick, Green issued a hard-hitting late night statement branding him a tainted and untrustworthy source who had been trying for some time to cause him political damage.

He dismissed the porn allegations as false, disreputable political smears from a discredited police officer acting in flagrant breach of his duty and little more than an unscrupulous character assassination. Quick subsequently threatened to sue Green for libel.

May was handed Heywoods report on Monday, and subsequently sought a second opinion from Sir Alex Allan, the prime ministers independent adviser on ministers interests.

Quick guide

Damian Green’s comments on the porn allegations

What Damian Green said:

4 November

The police have never suggested to me that improper material was found on my parliamentary computer, nor did I have a private computer, as has been claimed.

“The allegations about the material and computer, now nine years old, are false, disreputable political smears from a discredited police officer acting in flagrant breach of his duty to keep the details of police investigations confidential, and amount to little more than an unscrupulous character assassination.”

11 November

“I reiterate that no allegations about the presence of improper material on my parliamentary computers have ever been put to me or to the parliamentary authorities by the police. I can only assume that they are being made now, nine years later, for ulterior motives.”

20 December

I accept that I should have been clear in my press statements that police lawyers talked to my lawyers in 2008 about the pornography on the computers, and that the police raised it with me in a subsequent phone call in 2013.

“I apologise that my statements were misleading on this point. The unfounded and deeply hurtful allegations that were being levelled at me were distressing both to me and my family and it is right that these are being investigated by the Metropolitan polices professional standards department.

Photograph: Ben Stansall/AFP

A summary of the investigation, released by No 10 on Wednesday night, said: Mr Greens statements of 4 and 11 November, which suggested that he was not aware that indecent material was found on parliamentary computers in his office, were inaccurate and misleading, as the Metropolitan police service had previously informed him of the existence of this material.

As first secretary of state, Green effectively acted as deputy prime minister, standing in for May at prime ministers questions and sitting alongside her on the frontbench in the Commons.

Green was a friend of Mays from when the pair were at Oxford University together, and one of a handful of older ministers she brought back into government when she arrived in Downing Street in July last year and dispatched many of David Camerons allies to the backbenches.

May flies to Poland at the start of a two-day foreign trip on Thursday, and is not expected to appoint a replacement for Green until parliament returns from its Christmas recess in the new year.

She is then expected to carry out a wider reshuffle, bringing some of the new generation of Conservative MPs into the cabinet in order to refresh the government.

The allegations about Green emerged as women began to share their experiences of sexual misconduct in political life after the revelations of inappropriate behaviour by media mogul Harvey Weinstein.

Fallon stepped down as defence secretary after admitting he had not met the standards required of the armed forces of which he was in charge, after the journalist Jane Merrick said he had lunged at her after a lunch.

Several other investigations are continuing, including that into trade minister Mark Garnier, who admitted asking an assistant to buy sex toys.

Green has continued to carry out his ministerial duties since the investigation was announced, and colleagues including the Brexit secretary, David Davis supported him in the face of the allegations made by the police officers.

A retired Met detective, Neil Lewis, went public with claims that thousands of thumbnail images of legal pornography had been found.

Following Lewis and Quicks interventions, Cressida Dick, the Mets commissioner, said former officers who spoke out about investigations could face prosecution.

Labour said it was right that May had finally been forced to sack Green. A spokesperson said: The public deserve the highest standards from ministers, which begs questions around the prime ministers judgment and why she delayed this decision for so long. To lose her number two in government in such a way, and so soon after two other ministers, leaves her further weakened.

Read more: https://www.theguardian.com/politics/2017/dec/20/damian-green-resigns-as-first-secretary-of-state-after-porn-allegations

Universities deplore McCarthyism as MP demands list of tutors lecturing on Brexit

Tory whip writes to every vice-chancellor to ask for syllabus and any online material

Academics are accusing a Tory MP and government whip of McCarthyite behaviour, after he wrote to all universities asking them to declare what they are teaching their students about Brexit and to provide a list of teachers names.

Chris Heaton-Harris, Conservative MP for Daventry and a staunch Eurosceptic, wrote to vice-chancellors at the start of this month asking for the names of any professors involved in teaching European affairs with particular reference to Brexit. Neatly ignoring the long tradition of academic freedom that universities consider crucial to their success, his letter asks for a copy of each universitys syllabus and any online lectures on Brexit.

Prof David Green, vice-chancellor of Worcester University, felt a chill down his spine when he read the sinister request: This letter just asking for information appears so innocent but is really so, so dangerous, he says. Here is the first step to the thought police, the political censor and newspeak, naturally justified as the will of the British people, a phrase to be found on Mr Heaton-Harriss website. Green will be replying to the MP but not be providing the information requested.

MP's
Heaton-Harriss letter

Prof Kevin Featherstone, head of the European Institute at the LSE, is also outraged: The letter reflects a past of a McCarthyite nature. It smacks of asking: are you or have you ever been in favour of remain? There is clearly an implied threat that universities will somehow be challenged for their bias. Featherstone says LSE academics had already feared Brexit censorship after the Electoral Commission made inquiries during last years referendum campaign about academics debates and research, following a complaint by Bernard Jenkin, another Tory MP. Jenkin filed a complaint when the LSE hosted an event at which the secretary general of the Organisation for Economic Cooperation and Development said there was no upside for the UK in Brexit. Jenkin, a board member of the Vote Leave campaign, also accused the LSEs Centre for Economic Performance of producing partisan research designed to convince the public to stay in the EU. The commission, whose job is to ensure fair campaigning, investigated and took no action against the university.

A spokesman for the LSE strenuously denies all allegations of political bias. The freedom for academics to study the major issues facing society, reach their own conclusions, and engage in public debate is essential for the health of our universities and the UKs world-leading research base, he says.

Featherstone says: I understand the LSE received calls from the Electoral Commission asking about speakers and the costs of events on an almost daily basis throughout the campaign period. He argues that both Heaton-Harriss letter and the Electoral Commissions investigation pose a threat to the role of universities as free intellectual spaces where academics can explore and question ideas without political interference. He says both developments risk plunging universities into dangerous new political waters.

The Electoral Commission says universities have nothing to fear from its inquiries. We produce guidance to help all non-party campaigners understand the rules on campaigning and we can advise universities in cases where they may be affected. These do not prevent campaigning or engagement in public debate, but provide the public with transparency about who is spending what in order to influence their vote.

Prof
Prof David Green, vice-chancellor of Worcester University: Here is the first step to the thought police, the political censor. Photograph: James Watkins

More than 80% of academics voted to remain, according to a YouGov survey [pdf] commissioned by the University and College Union in January. And within university departments focusing on European affairs, Brexiters are a rarity.

However, university experts on Brexit insist their personal views do not jaundice their teaching, and students are encouraged to question received assumptions and look at issues from all sides.

Julie Smith, director of the European Centre in the politics and international studies department at Cambridge University, says she told a lecture full of graduates about Heaton-Harriss letter last week. I told the students what my personal views were and emphasised that they were personal views. I voted to remain, but as an academic, my job is to impart knowledge, encourage debate and develop skills of analytical argument, not to impose doctrine.

Smith, who is also a Liberal Democrat peer, adds: If it is the case that a politician thinks he should interfere in the content of what universities are teaching and look at syllabi in order to see whether the correct line is being delivered, that is profoundly worrying.

Prof Piet Eeckhout, academic director of University College Londons European Institute, says it is unsurprising if most academics working on Europe are in favour of the EU. I have been teaching EU law for the last 25 years. The fact that I am sufficiently interested to spend all my days working on it obviously means I think EU law is a good thing.

Prof
Prof Kevin Featherstone, director of the European Institute at the LSE: The letter reflects a past of a McCarthyite nature

Pro-Brexit academics working in this area are also unhappy with the MPs behaviour. Lee Jones, reader in international politics at Queen Mary University of London, is one of the few openly pro-Brexit academics in his field. During the referendum campaign I said what I wanted and no one tried to shut me up, but I know colleagues elsewhere who have been blanked in the corridors because they voted to leave.

Yet Jones, too, is outraged by Heaton-Harriss investigation. It is really troubling that an MP thinks it is within his remit to start poking his nose into university teaching, he says. Universities are autonomous and politicians have no right to intimidate academics by scrutinising their courses. I have colleagues who are die-hard remainers. But I know what they teach and it is not propaganda.

Chris Bickerton, reader in modern European politics at Cambridge University, and a fellow leave voter agrees. He adds: In my institution there is strong support for academic freedom. I applied for promotion after the referendum and never did I worry that my views on Brexit would affect the results or my promotional prospects. Nor did I feel any institutional pressure to think one way or the other in the runup to the vote itself.

Heaton-Harris did not respond to requests for a comment.

Read more: https://www.theguardian.com/education/2017/oct/24/universities-mccarthyism-mp-demands-list-brexit-chris-heaton-harris

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

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

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

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

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

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

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

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

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

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

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

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

Plastic fibres found in tap water across the world

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Terry Pratchett’s unfinished novels destroyed by steamroller

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

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

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

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

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

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

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

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

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

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

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

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

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

Teenage boys wear skirts to school to protest against ‘no shorts’ policy

Dozens of pupils at Isca academy in Exeter stage uniform protest after school insists they wear trousers despite heatwave

Some had borrowed from girlfriends, others from sisters. A few had gone the extra mile and shaved their legs. When the Isca academy in Devon opened on Thursday morning, an estimated 30 boys arrived for lessons, heads held high, in fetching tartan-patterned skirts. The hottest June days since 1976 had led to a bare-legged revolution at the secondary school in Exeter.

As the temperature soared past 30C earlier this week, the teenage boys had asked their teachers if they could swap their long trousers for shorts. They were told no shorts werent permitted under the schools uniform policy.

When they protested that the girls were allowed bare legs, the school no doubt joking said the boys were free to wear skirts too if they chose. So on Wednesday, a handful braved the giggles and did so. The scale of the rebellion increased on Thurday, when at least 30 boys opted for the attire.

Quite refreshing was how one of the boys described the experience, pointing out that if even Royal Ascot had allowed racegoers in the royal enclosure to remove their jackets, then the school ought to relax its dress code. Another said he rather enjoyed the nice breeze his skirt had afforded him.

A third, tall boy said he was told his short skirt exposed too much hairy leg. Some of the boys visited a shop on their way to Isca the name the Romans gave to Exeter to pick up razors to make sure they did not fall foul of any beauty police.

Ironically, the temperature had dropped in Exeter to a more manageable 20C, but some boys said they had enjoyed the freedom afforded by the skirts and that they might continue.

The school said it was prepared to think again in the long term. The headteacher, Aimee Mitchell, said: We recognise that the last few days have been exceptionally hot and we are doing our utmost to enable both students and staff to remain as comfortable as possible.

Shorts are not currently part of our uniform for boys, and I would not want to make any changes without consulting both students and their families. However, with hotter weather becoming more normal, I would be happy to consider a change for the future.

It was too late. The revolution was picked up by media organisations across the globe, and Devon county council was forced to help the school out with inquiries. A spokesperson said: About 30 boys arrived at school this morning wearing school skirts. None of the boys have been penalised no one was put in isolation or detention for wearing a skirt.

The mother of one of the boys who began the protest said she was proud of him. Claire Lambeth, 43, said her son Ryan, 15, had come home earlier in the week complaining about the heat. He said it was unbearable. I spoke to a teacher to ask about shorts and she said it was school policy [that they could not be worn]. I did say this was exceptional weather, but they were having none of it. If girls can wear skirts, why cant boys wear shorts?

Ryan came up with the idea of wearing a skirt, so that evening we borrowed one. He wore it the next day as did five other boys. Then this morning I didnt expect it to take off like that. The school is being silly really this is exceptional weather. I was very proud of Ryan. I think it was a great idea.

Another mother said: My 14-year-old son wanted to wear shorts. The headteacher told them: Well, you can wear a skirt if you like but I think she was being sarcastic. However, children tend to take you literally, and because she told them it was OK, there was nothing she could do as long as they were school skirts.

A third mother said: Children also dont like injustice. The boys see the female teachers in sandals and nice cool skirts and tops while they are wearing long trousers and shoes and the older boys have to wear blazers. They just think its unfair that they cant wear shorts in this heat.

There were signs that the revolution might be spreading. The Guardian has heard of at least one more school in Wiltshire where one boy turned up in a skirt, although it did not go down quite so well with his friends.

And schoolboys were not the only ones making controversial dress choices because of the heat. Michael Wood, who works as a porter at Watford general hospital, claimed he was facing disciplinary action from his employers Medirest for rolling his trousers up to try to cool down. A spokesperson for the company declined to comment on the case, but said: The health and safety of our colleagues is always our number one priority.

What happened to summer school uniforms? Matthew Easter, managing director of the schoolwear supplier Trutex, said they had become less popular for reasons of economy. Its really up to the individual school to decide, but the headteacher is in a difficult position. A decade or so ago, summer wear was more popular, but theres been a change recently to try to make uniforms as economical as possible. Summer uniforms are only worn for a matter of weeks.

If parents havent bought uniform shorts, then some children may feel disadvantaged, so perhaps the decision in this case is simply down to fairness.

It may be that the weather will solve the problem for the school. The Exeter-based Met Office situated up the road from the school predicts pleasant, but not searing, temperatures over the coming week.

Read more: https://www.theguardian.com/education/2017/jun/22/teenage-boys-wear-skirts-to-school-protest-no-shorts-uniform-policy

Top journalist sues Time magazine for sex and age discrimination

Catherine Mayer says she was fired from US publication after being sidelined by senior staff

The co-founder of the Womens Equality party, Catherine Mayer, is suing her former employer, Time magazine, for gender and age discrimination, making the weekly favoured by President Donald Trump the latest major media company to be embroiled in accusations of institutional sexism.

The case comes soon after publication of BBC salaries provoked outrage at both gender and race gaps in pay, and a year after a series of high-profile sexual harassment cases plunged US TV giant Fox News into turmoil.

It pits one of Britains most prominent journalists, who wrote a controversial biography of Prince Charles and was shortlisted for the Orwell prize, against one of Americas most famous magazines, nearly a century old and with millions of readers. Times brand is so powerful Trumps golf clubs were decorated with mocked-up covers showing his face. Mayers suit, filed in a New York court, covers the final three years of her employment at the title, and her dismissal in 2015.

The problems began soon after she was appointed Europe regional editor, after eight years of outstanding performance and appraisals, court documents allege. The suit alleges that Times foreign editor appointed Matt McAllester, a younger male colleague, as her deputy, without an open selection process and in violation of promises that she could choose her team. Mayer says McAllester began a campaign to undermine and supplant her, even though she repeatedly raised complaints.

Ultimately, Mayer claims, the company took away her responsibilities as Europe editor the year after she took on the position, then forced her to relinquish the title, which the company gave to McAllester. In April 2015 she was fired.

The suit, filed on 24 July, said: Time has violated [anti-discrimination and civil rights] laws by operating a system of male cronyism, by which men, especially former war correspondents, were favoured over women in recruitment, dismissal and promotion decisions.

It alleges that McAllester, now editor-in-chief of Newsweek, poisoned the atmosphere in the London office so much one employee was afraid to be alone with him and eventually resigned without having another job to go to. This was not the result of a tough but fair work regime, but from bullying some subordinates and favouring others. Non-macho men and women who did not conform to traditional expectations of gender roles did not fare well, the suit claims. Staff in London quickly concluded that McAllester was trying to oust plaintiff.

Mayer claims that when she raised concerns with the international editor, Jim Frederick, he did not provide support. He responded simply, You are two of my favourite people and I am sure you will find a way to work things out. Her treatment triggered serious health problems including depression, migraines and insomnia, Mayer alleges. She also claims the timing of her dismissal was particularly damaging because it coincided with publication of her controversial and high-profile biography of Prince Charles. [It] had a negative impact on book sales and her reputation, since many assumed Time had terminated her because her research for the book was defective or for other performance-related reasons, the suit said.

Mayer claims she contested her dismissal immediately. There was never a point when I accepted this was a valid redundancy, and never a point when I didnt fight back, she said. Of course money is relevant to this, but also they were doing me reputational damage, because of the timing of the decision.

However, the case has come to light only after she decided to sue. Mayer said that despite her prominent position as an advocate for gender equality, she had hoped to keep her personal battle with Time quiet by reaching a private settlement. Im not going to try to pretend that I started out doing this for other women, she said. Absolutely initially what you want to do is move on with your life.

Mayer chose to take legal action in New York, where Time and its senior management is based. She is a dual citizen of the US and Britain. After two years seeking a settlement, legal deadlines meant she had to go to court or drop her case, she said. But under the US system, that meant the suit would be public.

Mayer said that having the case made public has a silver lining. She can now discuss her personal experience, and how it forced her to confront wider problems across the profession. If this is happening to me, what is it like to be someone less well-defended than me? she asked.

Time did not respond to questions about the lawsuit and Mayers claims. Matt McAllester declined to comment.

Read more: https://www.theguardian.com/media/2017/aug/05/catherine-mayer-time-magazine-sex-discrimination-lawsuit

WannaCry ‘hero’ to plead not guilty to accusation he wrote banking malware

US prosecutors claim Marcus Hutchins, hailed as accidental hero for stopping major ransomware attack, admitted to creating Kronos malware targeting banks

The British security researcher who stopped a global ransomware attack admitted to police that he wrote the code of a malware that targeted bank accounts, US prosecutors said during a hearing on Friday, but his attorneys said that he planned to plead not guilty.

Marcus Hutchins, the 23-year-old hailed as a hero for stopping the WannaCry ransomware attack, is accused of helping to create, spread and maintain the banking trojan Kronos between 2014 and 2015 and is facing six counts of hacking-related charges from the US Department of Justice (DoJ), according to a recently unsealed indictment.

A judge ruled on Friday that Hutchins who had been in Las Vegas for the annual Def Con hacking conference could be released on $30,000 bail. The judge said the defendant was not a danger to the community nor a flight risk and ordered him to remain in the US with GPS monitoring.

Dan Cowhig, the prosecutor, argued in federal court that Hutchins should not be freed because he is a danger to the public, adding: He admitted he was the author of the code of Kronos malware and indicated he sold it.

As part of a sting operation, undercover officers had bought the code from Hutchins and his co-defendant, who is still at large, Cowhig said in court. The prosecutor said there is also evidence from chat logs between Hutchins and the co-defendant, revealing that Hutchins complained about the money he received for the sale.

After the hearing, Adrian Lobo, Hutchins defense attorney, said: We intend to fight the case.

She added: He has dedicated his life to researching malware, not to trying to harm people.

The attorney also told reporters that Hutchins supporters were raising money for his bond and that he should be released on Monday.

He has tremendous community support, local and abroad and in the computer world.

She declined to comment on the specifics of the charges, but said he was completely shocked by the indictment and that he was in good spirits.

The DoJ charges relate to the Kronos malware, which is a type of malicious software used to steal peoples credentials, such as internet banking passwords.

According to the indictment, Hutchins co-defendant advertised the malware for sale on AlphaBay, a darknet marketplace, and sold it two months later. The indictment did not make clear if the malware was actually sold through AlphaBay.

US and European police eventually seized servers for the marketplace, which was shut down on 20 July.

Hutchins, known on Twitter as @MalwareTechBlog, gained a reputation as an accidental hero in May for halting the global spread of the WannaCry ransomware attack. WannaCry infected hundreds of thousands of computers worldwide in less than a day, encrypting their hard drives and asking for a ransom of $300 in bitcoin to unlock the files. The cyberattack wreaked havoc on organisations including the UKs National Health Service, FedEx and Telefnica.

The cybersecurity researcher, working with Darien Huss from security firm Proofpoint, found and inadvertently activated a kill switch in the malicious software.

The kill switch was hardcoded into the malware in case the creator wanted to stop it spreading. This involved a very long nonsensical domain name that the malware makes a request to just as if it was looking up any website and if the request comes back and shows that the domain is live, the kill switch takes effect and the malware stops spreading.

Hutchins noticed the domain was unregistered and so bought it for $10.69, not knowing what it did at the time. It immediately started registering thousands of connections every second.

The intent was to just monitor the spread and see if we could do anything about it later on. But we actually stopped the spread just by registering the domain, he told the Guardian at the time.

The WannaCry malware ended up affecting more than 1m computers, but experts estimate that without Hutchins intervention it could have infected 10-15m computers. Hutchins was given a special recognition award at the cybersecurity SC Awards Europe for his role in halting the malware.

Lobo and the US attorneys office did not immediately respond to requests for comment on Friday.

The Press Association contributed reporting.

Read more: https://www.theguardian.com/technology/2017/aug/04/wannacry-marcus-hutchins-kronos-malware-arrest

Rule that patients must finish antibiotics course is wrong, study says

Experts suggest patients should stop taking the drugs when they feel better rather than completing their prescription

Telling patients to stop taking antibiotics when they feel better may be preferable to instructing them to finish the course, according to a group of experts who argue that the rule long embedded in the minds of doctors and the public is wrong and should be overturned.

Patients have traditionally been told that they must complete courses of antibiotics, the theory being that taking too few tablets will allow the bacteria causing their disease to mutate and become resistant to the drug.

But Martin Llewelyn, a professor in infectious diseases at Brighton and Sussex medical school, and colleagues claim that this is not the case. In an analysis in the British Medical Journal, the experts say the idea that stopping antibiotic treatment early encourages antibiotic resistance is not supported by evidence, while taking antibiotics for longer than necessary increases the risk of resistance.

There are some diseases where the bug can become resistant if the drugs are not taken for long enough. The most obvious example is tuberculosis, they say. But most of the bacteria that cause people to become ill are found on everybodys hands in the community, causing no harm, such as E coli and Staphylococcus aureus. People fall ill only when the bug gets into the bloodstream or the gut. The longer such bacteria are exposed to antibiotics, the more likely it is that resistance will develop.

The experts say there has been too little research into the ideal length of a course of antibiotics, which also varies from one individual to the next, depending in part on what antibiotics they have taken in the past.

In hospital, patients can be tested to work out when to stop the drugs. Outside hospital, where repeated testing may not be feasible, patients might be best advised to stop treatment when they feel better, they say. That, they add, is in direct contravention of World Health Organisation advice.

Other experts in infectious diseases backed the group. I have always thought it to be illogical to say that stopping antibiotic treatment early promotes the emergence of drug-resistant organisms, said Peter Openshaw, president of the British Society for Immunology.

This brief but authoritative review supports the idea that antibiotics may be used more sparingly, pointing out that the evidence for a long duration of therapy is, at best, tenuous. Far from being irresponsible, shortening the duration of a course of antibiotics might make antibiotic resistance less likely.

Alison Holmes, a professor of infectious diseases at Imperial College London, said a great British authority, Prof Harold Lambert, had made the same point in a Lancet article entitled Dont keep taking the tablets as early as 1999. It remains astonishing that apart from some specific infections and conditions, we still do not know more about the optimum duration of courses or indeed doses in many conditions, yet this dogma has been pervasive and persistent.

Jodi Lindsay, a professor of microbial pathogenesis at St Georges, University of London, said it was sensible advice. The evidence for completing the course is poor, and the length of the course of antibiotics has been estimated based on a fear of under-treating rather than any studies, she said. The evidence for shorter courses of antibiotics being equal to longer courses, in terms of cure or outcome, is generally good, although more studies would help and there are a few exceptions when longer courses are better for example, TB.

But the Royal College of GPs expressed concerns. Recommended courses of antibiotics are not random, said its chair, Prof Helen Stokes-Lampard. They are tailored to individual conditions and in many cases, courses are quite short for urinary tract infections, for example, three days is often enough to cure the infection.

We are concerned about the concept of patients stopping taking their medication midway through a course once they feel better, because improvement in symptoms does not necessarily mean the infection has been completely eradicated. Its important that patients have clear messages and the mantra to always take the full course of antibiotics is well known. Changing this will simply confuse people.

The UKs chief medical officer, Prof Dame Sally Davies, said: The message to the public remains the same: people should always follow the advice of healthcare professionals. To update policies, we need further research to inform them.

[The National Institute for Health and Care Excellence] is currently developing guidance for managing common infections, which will look at all available evidence on appropriate prescribing of antibiotics.

The Department of Health will continue to review the evidence on prescribing and drug-resistant infections, as we aim to continue the great progress we have made at home and abroad on this issue.

Read more: https://www.theguardian.com/society/2017/jul/26/rule-patients-must-finish-antibiotics-course-wrong-study-says

People taking heartburn drugs could have higher risk of death, study claims

Research suggests people on proton pump inhibitors are more likely to die than those taking different antacid or none at all

Millions of people taking common heartburn and indigestion medications could be at an increased risk of death, research suggests.

The drugs, known as proton pump inhibitors (PPIs), neutralise the acid in the stomach and are widely prescribed, with low doses also available without prescription from pharmacies. In the UK, doctors issue more than 50m prescriptions for PPIs every year.

Now researchers say the drugs can increase risk of death, both compared with taking a different type of acid suppressant and not taking any at all.

We saw a small excess risk of dying that could be attributed to the PPI drug, and the risk increased the longer they took them, said Ziyad Al-Aly, an epidemiologist from the University of Washington and co-author of the study.

The team say the study suggests those who take the drugs without needing to could be most at risk. They urged people taking PPIs to check whether this was necessary.

Previous research has raised a range of concerns about PPIs, including links to kidney disease, pneumonia, more hip fractures and higher rates of infection with C difficile, a superbug that can cause life-threatening sepsis, particularly in elderly people in hospitals.

But the latest study is the first to show that PPIs can increase the chance of death. Published in the journal BMJ Open, it examined the medical records of 3.5 million middle-aged Americans covered by the US veterans healthcare system.

The researchers followed 350,000 participants for more than five years and compared those prescribed PPIs to a group receiving a different type of acid suppressant known as an H2 blocker. They also took into account factors such as the participants age, sex and conditions ranging from high blood pressure to HIV.

The results show that those who took PPIs could face a 25% higher risk of death than those who took the H2 blocker.

In patients on [H2 blocker] tablets, there were 3.3 deaths per 100 people over one year. In the PPI group, this figure was higher at 4.7 per 100 people per year, said Al-Aly.

The team also reported that the risk of death for those taking PPIs was 15% higher than those taking no PPIs, and 23% higher than for those taking no acid suppressants at all.

Similar levels of increased risk were seen among people who used PPIs but had no gastrointestinal conditions, a result which the authors speculated might be driving the higher risk seen overall.

Gareth Corbett, a gastroenterologist from Addenbrookes hospital in Cambridge who was not involved with the study, cautioned against panic, pointing out that in most cases the benefits of PPI far outweighed any risk. What was more, he said, while the increased risk sounded high, it was still very low for each person.

PPIs are very effective medicines, proven to save lives and reduce the need for surgery in patients with bleeding gastric and duodenal ulcers and several other conditions, he said.

The studys authors said it was important that PPIs were used only when necessary and stopped when no longer needed.

Corbett agreed that many people take PPIs unnecessarily. They could get rid of their heartburn by making lifestyle changes, such as losing weight and cutting back on alcohol, caffeine and spicy foods, he said.

The authors said the study was observational, meaning it did not show that PPIs were the cause of the increased risk of death, and that it was unclear how the drugs would act to affect mortality. They said the drugs could affect components within cells, known as lysosomes, that help break down waste material, or shortening protective regions at the end of chromosomes, known as telomeres.

Aly said people on PPIs should check with their GP whether the drugs were still needed, adding: In some cases we expect that PPIs can be safely stopped, particularly in patients who have been taking them for a long time.

Read more: https://www.theguardian.com/science/2017/jul/04/people-taking-heartburn-drugs-could-have-higher-risk-of-death-study-claims