Your 12 Worst Allergy Mistakes

You’ve got clutter

Stuffed animals are cute, cuddly, and unfortunately, major magnets for dust, a common allergy trigger.

If your child has piles of fluffy friends, and he or she—or anyone in the household—has allergies, you’re better off storing or giving them away. (Many charities collect stuffed animals to give to needy kids, or even as puppy play toys.)

It’s best to limit youngsters to a select few, which can be occasionally washed, rather than a whole collection, Dr. Rosenstreich says.

Your 12 Worst Allergy Mistakes

Patients suffer worst ever winter for A&E admission delays

Emergency patients had the worst winter on record for being admitted to NHS hospitals in England, with nearly 200,000 waiting at least four hours.

Figures from the health service showed a near five-fold increase in the number of A&E patients suffering admission delays over the past five years.

Between December 2016 and February 2017 a total of 195,764 patients waited at least four hours to be admitted to hospital from A&E, up from 40,791 in 2011/12.

The figure is the highest since records began and marks a sharp rise on the winter months last year when 134,576 patients missed the four-hour target.

Total emergency admissions to NHS hospitals in England rose from 1.3 million in winter 2011/12 to 1.44 million in winter 2016/17.

Extreme waiting times also reached record levels, as 1,877 patients were forced to wait at least 12 hours before being admitted to hospital from A&E this winter, compared with 375 the previous year.

Research suggests hospitals are creaking under the weight of demand. A&E departments had to close their doors to ambulances almost twice as often this winter compared with the previous three years, a report from the Nuffield Trust showed.

The number of ambulance diverts in place at hospitals in England hit 478 for the three-month period from December to February, compared with an average of 249 over the same period in 2013/14, 2014/15 and 2015/16.

The number of days lost to so-called “bed-blockers” also hit record levels in England this winter. A total of 577,195 days were lost through delayed transfers of care from December to February, compared with 471,780 in winter 2015/16.

Patients suffer worst ever winter for A&E admission delays

Welcome to Onitsha: the city with the world’s worst air

Approaching Okpoko market through thick smog on the back of an okada (motorcycle taxi), the natural reaction is to cover your nose to protect yourself from the dust storm – but the effort is futile.

When a lorry zooms past, kicking up yet another red cloud of dirt, a trader turns the head of a sleeping toddler away from the road, a protective act that is as poignant as it is pointless.

This is a typical day in the southern Nigerian port city of Onitsha – which last year gained notoriety when it was ranked the worst city in the world for the staggering levels of PM10 particulate matter in its air.

Onitsha’s mean annual concentration was recorded at 594 micrograms per cubic metre by the World Health Organization – massively exceeding the WHO’s annual guideline limit for PM10s of 20μg/m3.

PM10 refers to coarse dust particles between 10 and 2.5 micrometres in diameter, while PM2.5s are even finer and more dangerous when inhaled, settling deep in a person’s lungs. Sources of both include dust storms, gases emitted by vehicles, all types of combustion, and industrial activities such as cement manufacturing, construction, mining and smelting. Onitsha scores highly on most of the above – as do other rapidly growing Nigerian cities such as Kaduna, Aba and Umuahia, all of which also featured in the WHO’s 20 worst offenders for PM10s.

In Onitsha’s very busy Okpoko market, my air quality monitor registers 140 for PM10s and 70 for PM2.5s – all way over recommended healthy levels, but still nothing compared to the readings triggered in other parts of this densely populated commercial and industrial hub.

The entire vicinity of the market is perpetually dusty, as wood-sellers saw lumber into different shapes and sizes. The air here is made worse by all the fine sand particles that fly off the back of trucks as they visit one of the many dredging companies on the bank of the River Niger, just behind the wood market.

Some residents of Onitsha are unaware of the dangerous levels of pollution. Photograph: Hadassah Egbedi for the Guardian

One female traffic warden has been working in the same spot here for two days. How does she cope with the dust? “I am just doing my job,” she replies reluctantly. “Dust does not kill people.”

But she is mistaken. According to the United Nations Environment Programme (Unep), around 600,000 deaths throughout Africa every year are associated with air pollution, while an October 2016 report by the Organisation for Economic Co-operation and Development (OECD) suggested that polluted air could be killing 712,000 people prematurely every year across the continent.

The warden’s attitude towards this invisible but deadly threat is widespread among Onitsha’s residents – but not necessarily because they are nonchalant about their health. Most are simply unaware of the issue.

Some say they have more pressing concerns, such as how to feed their family. Others have simply become accustomed to living in a dirty and polluted environment.

Onitsha is grossly polluted – not just in terms of the air quality, but also the solid waste that litters the streets, blocking drainages and canals. With not a single waste bin in sight, heaps of unregulated rubbish dumps occupy roadsides and street corners.

Rubbish clogs Onitsha’s streets, drainages and canals. Photograph: Hadassah Egbedi for the Guardian

Ikechukwu Obizue, a businessman in the neighbourhood of Nwangene, says residents can only do so much when there is little corresponding effort by the city’s government.

“Onitsha is quite dirty, but the government is not doing anything about it. We do environmental sanitation monthly, but then the city returns to being dirty,” Obizue says. “It is the government’s responsibility to keep the city clean, not the work of the residents – people in this city are too busy hustling to make an income.”

‘We don’t take air pollution seriously’

In Nwangene, my air monitor shows 667μg/m3 for PM10s – a reading in excess of the 594 annual figure that gave Onitsha its title of the world’s most polluted city. What’s more, the smaller and even more dangerous particulate (PM2.5) reading of 290 is far in excess of the WHO’s annual figure of 66.

We are in deep trouble. People will keep dying as stakeholders remain nonchalant

Nelson Aluya

The air quality proves just as bad at Ochanja market, with PM10s registered at 586 micrograms and PM2.5s at 266. Yet in these highly polluted areas, few people show any sign of trying to protect themselves from the threat.

There are only a few air masks in sight. A good number of aluminium and copper recyclers are not wearing masks, even while smelting metal scraps. Worse still, most smelting activities are done in the open, releasing monstrous clouds of smoke into the core of the city.

At one of the few state-approved dump sites on Creek Road, Ikechuckwu works at a smelting workshop. He is sweating profusely as he sits on a pile of ash, taking a break from work. He explains he has been smelting iron for a little over five years – but says not to worry about his health.

“I know how to take care of myself,” he brags. “I am not wearing a nose mask because I don’t need it. I take medicine to cater for my health.”

Residents conduct a monthly cleanup, but the city quickly fills with waste again. Many locals blame government inaction for the problem. Photograph: Hadassah Egbedi for the Guardian

It is hard to determine to what extent these high concentrations of particles are affecting the residents of Onitsha, since there is no official data – but the health effects attributed to sustained exposure to PMs, especially PM2.5s, are well proven.

For a state government that can barely manage its waste disposal system, however, regulating its air quality appears a far-fetched aspiration. The now defunct Anambra State Environmental Protection Agency was widely criticised for failing in its responsibility to effectively tackle environmental pollution, and in its place, the Anambra State Waste Management Agency was created – with little effect.

The state’s Ministry of Environment, Beautification and Ecology did not respond to the Guardian’s questions regarding air pollution in Onitsha.

“The major problem is that we don’t take air pollution seriously in Nigeria,” says medical practitioner Dr Nelson Aluya. “As the population increases and we become more industrialised, we ought to have active air-monitoring agencies and a federal environmental protection agency. We say they are there – but are they active?”

In truth, air quality monitoring and control is not on the radar of many African governments. Nigeria has a long list of environmental protection laws and regulations that are barely enforced.

“Even in the healthcare sector,” Aluya continues, “there is no standardised care to monitor those who have chronic obstructive pulmonary diseases resulting from exposure to bad air, and no standard procedure in hospitals to check for oxygen levels.

“So you see, we are in deep trouble. If we have not recognised the fact there’s a problem, then how do we solve it? Unfortunately, people will keep dying as stakeholders remain nonchalant.”

Guardian Cities is dedicating a week to investigating one of the worst preventable causes of death around the world: air pollution. Explore our coverage at The Air We Breathe and follow Guardian Cities on Twitter and Facebook to join the discussion

Welcome to Onitsha: the city with the world’s worst air

A&E in England sees worst ever delays in January, leak suggests

A&E patients in England experienced the worst month of delays in January since a four-hour target was introduced 13 years ago, leaked figures suggest.

Provisional data passed to the BBC says an unprecedented number of patients spent longer than the target time waiting to be seen in emergency wards in January.

It showed that more than 60,000 people waited between four and 12 hours for a hospital bed. And more than 780 waited more than 12 hours. Both figures are record highs since the introduction in 2004 of a target that 95% of patients must be seen and either admitted or discharged in under four hours.

The leaked document from NHS Improvement suggests that out of 1.4m visits in January, only 82% were dealt with within the four-hour target.

The NHS Providers chief executive, Chris Hopson, said: “These figures have not been verified and should therefore be treated with caution, but they are in line with the feedback we have been getting from trusts.

“NHS staff have responded magnificently to increased winter pressures, but the situation has become unsustainable. The rise in long trolley waits is particularly worrying, as there is clear evidence they can lead to worse outcomes for patients.”

Hospitals have not hit the target nationally since the summer of 2015.

A Department of Health spokesman said the January data was yet to be verified and that official figures, due out on Thursday morning, only covered December.

He said: “We do not recognise these figures – it is irresponsible to publish unverified data and does a disservice to all NHS staff working tirelessly to provide care around the clock.

“Despite the pressures of winter, the vast majority of patients are seen and treated quickly and hospitals have detailed plans in place to manage busy periods – supported by an extra £400m of funding.”

Dr Mark Porter, chair of the British Medical Association council, said delays in A&E were a symptom of a bigger crisis in social care, which the government was failing to grasp.

“When social care isn’t available, patients experience delays in moving from hospital to appropriate ongoing care settings – preventing patients being admitted at the front end in A&E,” he said.

“The prime minister cannot continue to bury her head in the sand as care continues to worsen.”

A&E in England sees worst ever delays in January, leak suggests

Mario, you crossed into our world at the worst time – it’s no game over here | Emily Reynolds

Mario is coming to a street near you. His latest outing, Super Mario Odyssey, was unveiled in a Nintendo trailer earlier this month, and shows the moustachioed plumber gleefully sprinting around a facsimile of New York, hopping over taxis and scaling skyscrapers. Elsewhere, he swings through dewy forests and slides through realistically animated streams. The angry, sentient plant pots may be slightly less believable, but that’s besides the point – Mario has been plucked from the multicoloured fantasy of the Mushroom Kingdom and dumped into our much less palatable reality.

Unfortunately for him he appears to have crossed dimensions at the worst possible time. Super Brexit Odyssey doesn’t sound like a very appealing venture, though Boris Johnson’s foppish faux-blustering would probably slot disturbingly easily into a fantasy game. In an ideal world, Donald Trump would remain a harmless parody of the boorish, hard-to-beat final boss in a video game; in the real world he is the newly inaugurated president of the United States, and already having a marked and negative impact on people’s lives.

His picks for cabinet have included a raft of ardent anti-choice climate change deniers, including a vice-president who supports “conversion therapy” for members of the LGBT community, and believes women should have to state in writing whether aborted or miscarried foetuses should be buried or cremated. The real world is currently looking pretty overrated.

And not only that, there will be no predetermined paths for Mario’s coin collection anymore. Unlike previous iterations of the game, which have taken place in set, closed-off levels, players will be able to roam a more open-ended world. Mario can cross roads, climb ladders, scale buildings and hitch a ride on taxis. That might sound like a good idea until you consider some of the political decisions made by the general public over the last year – maybe a lack of choice is good for us after all.

Tortuous analogies aside, there may be some genuine benefits to ignoring the real world in favour of unashamedly escapist entertainment. Games have long been posited to help with anxiety and stress: alongside bucketloads of anecdotal evidence, numerous studies have found positive links between gaming and mental health.

One, from the universities of Oxford and Cambridge, found that Tetris helped reduce stressful intrusive memories in patients with post-traumatic stress disorder. A study due to be published in March’s edition of the journal Computers in Human Behavior also found that games could encourage positive, co-operative, pro-social behaviour.

‘Numerous studies have found positive links between gaming and mental health.’ Photograph: Wavebreak Media ltd / Alamy/Alamy

More evidence came in a 2012 study from Stanford University that found gamers “hyper-stimulating” the brain’s mesolimbic pathways (associated with goals and motivations) and hippocampus (linked to learning and memory).

In 2014, Dutch researchers suggested that gaming can “foster real world psychosocial benefits” – cognitive, motivational, emotional and social. There’s no lack of evidence to suggest the positive impact gaming can have, especially on someone experiencing low-level stress, depression or anxiety.

And while Mario might not have a depression level yet – arch-enemy Bowser approaching asking “Have you tried yoga?” and saying “Cheer up!” – a growing number of games have been designed with mental health in mind. For example Sparx, a game designed to help residents of New Zealand with depression, which builds upon gaming’s mental health benefits to create something therapeutically valuable as well as fun.

Comments about how rightwing authoritarian regimes create the best conditions for creativity are obviously facile, especially now: people rightfully fearing discrimination need more than limp, empty reassurance that they needn’t worry because music, games or books are going to get really good again. When artists such as Amanda Palmer – white, able-bodied, rich, and privileged – say things like “Donald Trump is going to make punk rock great again” it’s a frustrating distraction from the potentially horrifying realities of the situation.

But that’s not to say that escapism isn’t a valuable tool if used correctly. Playing Mario – or any other game – is obviously not going to make you less miserable about the realities of any given political climate. What it can do, though, is provide a small amount of respite when you’re feeling stressed about something or you just want to pretend that the real world doesn’t exist for an hour or two. Perhaps Nintendo should bear this in mind when they design the next set of adventures for Mario – next time, maybe he should spend less time in our world, and we should spend more time in his.

Mario, you crossed into our world at the worst time – it’s no game over here | Emily Reynolds

Man"s best friend, bacteria"s worst enemy: dog sniffs out superbug in Canada hospital

Hospital ID badge dangling from his neck, Angus considered the empty bed in front of him. After a few strong sniffs, he moved on.

Nearing the next bed, his floppy ears perked up before he stopped dead in his tracks, tapping his paw and eyeing his handler expectantly.

The two-year-old English springer spaniel is believed to be the only canine hospital employee in the world trained to sniff out the notorious superbug Clostridium difficile, or C difficile.

The seeds of Angus’ unlikely career were planted three years ago, after Teresa Zurberg, a Vancouver resident, suffered a C difficile infection. Her bout with the bacteria – which attacks people whose immune systems have been weakened by antibiotics – left her in the hospital for five days and she lost 20 pounds.

“It was awful. I almost died,” Zurberg said.

Her husband, Markus, a nurse who works in patient safety and quality care, stumbled across an article on a beagle in the Netherlands who had been specially trained to check patients for C difficile.

Could Zurberg – a canine handler who trains bomb- and drug-detecting dogs – do the same thing in Vancouver? he wondered. “I told him, ‘If it’s got a smell, I can teach a dog to find it,’” Zurberg said. Their new beagle pup might be perfect for the job, she suggested.

The pair approached Vancouver Coastal Health, the health authority that oversees the city’s general hospital – and were surprised by the enthusiastic reaction they received. “I was expecting them to laugh at us but they were like: ‘Hey, that’s really cool.’”

Once Angus detects the bacteria, the area is cleaned with a robot that uses ultraviolet light to disinfect 99.9% of the C difficile spores. Photograph: Vancouver Coastal Health

Working with the health authority, Zurberg and Angus became part of a one-of-a-kind pilot program. The hope, said Nancy Desrosiers of Vancouver Coastal Health, was to find an innovative approach to address what has become a global concern.

“It really is one of those vicious cycles,” she said, pointing to a steadily rising number of infections that result in longer hospital stays and increase the likelihood of further infections. “In Canada, 64% of all of our C difficile cases are hospital-acquired.”

Unlike the patient-sniffing beagle in the Netherlands – who is now retired – Angus, it was decided, would focus exclusively on searching for C difficile in the hospital environment.

Hospitals normally use ultraviolet light to find the bacteria, but Angus can move much more quickly and efficiently through rooms. Once he detects the bacteria, the area is cleaned with a robot that uses ultraviolet light to disinfect 99.9% of the C difficile spores.

The decision to have him work on environments rather than patients minimised the chances of Angus triggering patients who may have allergies or sensitivities to dogs.

With the dog’s role in the hospital now clearly laid out, Zurberg began training Angus, mimicking the techniques used to train dogs to detect bombs or drugs.

“All of the detection work for the dogs, it’s just a game. To them, it’s just a way to get what they really want, which is their toy or their food, depending on what they’re rewarded with.”

As she taught him to associate the scent with a food reward, researchers from the hospital kept her stocked with a steady supply of the scent of C difficile – isolated from the bug – on cotton swabs.

Angus, the C difficile-sniffing dog. Photograph: Vancouver Coastal Health

The training took about 10 months. After passing a series of detection tests in a local nursing college with mock patient wards, Angus was brought into the hospital this summer.

Easily excitable when he’s not focused on work, Angus is accompanied by Zurberg at all times during the four days a week he spends at the hospital.

“It’s a very multi-ethnic health authority and I have to be really conscious of who’s around me and what issues they may have with dogs,” she said. “That’s part of the reason we chose a floppy-eared dog as opposed to a pointy-eared dog, because he’s not so intimidating-looking.”

Like any other member of the hospital staff, Angus faces a slight risk that he could be infected by C difficile. “He’s young and he’s not autoimmune compromised, so his risks are extremely low,” Zurberg said. His health is carefully monitored through regular veterinarian visits, she added.

His stint at the hospital has attracted global attention, and health authorities from Finland to Chile have contacted Zurberg with questions about replicating the idea. The aim, said Zurberg, is to develop a program that would train other dogs to sniff out C difficile and make them available to hospitals around the world.

Zurberg’s voice raises with excitement as she contemplates the possibility that Angus might hold the key to regaining control over a superbug that has affected so many people around the world.

“So many people come up to me and say: ‘My dad died of C diff,’ or ‘This person in my family has C diff,’ and they thank me for what we’re doing,” she said. “It opens the doors to other possibilities – what else can we have a dog detect? We’re only really limited by our imagination.”

Man"s best friend, bacteria"s worst enemy: dog sniffs out superbug in Canada hospital

"The worst conditions in memory": NHS doctors describe their week in A&E

The Guardian asked a number of doctors working in A&E departments across the country to explain how their departments have coped over the past seven days, said to have been the worst week ever for NHS emergency departments. These are some of their responses:

‘We are devastated by underemployment’

It’s been like an absolute war zone recently. The government at the moment, not to mention my regulatory bodies, are ignoring the worst hospital conditions in my memory. We have a brilliant team, but are devastated by underemployment and underinvestment. We have two permanent registrars on a rota of seven places.

On a recent shift, I walked in to patients waiting four and a half hours to see a doctor. This means every patient has failed the “breach” target by the time they’re seen. A diligent staff nurse asked me to take a look at a patient she was a ‘bit worried about’. The woman was devastatingly ill with a perforated bowel, and could have easily become fatally unwell. She survived thanks to the observational diligence of my colleague, and later our excellent surgical team.

The London ambulance service is similarly overwhelmed. They couldn’t provide me with a transfer ambulance for another emergency case, and 11-year-old with a sight-threatening infection, in less than 70 minutes. The target is eight minutes. It is a miracle the child didn’t lose an eye.”

‘Nothing can be done’

Our hospital is crumbling and is unsafe on a daily basis. On Thursday, there were 75 patients in an department that has 18 majors’ beds. Thirty-five of those were medical patients awaiting beds, 20 hadn’t been seen as there was nowhere to see them or no staff to triage them.

We have expressed our concerns verbally, via formal emails to trust, incident reports etc, but nothing can be done as it can’t elsewhere either. Medical professionals are talking about quitting as they believe soon someone will die on our watch … [It is] completely out of control. Maybe it has already happened and we just don’t know. I’m talking about a cohort of 11 doctors. God knows what people feel nationally. It scares me what we are heading for.

When a family member got admitted last weekend I panicked, not because it was that serious but I actually felt they may not be safe in hospital.

I am angry that it is being ignored and swept under the carpet. I am angry that we are left to pick up the pieces and apologise for a system we’ve put our hearts and souls into, but now have no control over.

‘It’s not acceptable to practise medicine in this way’

This past week in A&E has been horrendous. There are no beds in this busy teaching hospital. There are more than 20 patients queueing in the corridor at any given time. We’re seeing, treating and discharging patients in the queue. It’s undignified to ask a miscarrying pregnant woman about her blood loss in a queue, never mind in one filled with loud drunks. It’s just not acceptable to have to practise medicine in this way, but what choice do we have?

Patients in the queue have a substandard quality of care. Fact. So much for calling 999 in an emergency, then waiting an age for the crew to arrive because they’re all waiting in the corridors of A&E to unload patients. Even once you arrive at the department with said emergency, you’ll be waiting hours for any sort of assessment or treatment. My collusion in this depravity is solely in an attempt to keep my patients as safe as possible, but mistakes are being made and this is not sustainable.

‘We were truly swamped’

I was on call at night for the last week at a small district general hospital. We had to put the hospital on divert. There were 15 ambulances waiting for entry and consultants doing their assessments in the back of them. On surgery, despite phenomenal work from the registrar on call, we were truly swamped.

‘These are just some of my experiences this week in A&E …’

A four-bedded resus unit expected to make capacity for eight patients; leaving a shift to come back 24 hours later and finding some of the same patients still in resus; being in charge of the emergency department [ED] overnight with rota gaps; and requesting a divert for a few hours to allow us to catch up, only to be told that the policy has changed and capacity issues now had to be dealt with internally.

‘Everybody is terrified’

In the accident and emergency department where I work there is provision to keep up to 12 people overnight in case the wards are too full. On Tuesday night there were 27 sick patients all requiring hospital treatment who were kept on corridors and in the laundry room, being cared for by three nurses and one doctor.

It’s normal at the moment for 20 to be there overnight. We are having to send patients home we would rather admit, with little to no access to social care. Everybody is terrified. Everybody is waiting for something terrible to happen, because no matter how hard you work, there are too many cracks that are widening for patients to slip through. Stafford is where everything went down a few years ago. It seems the same situation is now happening on a nationwide level. I hope desperately that nobody I love or care about needs to be admitted to hospital right now. I just can’t believe how bad it is compared to last year.

‘The entire system is crumbling’

There are not enough staff and 12 ambulances regularly sitting in the corridor. There are designated corridor nurses. In this ED the patients can wait for eight hours. The emergencies do get seen first, as do the strokes, and the triage nurses pull the sickest out the corridor but sometimes they are seen in the corridor. A consultant is designated for the corridor to ensure safety.

A consultant has been staying overnight often lately due to the safety concerns, but that is unsustainable and they are burning out. No one is bothered about breaches anymore, it’s the 12-hour trolley waits because the CCG [clinical commissioning group] has to know then and trust board get involved. The entire system is crumbling. On New Year’s Eve our hospital asked for a divert when the wait was eight and a half hours with only 14 ambulances left on the roads in Merseyside. This is not uncommon. The divert was denied because the wait was not the longest, and every other department was in the same situation.

‘We have a daily lack of beds’

I’m a registrar in one of the busiest emergency departments in the country. This past week saw our busiest day on record with nearly 200 people waiting in our department at one point. There was a five-hour wait just to be seen, and a 14-hour wait for beds. I have people queuing to get a space in resuscitation and it regularly becomes dangerous. We have a daily lack of beds due to poor flow of patients out of hospital backing up to the emergency department. Patients are coming to harm and there are undoubtedly deaths arising from the current state of emergency medicine.

"The worst conditions in memory": NHS doctors describe their week in A&E

2016 was the worst year in NHS history – we must fight for its survival

The last 12 months have been the worst in the history of the NHS. Our health system is under pressure like never before. The moment of crisis many warned of has arrived, and it is not clear that the NHS can be retrieved from this state of affairs.

We used to say that flailing A&Es represented an early warning sign that the health service was under pressure. And so that has proven to be. England’s major A&Es are under record strain with black alerts being regularly sounded, and in some instances wards turning patients away. Last year the A&E crisis spread to other sectors.

Ambulance response times have reached critically low levels, with one third of ambulances failing to meet their targets for life threatening callouts. The acute care sector is bulging with unnecessary admissions particularly from over-75s who are presenting themselves at A&Es when they should be cared for by the social care sector that has suffered £5bn of cuts.

In the community, general practice is on life support; as more is demanded of it, the proportion of the NHS budget that goes to primary care has effectively shrunk. Primary care provides 90% of the consultations in the NHS yet only gets 8% of the budget. GPs are leaving, and new entrants are declining to enter general practice.

We once bickered with the Treasury for clawing back millions in Department of Health underspend under Labour. Under the Tories, that is a distant memory as NHS trusts recorded a deficit in excess of £2bn last year.

A government elected to fix near-bankrupted banks has replaced that by bankrupting our hospitals. Idiotic spending decisions in the NHS have been rife.

The most worrying aspect of the government delivering the lowest additional funding increase to the NHS in its history has been the knock-on effect on patients, in terms of treatment and facilities available. More than 13,000 beds have been closed, cutting the capacity of the NHS by 5 million a year.

So bad was 2016, that nine former health secretaries condemned the government for failing to live up to its promises on mental health.

Commissioners and providers alike have had to resort to rationing care to try to balance their books. Unfortunately, this is not always to the benefit of customers or patients.

As the health service’s budget faces greater pressure than before, it is difficult to ignore the toll the intrusion of the free market has taken. Last year, £13bn of healthcare was purchased from non NHS providers (pdf), a 76% increase since 2010. Given that the private sector has a stated goal to make 8%-14% profits from the NHS, can taxpayers really afford this choice?

While the NHS has increased the cash it takes from the private sector by 30% to £558m last year (pdf), waiting lists have soared to an eight-year high. Now, 4 million patients are on waiting lists. This in effect means NHS patients are being delayed in their treatment to make way for wealthy private patients who can afford to skip the queue.

The pressure on our staff has also reached unprecedented levels. Nurses have seen real-term pay cuts since 2010 of over £2,000. Moreover, aspiring nurses will also be denied a bursary to train and this at a time when unfilled nursing vacancies have climbed 600% since 2010. It will not surprise you to learn that applicants for trainee nursing courses have fallen 20% this year.

Likewise, the pressure on junior doctors remains intense. They too have seen real-term pay cuts, as well as an enforced contract.

It remains impossible to meet the demands of the ill-described seven-day NHS until serious funding issues have been resolved, otherwise we are asking our doctors to shoulder the blame for unsafe care.

The continuing media war Jeremy Hunt has waged against doctors has so depleted workforce morale that there are more doctors wanting to leave the NHS than are in training.

It will take a political will only witnessed twice in the last 70 years, 1948 and 1997, to alter the current trajectory on which the NHS is set. The £22bn of efficiencies (a euphemism for cuts), dressed up as sustainability and transformation plans smacks of what was tried with the Nicholson challenge. The National Audit Office has warned that these efficiencies are not possible without causing lasting damage to the NHS’s ability to provide safe care.

We are at a cliff edge. Do we carry on into the unknown with broken funding promises and more cuts or do we cry foul now, and demand a rethink before it is too late?

Let’s pledge in 2017 to fight for its survival. The NHS belongs to us, not the politicians and not the privateers. We cannot trust the government to be its safe custodian. It’s up to each and every one of us to fight for the NHS, otherwise it won’t be there to look after us, never mind the next generation.

Join the Healthcare Professionals Network to read more about issues like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views.

2016 was the worst year in NHS history – we must fight for its survival

NHS could face its worst January as it struggles with festive backlog, warns doctor

The NHS is facing “potentially the worst January” ever as it struggles to deal with the backlog of patients occupying beds over Christmas, a leading doctor has warned.

Dr Mark Holland, president of the Society for Acute Medicine (SAM), said hospitals had already seen large numbers of elderly patients over the festive period and that the health service was on the brink of a major crisis.

Holland, who is based in Manchester, said hospitals were operating under a “false sense of security” as elective procedures dipped during the Christmas period with those beds becoming available for emergency patients.

Once routine operations start up regularly this week, hospitals must make these allocated beds available again. A bout of flu, the winter vomiting virus, or even a cold snap, could prove the tipping point, he warned.

He said the service was going to face the health equivalent of the “credit card bill from hell” after the festive period and called on the government to announce its contingency plans for a “possible worst-case scenario”.

Holland, who leads the national body for acute hospital staff, told the Press Association: “There’s this problem over Christmas and New Year where actually, because you get this glut of beds that become available, you’re just building trouble up for ourselves in January.

“And then … when the flu kicks in, if the winter vomiting virus kicks in, which would potentially close a ward, or if there’s just a cold snap – when any of these things occur we will be under more pressure, but actually we’ll still be spending most of January trying to clear the Christmas and New Year backlog.”

This year January could be “one of the worst we have faced” due to record numbers of elderly patients who cannot be discharged because they are waiting for social care, he said.

Using an analogy of Christmas spending Dr Holland said it was down to the balance of beds within hospitals. “Imagine, at the end of January, we are going to get our credit card bill for Christmas,” he said.

“However, this January its like we’ve not paid last month’s credit card bill, we’ve not paid November’s credit bill, and over Christmas we’ve gone out and had a really good spend. The credit card bill we are going to get from January is just the credit card bill from hell … it’s going to be the worst ever credit card bill for the NHS.”

There were currently “too many unknowns to tell us if we will be able to get through January and avert a major crisis”, he added.

NHS could face its worst January as it struggles with festive backlog, warns doctor

The 5 worst diets in existence and why to avoid them

Many times in our lives, we get the choice to achieve something through hard work and perseverance….or to take the easy scenic route instead. When it comes to sustainable weight loss, specifically, taking the scenic route is never the right option. To attain a healthy, strong body, only hard work and dedication will get you there.

But sometimes, we can’t help but go to extreme measures to achieve our weight loss goals-we’re only human, after all.

Below are 5 examples of diets that were once popular (in part to their too-good-to-be-true concepts) but have been proven to be anything but effective (and best to avoid trying out altogether!)

1. The Apple Cider Vinegar Diet

Apple cider vinegar is a natural tonic known for its many health benefits (healing a cold, stuffy nose, hiccups and indigestion for starters) but one of its most well known perks is its ability to aid in weight loss. Apple cider vinegar can help suppress your appetite and increase your metabolism, making it a popular kitchen staple. However, the Apple Cider Vinegar Diet requires a person to drink 3 glasses of apple cider vinegar with cayenne pepper and honey a day.

While a tablespoon of apple cider vinegar can prove to be highly beneficial for your overall health, 3 glasses of this drink is more likely to be determinantal to your body. The level of acidity a person ingests in 3 glasses could be potentially dangerous and lead to digestive pain, nausea, teeth erosion, bone loss and low potassium levels. Avoid making this your go-to drink and stick to a maximum of 2 tablespoons of apple cider vinegar a day for optimum benefits.

2. The Tapeworm Diet

This one is pretty insane. There is a diet in existence that consists of people ingesting a real live tapeworm in order to spare themselves calories.The tapeworm supposedly feeds on the food a person eats before it’s absorbed into the body. This fad diet was one of the first of its time, dating back all the way to the 1800s!

Having a parasite living in your body is very risky to begin with. You can’t know for sure the tapeworm won’t move to other parts of the body and relocation in a new area of the body can lead to several side effects that include nausea, diarrhea, headaches and in extreme cases, stomach pain and death. A tapeworm isn’t easy to remove either. Besides all of those factors, having a tapeworm live inside your body for too long can also lead to severe malnutrition.

3. The Military Diet

The Military Diet became very popular last year as bloggers found out about the diet that allows you to eat hot dogs for a meal. Yes, really. The Military Diet doesn’t actually have any ties to the military; it simply consists of a strict 3 day meal plan followed by 4 days of normal eating.

The Military Diet focuses on eating small quantities of high fat food, something that might prove to have more negative results than positive.

The Military Diet’s fat burning combinations don’t have any scientific merit and the 3 days a person spends eating small quantities of food are likely to make you feel more hungry than satisfied. Your better option is to stick to a well balanced diet plan that doesn’t require you to go hungry or avoid entire food groups.

4. The Baby Food Diet

This one is exactly what you imagine it to be. The baby food diet consists of eating mainly pureed baby food that you can find in grocery stores. Baby food is essentially mashed fruits, vegetables and meats, and provides infants with the nutrition they need when they don’t have the teeth yet to chew solid foods. While not harmful on its own, many supporters of the baby food diet replace 1-2 meals of regular meals with jarred baby food.

The amount of nutrients and calories in a jar of mashed mush may be enough to sustain a baby, but it’s definitely not enough for a fully-grown adult. The baby food diet is unhealthy because it deprives individuals of the recommended nutrient and calorie intake per day, causing the body to go into starvation mode and actually prevent a person from losing weight.

5. The Low Fat Diet

There are many versions of this type of diet available and they’re all comprised of the same low fat meal plans that lead to cravings and hunger pains. There’s nothing wrong about being mindful about fat- the thing to keep to remember is that fat isn’t the bad guy.

When you avoid fat, your mind starts to crave low fat carbohydrates like pretzels, crackers and white bread- foods that lead to a rapid blood sugar crash and even more cravings. Change it up and choose foods that actually have a healthy fat intake (e.g- plain yogurt with fruit or fresh salad with olive oil and vinegar dressing) to feel satisfied and notice results.

Conclusion

Most effective diets are ones that combine healthy eating and regular exercise to get the results you want. Fad diets or meal plans with a central focus on one food group aren’t an effective long term solution and they certainly don’t consider your overall health. No amount of food deprivation or binge eating will get you the results you want. Your best bet is a well-balanced meal plan, exercise and a healthy lifestyle. Good luck!

The 5 worst diets in existence and why to avoid them

8 Worst Toxic Food Ingredients To Avoid

8 Worst Toxic Food Ingredients To Avoid

Jeremy Hunt says five-day doctors" strike will be "worst in NHS history"

Jeremy Hunt has accused junior doctors of inflicting “the worst doctors’ strike in NHS history” by announcing a five-day walkout later this month.

In a series of broadcast interviews on Thursday, the health secretary also tried to exploit divisions in the BMA, the doctors’ union, after members rejected a deal over new contracts recommended by the body’s leaders.

Speaking to Sky News, Hunt said: “Patients will be asking why it is that the BMA, who only in May said ‘this deal is a good deal for doctors, a good deal for patients, it’s good for the NHS, it’s good for equality’, are now saying it is such a bad deal that they want to inflict the worst doctors’ strike in NHS history.”

Dr Mark Porter, chair of the BMA council, said the decision to announce five consecutive days of strike from 12 September was made after “long and difficult debates”.

Hunt claimed he was ready to continue negotiations. Photograph: Neil Hall/PA

Repeatedly challenged on BBC Radio 4’s Today programme about the level of support for the strike, Porter did not dispute a claim that the council backed five-day strike action by only 16 votes to 14. But he denied that there had been block voting by consultants and GPs to reject the strike.

The latest planned strike action is the first since BMA members rejected the government’s final offer on the contract in a 58% to 42% vote in July, despite a recommendation to accept by the BMA’s leadership.

At the heart of the contract dispute is Hunt’s proposal to change what constitutes “unsocial” hours for which junior doctors can claim extra pay, turning 7am to 5pm on Saturday into a normal working day as part of a Tory manifesto pledge to create a “seven-day NHS”.

There have been five previous walkouts in the dispute, all this year. The longest lasted two consecutive days, and the first all-out strike – including junior doctors working in emergency departments – was held in April. More than 100,000 operations and outpatient appointments have been cancelled so far as a result of industrial action.

Porter said Hunt had left junior doctors with no alternative but to strike again.

He said: “The reason the strikes have been announced is the continued reluctance of the secretary of state for health to do anything other than impose a new contract on junior doctors, a contract in which junior doctors have demonstrated repeatedly that they do not have confidence.”

He also dismissed a claim by Chris Hopson, chief executive of NHS Providers, that the government and employers side had made 73 concessions in the negotiations.

Porter said: “Anyone could count up the number of commas changed and words inserted into a negotiated document containing tens of thousands of words and come up with a number like 73. That number is completely meaningless.”

He added: “It is time to give up the incremental approach of changing a word here or there. That is not going to work as the doctors have comprehensively shown in the latest referendum.”

“The only alternative that junior doctors have been left with is protracted strike action. The reason this dispute has become protracted … is the insistence of the government on moving ahead without agreement.”

Hunt claimed he was ready to continue negotiations.

“The way to solve the honest disagreement is to sit round the table and talk,” he said. “It is cooperation and dialogue and not confrontation and strikes, which is going to cause absolute misery to hundreds of thousands of families up and down this country.”

Hunt claimed there were only two outstanding issues to resolve. “In July they wrote to us and said there were just four outstanding issues of concerns – we have solved two of those four issues to their satisfaction.

“The main sticking point are two issues around pay: Saturday pay and automatic pay rises for part-time workers. Weekend pay rates for doctors are higher than for nurses, police officers, and fire officers. In the 24/7 society that we live in it is very fair and reasonable deal.”

Jeremy Hunt says five-day doctors" strike will be "worst in NHS history"

Chickenpox vaccines should be more available, says "worst case" toddler"s mother – video

Sarah Allen, whose two-year-old son Jasper was treated at Hinchingbrooke hospital in Huntingdon, Cambridgeshire, for a severe case of chickenpox, speaks on Tuesday about her son’s recovery. Allen says existing vaccinations should to be made more available on the NHS or affordable for parents to purchase

Chickenpox vaccines should be more available, says "worst case" toddler"s mother – video

"Worst case of chickenpox" sparks call for vaccination rethink

A mother whose two-year-old son spent five days in hospital fighting a severe case of chickenpox has called for anyone who wants them to get vaccinations on the NHS against the disease.

Sarah Allen urged ministers to rethink eligibility for immunisation, under which only those looking after children with a weakened immune system, for example because they are undergoing chemotherapy, can receive it.

Allen, a nursery manager in Cambridgeshire, spoke out after doctors said her son Jasper’s chickenpox was the worst case of the usually mild illness they had ever seen. The toddler became so ill last month that staff at Hinchingbrooke hospital in Huntingdon, Cambridgeshire, put him on an intravenous drip and gave him antibiotics, antiviral drugs and morphine.

Allen claims that Jasper was initially denied treatment when her GP practice refused to let her see a doctor. “When I first called our local GP’s surgery, I spoke to the receptionist to make an appointment for Jasper, but when I told her it was chickenpox, she said to me, ‘Every mother thinks their child has bad chickenpox.’ I knew I wasn’t being a neurotic mother. I have two children and have run a nursery and seen hundreds of kids with chickenpox before, so I knew this wasn’t normal.

“When Jasper was admitted to hospital, it was scary, but I was also relieved I was actually being taken seriously and that they were doing something about it. We couldn’t hold him for three days because he screamed every time we touched him.” Jasper’s chickenpox was so severe that he has had scans of his heart to ascertain whether he has suffered any long-term damage as a result, she added.

Immunisation against the disease is not part of the government’s childhood vaccination programme. Jabs are given only to adults and children who are in close contact with someone who is either immuno-suppressed or would otherwise be at risk if they got chickenpox.

Related: What’s the real reason Britons aren’t offered the chickenpox vaccine? | Jenny Rohn

Public Health England, which oversees NHS vaccination schemes, indicated that no change of policy was imminent. A spokesman added: “The expert advisory body the Joint Committee on Vaccination and Immunisation is currently undertaking a review of a childhood vaccination programme against chickenpox in the UK, based on the available scientific evidence, including consideration of the cost-effectiveness of any programme. This review is likely to be concluded next year.”

Cambridgeshire Community Services NHS Trust, which runs the children’s inpatient ward at Hinchingbrooke, where Jasper was treated, said in a statement that: “We can confirm Mrs Allen’s statement that Jasper Allen was treated on our children’s inpatient ward for five days with a severe case of chickenpox.”

Cambridgeshire and Peterborough clinical commissioning group, which oversees GP services in the area, said it could not comment on any individual patient’s treatment. It has not received a complaint from Allen about her local GP surgery refusing her an appointment. In a statement, it said: “Chickenpox is usually a mild illness from which most children recover on their own. Symptoms include a high temperature, aches and pains, and a rash of blisters. These usually pass within a week or two, and the blisters dry up and fade.

“The best treatment is to use soothing creams and/or appropriate doses of paracetamol to ease any discomfort, while keeping your child hydrated by giving them lots to drink.

“It is highly advisable that parents and carers keep a watchful eye on children who have chickenpox, as complications, although rare, can develop, especially in children who are very young, are on other medications, or who may have a weakened immune system.”

"Worst case of chickenpox" sparks call for vaccination rethink

To witness your child"s death is the worst factor

In the months that followed, he sank into a miasma of grief, shock, trauma and disbelief, and turned to writing a personal diary to chronicle his ideas and feelings. Two years on, with Debora’s encouragement, he has permitted it to be published.

A single can understand Thomas’s original hesitation. It is a raw and compelling read, weaving between the accident, its aftermath, valuable moments in Kadian’s daily life and the exclusive relationship amongst a father and son.

“I desired to introduce Kadian to men and women so they would know how particular he was,” he says. The guide is also a forensic analysis of bereavement, in which Thomas bares his soul. “I am naked in my grief,” he writes. “The soreness is unbearable.”

I inquire Thomas if creating had been cathartic. “Don’t say ‘cathartic’,” he replies. “It hasn’t been at all. I really do not feel greater for it. It was just some thing I had to do.”

Kadian was a impressive kid. At 10 he produced a checklist of “25 random observations about myself” on Facebook, like: “I have often wondered why we bathe instead of vacuum ourselves off.” He loved his German shepherd dog, Duke, was a computer whizz and by 14 had created a lot more than 25 podcasts and films.

_{Kadian pictured with Duke as a puppy}

It is not simple to uncover the correct thing to say to anyone who is bereaved – and in his book Thomas criticises people who “want to say the right factor but get it wrong. Individuals come up to us and say: ‘There are no phrases.’ But there are so many phrases, including, ‘How the —- can this come about to us?’ ” Now, he says: “The greatest way to take care of it is to say: ‘I am genuinely sorry,’ and let the man or woman who has suffered the reduction drive the conversation.”

We speak in the household home in Hampshire. Debora, 49, who has US and Uk citizenship, has just had an operation on her knee and sits with her leg up on a stool. Crutches are near by.

It is their very first interview collectively since Kadian’s death, and they are vulnerable and self-protective. Everyone grieves in a various way, and I wonder if Debora agreed with everything in Kadian Journal, A Father’s Story. “I had no thought what was in the guide till it was finished,” she says, seeking tearfully at Thomas, “and I was stunned by it. It was as if he had tapped a vein and permitted himself to bleed and bleed.”

“I was extremely anxious about her reaction,” Thomas adds. “I waited downstairs for eight hours whilst she read it upstairs.”

Born in London, Thomas is a Cambridge graduate and worked in tv and journalism before becoming an author. He and Debora – who ran a cycle store in Washington – met on a charity bike ride across the US in 1987. They have been married for five many years prior to they made a decision to have a kid.

“I was originally reluctant to be a father,” Thomas admits, “but was evangelical about it when Kadian was born. It became clear to me that I needed to be at least half involved in the childcare.” In 2001, they moved to the US, exactly where Thomas published a newspaper in West Virginia, prior to returning to Britain in 2008, setting up a Tv station in Oxford.

The two mothers and fathers talk about Kadian in the present and the previous, usually in the very same sentence a small indication of how challenging it is to assimilate the brutal reality. “We were so shattered,” Debora says. “It was so atrocious and such a horror I stored thinking it cannot be. I had to understand how to talk, eat and walk once again.”

“Grief wipes out your judgment and energy ranges,” Thomas adds. “I am incapable of doing work as I utilized to. We each gave up our firms in America.”

How is their daughter coping? “Sam is so close in age to Kadian that it is quite hard, and she has a enormous selection of feelings to grapple with.”

In the autumn of 2012, Thomas identified he could concentrate on editing Hanns and Rudolf. The book, published final year, is devoted to Kadian. “It was sold to a publisher just prior to Kadian was killed, and working on phrases, spelling and grammar gave me anything useful to do,” he says.

Studying helped a little, also. “I needed a street map out of our new-identified hell,” Thomas explains. “I felt certainly there was someone who could assist us.” They discovered a connection with CS Lewis’s A Grief Observed and Nicholas Wolterstorff’s Lament for a Son.

Today, they are each undergoing treatment. “I was genuinely broken and didn’t want to live,” Thomas reveals. “It has been very good for me to uncover a person who has wisdom and viewpoint and says you have the appropriate to have gone mad.” The Child Bereavement Believe in has also been valuable.

“For the initial three months, pals sorted out our meals and it took another three just before we sat down to consume a correct cooked meal,” Debora recalls. “Neither of us had the energy or brain electrical power to believe ahead and get food in the property or function out what to cook.”

Debora has been helped by a personalized trainer. “It has transformed me from not wanting to get out of bed to providing me a alter of vitality.” She has set up a site committed to Kadian.

Thomas, understandably, no longer enjoys cycling. “I truly feel unstable and unsafe on a bike,” he says. “Walking in the countryside assists with my trauma and shock, but I cannot cope when there are autos all around. People inform me I am performing greater, but it depends on the day.

“Nor can I deal with even mild conflict. Fortunately we have designed a bubble for ourselves exactly where we really feel protected, which occasionally is as small as our bedroom. Other occasions I consider to test the edges, and if it hurts also considerably, I back out.”

They say they are “closer than ever” as a family members. “I couldn’t have received by way of this without Deb,” says Thomas.

Shortly before Kadian was killed, Thomas advised his son off for fighting with his sister. Later Thomas felt he had been also challenging at midnight, seeing the light in Kadian’s bedroom nevertheless on, he knocked at the door. They apologised to each and every other, hugged, and then Kadian explained: “Best father in the globe.” Thomas replied: “Best son in the world.”

It is a moment Thomas will often keep in mind.

‘Kadian Journal, A Father’s Story’ by Thomas Harding is published by Heinemann (£16.99). A site committed to Kadian is at kadianharding.com

To witness your child"s death is the worst factor

To witness your child"s death is the worst thing

In the months that followed, he sank into a miasma of grief, shock, trauma and disbelief, and turned to creating a personal diary to chronicle his ideas and emotions. Two many years on, with Debora’s encouragement, he has permitted it to be published.

One particular can comprehend Thomas’s preliminary hesitation. It is a raw and compelling go through, weaving between the accident, its aftermath, precious moments in Kadian’s existence and the unique connection amongst a father and son.

“I wished to introduce Kadian to individuals so they would know how particular he was,” he says. The guide is also a forensic examination of bereavement, in which Thomas bares his soul. “I am naked in my grief,” he writes. “The pain is unbearable.”

I request Thomas if writing had been cathartic. “Don’t say ‘cathartic’,” he replies. “It hasn’t been at all. I do not come to feel greater for it. It was just anything I had to do.”

Kadian was a outstanding youngster. At 10 he produced a list of “25 random observations about myself” on Facebook, which includes: “I have always wondered why we bathe as an alternative of vacuum ourselves off.” He loved his German shepherd canine, Duke, was a pc whizz and by 14 had made a lot more than 25 podcasts and films.

_{Kadian pictured with Duke as a puppy}

It is not simple to uncover the appropriate point to say to anybody who is bereaved – and in his guide Thomas criticises people who “want to say the right issue but get it incorrect. Individuals come up to us and say: ‘There are no words.’ But there are so numerous words, including, ‘How the —- can this happen to us?’ ” Now, he says: “The ideal way to handle it is to say: ‘I am really sorry,’ and let the man or woman who has suffered the reduction drive the conversation.”

We talk in the loved ones house in Hampshire. Debora, 49, who has US and United kingdom citizenship, has just had an operation on her knee and sits with her leg up on a stool. Crutches are close by.

It is their very first interview collectively considering that Kadian’s death, and they are vulnerable and self-protective. Everyone grieves in a various way, and I wonder if Debora agreed with everything in Kadian Journal, A Father’s Story. “I had no notion what was in the book right up until it was completed,” she says, seeking tearfully at Thomas, “and I was stunned by it. It was as if he had tapped a vein and allowed himself to bleed and bleed.”

“I was exceptionally anxious about her reaction,” Thomas adds. “I waited downstairs for eight hrs whilst she study it upstairs.”

Born in London, Thomas is a Cambridge graduate and worked in tv and journalism ahead of becoming an author. He and Debora – who ran a cycle store in Washington – met on a charity bike trip across the US in 1987. They had been married for 5 many years prior to they determined to have a kid.

“I was initially reluctant to be a father,” Thomas admits, “but was evangelical about it as soon as Kadian was born. It grew to become clear to me that I needed to be at least half involved in the childcare.” In 2001, they moved to the US, in which Thomas published a newspaper in West Virginia, ahead of returning to Britain in 2008, setting up a Tv station in Oxford.

Each mothers and fathers talk about Kadian in the existing and the past, frequently in the very same sentence a modest indication of how difficult it is to assimilate the brutal actuality. “We had been so shattered,” Debora says. “It was so atrocious and this kind of a horror I stored thinking it can not be. I had to find out how to speak, eat and stroll once more.”

“Grief wipes out your judgment and power amounts,” Thomas adds. “I am incapable of working as I utilized to. We each gave up our firms in America.”

How is their daughter coping? “Sam is so near in age to Kadian that it is really tough, and she has a large range of feelings to grapple with.”

In the autumn of 2012, Thomas found he could focus on editing Hanns and Rudolf. The guide, published final 12 months, is focused to Kadian. “It was sold to a publisher just ahead of Kadian was killed, and doing work on phrases, spelling and grammar gave me anything useful to do,” he says.

Reading assisted a small, too. “I necessary a street map out of our new-found hell,” Thomas explains. “I felt absolutely there was somebody who could help us.” They found a connection with CS Lewis’s A Grief Observed and Nicholas Wolterstorff’s Lament for a Son.

Today, they are each undergoing treatment. “I was actually broken and didn’t want to live,” Thomas reveals. “It has been excellent for me to discover someone who has wisdom and perspective and says you have the correct to have gone mad.” The Little one Bereavement Believe in has also been helpful.

“For the first three months, friends sorted out our food and it took yet another three before we sat down to eat a proper cooked meal,” Debora recalls. “Neither of us had the vitality or brain electrical power to believe ahead and get meals in the house or perform out what to cook.”

Debora has been helped by a personal trainer. “It has changed me from not wanting to get out of bed to providing me a modify of energy.” She has set up a internet site focused to Kadian.

Thomas, understandably, no longer enjoys cycling. “I really feel unstable and unsafe on a bike,” he says. “Walking in the countryside aids with my trauma and shock, but I can’t cope when there are automobiles about. People tell me I am carrying out much better, but it depends on the day.

“Nor can I deal with even mild conflict. Fortunately we have produced a bubble for ourselves where we truly feel safe, which sometimes is as small as our bedroom. Other occasions I try to check the edges, and if it hurts as well significantly, I back out.”

They say they are “closer than ever” as a family. “I couldn’t have got by way of this with no Deb,” says Thomas.

Shortly prior to Kadian was killed, Thomas told his son off for fighting with his sister. Later on Thomas felt he had been too challenging at midnight, seeing the light in Kadian’s bedroom nevertheless on, he knocked at the door. They apologised to every other, hugged, and then Kadian explained: “Best father in the world.” Thomas replied: “Best son in the planet.”

It is a minute Thomas will constantly don’t forget.

‘Kadian Journal, A Father’s Story’ by Thomas Harding is published by Heinemann (£16.99). A internet site focused to Kadian is at kadianharding.com

To witness your child"s death is the worst thing