US teenager dies after succession of caffeine drinks in two hours

A teenager in the US died because he consumed too many high-caffeine drinks in a short space of time, a coroner has said.

Davis Allen Cripe died last month, about an hour after collapsing in his high school near Columbia, South Carolina. The 16-year-old had consumed a latte from McDonald’s, a large Mountain Dew drink and a highly caffeinated energy drink in just under two hours, Richland county coroner Gary Watts said.

Doctors said Davis died from a “caffeine-induced cardiac event causing a probable arrhythmia”, according to Watts.

He added that the teenager was considered healthy and the autopsy showed no sign of an existing undiagnosed heart condition.

“This is not a caffeine overdose,” said Watts. “We’re not saying that it was the total amount of caffeine in the system, it was just the way that it was ingested over that short period of time.”

Davis weighed about 90kg but would not have been considered morbidly obese, according to Watts, who added that he would have been unharmed by the same amount of caffeine on another day.

“We’re not trying to speak out totally against caffeine,” said Watts. “We believe people need to pay attention to their caffeine intake and how they do it, just as they do with alcohol or cigarettes.”

The particular energy drink Davis drank was not known but a witness said it was from a container the size of a large soft drink.

According to caffeineinformer.com, a McDonald’s latte has 142 milligrams of caffeine, a 20-ounce Mountain Dew has 90 mg, and a 16-ounce energy drink can have as much as 240 mg.

The US Food and Drug Administration and European Food Safety Authority both say that caffeine consumption of up to 400mg a day – about four or five coffees – is believed to be safe for adults. The EFSA says 200mg a day is safe for women who are pregnant or breastfeeding and that single doses of up to 200mg do not give rise to safety concerns. The American Academy of Pediatrics discourages the consumption of caffeine and other stimulants by children and teenagers.

Caffeine has been linked to previous deaths, although the cases are few and far between and the link not always clear-cut. In 2011, 14-year-old US schoolgirl Anais Fournier, who had a pre-existing heart condition, died after drinking two cans of Monster energy drink, containing a total of 480mg of caffeine. The company denied any responsibility.

In 2015, two students at Northumbria University, were were left fighting for their lives after they were accidentally given the equivalent of 300 cups of coffee in a botched experiment. They eventually made a full physical recovery.

Tony Heagerty, professor of medicine at Manchester University, said it was likely that Davis had a genetic heart condition, which may not have revealed itself in the autopsy, and that the caffeine put stress on his heart.

“I think the caffeine must have interacted with something wrong with this heart,” he said. “If you are an unfortunate person with a pre-existing condition and put yourself in a stressful situation by drinking too much caffeine you are in danger.”

But he said the levels consumed by Davis would not be harmful to the overwhelming majority of people, except for making them feel strange.

Mike Knapton, associate medical director at the British Heart Foundation, said: “It is well known that caffeine increases a person’s heart rate but it can also trigger more serious effects, including heart palpitations, in those who are more sensitive to caffeine.

“People with cardiac abnormalities, including inherited heart conditions, and those who drink toxic amounts of caffeine are more susceptible to the side-effects of caffeine. Tragic accidents like this are rare but, with increasingly strong coffees and caffeinated drinks on the market, moderation is key to monitoring your caffeine intake.”

Caffeine – what are the dangers?

The World Health Organisation recognises caffeine use disorder and caffeine dependence as illnesses.

Drinking large amounts of coffee can lead to unpleasant side-effects such as irritability, problems sleeping, restlessness, according to the NHS.

It can also result in babies having a low birth weight, which can increase the risk of health problems in later life, or miscarriage.

Caffeine constricts the coronary arteries, leading to a temporary rise in blood pressure. If drunk in sufficient quantities it causes calcium to be discharged from inside cells and causes the heart to beat faster. In the most extreme cases – caffeine toxicity – it causes major organs to shut down.

Symptoms of a caffeine overdose include dizziness, nausea, vomiting, convulsions and a high heart rate.

US teenager dies after succession of caffeine drinks in two hours

Ebola outbreak declared in Democratic Republic of Congo after three die

An Ebola outbreak has been declared in north-east Democratic Republic of the Congo, the World Health Organization (WHO) has said, after the virus caused three deaths since 22 April.

WHO said the outbreak had affected an equatorial forest region in Bas-Uele province, bordering Central African Republic.

The last Ebola outbreak in Congo in 2014 was quickly contained and killed 49 people, according to official figures.

In a television address, the country’s health minister, Oly Ilunga, confirmed the outbreak and urged the population not to panic.

“[The DRC] has taken all necessary measures to responde quickly and efficiently to this new outbreak,” he said.

WHO said it was working closely with Congolese authorities to help deploy health workers and protective equipment in the remote area to “rapidly control the outbreak”.

In 2013, an Ebola epidemic began in west Africa that killed 11,300 people in Guinea, Sierra Leone and Liberia and has left thousands more survivors with long-term health problems.

WHO was criticised at the time for responding too slowly and failing to grasp the gravity of the outbreak. An experimental vaccine was recently developed that WHO said could be used in emergencies.

Ebola outbreak declared in Democratic Republic of Congo after three die

Inspiral Carpets drummer killed himself after 20 years of "unbearable" tinnitus

The wife of the Inspiral Carpets drummer Craig Gill has said there needs to be a greater awareness of the devastating effects of tinnitus after an inquest into his death returned an open verdict.

Rose Marie Gill issued a statement about the condition after an inquest into her husband’s death heard how the only concern he had in his life was the tinnitus he had had for more than 20 years.

Gill told a coroner how she discovered her 44-year-old husband dead at their home in Greenfield, Greater Manchester, after returning with their children from a day out.

She told the inquest in Heywood, Greater Manchester, that her husband’s death had baffled everyone who knew him and that her husband had no history of depression or suicidal thoughts. “That’s what’s shocking about it. I have no idea where this has come from,” she told the senior coroner for north Manchester, Joanne Kearsley.

In a statement issued after the hearing, she said her husband’s tinnitus became “so unbearable he felt there was no cure” and urged more awareness of the problem and men’s mental health.

She said in the statement: “Instead of reaching out, on that day in November, Craig made the saddest and most tragic of decisions.”

Gill said: “For the past 20 years, Craig suffered from debilitating tinnitus, a condition caused by not protecting his hearing when enjoying the careers he loved the most – a successful musician, DJ and love of listening to music.

“His condition affected his day-to-day wellbeing and he suffered in silence with both sleep deprivation and anxiety.”

She said: “Although we struggle with the day-to-day existence of life without Craig, we are now able to discuss and promote awareness of tinnitus and men’s mental health. It takes courage for men to speak out, to talk to one another, to share their thoughts and their fears.

“If you are one of those men, like Craig, we urge you to reach out to those you love and find comfort in sharing your pain.”

Inspiral Carpets members Graham Lambert, Stephen Holt and Clint Boon attended the inquest. Boon read a statement from the band that said: “We will always remember Craig for his great sense of humour, his passion for music, his incredible skills as a musician and his devotion to his family.

“Craig was a friend, a loyal son and brother, philosophical father and important member of our gang. We feel extremely privileged to have spent the last 30 years making music with him.”

Earlier, Gill had told the inquest how the whole family had set off early in the morning on Sunday 18 November last year and travelled to Media City, in Salford, to watch the recording of a children’s TV Christmas special.

She said that after they arrived at the studios, her husband said it was not something he really wanted to do and they decided he would go home. She said she thought this was perfectly normal behaviour as most men would not want to spend a day watching a children’s show in Christmas jumpers.

Gill described how she spoke to her husband on the phone during the day but he was not at the station to meet them. She said she and the children walked the short distance home, where she discovered his dead body.

DI Ian Harratt said a police investigation had shown no sign of any disturbance at the house but also found no suicide note.

Harratt told the coroner: “There was nothing in the information we have received that this was premeditated or preplanned. It appears to me that this is something that was completely out of the blue. It was something that took everybody who knew Mr Gill completely by surprise.”

The coroner told Gill it was clear her husband was responsible for taking his own life but she could not record a conclusion of suicide because she could not be sure, to the criminal standard of proof, that he had intended to kill himself.

Recording an open conclusion, Kearsley said she was sorry she could not offer the family an explanation for what happened.

She said he was also described as a “pillar of the community” who was “thought of so highly by everybody”.

Gill was a founding member of the Inspiral Carpets and played with the band throughout their heyday in the 1990s, returning when the band reformed 20 years later to tour and record their self-titled album in 2014.

In the UK, the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14.

Inspiral Carpets drummer killed himself after 20 years of "unbearable" tinnitus

Mother of anorexic girl killed by train criticises care failings after inquest

The mother of a severely anorexic 15-year-old girl who died after stepping in front of a train has said that failings in her daughter’s care “from beginning to end” resulted in her death.

Pippa “Pip” McManus was granted home leave from the Priory hospital in Altrincham, Greater Manchester, ahead of completion of the formal discharge process, in December 2015.

Five days later, after a family row, she walked to Gatley station in Stockport and was hit by a train. She was pronounced dead at the scene.

A jury at South Manchester coroner’s court concluded on Wednesday that Pip had taken her own life, but said that the lack of support provided to her family and the delay in implementing a care plan when she arrived home could have been contributory factors in her death.

The court was told that Pip’s parents had reservations about their daughter’s release, as they believed she remained in danger of self harming but felt they had no option but to go along with the decision.

Reading a statement outside the court after the verdict, Pip’s mother, Marie McManus, said her daughter’s death had caused a “tear in the thread of our family [that] will never be mended”.

“Anorexia has the highest mortality rate attributed to any psychiatric illness, with as many as 40% of deaths [of those with anorexia] due to suicide,” she said. “Too many of our children are dying from this terrible illness. Effective treatment is needed more quickly and if this had been available to our beautiful daughter, maybe she would still be alive. Maybe we would not have needed this inquest.”

Jim McManus, Pip’s father, said that throughout the three years of his daughter’s illness there were many more failings than that of not creating an adequate plan for her discharge from the clinic. “From start to finish there were many hurdles, which we felt we were failed on,” he said.

The court was told that Pip talked to her mother about suicidal thoughts on many occasions and that once, the family had found goodbye letters written to her family, dog and doctor. One note read: “I do want to grow up and have a life; at the moment I don’t have one. I can’t fight anorexia any more. I have tried so very hard, but it has won me.”

A medical report made a week before the teenager died judged that absconding, suicide and deliberate self-harm were not “current risks” in Pip’s case. Janet Walsh, a consultant adolescent psychiatrist who was in charge of her care at the Priory, told the inquest that 40% of people with the teenager’s condition relapsed.

“She would still have risks with eating habits and exercise, it’s whether they could be managed,” she said. “There are going to be ongoing issues. You don’t get a young person at discharge without significant problems.

“It is about whether you can get a young person to a stage where it is reasonable to do a trial at home. I was concerned she might end up back in hospital, but it is an important learning process. My fears were about long-term hospitalisation. She had been in a long, long time and she was getting frustrated.”

The jury in Stockport decided that the decision to send Pip home had been appropriate, “as this was deemed to be the lowest risk option”. The jury foreman said: “The planning for discharge was not carried out in a timely manner. This resulted in not all necessary support packages being in place at the time of discharge.”

The jury also concluded that Pip’s parents had not been adequately warned of “the statistically increased risk of suicide in the first week following discharge”.

Pip was formally diagnosed with anorexia at 13, before a deterioration in her mental and physical health led her to be detained by the private hospital in Altrincham in September 2014 under section 3 of the Mental Health Act. When she arrived at the facility she weighed 27kg (4st 3lbs), which Dr Walsh said was “probably the most severe case” she had seen.

Responding to the inquest verdict, Paula Stanford, director of the Priory hospital in Altrincham, said: “Our heartfelt sympathies are with Pip’s family and we will now carefully consider the findings of the jury.”

Deborah Coles, director of the charity Inquest, said Pip’s death had exposed serious failings in the mental health system in relation to the discharge of a highly vulnerable child. “Her terrified family knew there was huge risk,” she said.

• In the UK, the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. Hotlines in other countries can be found here

Mother of anorexic girl killed by train criticises care failings after inquest

Surrey students offered meningitis B jab after undergraduate"s death

Students living on campus at the University of Surrey are being offered the meningitis B vaccine after a student died and two others were taken to hospital with the bug.

John Igboanugo, a first-year physics undergraduate, died earlier this month following a sports trip to Rimini in Italy.

Two other Surrey students also fell ill with meningitis but have now been discharged from hospital.

Public Health England (PHE) said laboratory reports had confirmed two of the students had meningitis B while the third was thought to have contracted the B strain of the bug as well.

About 4,200 full-time students living in halls on the Guildford campus – around a third of the total student population – are now being offered the jab to protect against meningitis B.

The vaccine is normally only routinely given on the NHS to young babies.

Prof Max Lu, vice-chancellor of the University of Surrey, said: “We are greatly saddened by the death of our student, and our hearts go out to his family and friends during what continues to be a very difficult time.

“The health and wellbeing of everyone on campus is of the utmost importance.

“We are working closely with PHE on a targeted vaccination programme and are reassured that the risk to staff, students and visitors is still very low.”

Prof Kamila Hawthorne, associate dean for medicine at the University of Surrey, added: “We appreciate that when cases of meningitis B occur there is increased concern about the potential spread, but evidence shows that meningococcal infection is not highly contagious, comparatively rare and the risk to the wider community remains very low.

“Only people who have prolonged, close contact with an ill person are at a slightly increased risk of becoming unwell.

“If anyone is in any doubt or concerned about their health, or the health of others, please call NHS 111 urgently.”

The university said there was no direct link between the three cases.

The two students who were taken to hospital had not been on the sports trip to Italy.

PHE said passengers on the coach trip had been offered antibiotics as a precaution.

It said the wider population in the town and non-students who visited but did not live on the university campus were not considered to be within the at-risk group.

Dr Peter English, consultant in communicable disease control from PHE in the south-east of England, said: “Meningococcal infection is comparatively rare and the risk of transmission is relatively low.

“People who have prolonged, close contact with an ill person are at a slightly increased risk of becoming unwell in the following days.

“This is why immediate contacts of the cases have already been offered antibiotics as a precautionary measure.

“After considering the medical evidence, we have decided to offer vaccination to around 4,200 students living in halls of residence at the university to reduce risk of further cases next term.

“I would like to reassure other students, teachers, their families and the local community that the risk of catching this infection remains very low, and any higher risk is confined to those being offered the vaccine.”

Students are regularly offered a vaccine against other strains of meningitis, known as the Men ACWY jab.

Meningitis can develop rapidly and is sometimes mistaken for flu. Those who survive can be left with life-changing disabilities.

Symptoms include a high temperature, feeling or being sick, exhaustion and irritability, a headache and aching joints, stiff neck and dislike of bright lights, confusion and a rash.

Surrey students offered meningitis B jab after undergraduate"s death

Britons could lose health cover in Europe after Brexit, report warns

Millions of Britons could have their access to free health insurance taken away after Brexit, a parliamentary report has said.

MPs on the health select committee urged the government to offer more guarantees for Britons visiting the continent after hearing evidence that without the right to receive treatment in countries that are part of the European Economic Area, people with cancer could find it too expensive to go to Europe.

In a strongly worded report on the effect of Brexit on health and social care, the committee said the challenges created by losing reciprocal health arrangements should not be underestimated.

British travellers can currently use the European health insurance card, which guarantees access to healthcare free or at a reduced cost in Europe. The EU member state providing treatment is able to claim back costs from the patient’s home country. Some estimates suggest that up to 27 million Britons have the cards.

The inquiry heard evidence that losing this agreement could create challenges for many travellers, including disabled people and those with mental or physical health conditions. Prof Martin McKee of the London School of Hygiene and Tropical Medicine said a week’s full private health insurance for a holiday in France for someone with diabetes or mild depression would cost between £800 and £2,500.

The report also noted that hundreds of thousands of expats living abroad could lose reciprocal healthcare rights, leaving some facing hardship. McKee, a professor of European public health, said many Britons in Spain have properties that are now worth little. “Many will come back in a state of poverty because they bought properties in Andalusia and other places … They will be throwing themselves on the mercy of the state when they come back,” he said.

Christopher Chantery, a British resident in France, told the committee many pensioners moved to the country “in good faith on the implicit promise that these arrangements would continue. Suddenly, something happens that brings those arrangements to an end. It is absolutely terrible for many people”.

British nationals living abroad have to get an S1 form, which gives them health cover, paid for by the UK, within Europe.

The committee, which includes Labour and Conservative MPs, called on the government to preserve the existing system as opposed to seeking a new arrangement. What was currently in place offered taxpayers good value for money, it said.

In the same report, the committee warned that the Brexit vote could lead to a brain drain, with morale among EU nationals in the NHS low due to uncertainty about their future. It called for more reassurances and said the government should continue to be able to recruit the “brightest and best from all parts of the globe” after Britain leaves the EU.

The Department of Health could not comment due to general election purdah rules. But when asked about reciprocal healthcare at the start of the year, the health secretary, Jeremy Hunt, said it was one of the rights of those who retired to Spain or France and he wanted to secure it early on in negotiations, but could not guarantee this.

Speaking to the Guardian, Prof Jean McHale, the director of the Centre for Health Law, Science and Policy at the University of Birmingham, said: “If questions of healthcare provision and patient mobility are not included in the negotiations, if there is not a transitional period and we move to hard Brexit, there will be major practical questions. What happens at midnight on Brexit D day to the person in hospital in another EU member state who has been in a car accident?”

Britons could lose health cover in Europe after Brexit, report warns

Backlash after report claims saturated fats do not increase heart risk

Saturated fat does not increase the risk of a heart attack by clogging up arteries, three cardiologists have said in a challenge to medical thinking, sparking a furious backlash.

In an editorial published in the British Journal of Sports Medicine the cardiologists also write that relying on foodstuffs marketed as “low fat” or “proved to lower cholesterol” to avoid heart disease is “misguided”.

A key previous research study, they say, “showed no association between saturated fat consumption and all-cause mortality, coronary heart disease, CHD mortality, ischaemic stroke or type-2 diabetes in healthy adults”. Instead they say that a Mediterranean-style diet and 22 minutes of walking a day are the best ways to prevent heart problems.

The paper co-authored by Pascal Meier, a cardiologist at University College London and editor of the journal BMJ Open Heart; Rita Redberg, the editor of the American journal JAMA Internal Medicine; and Aseem Malhotra, a cardiologist at the NHS’s Lister hospital in Stevenage, has triggered furious criticism from a range of experts in cardiology and evidence-based medicine. Some said the views were not based on reliable evidence and would mislead consumers and further confuse the public over which foods they should eat and which they should avoid.

They also dismiss the potential for a smaller intake of saturated fats to help prevent heart disease. “There is no benefit from reduced fat, including saturated fat, on myocardial infarction [heart attacks], cardiovascular or all-cause mortality,” they say.

Instead of adopting a low-fat diet, people seeking to cut their risk of heart problems should instead follow “an energy-unrestricted Mediterranean diet (41%) fat supplemented with at least four tablespoons of extra virgin olive oil or a handful of nuts”.

But critics responded by accusing the co-authors of naiveté, ignoring evidence which contradicts their theories and simplifying a hugely complex issue.

Dr Amitava Banrejee, a senior clinical lecturer in clinical data science and honorary consultant cardiologist at UCL, said: “Unfortunately the authors have reported evidence simplistically and selectively. They failed to cite a rigorous Cochrane systematic review which concluded that cutting down dietary saturated fat was associated with a 17% reduction in cardiovascular events, including CHD, on the basis of 15 randomised trials.”

Dr Gavin Sandercock, director of research at Essex University, rejected the trio’s claims about the benefit of “replacing refined carbohydrates with healthy high fat foods” as not true and not based on any existing evidence. “We must continue to research the complex links between fat, cholesterol and heart disease but we must not replace one myth with another”, Sandercock said.

Christine Williams, professor of human nutrition at Reading University, said the cardiologists’ dietary advice was impractical, especially for poorer people. “The nature of their public health advice appears to be one of ‘let them eat nuts and olive oil’ with no consideration of how this might be successfully achieved in the UK general population and in people of different ages, socioeconomic backgrounds or dietary preferences,” she said.

However, some experts did back the authors. Dr Mary Hannon-Fletcher, head of the school of health sciences at Ulster University, hailed their views as “the best dietary and exercise advice I have read in recent years. Walking 22 minutes a day and eating real food. This is an excellent public health message.

“The modern idea of a healthy diet where we eat low-fat and low-calorie foods is simply not a healthy option. All of these foods have been so altered they are anything but healthy. So eating real foods in moderation and exercising daily is the answer to keeping fit and healthy; it’s just too simple a message for the public to take on board,” she said.

Gaynor Bussell, a dietitician and member of the British Dietetic Association, also offered the authors qualified support. “Many of us now feel that a predominantly Med-style diet can be healthy with slightly more fats and fewer carbs, provided the fats are ‘good’ – such as in olive oil, nuts or avocados,” she said.

However, saturated fats should comprise no more than 11% of anyone’s food intake, she said – far less than the 41% fat level backed by the co-authors.

While carbohydrates should still be part of every meal, people should routinely consume high fibre or wholegrain versions, Bussell said.

Williams also accused the BJSM of publishing opinions seeking to portray saturated fats as “innocent” in the causation of heart disease in order to generate headlines. “Some would argue the journals have a very credible business model based on attracting controversy in an area of great importance to public health where clarity, not confusion, is required,” she said.

Backlash after report claims saturated fats do not increase heart risk

Government tries to shelve pollution action plan until after election

The government has made a last-minute application to the high court to delay the publication of its plan to tackle the air pollution crisis.

Ministers were under a court direction to produce tougher draft measures to tackle illegal levels of nitrogen dioxide pollution, which is largely caused by diesel traffic, by 4pm on Monday. The government’s original plans had been dismissed by judges as so poor as to be unlawful.

But following the announcement by Theresa May of a general election on 8 June, ministers lodged a lengthy application to the court late on Friday. It is understood they are asking judges to allow them to breach Monday’s deadline and submit a draft in June – after the general election.

It is understood that a full policy will not be produced until September this year.

The government has had months to come up with its air quality plans and Whitehall sources indicated to the Guardian this week they would be published in time.

The late application to delay publication was condemned by the environmental lawyers group ClientEarth, which successfully took the government to court over its air quality plans. MPs have said air pollution in the UK is a public health emergency that causes 40,000 premature deaths a year.

James Thornton, CEO of ClientEarth, said: “We are urgently considering the government’s application to delay the publication of the draft air quality plan which was received on Friday evening, less than one working day before the plans are due.

“It is far from acceptable that ministers have left this to the very last minute. The government proposes to delay the publication of the air quality plan despite the clear public health risk caused by illegal air quality. These plans are essential to safeguard public health and they should be put in place without delay.”

The application is likely to be considered by judges on Monday. Judges have already told ministers that their plans were taking too long and imposed the deadline to force the government to come up with new measures more quickly.

The government lodged a lengthy application shortly before 7pm on Friday to the court, which was too late for the court to accept. It will now be considered early next week.

Thornton said the general election was not an acceptable reason to delay taking action against air pollution.

“This is not a political issue but a public health issue. Whichever party is in power, the British public need to see an air quality plan which relies on good scientific evidence and which ensures that people no longer have to breathe toxic air and suffer the grave consequences to their health as a result,” he said.

Greenpeace also condemned the delaying tactics. Anna Jones, from Greenpeace UK said: “Ministers have had months to come up with a robust plan to tackle illegal air pollution. They have no excuses to delay its publication any further.

“The Cabinet Office guidance makes it clear that essential consultations can still be launched during purdah, and even mentions safeguarding public health as a ground for exceptions.

“Air pollution is a full-blown public health emergency, linked to thousands of premature deaths and a host of health problems. If the government intends to use the election as a pretext to buy more time, that would only be a sign that they just don’t get the gravity of the situation.”

A joint Guardian/Greenpeace investigation revealed this month that hundreds of thousands of children were being educated within 150 metres of a road where levels of nitrogen dioxide from diesel traffic breached legal limits.

A spokesman for the Department for Environment, Food & Rural Affairs said: “We are firmly committed to improving the UK’s air quality and cutting harmful emissions. We are seeking an extension to comply with pre-election propriety rules.”

Government tries to shelve pollution action plan until after election

Health push in Uganda after mystery disease turns out to be "mossy foot"

A public health campaign has been launched in western Uganda after scientists unexpectedly found the region was afflicted by a tropical disease that causes disfigurement and swelling.

The discovery came to light after experts were dispatched to Kamwenge district to investigate an outbreak of lymphatic filariasis, more commonly known as elephantiasis. A team of specialists from the Ugandan ministry of health, the World Health Organization and the Centers for Disease Control and Prevention was surprised to find that the condition causing limbs to swell was in fact podoconiosis, also known as non-filarial elephantiasis. The disease was previously unknown in the region.

Unlike lymphatic elephantiasis, which is contracted when a parasitic worm is transmitted to humans by mosquitoes, podoconiosis – also known as “mossy foot” because it causes moss-like warts called hyperkeratotic papilloma – is contracted by walking barefoot on irritant volcanic soils. Blood samples taken by scientists from 52 people tested for lymphatic filariasis found no worms present.

Philip Rosenthal, professor of medicine at the University of California, San Francisco, and editor of the American Journal of Tropical Medicine and Hygiene, which published the findings this month, said: “The study was pioneering in discovering that this syndrome was causing serious morbidity in a part of the world where previously we had no idea that podoconiosis existed. The real key is preventing this in future generations.”

Podoconiosis, a progressive, non-infectious disease with symptoms that include itching, foot pain and swelling, can lay undetected for decades, but is treatable.

Dr Christine Kihembo, a senior field epidemiologist with the Ugandan health ministry and the study’s lead author, said many patients had probably been “suffering silently without help for more than 30 years”.

Kihembo said Kamwenge district was forested until the 1960s, when migrants looking for farmland began tilling the soil. Early symptoms of the disease went undetected because it was never documented in western Uganda.

She said patients may not have associated initial symptoms with soil contact, and that “there was a tendency among those affected to stay at home with their disability and not go to a health facility”.

Gail Davey, professor of global health epidemiology at Brighton and Sussex Medical School and founder of the NGO Footwork, said it was unsurprising the disease had gone unnoticed for decades because it is the very poorest areas that are affected.

Podoconiosis affects an estimated 4 million people globally and is found in the highland areas of Africa, Latin America and south-east Asia.

It is caused by an inflammatory reaction to minerals in volcanic soils. On contact, the minerals penetrate the skin, causing severe itching and pain. They are taken up by white blood cells, triggering inflammation that produces a thickening of scar tissue, causing swelling and ulcerated sores in the lower limbs. Typically, both lower limbs are affected. Unlike parasitic elephantiasis, it rarely affects the genitals.

Many people avoid sufferers because they believe the disease to be infectious. Davey said the disease is “highly stigmatised, probably more so than leprosy”, with sufferers often hidden away in communities, where it is seen as a curse.

Boys work barefoot on a subsistence farm field in Sodo Wolaita, Ethiopia, where podoconiosis has also been found. Photograph: Jake Lyell/Alamy Stock Photo

Sufferers’ inability to work leads to a reduced income, which has a detrimental effect on mental health. Many victims experience depression.

The discovery of podoconiosis in the region has prompted a public health education campaign to highlight the importance of foot hygiene, and Footwork has trained local health workers to treat the condition.

Davey recalls a man she met at a clinic whose marriage ended because the disease left him unable to look after his farm: “He no longer saw his children because they thought it brought shame to the household. For him, just to hear that the condition can be treated was a bit of a light-bulb moment”.

“It is reversible – even the late stages can be improved enormously with careful hygiene and bandaging, and shoes and socks to protect.”

Podoconiosis will be among the neglected tropical diseases discussed at a summit in Geneva this week. Attendees will discuss the development of a global atlas of podoconiosis, which will map the global geography of the disease and inform efforts to eradicate it.

“We believe we can eliminate podoconiosis in our lifetime,” said Wendy Santis, Footwork’s executive director. “We know the cause and how to treat it. Now our most urgent need is for funding so that we can target our efforts to have the greatest impact.”

Health push in Uganda after mystery disease turns out to be "mossy foot"

Italy experiencing measles epidemic after fall-off in vaccinations

Italy has announced that it is experiencing a measles epidemic following a fall-off in vaccinations, as the United States issued a warning to visitors about the outbreak of the potentially fatal disease.

The Italian health ministry said on Wednesday there had been almost 1,500 registered cases of measles so far this year against some 840 in all of 2016 and some 250 in 2015.

“Italy and Romania have an epidemic at the moment,” said Walter Ricciardi, president of the Higher Health Institute, adding that he understood why the US Centers for Disease Control and Prevention issued an advisory this week.

Ricciardi told Radio 24 that unlike in Italy, the United States had launched a large campaign to convince parents to vaccinate their children.

The Higher Health Institute says only around 85% of two-year-olds are being vaccinated against measles at present, well below the 95% threshold recommended by the World Health Organisation to block the illness.

The centre-left government has accused the anti-establishment Five Star Movement (M5S) of spreading concern among parents by questioning the safety of some vaccines and by loudly denouncing efforts to make vaccinations mandatory.

“Vaccinations have played a vital role in eradicating terrible illnesses … but nonetheless, they bring a risk associated with side-effects,” the M5S founder Beppe Grillo wrote in 2015, saying mandatory vaccination represented a gift for multinational pharmaceutical firms.

A leading M5S politician, Andrea Cecconi, suggested last month that the jump in measles cases might be part of a natural cycle for the illness rather than a preventable epidemic.

Renewed concern over measles came amid fury among doctors over a programme on the state broadcaster RAI that highlighted the possible side-effects of the human papillomavirus (HPV) vaccine, which protects against cervical cancer.

The M5S defended the report, but health officials accused RAI of being unnecessarily alarmist.

“It is very serious that a TV programme, which is supposed to be at the service of citizens, spreads fear by telling lies and giving credence to the anti-vaccine lobby,” said Giuseppe Mele, chairman of the Italian Society of Paediatricians.

Italy experiencing measles epidemic after fall-off in vaccinations

Healthcare for Americans with mental illnesses worsened after recession

Six years after the recession, Americans with mental illness still had limited access to treatment, according to researchers.

US laws meant to improve that access, including the Affordable Care Act (ACA), were unable to overcome the crippling financial impact of the recession on the millions of Americans seeking care, according to a study published Monday in the journal Psychiatric Services.

“The study creates this picture of people who may have been marginally functioning, who were pushed over the edge and they just couldn’t get back: they couldn’t get jobs, they couldn’t back to the life they had before,” said Judith Weissman, the study’s lead investigator.

More than 8.3 million people have serious psychological distress (SPD), which indicates a person is likely to have a mental health problem that interferes with their life.

In 2014, the year the ACA was fully implemented, 9.5% of Americans with SPD did not have access to health insurance that could connect them with a counselor or psychiatrist, a small rise from 2006, when 9% of the population reported the same thing, according to the study.

Weissman, a research manager at New York University’s Langone medical center, said this population was worse off in 2014 than it was in 2006 when it comes to healthcare utilization, which is measured by things including an inability to get needed prescription drugs or delays in accessing treatment. “There is something very broken about the way we provide mental healthcare in the country,” she said.

Patterns in access to care between 2006 and 2014 were similar among adults with and without SPD. Both groups experienced a steep rise in lack of health coverage after the recession in 2008 and experienced a return to 2006 coverage levels in 2014.

But from 2006 to 2014, adults with SPD who could not afford medication continued to increase, which the study said “suggests they may not have had as complete an economic recovery as adults without SPD”.

Weissman said that while this early analysis suggests the mental health system has failed to bounce back from the economic recession, people are using available healthcare at increasing rates because of changes made under Obamacare. “I think that what we’re seeing now is that – really, likely the impact of the recession on people with mental illness,” Weissman said.

She was one of several researchers at Langone to conduct the analysis, which took four years to complete and is thought to be the first of its kind in more than a decade.

Their study provides a conservative estimate of mental healthcare access and utilization because it does not include the homeless population. In January 2016, one in five people experiencing homelessness had a serious mental illness, according to the Substance Abuse and Mental Health Services Administration.

John Snook, executive director of the Treatment Advocacy Center, a mental health advocacy organization, said he hopes the benefit of the ACA and other laws that expanded mental healthcare access will show up “more robustly” in future studies.

“What you hear from families all the time is it is still a really difficult process to get mental illness treatment – even in states that have expanded Medicaid,” he said. “There may be only one psychiatrist that’s available; she may be an hour and half away.”

He said this analysis provides data that the group has been seeking – and pushing policymakers to collect – for years, to support things the group has observed anecdotally.

Snook said: “As we get better and better data, what we are overwhelmingly finding is that we are doing a terrible job of prioritizing their care and we, as a result, are costing ourselves a huge amount of money and not benefitting this population.”

Healthcare for Americans with mental illnesses worsened after recession

BBC antiques expert died after "postpartum" psychotic episode

A jewellery expert from Antiques Roadshow died days after being restrained by five paramedics and police officers following suspected postpartum psychosis, an inquest has heard.

The psychotic episode that struck Alice Gibson-Watt, 34, resulted in delusions so severe she believed her five-week-old baby was communicating with her telepathically.

The inquest at west London coroner’s court that began on Tuesday will determine whether the way Gibson-Watt was restrained while being taken to hospital injured her.

Gibson-Watt was a jewellery expert at Sotheby’s who had appeared on the BBC1 antiques show. Her husband Anthony described to the court the “deeply traumatic” events of 13 November 2012, when his wife began crawling on the floor and screaming that her daughter had died, despite her being alive.

She had given birth to Chiara, her first child, the previous month and was thought to be suffering from postpartum psychosis, which can cause hallucinations, paranoia and delusions. The condition affects about one in 1,000 mothers.

PC Sue Thomson was one of those who helped to restrain Gibson-Watt in the ambulance that attended the couple’s home in Fulham, west London.

The officer said in evidence on Wednesday that Gibson-Watt, who had been strapped down with restraints across her chest and legs, was screaming so loudly that talking to the paramedic was difficult.

“She was thrashing from side to side and I was worried she could harm herself or those trying to help her,” Thomson said. She joined other personnel in the ambulance to help restrain Gibson-Watt, along with her mother Miranda Phillimore.

At one point Thomson said it appeared Gibson-Watt was “trying to bite out at someone’s arms”. After arriving at accident and emergency at Chelsea and Westminster hospital, she was given a sedative that calmed her.

Thomson said she then had a “normal conversation” with Gibson-Watt before she told her “she could hear the baby speaking to her and it was saying to her that it was dead”.

Consultant psychiatrist Dr Miriam Barrett, of the North West London mental health trust, told the inquest on Wednesday that in a meeting with Gibson-Watt at 6am on 14 November she “appeared quite rational and normal, but underneath she was showing in her thinking there were delusions”.

“She was convinced that she was communicating with her baby and the baby could communicate with her,” Barrett said. “The baby was part of her delusions and that is where the risk arose.”

She said during the meeting there was no sign Gibson-Watt was in pain or discomfort from any possible injury to the abdomen.

PC Thomson told the court that at no time did she see anyone touch the patient’s chest or abdomen. She had used “calm, even pressure on the shoulders and knees” to restrain her.

Other officers who gave evidence also said they did not see any of those restraining Gibson-Watt touching her chest or abdomen, or touching her in a way that could harm her or injure her liver.

After being assessed at A&E, Gibson-Watt was taken to a mental health unit at west Middlesex university hospital in Isleworth. There she suffered a cardiac arrest and it was then decided she required urgent surgery after a tear was found on her liver that had caused serious internal bleeding.

Gibson-Watt was transferred to an intensive care unit at Kings College hospital in south London, where she died on 20 November 2012.

The inquest is expected to continue until late April.

BBC antiques expert died after "postpartum" psychotic episode

NHS recruits must be given special status after Brexit, MPs urge

The government is under intense cross-party pressure to guarantee that EU nationals will still be able to work in the NHS, as concern grows that Brexit will cause a critical shortage of nurses and doctors.

Tory, Labour and Liberal Democrat MPs said ministers must not only guarantee that EU staff already working in the NHS can stay, but also that recruitment from EU countries can continue.

The calls for NHS workers from the EU to be given special status as Britain heads towards Brexit were echoed by former Tory health minister Dr Dan Poulter, who now combines his role as an MP with work as an NHS psychiatrist. Poulter told the Observer that unless action were to be taken on both fronts – to reassure those already here and to ensure a future flow from the EU – services to patients would be soon be seriously affected.

“The NHS is heavily reliant on the contributions made by many dedicated EU healthcare professionals, and without them, our health and care system simply wouldn’t be able to cope,” Poulter said.

“Protecting the rights of EU nationals to continue to live in the UK and care for patients is essential, but it is also important that we look after the best interests of the patients of tomorrow. Having the right work visa rules to ensure that in future, healthcare professionals from within the EU can continue to contribute to the NHS and care for patients, must be a priority.”

Poulter said he knew of many colleagues from EU countries who were concerned and of two fellow doctors who were planning to return to Spain by the end of the year. Fears that there could be a mass exodus from the NHS are growing as evidence mounts that EU nationals are already beginning to leave. Some 17,197 EU staff, including nurses and doctors, left their posts last year, compared with 11,222 for 11 months in 2014.

Merkel calls on all sides to protect everyday lives of EU citizens in UK – video

The supply of doctors is already a serious worry. A total of 10,363 – nearly 10% – of those working in England’s NHS Hospital and Community Health Services (HCHS) last year were from other member states.

Labour’s health spokesman, Jon Ashworth, highlighted NHS data showing that there are 22,081 EU nationals working as nurses in an NHS which is struggling to fill 26,000 vacancies.

Ashworth said: “This NHS crisis will be compounded if the 140,000 EU nationals working in the NHS and social care sector walk away. It’s time for an ‘NHS guarantee’ for these workers ensuring their rights – offering these workers who care for our sick and elderly the certainty that they deserve.

“What’s more, we need urgent guarantees that the NHS will be able to continue recruiting from the EU as it currently does. Yet we have no clarity whatsoever from the prime minister. Will health professionals from the EU be able to come to work in the UK after Brexit, will there be a cap on their numbers? The government need to tell us their plans and quickly.”

The Liberal Democrats are also demanding that the government grant an urgent “NHS passport” to every EU citizen working in our health service to encourage them to stay.

Theresa May has so far refused to guarantee that EU nationals will be allowed to stay after Britain leaves the EU. The prime minister reiterated last week when article 50 was triggered that she would not do so unless the rights of UK citizens living in other EU states were also guaranteed.

A total of 2,348 doctors from the 27 other EU states left NHS England between July and September 2016 compared with 1,281 in the same period in 2015. That is a rise of 83%.

There were also warnings yesterday that a potential exodus of EU workers could hit other sectors. A spokesman for the CBI said: “Since the referendum, we have heard from members in sectors who depend on EU workers to fill local shortages that they are having difficulties filling.”

As the growing season approaches for ​Britain’s £3bn horticulture industry, recruiters warned that it would be hit particularly hard by staff shortages. The head of the largest Romanian employment agency for temporary workers in the UK called on the Brexit secretary, David Davis, to be clear that EU workers still enjoyed the same rights.

“There was a lot of talk about restricting the rights of Romanians on the day article 50 was triggered but that did not happen in the end. For the next two years of negotiations there should be clear messages​,”​ said Alexandru Barbacaru​ of Est-Vest Services​​.

NHS recruits must be given special status after Brexit, MPs urge

NHS to fast-track nurses as record EU staff leave service after Brexit vote

NHS England is to launch a new nursing training programme to help plug the gap created by the record number of Europeans leaving the service in the wake of Britain’s vote to leave the European Union.

Simon Stevens, the chief executive of NHS England, acknowledged that the service relies on international staff, including more than 12,000 nurses who are EU nationals out of the 315,000 nurses on its payroll.

Speaking on the BBC Radio 4’s Today programme before the launch of a five-year plan for the NHS, he announced a training programme to “grow the workforce from within this country”.

The moves comes after new figures revealed that a record 17,197 EU nationals, including doctors and nurses, left the NHS last year.

Asked if he was worried about the impact of Brexit, Stevens said: “The NHS has always relied on international staff as well as staff from this country. It is about 4% of our nurses who come from the rest of the European Union. We are grateful for the work that they do.”

But he suggested newly trained British nurses could help fill the gap left by EU nationals once Britain leaves the bloc.

Stevens said: “We have got a curious situation where many more people in this country would like to train to be nurses than we have nurse training places. So we want to expand the number of nurse training places and the routes into nursing so that we can grow the work force from within this country as well.”

He said the new training programme would be modelled on an initiative to recruit more teachers.

“We are announcing a new programme called Nurse First, which is the equivalent of the Teach First programme, whereby new graduates can fast-track into nursing alongside other apprenticeship routes … so that we can expand the number of nurses we have.”

The programme will boost the number of newly qualified nurses by up to 2,200 more a year in 2019 when the UK is due to leave the EU.

In a wide-ranging interview, Stevens denied he was abandoning the 18-week waiting time target for non-urgent operations by relaxing the deadline for hospitals to meet the deadline.

He said: “Fifteen years ago you might be waiting 18 months for your hip or your knee operation, now for nine out of 10 people it’s 18 weeks. The average wait for an operation is 10 weeks. Over the next couple of years we want to have more funded operations on the NHS, but we recognise that the rate of growth is probably going to have to be a little bit slower than it has at points in the past, because we also want to make big improvements in cancer care, in GP services and in mental health services as well.”

The Royal College of Surgeons said the new guidelines amounted to “waving the white flag on the 18-week target”.

Asked if the target had been jettisoned, Stevens said: “It hasn’t. The reality is that there are pressures right across the health service. Under those circumstances we have to make a start on sorting out particularly those pressures in A&E departments which we have seen over the course of the last winter. But over the course of the next several years we want to continue to expand the amount of surgery that is being done, so that waiting times stay low.”

He also announced that all major A&E hospital departments will have to provide GP services to help emergency medics focus on the sickest patients. Steven said: “You can find about 60 hospitals right now that have got this arrangement. This is going to be rolled out to all major A&Es.”

Stevens confirmed that the NHS wanted to stamp out an estimated £4m spent on homeopathic medicine. He dismissed homeopathy as a “placebo at best” and said it was a “classic example of what we want to see less of”.

NHS to fast-track nurses as record EU staff leave service after Brexit vote

Joanna Cannon vows to keep working in NHS after £300,000 book deal

A bestselling debut novelist who wrote her book in a hospital car park as stress release from her job as a psychiatrist is to return to the NHS. Her decision comes despite a £300,000 deal for her second book and a contract for two more novels.

Joanna Cannon, whose first book The Trouble With Goats and Sheep has now sold more than 100,000 copies in paperback in the UK and has been optioned for film by the makers of the Amy Winehouse documentary Amy, said she was returning to the health service because she missed her patients.

“I am hoping to go back in a voluntary capacity, helping patients understand their own narrative,” she said. Cannon will work with Arts for Health, a programme run by South Staffordshire Healthcare Foundation, which brings the arts into hospital for patients.

“I made the choice to do this over the last few months after talking with consultants,” the author added. “The most valuable time I had working in wards was spent with patients, and because you can’t work part-time as a [hospital] psychiatrist, this is the perfect solution.”

Cannon’s decision emerged as it was announced that she had signed a deal for two further books with her publisher, the Borough Press, part of HarperCollins. Although she said it was “too early” to discuss books three and four, she revealed that her second would be called Three Things About Elsie. Published in January 2018, it will be about growing old and how elderly people are treated in society.

Real voices … Cannon will help NHS patients ‘understand their own narrative’. Photograph: Peter Byrne/PA

The author began her first novel after finding work on the wards stressful. Having left school at 15 with one GCSE, she went to university in her 30s and qualified as a doctor in her 40s. Inspiration for The Trouble With Goats and Sheep came from the way she saw society treat patients, as well as the case of Christopher Jefferies, a Bristol landlord who was hounded by the press and falsely implicated in the murder of his tenant Joanna Yeates in 2010.

“Working in psychiatry you meet a lot of patients who live at the edge of society, who are not listened to or even noticed unless something goes wrong,” the author said. “There is that prejudice about how people appear, and I wanted to say we are all a little bit different; it’s just that most of us are very good at hiding it.”

The writer, who lives in the Peak District, became a sensation in 2016 after she entered an X Factor-style writing competition at York festival that led to offers of representation by seven agents and a lucrative book deal for her debut.

The decision to divide her time between writing and working in the NHS was motivated, she said, by her love of the service and because she felt it would provide a balance to the “insularity” of the book world. “Anyone who writes needs to get out there and hear real voices,” she added.

While dealing with her newfound literary fame, Cannon admitted she had found it “distressing” to be away from the wards. “Someone said to me at an event that I used to write to relieve the stress of work,” she added. “Now that writing books brings its own stress, I need to go back to the wards.”

Joanna Cannon vows to keep working in NHS after £300,000 book deal

Stem cells help some men with erectile dysfunction after prostate surgery

Men unable to have an erection after prostate surgery enjoyed normal intercourse thanks to stem cell therapy, scientists are to report on Saturday at a medical conference in London.

In first-phase clinical trials, eight out of 15 continent men suffering from erectile dysfunction had sex six months after the one-time treatment, without recourse to drugs or penile implants.

The positive result showed no signs of flagging during a subsequent year-long monitoring period. “As far as we know, this is the first time that a human study with a 12-month follow up shows that the treatment is lasting and safe,” said Lars Lund, a professor at Odense University hospital in Denmark, who took part in the trials.

“That is much better than taking a pill every time you want to have intercourse,” he said.

The results were promising enough to convince Danish health authorities to authorise so-called phase III “double-blind” randomised trials in which one group of men is given stem cell therapy and another placebos.

Only men recovering from prostate cancer and able to control their bladders will be enrolled in the new experiments, Lund explained.

To perform the procedure, doctors remove fat cells from a patient’s abdomen via liposuction. The cells undergo a brief treatment and emerge as all-purpose stem cells, meaning they can mutate into almost any specialised cell in the body.

“We do not cultivate the cells or change them in any way,” said Lund’s colleague Martha Haahr, head researcher and lead author of a study detailing preliminary results, published last year in EBioMedicine.

The stem cells are then injected with a syringe into the penis, where they spontaneously begin to change in to nerve and muscle cells, as well as the endothelial cells that line blood vessels. Men are under general anaesthesia while all of this happens, and are discharged from hospital the same day.

Prostate surgery is responsible for about 13% of erectile dysfunction cases. Up to 80% of men experience difficulty having sex immediately after an operation, previous research has shown.

Diabetes accounts for 40% of erectile dysfunction cases, and vascular disease another 30%. Men with diabetes would be the next target group for clinical trials, Lund said.

The results reported at the European Association of Urology conference could be an effective “therapeutic option for patients suffering erectile dysfunction from other causes,” Haahr said.

It is estimated that nearly half of men between the ages of 40 and 70 experience erectile dysfunction to some degree.

The global market for drugs treating the disorder is expected to top $ 3.4 billion by 2019.

Failure to perform sexually can also, in some men, result from relationship problems, performance anxiety or repressed homosexuality, Haahr said.

Stem cells help some men with erectile dysfunction after prostate surgery

Less than half of women breastfeed after two months, survey finds

Almost three-quarters of women in England start breastfeeding after giving birth but less than half are still doing so two months later, according to NHS and Public Health England data.

PHE recommends exclusive breastfeeding for the first six months, as does the World Health Organisation, because it boosts a baby’s ability to fight illness and infection. But a comparison of initial breastfeeding rates and those after six to eight weeks in the final quarter of 2015 found that they were 40% lower for the latter (44% compared with 73%).

A survey of 500 mothers commissioned by PHE found that fears about breastfeeding among women included that it could be painful (74%), prevent them taking medication (71%) and be embarrassing in front of strangers (63%).

The PHE’s chief nurse, Viv Bennett, said:“We can all help women feel comfortable breastfeeding their baby wherever they are. Creating a wider culture of encouragement and support will help make a mother’s experience all the more positive.”

PHE has launched an interactive breastfeeding friend chatbot, accessed through Facebook messenger, to provide personal support for breastfeeding 24 hours a day. Bennett said it would help women through the “crucial” initial period, after which things generally became easier.

A study published in the Lancet last year found the UK had the lowest rate of breastfeeding in the world, with only one in 200 women breastfeeding their children after they reach their first birthday.

The WHO recommends that breastfeeding form part of a baby’s diet up to two years of age. As well as reducing the likelihood of babies getting diarrhoea and respiratory infections, breastfeeding also lowers a mother’s risk of ovarian and breast cancer and burns about 500 calories a day.

The PHE survey found that many women were not only embarrassed about breastfeeding in front of strangers, but also their partner’s family (59%) and around siblings and wider family members (49%).

The results, published on Thursday, suggested high-profile figures who promote breastfeeding can have a positive influence on other mothers. Just under half of respondents said the example of household names such as The Only Way is Essex star Sam Faiers, broadcaster Fearne Cotton and actor Blake Lively, who have recently championed breastfeeding on social media, had inspired them to do so themselves. About two-thirds (64%) said they felt more confident to breastfeed in public because of celebrity mums.

Other concerns raised by more than half of women were not being able to tell if their baby was getting enough or too much milk and that it could potentially place restrictions on the mother.

Jacque Gerrard, the director for England at the Royal College of Midwives, said: “Any initiative that goes towards helping mothers start and sustain breastfeeding for longer is positive as we know the health benefits from being breastfed last a lifetime.”

Less than half of women breastfeed after two months, survey finds

How can I ever work again after the trauma of whistleblowing?

Twice a week we publish problems that will feature in a forthcoming Dear Jeremy advice column in the Saturday Guardian so that readers can offer their own advice and suggestions. We then print the best of your comments alongside Jeremy’s own insights.

Six years ago I was a whistleblower at my workplace. I worked there for three years, but from my first day I noticed daily cover-ups, misuse of position and daily cash fraud.

This was my dream job, at a firm I had looked up to. I was shocked to see what was happening and, for a long time, blamed myself for being too sensitive and thought I was just being paranoid.

At one point the fraud became so serious, and the cover-up so intricate, that I was left with no choice but to report it internally.

I was 100% sure they would find out, correct the situation and give out warnings, and we would move on. But my first report was not taken seriously: they checked out the paperwork I mentioned but overlooked the obvious fraud. They simply dismissed any claims, and the case was closed.

Nothing changed and I decided I would quit as soon as I could. When I made that decision I also decided to become a whistleblower. I thought I had nothing more to lose.

I was very wrong. During the whole whistleblowing experience, I was bullied, snubbed by management as a disgruntled employee and accused of being a “disrespectful colleague”.

I have lost all my hope in humanity. I know it sounds severe, but I really feel this way. I am scared to be employed again, and have been working from home and living off my savings.

How will I ever gain any confidence in the world or in any company? The people I looked up to, those whom I had aspired to be like, have let me down beyond belief. I am a traumatised human who had no other choice but become a whistleblower.

Do you need advice on a work issue? For Jeremy’s and readers’ help, send a brief email to dear.jeremy@theguardian.com. Please note that he is unable to answer questions of a legal nature or to reply personally.

How can I ever work again after the trauma of whistleblowing?

Calls for ibuprofen sale restrictions after study finds cardiac arrest risk

There have been fresh calls for restrictions on the sale of the painkiller ibuprofen after another study found it heightens the risk of cardiac arrest.

Taking the over-the-counter drug was associated with a 31% increased risk, researchers in Denmark found.

Other medicines from the same group of painkillers, known as non-steroidal anti-inflammatory drugs (NSAIDs), presented an even higher risk, according to the findings published on Wednesday in the European Heart Journal.

Diclofenac, available over the counter in the UK until 2015 and still taken on prescription, raised the risk by 50%.

Prof Gunnar Gislason of the University of Copenhagen, who led the study, called for tighter controls on the sale of ibuprofen and other NSAIDs. He said: “Allowing these drugs to be purchased without a prescription, and without any advice or restrictions, sends a message to the public that they must be safe.

“The findings are a stark reminder that NSAIDs are not harmless. Diclofenac and ibuprofen, both commonly used drugs, were associated with significantly increased risk of cardiac arrest.”

The findings are the latest to raise alarm about the use of NSAIDs. Last September a study in British Medical Journal found they were linked to an increased risk of heart failure. Previous studies have linked the drugs to abnormal heart rhythm – which can cause heart failure – and an increased risk of heart attack and stroke if taken regularly.

Gislason urged people with heart problems to avoid ibuprofen and other NSAIDs. “NSAIDs should be used with caution and for a valid indication. They should probably be avoided in patients with cardiovascular disease or many cardiovascular risk factors,” he said.

“I don’t think these drugs should be sold in supermarkets or petrol stations where there is no professional advice on how to use them.”

Gislason suggested they should only be taken after consulting a doctor. “Over-the-counter NSAIDs should only be available at pharmacies, in limited quantities and in low doses,” he said.

He added: “The current message being sent to the public about NSAIDs is wrong. If you can buy these drugs in a convenience store then you probably think: ‘They must be safe for me.’

“Our study adds to the evidence about the adverse cardiovascular effects of NSAIDs and confirms that they should be taken seriously and used only after consulting a healthcare professional.”

The Danish investigators studied data on almost 29,000 patients who suffered an out-of-hospital cardiac arrest recorded in Denmark between 2001 and 2010. They found that use of any NSAID raised the likelihood of cardiac arrest by 31%.

The researchers speculated that the results could be explained by the effect of the drugs on the cardiovascular system, as they influence platelet aggregation and the formation of blood clots. They may also cause arteries to constrict, increase fluid retention and raise blood pressure.

Gislason said people should not take more than 1,200mg of ibuprofen in one day.

The Proprietary Association of Great Britain, the trade body representing manufacturers of over-the-counter medicines said the study had “several limitations,” and insisted that NSAIDs are safe.

John Smith, its chief executive, said: “Information about daily dosage was only based on estimates rather than accurate data and didn’t account for over-the-counter use. Prescribed NSAIDs would normally contain a higher dosage than those medicines available over-the-counter and would typically be used for longer durations.”

He added: “NSAIDs available over-the-counter, such as ibuprofen, are an effective and appropriately safe way to provide short-term pain relief if used in accordance with the clear on-pack instructions and the patient information leaflet inside. NHS Choices recommends NSAIDs to help relieve pain, reduce inflammation, and bring down a temperature.

“It is important for people with a history of heart disease or other long term condition to speak to a pharmacist before taking any over the counter medicine to check for any potential drug interactions or health concerns.”

Calls for ibuprofen sale restrictions after study finds cardiac arrest risk

After my suicide crisis I set up a centre to give others a safety net | Joy Hibbins

It took just minutes for a deeply traumatic experience in March 2012 to fracture my life. I experienced such terror during those moments that I couldn’t sit with my back to a door for weeks. I was convinced that someone would come in and harm me. The event replayed constantly in my mind. I couldn’t escape. I was in the grip of severe post-traumatic stress disorder and within days I was at the point of suicide.

I called my out of hours GP and was referred to a mental health crisis and home treatment team, but I found it hard to connect with the number of different people involved in my care. Their methods were very practical. They would tell me to distract myself when I felt suicidal. But what I wanted was emotional support from a team who knew and understood me as an individual. The clinical distance of psychiatric staff left me feeling detached and alone

On a summer’s day in that year I started to picture in my mind what would have helped me: a suicide crisis centre. It would be a place I could visit every day. If I was at imminent risk of suicide, I could be supported there over a number of hours. The staff would be highly trained, skilled professionals – but they would also be kind, caring and empathic.

In the months that followed I worked tenaciously to make that picture a reality: focusing on setting up the crisis centre gave me a reason to live. There are now 25 of us working there, and we will soon be marking four years of providing services. A high proportion of our clients are men, and this is significant; nationally, three times (pdf) as many men die by suicide as women.

We never set out to achieve zero suicides. That would have been a massive pressure on all of us. We simply set out to do everything that we could for each individual to help them survive. We have never had a suicide of a client under our care.

One of our clients says he carries us in his pocket. He feels that we are always with him

We don’t just provide a static centre for people to visit when they are in crisis. If they are very distressed, they may not be able to get to us, so sometimes we need to go out to them. The combination of an accessible crisis centre, home visits and our emergency phone lines places a safety net around our clients.

The quality of the relationship is so important when you’re supporting someone at risk. We work hard to build a strong connection with our clients. It’s the reason they call our emergency line at 3am, when they might not have called another service. They get through to someone they know and that makes a difference. Clients often say they wouldn’t have called an anonymous service at that point.

If you build a strong connection with clients, it can “hold” them even when you are not with them. One of our clients says he carries us in his pocket. He feels that we are always with him.

I sometimes get asked how I cope with the emotional intensity of the work. Firstly, we get excellent support and supervision from senior staff who are available at very short notice. Secondly, I see such wonderful personal qualities in our clients and that’s a source of optimism. They will go out into the world and affect other people in a positive way. That gives me huge hope for the future.

When I started to talk about my plans back in 2012, people were sceptical. It seemed such an ambitious project for a person who had recently been in crisis. But I knew it had to be set up.

MPs on the Commons health select committee recently asked us to provide evidence about our suicide crisis centre for an inquiry into suicide prevention. Their final report has just been published.

We are contacted by people from all over the country who would like a similar centre in their area. I hope that will be possible. I know how much they are needed.

• Joy Hibbins is founder and director of Suicide Crisis, which runs a suicide crisis centre in Cheltenham, Gloucestershire.

In the UK, the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. Hotlines in other countries can be found here.

Comments on this article will be switched on later. Comments on this article will be pre-moderated and will only be visible after being approved by a moderator.

The day I made a difference is the Guardian Voluntary Sector Network’s series that showcases the work of people involved with charities. If you have a story to share about a landmark moment in your life, email voluntarysectornetwork@theguardian.com.

Talk to us on Twitter via @Gdnvoluntary and join our community for your free fortnightly Guardian Voluntary Sector newsletter, with analysis and opinion sent direct to you on the first and third Thursday of the month.

After my suicide crisis I set up a centre to give others a safety net | Joy Hibbins