BBCIt had been the NHS’s longest-running and bitterest pay dispute – responsible for hundreds of thousands of cancelled operations and appointments.

Mariana Pajón is one of the world’s most accomplished BMX riders, and she can quickly recount some of her career totals: 18 world championships, two Olympic gold medals in racing (in 2012 and 2016) and one silver, in Tokyo in 2021.But Pajón, a Colombian, can also rattle off the much more painful totals of the cost of so much riding: 25 fractures, 12 screws, eight surgeries and countless tears of ligaments and tendons. The medical hardware in her left arm and knee included so much metal that she used to travel with her X-rays. Opening a door or serving a glass of water hurts.“My joints are of an 80-plus-year-old,” Pajón said with a laugh. She is 32.Pajón, who has been racing competitively since she was 4, wasn’t lamenting her injuries during a recent conversation. They are simply a fact of life for an athlete.Wear and tear naturally degrades human bodies, even the most talented ones. But performing at the elite level, especially in high-impact Olympic sports such as wrestling, rugby or gymnastics, inherently has more risks. Shoulders give out. Ligaments tear. And, for some, metal screws and titanium plates become just more hardware in the lifelong pursuit of gold, silver and bronze.Pajón training in Medellín, Colombia, in June. She has sacrificed her body “to achieve a dream,” she said.Federico Rios for The New York TimesConnor Fields, an American BMX rider, was badly injured during the men’s semifinals at the Tokyo Olympics in 2021.Chang W. Lee/The New York TimesWe 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.

The British Medical Association has called for the ban on puberty blockers for under 18s to be lifted.

A seven-year-old boy has become the first child in the UK to undergo surgery using a pioneering robot-assisted device.

SuppliedThe twin sister of a woman who died after being found under a coat while waiting for hours at an overcrowded A&E department says she cannot accept what happened to her.

Luciano Fregonese, the mayor of a town in Italy known for Prosecco, started walking to counter the calories he consumed at social obligations. His jaunts have become a sensation.In a world that seems consumed by the trials of capitalism and the unyielding pressure to work, Robin Leach, the British television personality who died in 2018, noted one place that did it differently: In Italy, Mr. Leach said, they add work and life onto food and wine.Luciano Fregonese, the mayor of Valdobbiadene — a rural town of 10,000 people in Italy’s picturesque northeast, famous for its Prosecco — has lived such truths.“It’s not easy, because every weekend there is one or two or three or maybe more events to attend to, and every event it is common to drink wine, or Prosecco, and also to eat,” the mayor said in an interview, with the help of a translator. “It’s not easy to say ‘no.’”Such are the burdens of a three-term mayor in this lush region of Italy, where Mr. Fregonese — concerned about the toll the job was taking on his health — has added a new assignment to his regular mayoral duties: On Thursdays, Mr. Fregonese walks.Luciano Fregonese, center, in a white shirt, on a stroll through the town with his constituents and other walking enthusiasts.Luciano FregoneseIt began as a lighthearted gag between friends, that the boisterous 47-year-old had taken his mayoral job to heart — and waistline. Mr. Fregonese, who says he has gained weight since first being elected mayor in 2014, was already becoming more concerned about his job’s toll on his health before he won a third term in June.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.

GPs in England could launch a work-to-rule which would see them limit the number of appointments each day.

Rachel/BBCMore people with mental health struggles are being sent far from home for in-patient treatment, despite ministers previously pledging to abolish the practice by 2021.

Matthew Carr-GommThe family of a diabetic woman who died when she went to a slapping workshop and stopped taking her insulin have called for greater regulation for alternative therapies.

It’s probably not selfishness, experts say. Even young adults who want children see an increasing number of obstacles.For years, some conservatives have framed the declining fertility rate of the United States as an example of eroding family values, a moral catastrophe in slow motion.JD Vance, the Republican vice-presidential nominee, recently came under fire for saying in 2021 that the nation was run by “childless cat ladies” who “hate normal Americans for choosing family over these ridiculous D.C. and New York status games.”Last year, Ashley St. Clair, a Fox News commentator, described childless Americans this way: “They just want to pursue pleasure and drinking all night and going to Beyoncé concerts. It’s this pursuit of self-pleasure in replace of fulfillment and having a family.”Researchers who study trends in reproductive health see a more nuanced picture. The decision to forgo having children is most likely not a sign that Americans are becoming more hedonistic, they say. For one thing, fertility rates are declining throughout the developed world.Rather, it indicates that larger societal factors — such as rising child care costs, increasingly expensive housing and slipping optimism about the future — have made it feel more untenable to raise children in the United States.“I don’t see it as a lack of a commitment to family,” said Mary Brinton, a sociologist who studies low fertility rates at Harvard. “I think the issues are very much on the societal level and the policy level.”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.