Category Archives: Beauty & Care

Will a sugar tax work? Well, it did at Jamie Oliver’s Italian restaurants

Jamie Oliver’s 10p tax on sugary drinks sold in his Italian restaurants has resulted in a significant drop in sales, a study has found.

The Jamie’s Italian chain introduced the sugary drinks tax to set an example as part of a campaign to persuade the government to take action. In June 2015, Oliver announced that every drink containing added sugar would cost 10p extra and that the money would help pay for food education and water fountains in schools.

A study of the effects of the levy, published in the Journal of Epidemiology & Community Health, has found that sales of sugar-sweetened drinks such as colas and lemonades fell by 11% in the first 12 weeks. At the end of six months, sales were 9.3% lower than they had been before the levy was introduced.

Prof Steven Cummins of the department of social and environmental health research at the London School of Hygiene and Tropical Medicine, who carried out the study, acknowledged that the clientele of Oliver’s restaurants tended to be affluent, and that the price hike on a drink costing between £2.60 and £3.25 might not make a lot of difference to them.


We can’t be sure that the fall in consumption of sugary drinks was entirely, or even mainly, caused by the extra 10p

“I don’t think the financial element of it is a massive disincentive,” he said. But he likened it to the plastic bag charge, which prompts people to think about having one.

The menu explains the purpose of the levy and, at the time of the launch, Oliver was fronting a television documentary on the potential damage of sugary drinks to children’s health, called Jamie’s Sugar Rush.

When it came to the government tax on drinks containing added sugar, which begins in April 2018 – assuming it is passed on to the consumer and not absorbed by some of the multinational companies making popular drinks – the impact would likely depend on how much educational messaging accompanied the price rise, said Cummins.

“If you want to optimise the effect at point-of-sale [in shops], perhaps signage or other elements that could be put on the shelves themselves might have an impact over and above the financial incentive,” he said.

In the 12 months leading up to the introduction of the levy, more than 2m non-alcoholic drinks were sold in the 37 Jamie’s Italian restaurants, of which 38% (773,230) were sugar sweetened.

The drop in sales at six months of 9.3% was only in the restaurants that previously had higher levels of sales of sweetened drinks. There was a general drop in sales on non-alcoholic beverages, except for fruit juices, which went up. There is no evidence as yet on whether alcohol sales also went up. Cummins said it was possible that more people were drinking tap water, which is not billed and therefore did not appear in the sales figures.

He said he thought the effect was “entirely transferable” to other less expensive chains. “There is no reason why other restaurants couldn’t do exactly the same,” he said. Those that have the highest sales of sweetened drinks would be likely to have the biggest falls.

Susan Jebb, professor of diet and population health at the University of Oxford said this was the first evidence of the effects of a price rise in a restaurant setting and could not be considered conclusive.

“Nonetheless this is a careful analysis and shows a greater than anticipated fall in sales, which is encouraging news for public health ahead of the introduction of the soft drink industry levy next year,” she said.

“Surprisingly, and unlike the experience in some other countries, there was also a decline in low- and no-sugar drinks, which is harder to explain. The gap in the paper is data on alcohol sales, since any compensatory increase (which may or may not have occurred) would be of considerable concern given the potential contribution to energy intake and health harms. Businesses will also want to understand more about the likely impact on turnover.”

Kevin McConway, emeritus professor of applied statistics at the Open University, said there was a lot more going on than just the price increase. “The menu was redesigned: it explained that the proceeds of the levy would go to the Children’s Health Fund, new drink products were introduced, and Jamie himself appeared in a television programme about sugar. So we certainly can’t be sure that the fall in consumption of sugary drinks was entirely, or even mainly, caused by the extra 10p.

“The researchers do provide some circumstantial evidence that the 10p played a role in the reduction in consumption, but they (rightly) make it clear that a study like this can’t prove what caused what. Actually, it doesn’t even establish that any of the specific changes at Jamie’s Italian restaurants had anything to do with the lower consumption – for instance, the researchers had no data from any other restaurants, and maybe consumption fell there as well.

“Jamie Oliver isn’t the only person to have been on TV pointing out the health consequences of too much sugar, and the general publicity that sugary drinks are bad for health is likely to have had some general effect on consumption,” McConway said.

No such thing as an ideal heating setting | Letters

As a thermal comfort researcher, men often complain to me that their wives turn up the thermostat because they prefer warmer conditions (Why women secretly turn up the heating, G2, 12 October). There is no such thing as a single comfort temperature. A thin lady is likely to feel colder than a plump one. A recent sample in English homes recorded living room temperatures from 10C to 25C. Thermostat settings are driven by many factors including environmental beliefs, customs, daily routines, incomes or different approaches to heating. The heating and energy industries would love us to heat whole buildings, but all we often need to do is heat the people inside them. Average winter living-room temperatures in New Zealand are around 14C where people sit by a small heater when relaxing. In Japanese homes temperatures can fall to 5C indoors because people keep warm with a “Kotatsu”, a small heater by their chair covered by a shared rug, as in parts of Spain. We all adapt to those temperatures we normally occupy. If uncomfortable, and we can afford to, we change our environments.
Emeritus Professor Sue Roaf
Oxford

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Private insurance reforms a mental health ‘work-around’

The national mental health commissioner, Prof Ian Hickie, has described private health insurance reforms affecting mental health as a “work-around” that will lead to more mental health hospital beds without providing the community-based services people need.

On Thursday the health minister, Greg Hunt, announced a private health insurance overhaul, including changes to mental healthcare. From April people will be able to upgrade their coverage to cover mental health treatment when they need it without facing waiting periods, and basic private policies will include mental health cover as standard.

Under the reforms it will be harder for insurers to place limits on mental health treatments and therapy sessions, such as group counselling sessions, electroconvulsive therapy or transcranial magnetic stimulation.

But Hickie told Guardian Australia he wanted to know what Hunt had planned to increase mental health services available under Medicare so that community-based mental health services would be more readily available.

“Private health insurance encourages growth in the wrong kind of service, which is hospital-based mental health services through more private hospital beds,” Hickie said. “But we also need to be building alternative services outside of hospitals to prevent people from going into hospitals in the first place.

“Of course, it’s unacceptable that private health insurers have been excluding mental health from policies … The bottom line is, though, the minister has developed a work-around to address junk policies that exclude mental health, but where the minister could make an enormous difference is by introducing regulatory changes that would permit private health insurers to cover specialised care outside of hospitals.”

He said state, territory and federal governments had been unwilling to address the gap in mental health services covered by Medicare, and that it could not be up to private health insurers alone to improve access to mental health support.

Inpatient mental heath programs in private hospitals varied widely in quality, he said.

“The danger is we end up with wrong sets of services,” he said. “These reforms are the first step but they are not the solution. They are the work-around while people are dealing with the holes. My worry is that sometimes the first step is so hard to take that it becomes the only step.”

The Greens leader Richard Di Natale, who is a medical doctor, said the ability of people to upgrade their coverage to cover mental health treatment without facing waiting periods was welcome.

“But let’s remember that half the population doesn’t have private health insurance, and this group are far more likely to have mental health issues,” he said. “This is mental health care only for those who can afford it.”

The chief executive of the Consumers Health Forum, Leanne Wells, said the changes would lead to “significant improvement in access to cover for mental healthcare, a much-needed provision given the demand for these services and their greater availability in the private sector”.

“A further positive development is the plan to boost the powers and resourcing of the health insurance ombudsman to assist people to make more informed choices about their policies, and to investigate claims of wrongdoing by health funds,” she said.

MPs urge action on lengthy wait for autism diagnosis

Parents of children with suspected autism are having to wait at least 44 months for diagnoses, prompting a cross-party group of more than 140 MPs to write to the health secretary, Jeremy Hunt, demanding urgent action.

The startling new figures, revealed in response to a freedom of information request, relate to children under the age of five who need a specialist autism assessment after being referred by a GP or other health professional.

The request, submitted by a concerned member of the public, relates to an area of Teesside covered by the Tees, Esk and Wear Valleys NHS foundation trust. But Mark Lever, chief executive of the National Autistic Society, said that such “unacceptable” delays were a problem in many parts the country but varied hugely from one region to the next.

“An autism diagnosis can be life-changing,” he said. “It can explain years of feeling different and help unlock crucial advice and support. The longer someone lives without the right support, the higher – and more expensive – their needs can become.”

The official response to the request showed that if a child aged under five and living in Stockton was referred to a specialist assessment team today, the family would have to wait roughly 44 months before receiving any answer. In neighbouring Middlesbrough the waiting time was six months.

Experts in the NHS cite several reasons for the long waiting times, including a lack of coordination between professionals throughout the assessment, as well as a lack of resources.

The matter was taken up by the Labour MP for Stockton South, Paul Williams, who is also a GP. Williams has rallied the support of 142 MPs to write to Hunt demanding that he introduce a maximum interval of three months from point of referral to beginning of specialist assessment. This would bring waiting in line with National Institute for Health and Care Excellence (Nice) guidelines.

The letter, sent on Friday, welcomed the Department of Health’s recent commitment to record waiting times as “progress”, but warned: “Recording data alone does not tackle delays.”

Williams said: “This is an issue of profound unfairness. While children are waiting and their parents are struggling, they often don’t get much-needed access to support in school, and they fall behind their peers.”

The Observer spoke to several parents in the area covered by the freedom of information request, many of whom had been on the waiting list for far longer than the three months recommended by Nice. Nichola Binks said she was struggling to navigate the system with her three-year-old son, Thomas.


It’s so important for Thomas to get the help now. He’s never going to catch up if not

Nichola Binks, mother

In a letter to Binks in January, her local NHS trust said that the proposed date for her son’s assessment was August 2019. “It’s so stressful and upsetting. It’s a postcode lottery,” she said, explaining that those living five miles down the road were waiting a fraction of the time.

“I have to chase everything up all the time,” she said. As long as Thomas did not have a formal diagnosis, they were unable to access respite care, send him to a special school, or get help with his sensory issues. She said she worried that he would not finish the assessment process before he entered primary school: “It’s so important for him to get the help now. He’s never going to catch up if not.”

Dr James Cusack, director of science at UK research charity Autistica, said that it was possible to improve a child’s communication skills by making early interventions, but the average age of diagnosis was “avoidably high” and had not changed in a decade: “Late diagnosis represents a missed opportunity for autistic children.”

Children’s tsar savages NHS over paucity of mental healthcare

The children’s commissioner has launched a savage attack on the head of the NHS, accusing him of denigrating research that shows an “unacceptable” lack of children’s mental health provision.

In a highly unusual move, Anne Longfield has published an open letter to Simon Stevens, chief executive of NHS England, accusing him of ignoring young people’s experiences of the service and the frustrations of their parents.

Laying out a list of grievances against him and his team, she also threatens to use the law to compel him to hand over data on waiting times for children’s mental health services.

Longfield made the decision to go public with her complaints – published on the commissioner’s website – after Stevens rubbished many of the claims in her recent report into children’s mental health, an issue she identified as her top priority after consulting with children.

“Many told me about their desperate attempts, sometimes lasting years, to access support, and even primary school children raised concerns about anxiety,” Longfield told Stevens in the letter.

The report, published to coincide with World Mental Health Day last week, estimated that only between a quarter and a fifth of children with mental health conditions received help last year. It stated: “Progress in improving children’s mental health services has been unacceptably slow.”

Longfield warned that provision for young people was a postcode lottery and said that “children’s inability to access mental health support” was leading to a range of extra problems, “from school exclusions to care placements breaking down to children ending up in the youth justice system”.

It is highly unusual for the holders of two important public offices to be involved in such a public argument, particularly over an issue as sensitive as children’s mental health. Longfield, whose role is to promote and defend the rights of children, was appointed to the post by then education secretary Nicky Morgan in 2014.

Stevens took his job at the head of NHS England (NHSE) in the same year. Longfield’s report made difficult reading for the government at a time when concerns over the health service have reached a critical level.

Theresa May identified improving mental health as a key issue but, before the busy winter period, there are concerns the NHS will struggle to cope with demand even for what are considered priority services, such as accident and emergency.

Stevens’s robust criticisms that the report contained “basic errors” were a powerful retort to Longfield’s claims. However, in a move that will ensure mental health provision for young people once again becomes a major political issue, Longfield has hit back, saying the report was published only after consultation with NHS England.

“The briefing was prepared using the NHS’s own data,” Longfield writes. “My conclusion on reading, checking and rechecking was that the service that exists at the moment is worryingly poor, a conclusion I stand by.”

In a highly personalised attack, Longfield tells Stevens: “I was very disappointed that NHS England’s response to our report, and your own personal response in front of the Commons health select committee, was to attempt to denigrate the research.

“Not once did you address the central issues raised. Instead, you and your team sought to undermine the important evidence that we are putting forward and strangely ignore the reality of children’s experiences of the service and the frustrations of their parents.”

Longfield suggested that Stevens’s claims that she and her team had not bothered to check the report were “untrue”. Similarly, claims that NHSE had not been given adequate time to review the report before commenting were also without foundation, according to Longfield. “I am under no duty or obligation to share my work in advance, yet we did so, out of courtesy.”

Stevens had indicated that NHSE was in possession of data that could be used to refute many of Longfield’s claims. However, the commissioner said: “If the NHS has data not in the public domain that disputes the picture we painted, then in the interests of transparency and accountability NHSE should publish it.”

She adds: “I hope you will feel able to share this data. As you will know, I am also able to demand such data under section 2f of the Children’s Act 2014.”

She concludes: “I hope in future we could all concentrate our efforts on tackling [health issues] rather than trying to undermine the work of those who make valid and constructive criticisms.”

Stevens is standing his ground. In a response to Longfield, obtained by the Observer, he suggests NHSE was “bounced” into giving a response to the report only after aspects of it were shared with journalists.

He said that a key finding of the report, that “the government’s much-vaunted prioritisation of mental health has yet to translate into change at a local level”, was “demonstrably factually inaccurate”.

Stevens writes: “I’m afraid we stand by our view that your report did indeed in places give a misleading view of NHS care.”

Sarah Wollaston, chair of the health select committee, said the row would be discussed when the committee met on Tuesday: “It’s very important that there is a constructive relationship between the Office of the Children’s Commissioner and NHS England. This has raised important matters about the funding of mental healthcare.”

Trump’s biggest enemy isn’t the media. It’s poor people | Ross Barkan

Whenever talk turns to Donald Trump’s enemies, the Democrats and the media are always assumed to be at the top of his hit list. This is a man, after all, who cries out “Fake News!” almost as often as he draws breath.

But Trump’s truest enemy isn’t any card-carrying journalist, progressive Democrat, or disgruntled member of the Deep State. It’s any American who doesn’t have much money.

The irony of Trump was always his tin pot populism, speaking to people’s economic anxiety while doing everything possible to screw them over. It’s a testament to his cult of personality that he even retains the little popularity he has.

Trump’s most dramatic move yet to dismantle Obamacare will surely punish many of the poor people who voted for him and the rest who didn’t. It will hurt the sickest and most vulnerable. More than anything else, that is Trump’s modus operandi.

On Thursday, the White House announced that it would scrap subsidies to health insurance companies that help pay out-of-pocket costs for low-income people. This move came hours after Trump said cheaper policies with fewer benefits and protections for consumers would eventually hit the market.

While some younger, healthier people could benefit from low-cost plans, both announcements threaten to further destabilize the Obamacare marketplace. If healthier people opt out of more comprehensive coverage, the cost of care for the oldest, sickest, and poorest will skyrocket.

Obamacare is imperfect, but it did promise coverage to people with preexisting conditions who, under the old system, would’ve been locked out of the healthcare market.

None of this matters to Trump. Since the Affordable Care Act – once upon a time, a market-driven approach to healthcare championed by conservatives – was Barack Obama’s signature achievement as president, it deserves to be destroyed. He cannot stomach anything related to the legacy of the first black president. If it carries Obama’s stamp, it must be eradicated.

Trump couldn’t do this legislatively because he had no serious alternative to Obamacare. Republicans in the Senate balked at his madness. Now, he will chip away at our healthcare system anyway he can, proving to his frothing base he is trying his best to eviscerate what Obama left behind.

The poor, of course, will be collateral damage, and in that way Trump is more your conventional 21st century Republican, only less organized in thought and action. Had Marco Rubio or Ted Cruz prevailed last year, they would also likely be in the process of trying rip healthcare away from people. The national Republican party is the plutocrat party. Its entire intellectual foundation rests on the assumption that the poorest and weakest deserve to suffer.

This isn’t to excuse Democrats, who have been too beholden to corporate interests. The greatest corrective to Obamacare, a public option, died during negotiations because insurance companies with plenty of clout in a Democratic Congress insisted they shouldn’t have to compete with a cheaper, government-run plan. Obamacare was good for insurance companies: it created new customers.

A single-payer, Medicare-for-all plan is the only humane answer here, though a public options could at least help stabilize markets. We know Trump has no interest in pursuing either path. He is a rich bully who fights for rich bullies. As vacuous as he is mean, he is willing to shred healthcare as we know it to make a point.

What he doesn’t understand is how much his own party will be blamed for this coming debacle. Barack Obama doesn’t live in the White House anymore. Republicans control every level of government. Were Trump a different kind of person – wiser, saner – he would probably give this some thought.

‘Dr Huge’: the champion of dangerous weight-loss drug DNP

The two men behind Sacramento-based Enhanced Athlete – the company believed to be behind UK sales of the deadly weight-loss drug DNP – are a former lawyer and champion bodybuilder, known as Dr Tony Huge, and a convicted fraudster, Scott Cavell, who served time in Ireland and the US.

Dr Huge – whose real name is Charles Anthony Hughes – is the very visible face (and muscle) of Enhanced Athlete, promoting the fat-burning and bodybuilding supplements it allegedly sells in the US, Europe and Australia through numerous YouTube videos.

Among them is a video diary series entitled “DNP: World’s Most Dangerous Fat Loss Drug”, featuring Hughes swallowing the pills he sells and working out. “Will I die or will I arise shredded?” asks the caption. In another he shows off his Ferrari 430 Scuderia, at one point lifting a scantily clad woman above his head in front of the bonnet.

Hughes is not a medical doctor. His videos all feature warnings that he is experimenting with his own body and that DNP is a dangerous drug that is not for human consumption – before he consumes it or discusses its use with other people.

On another bodybuilding site, Hughes is filmed in England discussing the enthusiasm that people have for DNP. “It seems like everybody in England takes DNP. I’ve never been to a country or a place where so many people take DNP,” he says. “It’s incredibly more popular here in England than it is in the United States.”

The British bodybuilder he is talking to says says people are not afraid of it. “Only a couple of years ago, a teenage girl died of DNP overheating and her mum found her dead in a cold bath. DNP obviously isn’t for human consumption but having said that I think the only people that die from it are the people that abuse it.”

Cavell was involved in a $ 7.4m (£5.6m) mortgage fraud in the US. He and his accomplice, Christopher Warren, who managed a finance company in Sacramento, converted the loot into “travel friendly” gold and coins, according to the FBI and went on the run in 2009.

Both headed for Ireland, but Warren then paid $ 156,000 for a private charter plane to Lebanon. He was caught trying to re-enter the US with a fake passport and $ 70,000 hidden in his cowboy boots.

Cavell lay low in Ireland with a false Irish passport in the name of Marcus Dwyer. He opened two Irish bank accounts and lived in a comfortable apartment in Dublin on the $ 1.7m he had hidden in his luggage until the gold ran out. Then he took to drug dealing, growing cannabis in his apartment. In February 2011, the Irish drug squad turned up. Cavell was said to be out at the time but arrived during the raid and was arrested.

Nobody knew that Marcus Dwyer was not his real name until one of the detectives, curious about his American accent, sent his fingerprints to Interpol, who identified him as Cavell, a wanted man. However, at his trial, the judge allowed bail and he went on the run again, continuing to fund himself through drug peddling.

He was arrested in possession of 28 ecstasy tablets at the Electric Picnic festival in Ireland in September 2011, but released without charge. Eventually the gardai tracked him down in a modest rented house in Dublin, where they found equipment to make ecstasy tablets worth €20,000. He spent about eight months in Mountjoy prison before being deported.

Cavell was sentenced to five years for the mortgage fraud – considerably less than the 14 months that his accomplice Warren got, partly because it was claimed in court that he had suffered in the Irish prison.

“The conditions were deplorable, with buckets used as a latrine, rodent infestation, no running water, severe overcrowding, and no heat or air conditioning,” his attorney John Manning wrote in a memo to the court. “It is a place where Ireland houses the worst of the worst.”

‘Dr Huge’: the champion of dangerous weight-loss drug DNP

The two men behind Sacramento-based Enhanced Athlete – the company believed to be behind UK sales of the deadly weight-loss drug DNP – are a former lawyer and champion bodybuilder, known as Dr Tony Huge, and a convicted fraudster, Scott Cavell, who served time in Ireland and the US.

Dr Huge – whose real name is Charles Anthony Hughes – is the very visible face (and muscle) of Enhanced Athlete, promoting the fat-burning and bodybuilding supplements it allegedly sells in the US, Europe and Australia through numerous YouTube videos.

Among them is a video diary series entitled “DNP: World’s Most Dangerous Fat Loss Drug”, featuring Hughes swallowing the pills he sells and working out. “Will I die or will I arise shredded?” asks the caption. In another he shows off his Ferrari 430 Scuderia, at one point lifting a scantily clad woman above his head in front of the bonnet.

Hughes is not a medical doctor. His videos all feature warnings that he is experimenting with his own body and that DNP is a dangerous drug that is not for human consumption – before he consumes it or discusses its use with other people.

On another bodybuilding site, Hughes is filmed in England discussing the enthusiasm that people have for DNP. “It seems like everybody in England takes DNP. I’ve never been to a country or a place where so many people take DNP,” he says. “It’s incredibly more popular here in England than it is in the United States.”

The British bodybuilder he is talking to says says people are not afraid of it. “Only a couple of years ago, a teenage girl died of DNP overheating and her mum found her dead in a cold bath. DNP obviously isn’t for human consumption but having said that I think the only people that die from it are the people that abuse it.”

Cavell was involved in a $ 7.4m (£5.6m) mortgage fraud in the US. He and his accomplice, Christopher Warren, who managed a finance company in Sacramento, converted the loot into “travel friendly” gold and coins, according to the FBI and went on the run in 2009.

Both headed for Ireland, but Warren then paid $ 156,000 for a private charter plane to Lebanon. He was caught trying to re-enter the US with a fake passport and $ 70,000 hidden in his cowboy boots.

Cavell lay low in Ireland with a false Irish passport in the name of Marcus Dwyer. He opened two Irish bank accounts and lived in a comfortable apartment in Dublin on the $ 1.7m he had hidden in his luggage until the gold ran out. Then he took to drug dealing, growing cannabis in his apartment. In February 2011, the Irish drug squad turned up. Cavell was said to be out at the time but arrived during the raid and was arrested.

Nobody knew that Marcus Dwyer was not his real name until one of the detectives, curious about his American accent, sent his fingerprints to Interpol, who identified him as Cavell, a wanted man. However, at his trial, the judge allowed bail and he went on the run again, continuing to fund himself through drug peddling.

He was arrested in possession of 28 ecstasy tablets at the Electric Picnic festival in Ireland in September 2011, but released without charge. Eventually the gardai tracked him down in a modest rented house in Dublin, where they found equipment to make ecstasy tablets worth €20,000. He spent about eight months in Mountjoy prison before being deported.

Cavell was sentenced to five years for the mortgage fraud – considerably less than the 14 months that his accomplice Warren got, partly because it was claimed in court that he had suffered in the Irish prison.

“The conditions were deplorable, with buckets used as a latrine, rodent infestation, no running water, severe overcrowding, and no heat or air conditioning,” his attorney John Manning wrote in a memo to the court. “It is a place where Ireland houses the worst of the worst.”

‘Dr Huge’: the champion of dangerous weight-loss drug DNP

The two men behind Sacramento-based Enhanced Athlete – the company believed to be behind UK sales of the deadly weight-loss drug DNP – are a former lawyer and champion bodybuilder, known as Dr Tony Huge, and a convicted fraudster, Scott Cavell, who served time in Ireland and the US.

Dr Huge – whose real name is Charles Anthony Hughes – is the very visible face (and muscle) of Enhanced Athlete, promoting the fat-burning and bodybuilding supplements it allegedly sells in the US, Europe and Australia through numerous YouTube videos.

Among them is a video diary series entitled “DNP: World’s Most Dangerous Fat Loss Drug”, featuring Hughes swallowing the pills he sells and working out. “Will I die or will I arise shredded?” asks the caption. In another he shows off his Ferrari 430 Scuderia, at one point lifting a scantily clad woman above his head in front of the bonnet.

Hughes is not a medical doctor. His videos all feature warnings that he is experimenting with his own body and that DNP is a dangerous drug that is not for human consumption – before he consumes it or discusses its use with other people.

On another bodybuilding site, Hughes is filmed in England discussing the enthusiasm that people have for DNP. “It seems like everybody in England takes DNP. I’ve never been to a country or a place where so many people take DNP,” he says. “It’s incredibly more popular here in England than it is in the United States.”

The British bodybuilder he is talking to says says people are not afraid of it. “Only a couple of years ago, a teenage girl died of DNP overheating and her mum found her dead in a cold bath. DNP obviously isn’t for human consumption but having said that I think the only people that die from it are the people that abuse it.”

Cavell was involved in a $ 7.4m (£5.6m) mortgage fraud in the US. He and his accomplice, Christopher Warren, who managed a finance company in Sacramento, converted the loot into “travel friendly” gold and coins, according to the FBI and went on the run in 2009.

Both headed for Ireland, but Warren then paid $ 156,000 for a private charter plane to Lebanon. He was caught trying to re-enter the US with a fake passport and $ 70,000 hidden in his cowboy boots.

Cavell lay low in Ireland with a false Irish passport in the name of Marcus Dwyer. He opened two Irish bank accounts and lived in a comfortable apartment in Dublin on the $ 1.7m he had hidden in his luggage until the gold ran out. Then he took to drug dealing, growing cannabis in his apartment. In February 2011, the Irish drug squad turned up. Cavell was said to be out at the time but arrived during the raid and was arrested.

Nobody knew that Marcus Dwyer was not his real name until one of the detectives, curious about his American accent, sent his fingerprints to Interpol, who identified him as Cavell, a wanted man. However, at his trial, the judge allowed bail and he went on the run again, continuing to fund himself through drug peddling.

He was arrested in possession of 28 ecstasy tablets at the Electric Picnic festival in Ireland in September 2011, but released without charge. Eventually the gardai tracked him down in a modest rented house in Dublin, where they found equipment to make ecstasy tablets worth €20,000. He spent about eight months in Mountjoy prison before being deported.

Cavell was sentenced to five years for the mortgage fraud – considerably less than the 14 months that his accomplice Warren got, partly because it was claimed in court that he had suffered in the Irish prison.

“The conditions were deplorable, with buckets used as a latrine, rodent infestation, no running water, severe overcrowding, and no heat or air conditioning,” his attorney John Manning wrote in a memo to the court. “It is a place where Ireland houses the worst of the worst.”

Great Ormond Street hospital ‘failing’ intersex patients

Great Ormond Street hospital is failing to meet national standards and guidelines of care for intersex patients, it has been claimed.

NHS regulator, the Care Quality Commission, is investigating after the BBC said it found that some intersex patients and their families were not provided with any psychological care before irreversible surgery at the world famous hospital.

The broadcaster said it also found evidence that some operations were taking place on intersex babies and children without discussion by specialist teams.

The hospital is one of the leading authorities on care for people who are intersex, which means they are born with reproductive or sexual anatomy that does not seem to fit typical definitions of male or female.

Up to 1.7% of people have intersex traits, roughly the same proportion of the population who have red hair, according to the Office of the United Nations High Commissioner for Human Rights. The British charity DSD Families estimates that around 130 babies born in this country each year need investigations before their sex is assigned, although in many cases problems are only identified later in life.

The BBC says Gosh declined to say if it was meeting national standards.

Prof Ted Baker, chief inspector of hospitals at the Care Quality Commission, said: “We have asked Gosh to provide further information about the concerns, which were brought to our attention by the BBC.

“We are clear that NHS trusts and all providers of health and social care must have regard for nationally recognised guidance about delivering safe care and treatment. This could include guidance from NHS England and from the British Society for Paediatric Endocrinology and Diabetes around the need for multidisciplinary team involvement in decision making prior to performing surgery on children who are intersex or have variances in sex characteristics.

“We await the response from Gosh but in the meantime if anyone has any concerns about the care they or a loved one have received, they should get in contact with us.”

The BBC said it found that there was currently no face-to-face psychological support for children and families at Gosh who have been referred in the last six months but surgery continues to be carried out.

It also claimed that operations were taking place on intersex patients at Gosh without first discussing their cases with an expert panel at the hospital. The BBC further alleged that a lack of written information for parents to take home made it difficult for them to understand the treatments they were consenting to.

Ieuan Hughes, emeritus professor of paediatrics at Cambridge University, told the BBC the failure to provide this care was against national guidance. “No surgery should be undertaken without the whole team being involved with the decision,” he said.

“Making and signed up collectively to whatever that decision was to have surgery or not to have surgery, it’s the collective decision of the team.”

Gosh said in a statement that patients diagnosed at the hospital were discussed by multidisciplinary teams and that a new specialist psychologist would be joining in the coming weeks.