It can be hard to sort through the conflicting and evolving information about vaccines. Here’s the latest guidance on Covid boosters, flu shots, childhood immunizations and more.The vaccine situation in the United States has become confusing and chaotic. With evolving policies and recommendations, it can be hard to keep up.Members of the Centers for Disease Control and Prevention’s vaccine guidelines committee convened last week and voted to limit access to updated Covid vaccines and combination shots for measles, mumps, rubella and chickenpox, pursuing an agenda pushed by Health Secretary Robert F. Kennedy Jr. The full consequences of the changes are not yet clear, but if adopted by the acting director of the C.D.C., they have the potential to affect both patient decisions and insurance coverage.President Trump and Mr. Kennedy have also repeatedly suggested that vaccines may be linked to the rise of autism diagnoses, a claim that has been discredited by decades of scientific studies.We know you have questions about vaccines. After we asked what readers wanted to know, we received hundreds of queries about efficacy, safety, cost and access.Here are some of the most common ones we received, answered by New York Times health and science reporters.Here’s what you need to know:Are updated Covid shots available? Who can get them?Are updated flu shots available?What has changed about access to the M.M.R.V. vaccine?Why do newborns get the hepatitis B vaccine?Will my insurance keep paying for vaccines?If I have to pay out of pocket, how much do vaccines cost?Will I be able to get vaccines at a pharmacy, doctor’s office or health clinic?How are vaccines and their ingredients tested for safety?Is it safe for my child to follow the childhood vaccine schedule? How about to receive multiple vaccines at once?Do vaccines cause autism?How common are serious reactions to vaccines? Are certain groups more susceptible to them?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.

As a wound heals, it goes through several stages: clotting to stop bleeding, immune system response, scabbing, and scarring.
A wearable device called “a-Heal,” designed by engineers at the University of California, Santa Cruz, aims to optimize each stage of the process. The system uses a tiny camera and AI to detect the stage of healing and deliver a treatment in the form of medication or an electric field. The system responds to the unique healing process of the patient, offering personalized treatment.
The portable, wireless device could make wound therapy more accessible to patients in remote areas or with limited mobility. Initial preclinical results, published in the journal npj Biomedical Innovations, show the device successfully speeds up the healing process.
Designing a-Heal
A team of UC Santa Cruz and UC Davis researchers, sponsored by the DARPA-BETR program and led by UC Santa Cruz Baskin Engineering Endowed Chair and Professor of Electrical and Computer Engineering (ECE) Marco Rolandi, designed a device that combines a camera, bioelectronics, and AI for faster wound healing. The integration in one device makes it a “closed-loop system” — one of the firsts of its kind for wound healing as far as the researchers are aware.
“Our system takes all the cues from the body, and with external interventions, it optimizes the healing progress,” Rolandi said.
The device uses an onboard camera, developed by fellow Associate Professor of ECE Mircea Teodorescu and described in a Communications Biology study, to take photos of the wound every two hours. The photos are fed into a machine learning (ML) model, developed by Associate Professor of Applied Mathematics Marcella Gomez, which the researchers call the “AI physician” running on a nearby computer.

“It’s essentially a microscope in a bandage,” Teodorescu said. “Individual images say little, but over time, continuous imaging lets AI spot trends, wound healing stages, flag issues, and suggest treatments.”
The AI physician uses the image to diagnose the wound stage and compares that to where the wound should be along a timeline of optimal wound healing. If the image reveals a lag, the ML model applies a treatment: either medicine, delivered via bioelectronics; or an electric field, which can enhance cell migration toward wound closure.
The treatment topically delivered through the device is fluoxetine, a selective serotonin reuptake inhibitor which controls serotonin levels in the wound and improves healing by decreasing inflammation and increasing wound tissue closure. The dose, determined by preclinical studies by the Isseroff group at UC Davis group to optimize healing, is administered by bioelectronic actuators on the device, developed by Rolandi. An electric field, optimized to improve healing and developed by prior work of the UC Davis’ Min Zhao and Roslyn Rivkah Isseroff, is also delivered through the device.
The AI physician determines the optimal dosage of medication to deliver and the magnitude of the applied electric field. After the therapy has been applied for a certain period of time, the camera takes another image, and the process starts again.
While in use, the device transmits images and data such as healing rate to a secure web interface, so a human physician can intervene manually and fine-tune treatment as needed. The device attaches directly to a commercially available bandage for convenient and secure use.
To assess the potential for clinical use, the UC Davis team tested the device in preclinical wound models. In these studies, wounds treated with a-Heal followed a healing trajectory about 25% faster than standard of care. These findings highlight the promise of the technology not only for accelerating closure of acute wounds, but also for jump-starting stalled healing in chronic wounds.

AI reinforcement
The AI model used for this system, which was led by Assistant Professor of Applied Mathematics Marcella Gomez, uses a reinforcement learning approach, described in a study in the journal Bioengineering, to mimic the diagnostic approach used by physicians.
Reinforcement learning is a technique in which a model is designed to fulfill a specific end goal, learning through trial and error how to best achieve that goal. In this context, the model is given a goal of minimizing time to wound closure, and is rewarded for making progress toward that goal. It continually learns from the patient and adapts its treatment approach.
The reinforcement learning model is guided by an algorithm that Gomez and her students created called Deep Mapper, described in a preprint study, which processes wound images to quantify the stage of healing in comparison to normal progression, mapping it along the trajectory of healing. As time passes with the device on a wound, it learns a linear dynamic model of the past healing and uses that to forecast how the healing will continue to progress.
“It’s not enough to just have the image, you need to process that and put it into context. Then, you can apply the feedback control,” Gomez said.
This technique makes it possible for the algorithm to learn in real-time the impact of the drug or electric field on healing, and guides the reinforcement learning model’s iterative decision making on how to adjust the drug concentration or electric-field strength.
Now, the research team is exploring the potential for this device to improve healing of chronic and infected wounds.
Additional publications related to this work can be found linked here.
This research was supported by the Defense Advanced Research Projects Agency and the Advanced Research Projects Agency for Health.

The cultivation of rice — the staple grain for more than 3.5 billion people around the world — comes with extremely high environmental, climate and economic costs. But this may be about to change, thanks to new research led by scientists at the University of Massachusetts Amherst and China’s Jiangnan University. They have shown that nanoscale applications of the element selenium can decrease the amount of fertilizer necessary for rice cultivation while sustaining yields, boosting nutrition, enhancing the soil’s microbial diversity and cutting greenhouse gas emissions. What’s more, in a new paper published in the Proceedings of the National Academy of Sciences, they demonstrate for the first time that such nanoscale applications work in real-world conditions.
“The Green Revolution massively boosted agriculture output during the middle of the last century,” says Baoshan Xing, University Distinguished Professor of Environmental and Soil Chemistry, director of UMass’ Stockbridge School of Agriculture, and co-senior author of the new research. “But that revolution is running out of steam. We need to figure out a way to fix it and make it work.”
Part of what made the Green Revolution so revolutionary was the invention of synthetic, nitrogen-heavy fertilizers that could keep agricultural yields high. But they’re expensive to make, they create an enormous amount of carbon dioxide, and much of the fertilizer washes away.
Most crops only use about 40-60% of the nitrogen applied to them, a measurement known as nitrogen use efficiency, or NUE, and the NUE of rice can be as low as 30% — which means that 70% of what a farmer puts on their fields washes away into streams, lakes and the oceans, causing eutrophication, dead zones and a host of other environmental problems. It also means that 70% of the cost of the fertilizer is likewise wasted.
Furthermore, when nitrogen is applied to soils, it interacts with the soil’s incredibly complex chemistry and microbes, and ultimately leads to vastly increased amounts of methane, ammonia and nitrous oxide — all of which contribute to global warming. Furthermore, synthesizing fertilizer itself is a greenhouse-gas-heavy enterprise.
“Everybody knows that we need to improve NUE,” says Xing — the question is how?
What Xing and his co-authors, including lead author Chuanxi Wang and another senior author, Zhenyu Wang, professors of environmental processes and pollution control at Jiangnan University discovered, is that nanoscale selenium, an element crucial for plant and human health, when applied to the foliage and stems of the rice, reduced the negative environmental impacts of nitrogen fertilization by 41% and increased the economic benefits by 38.2% per ton of rice, relative to conventional practices.

“We used an aerial drone to lightly spray rice growing in a paddy with the suspension of nanoscale selenium,” says Wang. “That direct contact means that the rice plant is far more efficient at absorbing the selenium than it would be if we applied it to the soil.”
Selenium stimulates the plant’s photosynthesis, which increased by more than 40%. Increased photosynthesis means the plant absorbs more CO2, which it then turns into carbohydrates. Those carbohydrates flow down into the plant’s roots, which causes them to grow. Bigger, healthier roots release a host of organic compounds that cultivate beneficial microbes in the soil, and it’s these microbes that then work symbiotically with the rice roots to pull more nitrogen and ammonium out of the soil and into the plant, increasing its NUE from 30 to 48.3%, decreasing the amount of nitrous oxide and ammonia release to the atmosphere by 18.8-45.6%.
With more nutrients coming in, the rice itself produces a higher yield, with a more nutritious grain: levels of protein, certain critical amino acids, and selenium also jumped.
On top of all of this, Xing, Wang and their colleagues found that their nano-selenium applications allowed farmers to reduce their nitrogen applications by 30%. Since rice cultivation accounts for 15-20% of the global nitrogen use, this new technique holds real promise for helping to meet the triple threat of growing population, climate change, and the rising economic and environmental costs of agriculture.

“This concerns the biosynthesis of a molecule that has a very long history with humans,” explains Prof. Dirk Hoffmeister, head of the research group Pharmaceutical Microbiology at Friedrich Schiller University Jena and the Leibniz Institute for Natural Product Research and Infection Biology (Leibniz-HKI). “We are referring to psilocybin, a substance found in so-called ‘magic mushrooms’, which our body converts into psilocin – a compound that can profoundly alter consciousness. However, psilocybin not only triggers psychedelic experiences, but is also considered a promising active compound in the treatment of therapy-resistant depression,” says Hoffmeister.
Two paths, one molecule
The study, which was conducted within the Cluster of Excellence ‘Balance of the Microverse’, shows for the first time that fungi have developed the ability to produce psilocybin at least twice independently of each other. While Psilocybe species use a known enzyme toolkit for this purpose, fiber cap mushrooms employ a completely different biochemical arsenal – and yet arrive at the same molecule. This finding is considered an example of convergent evolution: different species have independently developed a similar trait, but the ‘magic mushrooms’ have gone their own way in doing so.
Searching for clues in fungal genomes
Tim Schäfer, lead author of the study and doctoral researcher in Hoffmeister’s team, explains: “It was like looking at two different workshops, but both ultimately delivering the same product. In the fiber caps, we found a unique set of enzymes that have nothing to do with those found in Psilocybe mushrooms. Nevertheless, they all catalyze the steps necessary to form psilocybin.”
The researchers analyzed the enzymes in the laboratory. Protein models created by Innsbruck chemist Bernhard Rupp confirmed that the sequence of reactions differs significantly from that known in Psilocybe. “Here, nature has actually invented the same active compound twice,” says Schäfer.
However, why two such different groups of fungi produce the same active compound remains unclear. “The real answer is: we don’t know,” emphasizes Hoffmeister. “Nature does nothing without reason. So there must be an advantage to both fiber cap mushrooms in the forest and Psilocybe species on manure or wood mulch producing this molecule – we just don’t know what it is yet.”
“One possible reason could be that psilocybin is intended to deter predators. Even the smallest injuries cause Psilocybe mushrooms to turn blue through a chemical chain reaction, revealing the breakdown products of psilocybin. Perhaps the molecule is a type of chemical defense mechanism,” says Hoffmeister.

More tools for biotechnology
Although it is still unclear why different fungi ultimately produce the same molecule, the discovery nevertheless has practical implications: “Now that we know about additional enzymes, we have more tools in our toolbox for the biotechnological production of psilocybin,” explains Hoffmeister.
Schäfer is also looking ahead: “We hope that our results will contribute to the future production of psilocybin for pharmaceuticals in bioreactors without the need for complex chemical syntheses.” At the Leibniz-HKI in Jena, Hoffmeister’s team is working closely with the Bio Pilot Plant, which is developing processes for producing natural products such as psilocybin on an industry-like scale.
At the same time, the study provides exciting insights into the diversity of chemical strategies used by fungi and their interactions with their environment. It thus addresses central questions of the Collaborative Research Center ChemBioSys and the Cluster of Excellence ׅ’Balance of the Microverse’ at Friedrich Schiller University Jena, within the framework of which the work was carried out and funded by the German Research Foundation (DFG), among others. While the CRC ChemBioSys investigates how natural compounds shape biological communities, the Cluster of Excellence focuses on the complex dynamics of microorganisms and their environment.

15 minutes agoShareSaveJames GallagherHealth and science correspondentShareSaveBBC/Fergus WalshOne of the cruellest and most devastating diseases – Huntington’s – has been successfully treated for the first time, say doctors.The disease runs through families, relentlessly kills brain cells and resembles a combination of dementia, Parkinson’s and motor neurone disease.An emotional research team became tearful as they described how data shows the disease was slowed by 75% in patients.It means the decline you would normally expect in one year would take four years after treatment, giving patients decades of “good quality life”, Prof Sarah Tabrizi told BBC News.The new treatment is a type of gene therapy given during 12 to 18 hours of delicate brain surgery.The first symptoms of Huntington’s disease tend to appear in your 30s or 40s and is normally fatal within two decades – opening the possibility that earlier treatment could prevent symptoms from ever emerging.Prof Tabrizi, director of the University College London Huntington’s Disease Centre, described the results as “spectacular”. “We never in our wildest dreams would have expected a 75% slowing of clinical progression,” she said.None of the patients who have been treated are being identified, but one was medically retired and has returned to work. Others in the trial are still walking despite being expected to need a wheelchair.Treatment is likely to be very expensive. However, this is a moment of real hope in a disease that hits people in their prime and devastates families.BBC/Fergus WalshHuntington’s runs through Jack May-Davis’ family. He has the faulty gene that causes the disease, as did his dad, Fred, and his grandmother, Joyce.Jack said it was “really awful and horrible” watching his dad’s inexorable decline. The first symptoms appeared in Fred’s late 30s, including changes in behaviour and the way he moved. He eventually needed 24/7 palliative care before he died at the age of 54, in 2016.Jack is 30, a barrister’s clerk, newly engaged to Chloe and has taken part in research at UCL to turn his diagnosis into a positive.But he’d always known he was destined to share his father’s fate, until today.Now he says the “absolutely incredible” breakthrough has left him “overwhelmed” and able to look to a future that “seems a little bit brighter, it does allow me to think my life could be that much longer”.May-Davis familyHuntington’s disease is caused by an error in part of our DNA called the huntingtin gene.This mutation turns a normal protein needed in the brain – called the huntingtin protein – into a killer of neurons.The goal of the treatment is to reduce levels of this toxic protein permanently, in a single dose.The therapy uses cutting edge genetic medicine combining gene therapy and gene silencing technologies.It starts with a safe virus that has been altered to contain a specially designed sequence of DNA.This is infused deep into the brain using real-time MRI scanning to guide a microcatheter to two brain regions – the caudate nucleus and the putamen. This takes 12 to 18 hours of neurosurgery.The virus then acts like a microscopic postman – delivering the new piece of DNA inside brain cells, where it becomes active.This turns the neurons into a factory for making the therapy to avert their own death.The cells produce a small fragment of genetic material (called microRNA) that is designed to intercept and disable the instructions (called messenger RNA) being sent from the cells’ DNA for building mutant huntingtin.This results in lower levels of mutant huntingtin in the brain.UCLHResults from the trial – which involved 29 patients – have been released in a statement by the company uniQure, but have not yet been published in full for review by other specialists.The data showed that three years after surgery there was an average 75% slowing of the disease based on a measure which combines cognition, motor function and the ability to manage in daily life.The data also shows the treatment is saving brain cells. Levels of neurofilaments in spinal fluid – a clear sign of brain cells dying – should have increased by a third if the disease continued to progress, but was actually lower than at the start of the trial.”This is the result we’ve been waiting for,” said Prof Ed Wild, consultant neurologist at the National Hospital for Neurology and Neurosurgery at UCLH.”There was every chance that we would never see a result like this, so to be living in a world where we know this is not only possible, but the actual magnitude of the effect is breathtaking, it’s very difficult to fully encapsulate the emotion.”He said he was “a bit teary” thinking about the impact it could have on families.The treatment was considered safe, although some patients did develop inflammation from the virus that caused headaches and confusion that either resolved or needed steroid treatment.Prof Wild anticipates the therapy “should last for life” because brain cells are not replaced by the body in the same manner as blood, bone and skin are constantly renewed.Approximately 75,000 people have Huntington’s disease in the UK, US and Europe with hundreds of thousands carrying the mutation meaning they will develop the disease.UniQure says it will apply for a licence in the US in the first quarter of 2026 with the aim of launching the drug later that year. Conversations with authorities in the UK and Europe will start next year, but the initial focus is on the US.Dr Walid Abi-Saab, the chief medical officer at uniQure, said he was “incredibly excited” about what the results mean for families, and added that the treatment had “the potential to fundamentally transform” Huntington’s disease.However, the drug will not be available for everyone due to the highly complex surgery and the anticipated cost.”It will be expensive for sure,” says Prof Wild.There isn’t an official price for the drug. Gene therapies are often pricey, but their long-term impact means that can still be affordable. In the UK, the NHS does pay for a £2.6m-per-patient gene therapy for haemophilia B.Prof Tabrizi says this gene therapy “is the beginning” and will open the gates for therapies that can reach more people.She paid tribute to the “truly brave” volunteers who took part in the trial, saying she was “overjoyed for the patients and families”.She is already working with a group of young people who know they have the gene, but don’t yet have symptoms – known as stage zero Huntington’s – and is aiming to do the first prevention trial to see if the disease can be significantly delayed or even stopped completely.

31 minutes agoShareSaveCatherine SnowdonHealth ProducerShareSaveGetty ImagesThousands of pharmacies in England will offer free NHS flu spray doses to toddlers for the first time this year.The vaccination is given via a child’s nose and two and three-year-olds could previously access them at their GP surgery.Around 4,000 pharmacies have signed up to deliver the vaccine to 1.2 million eligible toddlers from 1 October.Both walk-in and booked flu vaccine appointments will be available as part of the NHS drive to increase vaccine uptake nationally.NHS England stats show that last winter, there were more than 300,000 hospital bed days taken up by patients with flu – almost double the previous winter.It’s a situation Health Minister Ashley Dalton said “we cannot afford a repeat of” this year.The hope is that by vaccinating young children, they are not only protected from catching flu, but they will also not pass the virus on to others.Flu vaccines are available on the NHS for:everyone aged 65 and over under 65s in clinical risk groupscare home residents and carers close contacts of those who are immunosuppressed frontline social care workers health and social care staffchildren and pregnant womenThe move to increase the use of pharmacies is part of a wider campaign by the NHS to improve vaccination rates. In some areas with low uptake, vaccines will be delivered in nurseries and mobile vaccination buses will be deployed to help reach more vulnerable people of all ages.”For busy families, it can be hard to fit everything in, but parents will now be able to pop into a pharmacy in their local high street or supermarket to get their little ones protected ahead of winter, when bugs tend to circulate,” said Duncan Burton, chief nursing officer for England.”Flu can make young children and toddlers seriously unwell, and vaccination is the best way to shield them, so we’re making it easier than ever before to get the vaccine closer to home.”Henry Gregg, chief executive of the National Pharmacy Association, which represents about 6,000 independent community pharmacies, said the move to use pharmacies for toddler vaccinations was “excellent news”.”Pharmacies are quick and convenient to access for patients and the government should use them for more NHS vaccination campaigns, if they are to maximise take up and prevent more serious illness.”

When children are exposed to acetaminophen — also known by the brand name Tylenol or as paracetamol — during pregnancy, they may be more likely to develop neurodevelopmental disorders (NDDs) including autism and ADHD, according to a new study.
The study was published recently in BMC Environmental Health. Andrea Baccarelli, dean of the faculty at Harvard T.H. Chan School of Public Health and professor of environmental health, was senior author. The study was led by the Icahn School of Medicine at Mount Sinai and also included co-authors from other institutions.
The researchers analyzed results from 46 previous studies worldwide that investigated the potential link between prenatal acetaminophen use and subsequent NDDs in children. The researchers used the Navigation Guide Systematic Review methodology — a gold-standard framework for synthesizing and evaluating environmental health data — which enabled them to conduct a rigorous, comprehensive analysis that supported evidence of an association between acetaminophen exposure during pregnancy and increased incidence of NDDs.
The researchers noted that while steps should be taken to limit acetaminophen use, the drug is important for treating pain and fever during pregnancy, which can also harm the developing fetus. High fever can raise the risk of neural tube defects and preterm birth. “We recommend judicious acetaminophen use — lowest effective dose, shortest duration — under medical guidance, tailored to individual risk-benefit assessments, rather than a broad limitation,” they wrote.
In late September, the Food and Drug Administration announced it would issue a letter to clinicians urging them to be cautious about the use of acetaminophen in pregnancy. Baccarelli said he had discussed his study with Health and Human Services Secretary Robert F. Kennedy Jr. in the weeks leading up to that announcement and provided the White House team with an statement noting his research found “evidence of an association” between prenatal exposure to acetaminophen and neurodevelopmental disorders. “That association is strongest when acetaminophen is taken for four weeks or longer,” Baccarelli said.
The statement continued: “Further research is needed to confirm the association and determine causality, but based on existing evidence, I believe that caution about acetaminophen use during pregnancy — especially heavy or prolonged use — is warranted.”
Baccarelli noted in the “competing interests” section of the research paper that he has served as an expert witness for plaintiffs in a case involving potential links between acetaminophen use during pregnancy and neurodevelopmental disorders.
The study was conducted in collaboration with the University of California, Los Angeles; University of Massachusetts Lowell; and Harvard T.H. Chan School of Public Health.
Funding for this study was provided by the National Cancer Institute (U54CA267776), the National Institute of Environmental Health Sciences (R35ES031688), and the National Institute on Aging (U01AG088684).

An NHS trust at the centre of concerns over its poor maternity services has had to repay almost £5m after wrongly claiming it provided safe care to mothers and their babies.Leeds Teaching Hospitals NHS Trust was paid the money after saying its services met safe standards of care and staffing.But a subsequent investigation by the health service’s litigation arm, NHS Resolution, found the trust had not met the standards and asked for the money to be repaid to the NHS.The Leeds trust said they had allocated additional funding to improve maternity services.The trust received the money under a programme called the Maternity Incentive Scheme, which is run by NHS Resolution to encourage the health service to provide good maternity care. Hospitals are asked to judge their performance against a range of standards, including listening to patients’ concerns, staffing levels and properly investigating deaths.If a trust meets all 10 safety measures, it can get a rebate on its insurance premiums as well as a share of the money paid by trusts that do not meet all the goals.For the past two years, the Leeds trust reported it had met all 10 standards and was paid £4,887,084 from the scheme. But the regulator, the Care Quality Commission (CQC), published a damning report in June about maternity services at the trust. Care was rated as inadequate, the lowest level, and it warned that women and babies were being exposed to “significant risk”.The report prompted NHS Resolution to ask Leeds to re-examine its submissions to the Maternity Incentive Scheme. The subsequent review found not all safety standards had been met, forcing the trust to repay all the money it had received.”The repayment of the award is long overdue and should be going back even further,” said Fiona Winser-Ramm, who lost her daughter Aliona in 2020 after what an inquest found to be a number of “gross failures” in the care they received.”This provides yet further evidence for the need for a full, independent inquiry into the Leeds trust,” she said, believing this should be led by senior midwife Donna Ockenden.Mrs Winser-Ramm was among a group of parents who met Health Secretary Wes Streeting last week and demanded an investigation into maternity services at the trust. Streeting has so far refused to order such an inquiry but the families, who have all experienced poor maternity care, said they remained hopeful. Over the past few months, dozens of families have told the BBC they received inadequate care at the trust.The Maternity Incentive Scheme has been beset by problems since it was set up in 2018 by the then health secretary, Jeremy Hunt. NHS trusts with poor maternity safety records, including Shrewsbury and Telford, Morecambe Bay, East Kent and Nottingham have all claimed to have met the 10 standards and been paid millions of pounds only to later have to repay it. An analysis published by NHS Resolution in July found 24 trusts have had to repay premiums over the first four years of the scheme, with 18 of them having to do so more than once.”Nationally, families have long raised concerns about the huge flaws of the self- assessment involved by individual trusts in the maternity incentive scheme,” said Mrs Winser-Ramm. “Serious questions need to be asked about how, if trusts are unable to accurately self-report compliance, how satisfied can we be that similar misreporting is not commonplace in other areas of self-reporting.”After the review found Leeds had to repay the money it had received, the trust applied to a separate fund run by NHS Resolution for maternity improvement support and was allocated £2.1m.In a statement to the BBC, the Leeds Teaching Hospitals NHS Trust did not explain how it had erroneously self-reported that it was compliant with all the standards of the scheme.”We identified that we were not fully compliant with the MIS scheme,” said Magnus Harrison, the trust’s chief medical officer. “We have now been allocated £2.1m to support our action plan to achieve compliance, which forms part of our Maternity and Neonatal Improvement Programme.”

19 minutes agoShareSaveYasmin RufoBBC NewsShareSaveGetty ImagesFor many of us, our first lessons about periods were brief and practical, often limited to learning how to use pads or tampons.Alongside these traditional options, there’s now a wider range of products available, including reusable options such as menstrual cups, period pants and washable pads.Making the choice about which one is best for you can be overwhelming. You might wonder how these products work and whether they’re foolproof enough to put the fear of bleeding through your clothes at bay. Dr Tempest, a consultant gynaecologist at the University of Liverpool, spoke to Radio 4’s Sliced Bread about how each product works and the pros and cons to help you decide which might suit you best.Menstrual cupGetty ImagesMenstrual cups are small flexible cups made of medical-grade silicone. You fold and insert them into the vagina, where they collect blood rather than absorbing it.Dr Tempest says there are different types of cups available to buy based on how heavy your flow is or whether you’ve had children.Hygiene is also really important so make sure you wash your hands before you insert the cup and clean the cup between uses, she adds.ProsThe most eco-friendly period product Holds up to three times more blood than a tampon Can be worn for up to 12 hours Reusable for years – they can last up to 10 years but between two and four years is the average Cost effective over time ConsTakes practice to insert and remove May take time to find the right fit Messy to empty, especially in a public toilet Needs sterilising between cycles Larger upfront cost which can be around £20 to £25Period pants Getty ImagesPeriod pants are underwear with built-in absorbent layers. You wear them like normal pants then rinse, wash and dry them for reuse.They’re particularly popular for sleeping or on lighter days. Leakage worries are normal but Dr Tempest says they are reliable for most people and have a built-in waterproof layer and odour lining.ProsLooks and feels like regular underwear No shifting around and last between six and eight hoursReusable and eco-friendly – they last between two and three years Can be layered with other products for extra protections ConsCan have an expensive upfront cost – prices start from around £10 and go up to £50 Requires washing and drying between uses May not be absorbent enough for heavy flows Inconvenient for travel without access to laundry Will need to carry a used pair home with you if changing them during the dayReusable padsGetty ImagesReusable pads look similar to disposable ones but are usually made from cotton or bamboo and fasten around your underwear with poppers. Instead of throwing them away, you rinse, wash and dry them to use again.Pros Softer and more comfortable to wear than plastic-based pads Eco-friendly so popular if you’re wanting a more sustainable optionVariety of sizes and absorbencies Cost effective over timeCan last between three and five yearsConsNeed to be washed after each use Requires planning – they must be dried properly between uses says Dr Tempest as damp fabric against your skin can increase the risk of infectionBulkier than disposable padsLess convenient if you’re out of the house as you’ll need to carry the used ones home with youDisposable PadsGetty ImagesDisposable sanitary pads are the most commonly used period product – they stick into your underwear, absorb blood externally and are wrapped and binned after use.Dr Tempest advises changing pads regularly (every four to six hours) and they shouldn’t be worn for more than eight hours as they can irritate the skin if worn for too long. ProsSimple to use Widely available in many different sizes from ultra-thin to thick night padsGood for overnight protectionCan be more comfortable for beginners ConsCan feel bulky or shift out of place Not practical for water-based sports, such as swimmingEnvironmentally harmful – an average pack of pads holds the same amount of plastic as five carrier bags according to Dr TempestMore expensive than reusable options over time – women spend around £5,000 on period products over a lifetimeTampons Getty ImagesTampons are also commonly used and inserted into the vagina, where they soak up blood before it leaves the body.Dr Tempest stresses that they must be correctly disposed of.Every day, 2.5 million tampons are flushed down the toilet when they should be placed in a bin. ProsDiscreet and small enough to carry in a pocketGood for sports and swimming Range of absorbenciesConsRequires insertion which some people may find uncomfortable Low risk of Toxic Shock Syndrome (TSS) if worn for too long Environmentally unfriendlyMore expensive over a lifetime compared to reusable products

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