Ask the Therapist columnist Lori Gottlieb advises a reader who wants his spouse to be more compassionate about his worsening recall.I’m a 70-year-old active man. I go to the gym, bowl and play billiards and poker. I’m enjoying my retirement, but I’m also experiencing memory loss.The problem isn’t day-to-day memory, but going back beyond three years or so, my memories can be sketchy.I recognize this, but my husband, 65, continues to remind me of my memory loss. For instance, I say, “Let’s watch Tom Cruise in ‘War of the Worlds.’ I saw the ’50s version, but not this one.” He then says, “We watched it already.”This upsets me because what I hear is, “You’re getting Alzheimer’s.”He’s done it many times, and I try to explain how his comments hurt. He doesn’t see why they would because he’s simply stating a fact. I would like a more compassionate and understanding response. I’d take: “Oh honey, we had such a good time watching that movie. I remember how you kept comparing Cruise to Gene Barry!”After my silent treatment for the next hour or so, he apologizes, but it doesn’t come off as very sincere, particularly with repeated similar scenarios.We’ve been together for 24 years. Is it wrong to ask that much?From the Therapist: It’s not wrong to ask to be treated more gently, especially because losing your memory can be scary and disorienting. It brings with it a heightened sense of vulnerability, and you want the person beside you to hold you with tenderness. But you’re likely to get a better response if you understand what’s happening beneath the surface. When one partner is dealing with a medical issue, both people in the relationship experience the challenge differently. And when the issue involves cognitive decline, the relationship faces a distinct kind of strain — one that threatens its identity.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

Yoga, Tai Chi, walking and jogging may be the best forms of exercise to improve sleep quality and ease insomnia, suggest the findings of a comparative pooled data analysis published in the online journal BMJ Evidence Based Medicine.
The findings back the use of exercise as a primary treatment strategy for poor sleep patterns, say the researchers.
Characterized by difficulties falling and staying asleep, and early morning awakening, the prevalence of insomnia ranges from 4-22%, note the researchers. It is associated with heightened risks of various mental and physical health conditions, including dementia and cardiovascular disease.
Drug treatments for insomnia are not without their side effects, and cognitive behavioral therapy (CBT), while effective, isn’t always available due to the shortage of trained therapists, explain the researchers.
An emerging body of research suggests that exercise is helpful, but current guidelines don’t specify which types of exercise might be most beneficial. The researchers therefore set out to plug this knowledge gap, with a view to informing clinical practice and helping patients choose the most appropriate exercise for managing their insomnia.
They scoured research databases looking for relevant randomized clinical trials published up to April 2025 and included 22 in a network meta analysis — a statistical technique used to simultaneously compare multiple interventions.
The trials involved 1348 participants and 13 different treatment approaches to ease insomnia, seven of which were exercise based: yoga; Tai Chi; walking or jogging; aerobic plus strength exercise; strength training alone; aerobic exercise combined with therapy; and mixed aerobic exercises. These programs ranged from 4 up to 26 weeks in length.

The other approaches included CBT; sleep hygiene; Ayurveda; acupuncture/massage; nothing; and existing treatment, such as usual care and/or lifestyle changes, the durations of which ranged from 6 to 26 weeks.
Validated scoring systems for sleep quality and insomnia severity — PSQI and the ISI45 — as well as subjective and objective measures of total sleep time, sleep efficiency (percentage of time spent asleep while in bed), number of awakenings after going to sleep, and time taken to fall asleep (sleep latency) were used to assess sleep patterns.
Compared with existing treatment, CBT is likely to result in a large increase in total sleep time based on subjective sleep diary data. It may also improve sleep efficiency, and shorten the amount of time spent awake after falling asleep as well as sleep latency, with sustained improvements, the findings suggest.
But some of the exercise-based interventions also seemed to be effective, when compared with existing treatment.
Yoga likely results in a large increase in total sleep time of nearly 2 hours and may improve sleep efficiency by nearly 15%. It may also reduce the amount of time spent awake after falling asleep by nearly an hour, and shorten sleep latency by around half an hour.
Walking or jogging may result in a large reduction in insomnia severity of nearly 10 points, while Tai Chi may reduce poor sleep quality scores by more than 4 points, increase total sleep time by more than 50 minutes, and reduce time spent awake after falling asleep by over half an hour. It may also shorten sleep latency by around 25 minutes.

Further in-depth analyses revealed that Tai Chi performed significantly better on all subjectively and objectively assessed outcomes than existing treatments for up to 2 years.
There are potentially plausible biological explanations for the findings, say the researchers.
With its focus on body awareness, controlled breathing, and attentional training, yoga may alter brain activity, thereby alleviating anxiety and depressive symptoms which often interfere with a good night’s sleep, they suggest.
Tai Chi emphasizes breath control and physical relaxation and has been shown to decrease sympathetic nervous system activity, dampening down hyperarousal, they add. And its combination of meditative movement and mindfulness may promote emotional regulation, deactivate ‘mental chatter’, and reduce anxiety. It may also help to curb the production of inflammatory chemicals over longer periods, they suggest.
Walking or jogging may improve sleep by increasing energy expenditure, curbing cortisol production, improving emotional regulation, boosting secretion of the sleep hormone melatonin, and enhancing the amount of deep sleep, they continue.
The researchers acknowledge that 15 (68%) of the included trials contained design and methodological flaws. And there were no standardized, quantifiable metrics for the frequency or intensity of exercise interventions, while the sample sizes of some of the studies were small.
Nevertheless, they conclude: “The findings of this study further underscore the therapeutic potential of exercise interventions in the treatment of insomnia, suggesting that their role may extend beyond adjunctive support to serve as viable primary treatment options.
“Although current clinical guidelines make only limited mention of exercise, this study provides relatively comprehensive comparative evidence that may inform the development of more specific and actionable clinical recommendations.
“Given the advantages of exercise modalities such as yoga, Tai Chi, and walking or jogging — including low cost, minimal side effects, and high accessibility — these interventions are well-suited for integration into primary care and community health programs.”
And there may well be one type of exercise that is best suited to easing a particular symptom of insomnia, they suggest, which further research may clarify.

Premature menopause has been described as a life-changing diagnosis with profound physical, psychological, and social consequences. Affected women not only experience the effects of estrogen deficiency, but they also experience the unanticipated loss of reproductive function. However, some women are more adversely affected by these changes than others. A new study helps explore reasons for these differences. Results are published on July 16 in Menopause, the journal of The Menopause Society.
Premature menopause, medically known as premature or primary ovarian insufficiency (POI), is a condition in which the ovaries cease to function normally before the age of 40. It has been linked to an elevated lifetime risk for depression and anxiety. A recent meta-analysis revealed an odds ratio of 3.3 for depression and 4.9 for anxiety in women with POI compared with those without the condition. The increased risk is understandable given the combined experience of infertility and the additional burdens resulting from estrogen deficiency, such as hot flashes, vaginal dryness, reduced bone mineral density, and an increased risk of cardiovascular disease, among others. For some women, infertility means altered life goals, loss of sense of control, social stigma, and disrupted social roles.
However, not all women experience depression or the same level of depression when presented with the same diagnosis. In this new study, researchers gathered data from nearly 350 women with POI to try to identify the specific variables that contribute to the likelihood of depressive symptoms. Their first observation was the high prevalence of depression among participants. Nearly one-third (29.9%) of the women with POI suffered from depressive symptoms.
The researchers additionally found that a younger age at POI diagnosis, severe menopause symptoms, fertility-related grief, and lack of emotional support were risk factors. No significant difference was found in depressive symptoms between women using estrogen plus progestogen therapy and those not using hormone therapy, underscoring the role of psychosocial factors. Interestingly, a genetic cause for POI was associated with lower depressive symptoms. Another unexpected result was that, even though a higher burden of menopause symptoms was independently associated with depressive symptoms, hot flashes (specifically night sweats) were not.
This is the first known large-scale study to investigate specific variables that are associated with depressive symptoms in women with POI. The researchers believe its results highlight the importance of comprehensive care addressing both physical and psychological aspects of menopause at an early age.
Survey results are published in the article “Depressive symptoms in women with premature ovarian insufficiency (POI): a cross-sectional observational study.”
“The high prevalence of depressive symptoms in those with POI highlights the importance of routine screening in this vulnerable population. Although hormone therapy is recognized as the standard of care for those with POI for management of some menopause-related symptoms and preventive care, it is not first-line treatment for mood disorders. This was evident in this study in which there was no difference in depressive symptoms between those using hormones and those not using hormone therapy. Addressing behavioral-health concerns with evidence-based interventions should be part of any comprehensive POI care plan,” says Dr. Monica Christmas, associate medical director for The Menopause Society.

22 minutes agoShareSaveJames GallagherShareSaveEight babies have been born in the UK using genetic material from three people to prevent devastating and often fatal conditions, doctors say.The method, pioneered by UK scientists, combines the egg and sperm from a mum and dad with a second egg from a donor woman.The technique has been legal here for a decade but we now have the first proof it is leading to children born free of incurable mitochondrial disease.These conditions are normally passed from mother to child, starving the body of energy.This can cause severe disability and some babies die within days of being born. Couples know they are at risk if previous children, family members or the mother has been affected.Children born through the three-person technique inherit most of their DNA, their genetic blueprint, from their parents, but also get a tiny amount, about 0.1%, from the second woman. This is a change that is passed down the generations.None of the families who have been through the process are speaking publicly to protect their privacy, but have issued anonymous statements through the Newcastle Fertility Centre where the procedures took place.’Overwhelmed with gratitude'”After years of uncertainty this treatment gave us hope – and then it gave us our baby,” said the mother of a baby girl.”We look at them now, full of life and possibility, and we’re overwhelmed with gratitude.”The mother of a baby boy added: “Thanks to this incredible advancement and the support we received, our little family is complete.”The emotional burden of mitochondrial disease has been lifted, and in its place is hope, joy, and deep gratitude.”Getty ImagesMitochondria are tiny structures inside nearly every one of our cells. They are the reason we breathe as they use oxygen to convert food into the form of energy our bodies use as fuel.Defective mitochondria can leave the body with insufficient energy to keep the heart beating as well as causing brain damage, seizures, blindness, muscle weakness and organ failure.About one in 5,000 babies are born with mitochondrial disease. The team in Newcastle anticipate there is demand for 20 to 30 babies born through the three-person method each year. Some parents have faced the agony of having multiple children die from these diseases.Mitochondria are passed down only from mother to child. So this pioneering fertility technique uses both parents and a woman who donates her healthy mitochondria.The science was developed more than a decade ago at Newcastle University and the Newcastle upon Tyne Hospitals NHS Foundation Trust and a specialist service opened within the NHS in 2017.The eggs from both the mother and the donor are fertilised in the lab with the dad’s sperm.The embryos develop until the DNA from the sperm and egg form a pair of structures called the pro-nuclei. These contain the blueprints for building the human body, such as hair colour and height.The pro-nuclei are removed from both embryos and the parents’ DNA is put inside the embryo packed with healthy mitochondria.The resulting child is genetically related to their parents, but should be free from mitochondrial disease.A pair of reports, in the New England Journal of Medicine, showed 22 families have gone through the process at the Newcastle Fertility Centre.It led to four boys and four girls, including one pair of twins, and one ongoing pregnancy.”To see the relief and joy in the faces of the parents of these babies after such a long wait and fear of consequences, it’s brilliant to be able to see these babies alive, thriving and developing normally,” Prof Bobby McFarland, the director of the NHS Highly Specialised Service for Rare Mitochondrial Disorders told the BBC.All of the babies were born free of mitochondrial disease and met their expected developmental milestones. Getty ImagesThere was a case of epilepsy, which cleared up by itself and one child has an abnormal heart rhythm which is being successfully treated.These are not though to be connected to defective mitochondria. It is not known whether this is part of the known risks of IVF, something specific to the three-person method or something that has been detected only because the health of all babies born through this technique is monitored intensely.Another key question hanging over the approach has been whether defective mitochondria would be transferred into the healthy embryo and what the consequences could be.The results show that in five cases the diseased mitochondria were undetectable. In the other three, between 5% and 20% of mitochondria were defective in blood and urine samples.This is below the 80% level thought to cause disease. It will take further work to understand why this occurred and if it can be prevented.Getty ImagesProf Mary Herbert, from Newcastle University and Monash University, said: “The findings give grounds for optimism. However, research to better understand the limitations of mitochondrial donation technologies, will be essential to further improve treatment outcomes.”The breakthrough gives hope to the Kitto family. Kat’s youngest daughter Poppy, 14, has the disease. Her eldest Lily, 16, may pass it onto her children.Poppy is in a wheelchair, is non-verbal and is fed through a tube. “It’s impacted a huge part of her life,” says Kat, “we have a lovely time as she is, but there are the moments where you realize how devastating mitochondrial disease is”.BBC/Josh ElginDespite decades of work there is still no cure for mitochondrial disease, but the chance to preventing it being passed on gives hope to Lily. “It’s the future generations like myself, or my children, or my cousins, who can have that outlook of a normal life,” she says.’Only the UK could do this’The UK not only developed the science of three-person babies, but it also became the first country in the world to introduce laws to allow their creation after a vote in Parliament in 2015.There was controversy as mitochondria have DNA of their own, which controls how they function.It means the children have inherited DNA from their parents and around 0.1% from the donor woman.Any girls born through this technique would pass this onto their own children, so it is a permanent alteration of human genetic inheritance.This was a step too far for some when the technology was debated, raising fears it would open the doors to genetically-modified “designer” babies.Prof Sir Doug Turnball, from Newcastle University, told me: “I think this is the only place in the world this could have happened, there’s been first class science to get us to where we are, there been legislation to allow it to move into clinical treatment, the NHS to help support it and now we’ve got eight children that seem to free of mitochondrial disease, what a wonderful result.”Liz Curtis, the founder of the Lily Foundation charity said: “After years of waiting, we now know that eight babies have been born using this technique, all showing no signs of mito. “For many affected families, it’s the first real hope of breaking the cycle of this inherited condition.”

The health secretary ousted his chief of staff and a deputy chief of staff, both of whom were seen as practical and effective government veterans.Health Secretary Robert F. Kennedy Jr. fired two of his top aides this week, shaking up his leadership team at the Department of Health and Human Services amid an aggressive effort to reshape public health policy.The firings included Heather Flick Melanson, his chief of staff, and Hannah Anderson, his deputy chief of staff for policy, according to two people familiar with the matter. They spoke on the condition of anonymity because they were not authorized to speak publicly about the personnel changes.The reason for the ousters, which were first reported by CNN, was not immediately clear.Both Ms. Flick Melanson and Ms. Anderson were seen as steady and effective government veterans. During a recent Senate hearing, Mr. Kennedy indicated that they were the people in his office to call to get things done. When one lawmaker raised a concern about regulations governing the amount of sugar in orange juice, Mr. Kennedy advised: “Why don’t you call Heather Flick or Hannah Anderson this week? And we will act on that as quickly as we can.”But Mr. Kennedy has also demonstrated that he is willing to muscle his agenda forward. He has pushed ahead with a plan to fire about 20,000 staff members from the health department and pare down 28 divisions to 15 — all amid court challenges. His pressure campaign to rid the nation’s food supply of synthetic dyes has produced some results. Under Mr. Kennedy, the department has also taken a series of actions around vaccines that have chipped away at public confidence in the efficacy and safety of the shots.He fired all 17 members of a federal vaccine policy board that makes influential decisions on the availability of the shots. At least three of the people Mr. Kennedy selected to replace the experts he ousted have taken part in lawsuits casting doubt on the safety or efficacy of vaccines.In its first meeting, the new panel voted to rescind recommendations for flu vaccines that contain the ingredient thimerosal, which Mr. Kennedy has long linked to harms.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

People with Parkinson’s disease (PD) have an odour that can be reliably detected from skin swabs by trained dogs, a new study has shown.
The research, in collaboration with Medical Detection Dogs and the Universities of Bristol and Manchester, was published on July 15 in The Journal of Parkinson’s Disease.
Two dogs were trained by the charity, Medical Detection Dogs, to distinguish between sebum swabs from people with and without Parkinson’s disease.
In a double blind trial, they showed sensitivity of up to 80% and specificity of up to 98%.
Not only that, they detected it in samples from patients who also had other health conditions.
The dogs were trained over a number of weeks on over 200 odor samples from individuals that had tested positive for PD and control samples from people who did not have the disease. Samples were presented to the dogs on a stand system and the dogs were rewarded for correctly indicating a positive sample and for correctly ignoring a negative sample.
In the double-blind testing, meaning that only a computer knew where the correct samples were, each line was also presented in reverse order so that samples for which no decision was made were re-presented. Then any unsearched samples were collected together in new lines, until a decision had been made for all samples.

A definitive diagnostic test for Parkinson’s Disease (PD) remains elusive, so identification of potential biomarkers could help diagnosis and timely intervention.
Claire Guest, Medical Detection Dogs CEO and Chief Scientific Officer, says: “We are extremely proud to say that once again, dogs can very accurately detect disease.
“There is currently no early test for Parkinson’s disease and symptoms may start up to 20 years before they become visible and persistent leading to a confirmed diagnosis.
“Timely diagnosis is key as subsequent treatment could slow down the progression of the disease and reduce the intensity of symptoms.”
Nicola Rooney, Associate Professor at Bristol Veterinary School at the University of Bristol and lead author, says: “Identifying diagnostic biomarkers of PD, particularly those that may predict development or help diagnose disease earlier is the subject of much ongoing research. The dogs in this study achieved high sensitivity and specificity and showed there is an olfactory signature distinct to patients with the disease. Sensitivity levels of 70% and 80% are well above chance and I believe that dogs could help us to develop a quick non-invasive and cost-effective method to identify patients with Parkinson’s disease.”
Perdita Barran, Professor of Mass Spectrometry at The University of Manchester, said: “It’s wonderful to be part of this research inspired by Joy Milne and our Nose2Diagnose programme. This study adds to the growing body of evidence showing that simple, non-invasive skin swabs can be used to diagnose Parkinson’s disease, offering a faster and more accessible method for early detection.”
The two dogs in the study were Golden Retriever, Bumper and Black Labrador, Peanut.

Insomnia could explain why adults with ADHD traits report having a lower quality of life, according to new research led by the University of Southampton and the Netherlands Institute of Neuroscience.
A study published on July 15 in BMJ Mental Health found that having higher ADHD traits was associated with a lower quality of life and that insomnia could be part of the reason why.
At least one in four people with attention deficit hyperactivity disorder (ADHD) report having a sleep disorder, with insomnia being the most common of these.
“Our findings show a link between ADHD traits, insomnia severity, and reduced life satisfaction,” says Dr Sarah L. Chellappa, Associate Professor in Psychology at the University of Southampton and senior author on the research paper.
“We know that sleep disruption can impact neurobehavioral and cognitive systems, including attention and emotional regulation. At the same time, sleep disruption may arise from ADHD-related impulsivity and hyperactivity, suggesting a reinforcing cycle between sleep disorders and ADHD.”
Researchers from the University of Southampton and the Netherlands Institute for Neuroscience (Prof Eus Van Someren) examined data from the Netherlands Sleep Registry, an online survey with more than ten thousand adult participants.
The team analysed responses from 1,364 participants who had answered questions about ADHD traits, sleep disturbances, circadian factors, depression, and quality of life.

They found ADHD traits were associated with worse depression, more severe insomnia, lower sleep quality, and a preference for going to bed and waking up later.
ADHD and insomnia severity both predicted a lower quality of life, with analysis suggesting insomnia was the potential link in this association.
“Adults with ADHD traits may be more likely to have low sleep quality, insomnia complaints, and low mood levels, all of which lead to reduced life satisfaction,” says Professor Samuele Cortese, a co-author on the paper, also from the University of Southampton.
“There needs to be more research to understand this complex interplay. By improving our understanding, we could uncover treatment options that improve the quality of life of people with ADHD. For instance, targeting insomnia complaints in individuals with higher ADHD traits, with Cognitive Behavioural Therapy for Insomnia or Sleep Restriction therapy may help improve their quality of life.”
The paper Associations of ADHD symptom severity, sleep/circadian factors, depression, and quality of life is published in BMJ Mental Health and is available online.
The research was supported by the Netherlands Organisation for Scientific Research and the European Research Council.

It turns out the Dark Ages weren’t all that dark! According to new research, medieval medicine was way more sophisticated than previously thought, and some of its remedies are trending today on TikTok.
A new international research project featuring faculty at Binghamton University, State University of New York reveals that people in the Middle Ages weren’t cooped up in castles, wallowing in superstition. They were developing health practices based on the best knowledge they had at the time – some of which mirror modern wellness trends.
“People were engaging with medicine on a much broader scale than had previously been thought,” said Meg Leja, an associate professor of history at Binghamton University who specializes in the political and cultural history of late antique and medieval Europe. “They were concerned about cures, they wanted to observe the natural world and jot down bits of information wherever they could in this period known as the ‘Dark Ages.'”
The Corpus of Early Medieval Latin Medicine (CEMLM), funded by the British Academy, has collected hundreds of medieval manuscripts containing medical material predating the 11th century. Countless manuscripts that have been left out of previous catalogs were included, nearly doubling the number of known medical manuscripts from the Dark Ages.
Some of the recipes resemble health hacks promoted by modern-day influencers, from topical ointments to detox cleanses. Have a headache? Crush the stone of a peach, mix it with rose oil and smear it on your forehead. It might sound odd, but one study published in 2017 showed that rose oil may actually help alleviate migraine pain.
Then there’s lizard shampoo, where you take pieces of lizard to help your hair become more luscious and flowing – or even to remove it, a modern-day parallel to waxing.
“A lot of things that you see in these manuscripts are actually being promoted online currently as alternative medicine, but they have been around for thousands of years,” said Leja.

Leja spent the last two years with the rest of the team preparing the new catalogue (which was just released online), reviewing manuscripts from throughout Europe, and editing and formatting the catalog. She had previously written about medieval medicine in her first book, Embodying the Soul: Medicine and Religion in Carolingian Europe.
Many of the writings were found within the margins of books totally unrelated to medicine — manuscripts on grammar, theology, poetry , etc. Leja said that this speaks to a preoccupation with the body’s health and figuring out ways to control it.
“It’s true that we do lack a lot of sources for the period. In that sense, it is ‘dark.’ But not in terms of any kind of ‘anti-science’ attitudes — people in the early Middle Ages were quite into science, into observation, into figuring out the utility of different natural substances, and trying to identify patterns and make predictions” said Leja.
The research team will continue to update the catalog with new manuscripts and are working on new editions and translations of medical texts that could be used in teaching. Leja noted that while previously catalogs focused on texts from well-known authorities like Hippocrates, this isn’t necessarily material that people in the Dark Ages would have prioritized, and a more comprehensive catalog will allow historians to show medicine in its fullness.
The Corpus of Early Medieval Latin Medicine (CEMLM) is available online, produced by team members from Binghamton, Fordham, St. Andrews, Utrecht, and Oslo.

2 hours agoShareSavePhilippa RoxbyHealth ReporterShareSaveGetty ImagesPhysician associates (PAs) and anaesthesia associates (AAs), who assist doctors in GP surgeries and hospitals, should be known as “assistants” to avoid confusing patients, an independent review says.The review recommends PAs and AAs wear standardised clothing and badges to distinguish them from doctors and should only see patients in limited circumstances. Health Secretary Wes Streeting announced the review last year, following a heated debate over the roles and responsibilities of the healthcare positions.The doctor’s union, the BMA, says the review should have gone further but the union representing PAs and AAs said the plan could make waiting lists longer. Review author Prof Gillian Leng talked to doctors, patients and the public to collect evidence on the safety and effectiveness of the roles of PAs and AAs.She said a clear vision “was largely missing” when they were introduced in 2000 and there was no national plan for how the new roles would fit into existing teams, resulting in growing “confusion about the roles’ purpose and remit”. “Where capacity was limited in local services, gaps in medical posts were sometimes covered by PAs, without taking into account their more limited training or ensuring that supervisors had the necessary understanding of the roles and the time and skills required to provide appropriate oversight,” Prof Leng added.Prof Leng also listened to families of relatives who died after being treated by PAs, believing them to be qualified doctors.”Safety concerns raised in relation to PAs were almost always about making a diagnosis and deciding the initial treatment,” says the review. “It is here that the risk of missing an unusual disease or condition is highest.” Emily Chesterton was told the calf pain she was experiencing in October 2022 was a sprain but it was in fact a blood clot. She died, aged 30, after being seen twice by a physician associate.Susan Pollitt, 77, was being treated by a PA in hospital two years ago after a drain was left in her abdomen for 15 hours longer than it should have been. She died from an infection two days later.Her daughter Kate says the family have never blamed the PA involved but want more clarity. “As a family, when you’ve got someone in hospital, you don’t think straight because you’re just worried about your relative,” she says.”Even though people are telling you who they are, you’re not registering it. So I do think it needs to be made clear, with the uniform and the badges and the name. So we do welcome that,” Kate says.In other cases, patients said they were satisfied after seeing a PA and felt listened to, the review says.The review recommends physician associates should:be renamed “physician assistants” to reflect their supportive role in medical teamsnot see new patients in primary or emergency care until they have been triaged and deemed to have a minor ailmenthave at least two years’ hospital experience before working in a GP surgery or mental health trustbe part of a team led by a senior doctor wear badges, lanyards and clothing to set them apart from doctorsAnaesthesia associates should be renamed “physician assistants in anaesthesia” or PAAs.In addition, patients should be given clear information about the role of a PA and there should be a faculty to represent PAs and set standards for training. Physician associates (PAs) and anaesthesia associates (AAs) were introduced into the NHS in the early 2000s to ease doctors’ workload.As their numbers grew, concerns were raised about the safety of the roles, the lack of clarity around their responsibilities and the impact they had on junior medics’ work and training.PAs are not authorised to prescribe medication but they can order certain scans, take medical histories and conduct physical examinations.Anaesthesia associates (AAs) support surgery teams and are a much smaller group.There are now more than 3,000 PAs and AAs in England but the NHS workforce plan envisages that increasing to 12,000 by 2036.Both PAs and AAs have to complete a two-year postgraduate course. To be eligible they need to have either a science-related undergraduate degree or be a registered healthcare professional already.The Academy of Medical Royal Colleges said there was a growing campaign against their use, fuelled by unsubstantiated claims on social media. It requested an independent review to set out the jobs they can safely do.PAs and AAs have been regulated by the General Medical Council, the body which also regulates doctors, since December 2024.Doctors’ training takes many years longer, and anti-social hours and exams are a regular occurrence.The British Medical Association has said PAs and AAs were being asked to do tasks they were not meant to do and the lines with doctors were getting blurred.Dr Emma Runswick, from the BMA, says the name change to physician assistants is “positive” but doctors haven’t got everything they wanted and more still needs to be done.”Patients can know who they are seeing, but it does not make the key changes that we are looking for in terms of setting out what they can and cannot do.””But we would be a fool to say that it wasn’t some progress.”United Medical Associate Professionals (UMAPs) which represents PAs and AAs broadly welcomes the findings but has concerns, particularly over PAs only treating patients who have already had a diagnosis.”We believe this will only compound the backlog for appointments with GPs and consultants and entirely negates the benefit of having such highly trained medical professionals available on wards and in local surgeries,” said general secretary Stephen Nash.Dr Hilary Williams, incoming vice president of the Royal College of Physicians, said the review was “thoughtful” and “thorough”, and showed that “reform is urgently needed” to ensure safe teamworking in the NHS.

2 hours agoShareSaveShareSaveGetty ImagesA young child has died at Liverpool’s Alder Hey Hospital after contracting measles, raising concerns about the spread of the disease.Cases have been rising in the UK and around the world, with more than 500 reported since January in England alone.The increase is being blamed on the poor uptake of the MMR (measles, mumps and rubella) vaccine. What is measles and what are the symptoms?Measles is a highly contagious disease which is spread by coughs and sneezes.Common symptoms include:high feversore, red and watery eyescoughingsneezingSmall white spots may appear inside the mouth.A blotchy red or brown rash usually appears after a few days, typically on the face and behind the ears, before spreading.The rash can be harder to see on brown and black skin.Measles normally clears up within seven to 10 days. However, it can lead to pneumonia, meningitis, blindness and seizures.Babies and young children, pregnant women and those with a weakened immune system are at increased risk.Measles can be fatal, but this is rare.Between 2000-2023, 26 children and adults died in England and Wales from measles or related infections.Before the latest case in Liverpool, the last child to die as a result of measles complications was 10-year-old Renae Archer, in 2023. Can adults get measles and can you catch it twice?You can catch measles at any age. It is possible – but highly unlikely – to catch it twice as the body builds up immunity to the disease after being infected.Getting it while pregnant can lead to stillbirth, miscarriage or babies being born small.The NHS advises adults to ensure they have had both doses of the MMR vaccine before starting a family.How common is measles in the UK?There were 2,911 confirmed cases of measles in England in 2024, which is the highest annual total since 2012.According to the UK Health Security Agency (UKHSA), this started with an outbreak in Birmingham, which was then overtaken by a surge of cases in London. More than 60% of the 2024 cases were in children aged 10 and under. As at 3 July, there had been 529 reported cases in England in 2025, with 68% occurring in children under 10:44% (233) in London12% (64) in the East of England12% (64) in the North WestAlder Hey Hospital has treated 17 children for measles since June. How common is measles in Europe and the US? The World Health Organization (WHO) and Unicef have warned that the number of measles cases in the European region doubled to 127,350 in 2024 – the highest level in 25 years.A report from the two organisations said children under the age of five accounted for more than 40% of the cases reported in Europe and central Asia.As at 4 July, there were nearly 1,300 confirmed measles cases in the US – a 33-year high.More than nine in 10 of those affected (92%) were either unvaccinated or did not know their vaccination status. Texas is the the worst-hit state with more than 700 cases. Kansas and New Mexico have also had outbreaks. At least three people have died and 155 others have been hospitalised. EPAWhy are measles cases rising?The number of young primary school children in the UK who have had both recommended doses of the MMR vaccine is below WHO targets.NHS figures for 2023-2024 show that 84.5% of children across the UK had received two MMR doses by their fifth birthday. The recommended figure is 95%.Across England, London had the lowest take-up at 73.3%, followed by the West Midlands at 83.1% and the North West at 84.5%. The WHO said vaccination rates have also fallen across Europe, leaving millions of children at risk. Child health experts say some parents underestimate the seriousness of measles because the success of the vaccine programme meant it had largely been eradicated.In addition, many routine health appointments were missed during the Covid pandemic.There are also still people who wrongly believe the MMR jab is linked to autism. Researcher Andrew Wakefield falsely claimed the two were connected in 1998.His work was later dismissed, and Wakefield was struck off by the General Medical Council in 2010, but fears about the jab persisted despite being disproven.ReutersHow can I get the MMR vaccine in the UK?The first measles vaccinations were introduced in the UK in 1968. The current two-dose MMR vaccine started in 1996 and is very effective.After both MMR doses, 99% of people are protected against measles and rubella and 88% are protected against mumps.The first MMR dose is usually given at 12 months old, while the second jab is administered at about three years and four months, before children start primary school.However, adults and children can have the MMR jab at any point via their GP.People who do not eat pork products can request an alternative jab called Priorix.If the MMR is not suitable, someone at immediate risk of catching measles can have a treatment called human normal immunoglobulin (HNIG).Most MMR side effects are mild but the injection site can be red, sore and swollen for a few days.Babies and young children may develop a high temperature for up to 72 hours.There is no evidence linking the MMR vaccine with autism.Related internet links