Publisher Health

Health Secretary Wes Streeting has told health chiefs in England to prioritise safety even if it means performance against the four-hour A&E target slips this winter.

Dawn was still hours away when Angel Cholka was awakened by the beams of a police flashlight through the window. At the door was an officer, who asked if someone named Madi lived there. He said he needed to check on her. Ms. Cholka ran to her 16-year-old’s bedroom, confused and, suddenly, terrified.Ms. Cholka did not know that A.I.-powered software operated by the local school district in Neosho, Mo., had been tracking what Madi was typing on her school-issued Chromebook.While her family slept, Madi had texted a friend that she planned to overdose on her anxiety medication. That information shot to the school’s head counselor, who sent it to the police. When Ms. Cholka and the officer reached Madi, she had already taken about 15 pills. They pulled her out of bed and rushed her to the hospital.Thousands of miles away, at around midnight, a mother and father in Fairfield County, Conn., received a call on their landline and were unable to reach it in time to answer. Fifteen minutes later, the doorbell rang. Three officers were on the stoop asking to see their 17-year-old daughter, who had been flagged by monitoring software as at urgent risk for self-harm.The girl’s parents woke her and brought her downstairs so the police could quiz her on something she had typed on her school laptop. It took only a few minutes to conclude that it was a false alarm — the language was from a poem she wrote years earlier — but the visit left the girl profoundly shaken.“It was one of the worst experiences of her life,” said the girl’s mother, who requested anonymity to discuss an experience “traumatizing” to her daughter.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.

PAWhen the BBC reported that waiting lists for gynaecology appointments across the UK

Getty ImagesIt is among the most delicate and controversial challenges in modern medicine – how to determine whether the benefits of puberty blockers (or drugs that delay puberty) outweigh the potential harms.

On Sept. 30, 2023, an anxious father brought his 5-year-old son to the hospital in Kamituga, a muddy, bustling town carved out of the thick forest in the eastern Democratic Republic of Congo. The boy had a high fever and oozing sores on his torso and face.Nurses diagnosed chickenpox. They admitted him to the pediatric ward, part of a sprawl of low-slung brick buildings that date to the colonial era, and tried to manage his fever.Days passed, and the child’s health did not improve. His fever climbed higher, the lesions spread, blistering even the soles of his small feet.Perplexed, the pediatric staff called Dr. Steeve Bilembo, who was managing urgent care. He and a trusted nurse colleague, Fidèle Kakemenge, examined the boy and named, and then quickly eliminated, possibilities: Not chickenpox, not measles, not rubella, not a bad case of dermatitis — he would be improving by now if he had any of those ailments.The spreading sores meant it wasn’t malaria or typhoid or cholera, the diseases afflicting other children in the crowded ward.“And then at one point, we said, ‘Could it be mpox?’” Dr. Bilembo recounted. “Although we have never seen it — only in books.”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.

“We’re putting another burden on the elderly that we don’t have to,” one researcher said.Some things you can no longer do with cash: Buy a well-loaded hot dog at any of the five Devil Dawgs eateries in and around Chicago. Order a Vermont Pale Lager from Hill Farmstead Brewery’s taproom in Greensboro Bend, Vt.Attend the annual BeachLife Festival in Redondo Beach, Calif., or buy food, drinks or merchandise there. Purchase admission to the Home of Franklin D. Roosevelt National Historic Site in Hyde Park, N.Y., or to many other sites maintained by the National Park Service.The park service’s expanding no-cash policy exasperated several would-be visitors enough for them to sue in federal court earlier this year.Anne Ronan, 70, a retired attorney, walks around Lake Merritt in Oakland, Calif., a few times a week. After the three-mile-plus trek, she sometimes stops at one of two local cafes. Neither accepts payment in cash.Nor do a restaurant and a cocktail lounge nearby on Grand Avenue. “I don’t find it unusual anymore,” Ms. Ronan said.To buy coffee and a croissant, she routinely carries a credit card in her pocket. She doesn’t find that bothersome, but “as a public policy, it’s not a good thing.”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.

Every day at dawn, tens of thousands of people begin lining up at Acadia Healthcare’s addiction clinics to get a cup of methadone. The daily dose staves off opioid withdrawal and keeps many from turning to dangerous street drugs like fentanyl.The for-profit chain of 165 methadone clinics — the country’s largest — has generated more than $1.3 billion in revenue since 2022. It is “a business that we continue to feel great about,” Acadia’s chief executive told investors this year.That business has been built in part on deception, a New York Times investigation found.Methadone is a narcotic, and the clinics are heavily regulated by federal and state governments. In addition to handing out methadone, the clinics are required to provide counseling and other services, like drug testing.But Acadia often fails to provide that counseling, according to five dozen current and former employees in 22 of the 33 states where the company has clinics. Instead, employees at times falsify the medical records that Acadia uses to bill insurers, according to the employees and internal emails.Sometimes a counseling session recorded in a patient’s medical chart is simply a chance encounter. For example, medical records for a patient in Iowa show she had a 40-minute counseling session in December 2023, but the patient said in an interview that it was actually a hallway chat that lasted less than five minutes.Acadia’s business is built on volume. Its counselors carry caseloads that are sometimes more than double the limit set by state regulators, according to employees and inspection records. With so many patients, the clinics can become assembly lines, offering little more than a cup of methadone.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.

And how to lessen the blow.When Krystle Dullas’s close friend left their city for an extended cross-country road trip in 2022, they vowed to stay in touch. But as life got busier, their long telephone conversations and video exchanges slowly dissipated, Ms. Dullas said.In January, when she saw on social media that her friend visited home without seeing her, Ms. Dullas felt confused and hurt. And her inquiry about the visit received only a curt response, she said.The two haven’t spoken since.Ms. Dullas, 37, felt as if she’d been unceremoniously dumped by someone she’d been close to for nearly five years. And while she doesn’t regret losing a friend who was unwilling to make time for her, Ms. Dullas was surprised by how much the breakup stung. Indeed, cutting ties with a close friend can be as tough as splitting with a romantic partner, relationship experts said, though there’s no cultural script for processing the end of a friendship.“It was just really, really sad because you’re mourning a person who’s still alive,” said Ms. Dullas, a sales representative at a board game distributor in Richmond, Va.Such breakups represent an “unrecognized kind of grief,” said Beverley Fehr, a social psychologist with the University of Winnipeg who studies close relationships. “If someone goes through a divorce or is widowed, there’s generally support for the person — or at least an acknowledgment of the pain they are experiencing,” Dr. Fehr said. “That tends not to happen so much with friendships.”Here’s why losing a friend can feel so painful, and some expert tips if you’re considering a breakup.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.

It was almost a year ago that Adele Darlington, who is 41 and from Warrington, was in a critical condition in hospital following massive bleeding while giving birth to her baby girl.

It’s not the just the elderly. More than three-quarters of heat-related deaths in Mexico occurred among people younger than 35, researchers reported.As climate change pushes global temperatures higher, attention has focused predominantly on the threat that heat poses to older adults, whose physiology makes them more susceptible to health complications.But a study published on Friday in the journal Science Advances found that certain types of young people — including seemingly hardy working-age adults — may also be particularly vulnerable to rising temperatures.The researchers analyzed deaths in Mexico from 1998 to 2019 and discovered that people younger than 35 accounted for three-fourths of heat-related fatalities.“These age groups are also quite vulnerable to heat in ways that we don’t expect even at temperatures that we don’t think of as particularly warm,” said Andrew Wilson, a first author of the paper and an environmental social scientist at Stanford University.Measuring heat-related deaths is complicated, since death certificates rarely name heat as a cause. A proximate cause of death, like cardiovascular failure, is often listed instead.To get around this, Dr. Wilson and his colleagues used a common statistical approach to estimate how daily mortality rates across Mexico change in response to fluctuations in the “wet bulb” temperature, a measurement that uses humidity and air temperature to capture how well humans can cool their bodies through sweating.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.