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.

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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.

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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?

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

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

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

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

Plastic fibres found in tap water across the world

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

May adopts contrite tone after Tory MPs vent anger over election

Prime minister apologises to Tories who lost seats and reaffirms top cabinet posts in DUP-backed minority government

A chastened Theresa May has apologised to her party colleagues, after squandering the Conservatives majority with an ill-fated snap general election, forcing her to turn to Northern Irelands Democratic Unionist party for backing.

A surge in support for Jeremy Corbyns Labour party and its anti-austerity message drove the Conservatives into retreat, leaving them unable to form a majority government alone.

Labour won the last seat to declare, Kensington and Chelsea, meaning it had 262 MPs and the Conservatives 318 MPs. The prime minister will seek to govern with the help of the DUPs 10 MPs.

In a contrite interview, May said: I wanted to achieve a larger majority. That was not the result we secured. And Im sorry for all those candidates and hard-working party workers who werent successful, but also for those colleagues who were MPs and ministers and contributed so much to our country and who lost their seats and who didnt deserve to lose their seats.

Her explicit apology came after some colleagues were infuriated by an earlier statement in Downing Street that failed to acknowledge the disastrous election result, which many regard as self-inflicted.

After returning from Buckingham Palace, where she received the Queens blessing to form a government, May had promised to provide certainty, and urged her colleagues: Lets get to work.

The prime minister received the staunch backing of pro-Brexit MPs, including Brexit secretary David Davis, amid fears that the election result could stall the process of leaving the European Union, with formal talks due to start within 10 days.

Steve Baker, chair of the influential pro-Brexit European Research Group of backbench MPs, said: My principal thought is that its essential that Conservative MPs support Theresa May as prime minister and make it possible to form the most stable government possible.

But throughout the day, the prime minister faced a growing public backlash from MPs and defeated candidates, who expressed their fury publicly at the way the campaign was run, and the secretive, controlling management style of Mays joint chiefs of staff: Fiona Hill and Nick Timothy.

Nicky Morgan, who was sacked as education secretary by May, said: Im reeling. I think were all reeling. I think theres real fury against the campaign and the buck stops at the top.

She said it was right for the prime minister to continue in office for the time being, but added: I think she wont fight another election and I think eventually, whether it takes weeks or months, we will have to look at the leadership.

Other MPs speculated openly about the likelihood that May could be forced to call another election within months, as she struggles to govern with a wafer-thin majority, even with the backing of the DUP.

Sarah Wollaston, the Conservative MP for Totnes and former chair of the Commons health committee, said: I do think she should stay on but I wouldnt be surprised if we end up having another election soon and people will be absolutely appalled by it.

May, who used a threat of a Labour-led coalition of chaos as a key attack line during the campaign, will not enter into a formal deal with the DUP but hopes to win its backing on a vote-by-vote basis. She is expected to address parliamentary colleagues next week in a bid to shore up support.

Liberal Democrat leader Tim Farron accused her of trying to form her own coalition of chaos. He said: She put her party before her country. She has been found out. She should be ashamed.

She has brought weakness and uncertainty. If she has an ounce of self-respect she will resign.

In a sign of the prime ministers weakened authority, she reappointed the five senior cabinet members Amber Rudd, Davis, Boris Johnson, Philip Hammond and Michael Fallon despite expectations that Hammond, and perhaps Johnson, could be moved aside if she enhanced her majority.

One cabinet source said May had offered them a reassurance that things will be changing, and a remark in her television interview that she would announce further personnel changes was read by insiders as a hint that she could be ready to sacrifice Hill and Timothy. The pair were not in their usual place at her side in No 10 on Friday night, Downing Street insiders said.

More junior appointments are expected to be made at the weekend as the prime minister replaces frontbenchers who lost their seats including Ben Gummer, the former Ipswich MP who was one of the key authors of the ill-fated manifesto, and housing minister Gavin Barwell, who lost Croydon Central.

While Labour fell well short of a parliamentary majority, Corbyns team believe the result was a vindication of their upbeat, anti-cuts message, and will seek to obstruct fresh austerity measures, including Tory manifesto policies such as means-testing the winter fuel allowance, in the voting lobbies.

A spokesman for Corbyn said: We will be using the changed parliamentary arithmetic to drive home the fact that the Tory programme for five more years of austerity will not go on as before.

Labour was invigorated by an upbeat campaign, which saw the party leader address scores of mass rallies, and resulted in many MPs significantly increasing their majorities.

Longtime Conservative seats, including Canterbury in Kent, were snatched by a resurgent Labour, which polled 40% of the vote, with the Conservatives on 42%, as minor parties were squeezed. The increase in Labours vote share was the largest for any party between two general elections since 1945.

Corbyns colleagues, including those who had previously expressed strong criticism of his leadership, praised his campaign. Owen Smith, who challenged Corbyn for the party leadership last summer after saying he was unfit for the job, said: I take my hat off to him, Chuka Umunna, the Streatham MP previously considered a potential leadership challenger, said he would consider accepting a role in a Corbyn-led shadow cabinet.

In Scotland the Scottish National party lost 21 of its 56 seats, including those of party heavyweights Angus Robertson and Alex Salmond, with the Conservatives, Lib Dems and Labour all making gains.

Nicola Sturgeons dramatic demand for a second independence referendum before the UK leaves the EU appeared not to have enthused the electorate.

Ruth Davidsons Scottish Conservatives, who put preserving the union at the centre of their campaign, achieved the best Tory result in Scotland since 1983. Davidson pointedly tweeted a recent speech she made about gay marriage on Friday, after Mays announcement that she would work closely with the socially conservative DUP, which is opposed to gay marriage.

One explanation for Labours better-than-expected performance was its success in picking up a share of the votes lost by Ukip, which withdrew from many seats and saw its support collapse in others. Corbyns party has made a deliberate populist pitch for left behind voters; and sought to neutralise the issue of Brexit by backing Mays legislation triggering Article 50.

Ukip leader Paul Nuttall announced on Friday that he would be stepping down, after less than a year in the post, prompting speculation that Nigel Farage could step back into the role. In a speech in London, Nuttall promised his party would continue to be the guard dogs of Brexit in the months ahead.

Read more: https://www.theguardian.com/politics/2017/jun/09/theresa-may-hopes-to-remain-pm-as-voters-deliver-hung-parliament

General election: May falters during challenge over record on public services

PM confronted by nurse over issue of low pay in Question Time special, while Jeremy Corbyn is questioned over Trident and national security

Theresa May came under sustained pressure over the Conservative partys record on public sector pay, mental health services and social care in a combative election edition of BBC1s Question Time broadcast less than a week before polling day.

The prime minister faced a string of awkward questions from members of the public, including a challenge from a nurse, Victoria Davey, who left May faltering after confronting her over the 1% pay increase received by NHS staff.

May said she recognised the hard work people did in the health service but said her party had taken the difficult decision of enforcing pay restraint. Im being honest with you saying we will put more money in, but there isnt a magic money tree that we can shake to get everything we want, she said.

The prime minister claimed wages in the NHS had increased, to which a man in the audience shouted that there had been a real-terms salary drop of 14% since 2010, adding: So dont tell us were getting a pay rise.

One woman from the audience became emotional as she described emerging from a fitness-for-work test in tears after being asked about her suicide attempts. Im not going to make any excuses for the experience youve had, said the prime minister.

Under pressure after refusing to turn up for a TV debate earlier in the week, May was animated at first and rejected an accusation that she had performed a U-turn by calling a snap general election. No its not, sir I had the balls to call an election, she said.

Appearing straight after May on the programme, Jeremy Corbyn also faced hostile questioning, coming under pressure over defence and security.

Pressed over his willingness to push the nuclear button in the face of imminent threat, the Labour leader said: I think the idea of anyone ever using a nuclear weapon anywhere in the world is utterly appalling and terrible. It would result in the destruction of lives and community and environment of millions of people. I would be actively engaged to ensure that danger didnt come about.

Asked again if there were any circumstances in which he would use such a weapon, Corbyn said his party had committed to renew Trident. I would view the idea of using a nuclear weapon as something resulting in a failure of the whole worlds diplomatic system, he said. There has to be no first use. There has to be a process of engagement to bring about ultimately global nuclear disarmament You cannot countenance a world in which we could all be destroyed by nuclear war.

Jeremy
Jeremy Corbyn takes questions from the audience. Photograph: WPA Pool/Getty Images

The comments led to a heated exchange, with an exasperated member of the audience asking if Corbyn would not even fire back if attacked.

I would say no first use of the weapon. That has to be the basis of what we do, the Labour leader said.

He then argued: Weve only got one planet, lets get together when we live on it and above all lets not destroy it The most effective use of it is not to use it because it is there.

Corbyn did receive support from one woman in the audience who said she could not understand why others wanted to kill millions of people by discharging a nuclear weapon.

Boris Johnson, the foreign secretary, said later: There is no point in having a nuclear weapon unless you are willing in principle to deploy it. Im afraid there is a lesson here about Jeremy Corbyns psychology and his politics and his naivety, with which he approaches not just the logic of the nuclear deterrent but also the Brexit negotiations.

Corbyn began his appearance, and received cheers, when he said that he would have preferred to be debating the prime minister head-to-head. He challenged May to spell out the impact of her dementia tax in the final days of the election, saying it was staggering that pensioners would not be told the level of a promised cap on social care costs.

In her session, May was asked why she was not able to provide details of the maximum amount of money people would have to spend on social care, which was only promised after days of backlash against the policy.

May defended her failure to set out additional details, even though the policy is blamed for reducing the Conservatives lead in the polls in the past fortnight. Were talking about two different things. On the floor, its important people have a protection of their savings, which is greater than it is today. Thats why weve set it at 100,000. But on the cap, I think its right we have that consultation, with individuals, with organisations that deal with these issues, with charities to make sure we get that at the right level, she said.

May focused on Brexit and attacks on Labour over the question of leadership two subjects her campaign is planning to concentrate on in the final few days of the campaign.

I called a general election because I believe the British people have a right to vote and say who they want to see leading them through the Brexit process, she said. And I believe they should have a prime minister with a resolute determination to carry out their will.

On Friday, May attempted to court business with a Financial Times interview in which she vowed to consult companies during Brexit negotiations. She promised she would work with business and identify with them what their main concerns are when it comes to designing a new immigration system, and stressed that there would be an implementation phase.

On the BBC1 programme, she hit out at Corbyn with her election mantra that he could only get into Downing Street propped up by the Lib Dems and the Scottish Nationalists, adding: Youd have Diane Abbott, who cant add up around the cabinet table, John McDonnell who is a Marxist, Nicola Sturgeon who wants to break our country up and Tim Farron who wants to take us back into the EU.

The audience challenged Corbyn on Labours policies on a higher minimum wage, corporation tax rises and zero-hour contracts, with one man claiming the agenda would hurt business.

The Labour leader responded by saying there would be support for small firms to cope with the increase in the wages that employees would be entitled to. There are many big companies that could well afford to pay it and shouldnt be just paying the minimum wage, he said.

Small companies could have problems, we fully recognise that, Corbyn added, but said a Labour government would work with them, either to give them tax relief or support in order to make sure the real living wage was paid but they didnt close down as a result.

Asked by student Edward Robbins about the zero-hours contracts that offer casual, flexible work, Corbyn said: Im not going to stop you working, its OK.

Andrew Gwynne, Labours election coordinator said: Its very regrettable the prime minister wouldnt debate with Jeremy and, after tonight, I can see why. She has no answers to the issues that really concern people on the doorstep, the NHS and cuts facing our schools, and far from appearing strong and stable, she was definitely on the back foot answering most of the questions pitched to her.

Read more: https://www.theguardian.com/politics/2017/jun/02/general-election-may-falters-during-challenge-over-record-on-public-services