Publisher Health

HANDOUTThe number of babies born in England and Wales is now the lowest since the 1970s, official statistics show.

He worked alongside another doctor to show that a simple rehydration therapy could check the ravages of cholera and other diarrhea-inducing diseases.Richard A. Cash, who as a young public-health researcher in South Asia in the late 1960s showed that a simple cocktail of salt, sugar and clean water could check the ravages of cholera and other diarrhea-inducing diseases, an innovation that has saved an estimated 50 million lives, died on Oct. 22 at his home in Cambridge, Mass. He was 83.His wife, Stella Dupuis, said the cause was brain cancer.In the 1960s, diseases like cholera and dysentery killed some five million children worldwide per year, primarily through dehydration caused by diarrhea and vomiting. Patients could go “from a grape to a raisin” within hours, Dr. Cash often said.It was widely understood that rehydration could save many of them, but that was easier said than done: intravenous drips, the standard method, required equipment, training and clinical settings that were often hard to come by in the impoverished communities where the diseases festered.Dr. Cash, the son of a family doctor, arrived in East Pakistan, today Bangladesh, in 1967 as part of a project through the U.S. Public Health Service. There he worked with another young American doctor, David Nalin, to respond to a cholera outbreak outside the capital, Dhaka.The two had already been researching a simple oral rehydration therapy and knew of other, previous efforts, all of which had failed. But they believed that the therapy held promise, especially in the face of mounting deaths.They realized that a main problem was volume: Past efforts had resulted in too little or too much hydration. Dr. Cash and Dr. Nalin conceived a trial in which they carefully measured the amount of liquid lost and replaced it with the same amount, mixed with salt and sugar to facilitate absorption.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.

The new director overseeing medical devices will confront criticisms about hasty approvals as she ushers in revolutionary technology.There are now artificial intelligence programs that scan M.R.I.s for signs of cancer, Apple AirPods that work as hearing aids and devices that decode the electrical blips of the brain to restore speech to those who have lost it.Medical device technology is now deeply entrenched in many patients’ health care and can have a stunning impact on their lives. As advancements become more tangible to millions of Americans, regulation of the devices has commanded increasing attention at the Food and Drug Administration.Dr. Michelle Tarver, a 15-year-veteran of the agency, is stepping into that spotlight at a critical time. She is taking the reins of the F.D.A.’s device division from Dr. Jeffrey Shuren, who forged deep ties with the device industry, sped up the pace of approvals and made the agency more approachable to companies. Some of those device makers were represented by Dr. Shuren’s wife and her law firm, posing ethical conflicts for him that continue to draw scrutiny.Dr. Michelle Tarver, an ophthalmologist and a 15-year veteran of the F.D.A.’s medical device division.U.S. Food and Drug AdministrationMore broadly, congressional lawmakers and consumer advocates have become increasingly concerned about the device industry’s influence over the sprawling division, which has a budget of about $790 million and a staff of 2,500. Device safety and standards for agency approvals of products as intimate as heart valves or neural implants will be at the forefront of the division’s mission in the coming years. Among the issues Dr. Tarver will encounter:Brains, computers and Elon MuskFew devices will require such intense oversight as one of the most breathtaking technologies in development: brain-computer interfaces that dip into the surface layers of the brain to decode its electrical noise — and return function to people who have lost it.Researchers from a number of teams have demonstrated the capability to restore the voice and speech of a California man with ALS, to enable a paralyzed man to walk and to help a man who is paralyzed below the neck to play Mario Kart by simply thinking about steering left or right.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.

The government is looking again at whether disabled people in England should be able to claim more than £30,000 to make adaptations to their homes.

If every emergency room in the United States were fully prepared to treat children, thousands of lives would be saved and the cost would be $11.84 or less per child, researchers found.The morning after Phyllis Rabinowitz brought her newborn daughter home from the hospital, she knew something was terribly wrong. The baby, Rebecca, had thick mucus, trouble breathing and lethargy unlike anything Ms. Rabinowitz had seen in her first child.But during multiple visits to the emergency room, doctors told Ms. Rabinowitz that Rebecca had a common cold and sent them home. At nine days old, Rebecca died; her parents learned from an autopsy that the cause was a viral infection that could have been managed had she been admitted.More than 80 percent of emergency departments in United States hospitals are not fully prepared for pediatric cases, a new study finds, despite the fact that children make up about 20 percent of visits each year.The new analysis, published Friday in the journal JAMA Network Open, estimated that if every emergency department in the United States had the core features of “pediatric readiness,” more than a quarter of the child deaths that follow E.R. visits could be prevented, a figure that equates to thousands of young lives each year.Even in the most ill-prepared states, the cost to ready every emergency room would be less than $12 per child living there, the researchers found.“You can now find your state and see: How many children who would otherwise die could we expect to save if we implemented universal pediatric readiness at a high level?” said Dr. Craig Newgard, who was the lead author on the paper, and is the director of the Center for Policy and Research in Emergency Medicine at Oregon Health & Science University.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 are calling on the government to exempt them from tax rises for employers announced at the Budget, warning it could hit services for patients.

A mother from Aylesham, Kent, who says she pays £2,000 a month for her daughter’s medicinal cannabis supply has called for greater access to the drug on the NHS.

Getty ImagesGPs, care homes and hospices have voiced concerns about the impact of the rise in employer National Insurance contributions announced in the Budget.

BBCThousands of people will march on London on Sunday at a family-friendly rally to highlight the importance of clean water in their lives. The BBC speaks to residents near one rural waterway, which scientists found had the second highest levels of active pharmaceutical pollution in the UK.

British data shows that children conceived and born during a period of sugar rationing were less likely to develop diabetes or high blood pressure later in life.People who were restricted to limited amounts of sugar in the first few years of life were less likely to develop diabetes and high blood pressure decades later, a new study has found.The study, published Thursday in the journal Science, took advantage of a unique situation in the United Kingdom. The country was under strict rationing during World War II and its aftermath. When the rationing ended, in September 1953, the average sugar intake by people in Britain doubled. That provided a natural experiment and allowed the researchers to ask: What happened to the health of people who were conceived and born when sugar was rationed compared with people conceived and born just after sugar rationing ended?To find out, the researchers, Tadeja Gracner, an economist at the University of Southern California, and her colleagues, Claire Boone of McGill University and Paul J. Gertler of the University of California, Berkeley, turned to the UK Biobank. It contains genetic and medical information on half a million people, and steps have been taken to preserve contributors’ privacy. Using the data, the investigators analyzed the health of 60,183 people who were born from October 1951 through March 1956, and were age 51 to 60 when they were surveyed.The investigators reported that those exposed to sugar rationing early in life had a 35 percent lower risk of diabetes and a 20 percent lower risk of high blood pressure in middle age. The onset of those chronic diseases was also delayed by four years for diabetes and two years for high blood pressure. They also found that disease protection was greatest for those who had been conceived during sugar rationing and were babies while rationing continued. Those who were exposed to sugar rationing only before birth and then grew up with higher sugar intake had higher disease rates.The results contribute to a body of evidence suggesting that nutrition very early in life can affect health much later. But because of the unique circumstances of British sugar rationing, the new study provides additional rigor, experts said.For example, a study of military records of men whose mothers were in the first half of pregnancy during the Dutch famine, or Hunger Winter, during World War II found that the men were more likely to be obese at age 19 than men born after that event. Another study found that women whose mothers were pregnant during the famine were heavier at age 50 than women born later.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.