Category Archives: Psoriasis

One in eight people set to have type 2 diabetes by 2045, says study

One in eight people in the world will have type 2 diabetes by 2045 if obesity continues to climb at the present rate, according to a new study.

Last year, 14% of the global population was obese and 9% had type 2 diabetes. By 2045, 22% will be obese and 14% will be suffering from type 2 diabetes, estimates presented at the European Congress on Obesity in Vienna suggest.

The implications of the expanding numbers are severe for health systems in every country. Diabetes UK estimates that the NHS spends £14bn a year on the disease already, which is about 10% of its budget. People with diabetes need monitoring, treatment and care for the serious potential complications which can include amputations and blindness.

The study was carried out by scientists funded by the pharmaceutical company Novo Nordisk, which makes diabetes treatments, together with the Steno Diabetes Centre in Gentofte, Denmark, and University College London. They say that to prevent type 2 diabetes rates rising above 10%, obesity levels must come down by a quarter.

The institutions collaborated to launch the Cities Changing Diabetes programme in 2014 to accelerate the global fight against urban diabetes. The program began with eight cities: Copenhagen, Rome, Houston, Johannesburg, Vancouver, Mexico City, Tianjin and Shanghai. These have since been joined by a further seven cities: Beijing, Buenos Aires, Hangzhou, Koriyama, Leicester, Mérida and Xiamen.

“These numbers underline the staggering challenge the world will face in the future in terms of numbers of people who are obese, or have type 2 diabetes, or both. As well as the medical challenges these people will face, the costs to countries’ health systems will be enormous,” said Dr Alan Moses of Novo Nordisk Research and Development in Søborg, Denmark.

“The global prevalence of obesity and diabetes is projected to increase dramatically unless prevention of obesity is significantly intensified. Developing effective global programs to reduce obesity offer the best opportunity to slow or stabilise the unsustainable prevalence of diabetes. The first step must be the recognition of the challenge that obesity presents and the mobilisation of social service and disease prevention resources to slow the progression of these two conditions.”

The researchers have calculated the likely rise in obesity for individual countries. If current trends in the US continue, obesity will increase from 39% in 2017 to 55% in 2045, and diabetes rates from 14% to 18%. To keep diabetes rates in the US stable between 2017 and 2045, obesity must fall from 38% today to 28%.

In the UK, they say, current trends predict that obesity will rise from 32% today to 48% in 2045, while diabetes levels will rise from 10.2% to 12.6%, a 28% rise. To stabilise UK diabetes rates at 10%, obesity prevalence must fall from 32% to 24%.

“Each country is different based on unique genetic, social and environmental conditions which is why there is no ‘one size fits all’ approach that will work. Individual countries must work on the best strategy for them,” said Moses.

The tide could be turned, he said, “but it will take aggressive and coordinated action to reduce obesity and individual cities should play a key role in confronting the issues around obesity.”

The Guardian view on Gove’s clean air plan: just hot air | Editorial

Michael Gove, the environment secretary, made his name during the Brexit campaign for quipping that “the people have had enough of experts” and likening economists who warned against leaving the European Union to Nazi propagandists against Einstein. Mr Gove knows how to attract an audience. Nor has he discarded his insight that the public, if presented with facts that contradict a deeply held belief, will ditch the facts. This week Mr Gove was at it again: making headlines without making policy. The cabinet minister produced a clean air strategy which purported to tackle a public health crisis by getting families to open their windows more often because “air pollution inside the home can often be higher than outside”. This is true, but it smacks of the kind simplistic commonsense answer that Mr Gove favours because it avoids the knotty trade-offs called for in any policy, be it Brexit or the environment.

The main contributor to the air quality crisis, one that sees thousands of lives ended prematurely, is road transport – a subject about which Mr Gove has strangely little to say. Instead, his plan envisages local authorities finding the cash, presumably by defunding libraries or other essential public goods, to pay for an army of local inspectors to check the dryness of the wood being sold on petrol station forecourts that is used as fuel for stoves. Given his policy’s impotence, it would be absurd to say Mr Gove is taking the issue seriously. As lives are at stake, it is actually offensive.

It is also audacious to argue, as the environment secretary did, that “Brexit will allow us to clean up Britain’s air” when his government’s air pollution plan has been rejected by the courts three times because it failed to meet legal limits set by the EU eight years ago. It becomes outrageous when one knows that Mr Gove’s strategy is a response to an EU air quality law that set legally binding emission reduction targets for five pollutants.

The question is whether such a committed Brexiter would develop such a strategy if we were not in the EU? Mr Gove’s record of pushing for deregulation and repressing teaching on climate change in schools bodes ill. He was found to be acting illegally under EU laws, which can be disappeared from March 2019. Who will hold the government to account following Brexit? Will it be Mr Gove’s environmental watchdog, one so toothless it can only scare ministers into meeting standards by issuing advisory notices? If that is the enforcement agency, then every climate sceptic and fossil fuel fan ought to be celebrating in the streets.

If ministers are serious about dealing with a public health emergency that is “cutting lives short, damaging children’s health and poisoning our natural environment”, then they will have to change the car culture in this country and support that kind of change in behaviour by going with the grain of what people want to do, which is to be sustainably mobile. The government needs to encourage a virtuous circle of declining car use coupled with increasing use of greener modes of public transport. This needs cash, and crucially must allow local government to charge motorists to use road space. Ministers will have to face down the motor lobby and embrace electric cars, as they have done in Norway. Charging car batteries from central power stations is more efficient than burning fuel in separate engines. If Mr Gove wants to be remembered for more than just PR stunts that divert attention from a trick being pulled, he should adopt a policy that hastens the demise of the internal combustion engine.

Ex-footballer Terry Butcher accuses British army of failing his son

The former England football captain Terry Butcher has accused the British army of failing his son, who died after developing post-traumatic stress disorder (PTSD).

Butcher told an inquest on Monday that Christopher, 35, had turned to alcohol and drugs after being discharged from the armed forces in April 2015, due to the mental health condition.

“Christopher passed away several months ago. But, in reality, the Chris that we all knew and loved had ceased to exist years before,” Butcher told Ipswich coroner’s court.

“Diagnosed with severe post-traumatic stress disorder, his life spiralled downwards as the demons took control of his mind. In truth after intense tours of Iraq and Afghanistan he became a victim of war.

“These circumstances are all too familiar. Our country has a number of veterans suffering from the same condition, released from the armed forces too early and having to rely on an overloaded NHS that is ill-equipped and underfunded to cope.”

Butcher, who struggled to hold back tears during the hearing, said the armed forces’ duty of care towards personnel had been “discarded too easily, which has resulted in a growing number of our veterans turning to anything that might help including alcohol, drugs and suicide as a means of alleviating the flashbacks and nightmares”.

The inquest heard how Christopher, a former captain in the Royal Artillery, had been haunted by nightmares and flashbacks about the deaths of comrades and civilians in Afghanistan.

Butcher found his son’s body wedged between his bed and a wall when he went to check on him on the morning of 16 October last year at his home in Suffolk.

A postmortem failed to identify Christopher’s cause of death, but found he had an enlarged heart, which could have been caused by drug use. Toxicology tests revealed he had non-lethal levels of cocaine and heroin in his body, as well as prescription drugs he had been taking for several years. A makeshift crack pipe in a sunglasses case was also found in his room.

Suffolk’s assistant coroner, Dr Dan Sharpstone, concluded that Christopher died from an enlarged heart due to uncertain causes with a background of drug use and PTSD.

Butcher remembered his son as a man who had a “glittering career in the army ahead of him, a loving wife and dreams of having children of his own. His unnecessary death has deprived us of a wonderful son, husband, brother and grandson, friend and comrade”.

Sharpstone said: “When people serve in the armed forces, they give everything in the defence of our country and this may result in death or serious injury. However, it can also result in PTSD.”

  • In the UK the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. Other international suicide helplines can be found at www.befrienders.org.

Ex-footballer Terry Butcher accuses British army of failing his son

The former England football captain Terry Butcher has accused the British army of failing his son, who died after developing post-traumatic stress disorder (PTSD).

Butcher told an inquest on Monday that Christopher, 35, had turned to alcohol and drugs after being discharged from the armed forces in April 2015, due to the mental health condition.

“Christopher passed away several months ago. But, in reality, the Chris that we all knew and loved had ceased to exist years before,” Butcher told Ipswich coroner’s court.

“Diagnosed with severe post-traumatic stress disorder, his life spiralled downwards as the demons took control of his mind. In truth after intense tours of Iraq and Afghanistan he became a victim of war.

“These circumstances are all too familiar. Our country has a number of veterans suffering from the same condition, released from the armed forces too early and having to rely on an overloaded NHS that is ill-equipped and underfunded to cope.”

Butcher, who struggled to hold back tears during the hearing, said the armed forces’ duty of care towards personnel had been “discarded too easily, which has resulted in a growing number of our veterans turning to anything that might help including alcohol, drugs and suicide as a means of alleviating the flashbacks and nightmares”.

The inquest heard how Christopher, a former captain in the Royal Artillery, had been haunted by nightmares and flashbacks about the deaths of comrades and civilians in Afghanistan.

Butcher found his son’s body wedged between his bed and a wall when he went to check on him on the morning of 16 October last year at his home in Suffolk.

A postmortem failed to identify Christopher’s cause of death, but found he had an enlarged heart, which could have been caused by drug use. Toxicology tests revealed he had non-lethal levels of cocaine and heroin in his body, as well as prescription drugs he had been taking for several years. A makeshift crack pipe in a sunglasses case was also found in his room.

Suffolk’s assistant coroner, Dr Dan Sharpstone, concluded that Christopher died from an enlarged heart due to uncertain causes with a background of drug use and PTSD.

Butcher remembered his son as a man who had a “glittering career in the army ahead of him, a loving wife and dreams of having children of his own. His unnecessary death has deprived us of a wonderful son, husband, brother and grandson, friend and comrade”.

Sharpstone said: “When people serve in the armed forces, they give everything in the defence of our country and this may result in death or serious injury. However, it can also result in PTSD.”

  • In the UK the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. Other international suicide helplines can be found at www.befrienders.org.

Secret Teacher: I hated teaching – until I realised my school was the problem

Not so long ago, I was ready to quit teaching. Now, I’ve got my sights on leadership. The difference is my headteacher.

Under my previous head, I got the point where I couldn’t go on. I was signed off work with anxiety and stress. At school, we’d been under intense pressure to get more children to expected levels to show the school was improving – and were always on edge thanks to drop-in observations. As a member of the school leadership team, the headteacher expected me to remain distant from the rest of the staff, meaning I was isolated from my colleagues.

To make matters worse, a child who had special educational needs was subjecting me to frequent physical assaults. One day, I ended up in hospital with concussion and a suspected broken nose.

I expected my headteacher to support me. But when I returned to work the following day, I discovered there had been no consequence for the student. I explained that staff needed to be protected, only to be told that I was overreacting. Nothing changed.

Across the school, issues with violent and disruptive behaviour had become the norm. Teachers often missed their PPA (planning, preparation and assessment) time because they were dealing with pupils’ behaviour. When staff sought support, they were made to feel it was their fault, and their responsibility alone to deal with it. Morale was low – everyone had given up any hope of getting help. People were often found silently crying in various rooms around the school. I felt completely inadequate.


When staff sought support, they were made to feel it was their fault – and their responsibility alone to deal with it

But then I moved schools – and I saw that it wasn’t the profession that was the problem, but the leadership. My new head puts students at the heart of every decision they make. Learning is thought of as something that should be fun, and children are encouraged to explore their full range of abilities, not just English and maths. The school focuses on progress, while also recognising that it’s not about endless Sats drills. We don’t have target cards, because how does that really help pupils to learn?

The head puts just as much emphasis on the wellbeing of staff. We’re often treated to staff breakfasts, dinners on parents’ evenings, and simple messages and demonstrations of thanks. We’re encouraged to aspire to reach our professional goals, and the head recognises our strengths and encourages us to use them.

I even have my life back. Marking is done with students in lessons, so I haven’t needed to take any books home since I started, and the school is closed over the holidays so there’s no expectation to work on our classrooms. Instead, the expectation is that we rest and feel refreshed for the next term.

I’m still in disbelief that I’ve got to this point, considering where I was before. I have fallen in love with teaching again, and I now know that this can be the best job in the world – you just need to find the right school.

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Ed Sheeran denounces use of song in anti-abortion campaign in Ireland

Ed Sheeran has denounced anti-abortion campaigners after reports they used one of his songs less than a week before Ireland’s referendum on abortion.

The British pop star’s song Small Bump was reportedly being played by anti-abortion activists campaigning in Dublin’s city centre. Sheeran distanced himself from those using his song, saying in a post on Instagram that “it does not reflect what the song is about”.

Instagram story by Ed Sheeran @teddysphotos


Sheeran’s Instagram post. Photograph: Ed Sheeran

Small Bump, released in 2011, is from Sheeran’s debut album +, and his objection comes as Ireland prepares to vote on Friday 25 May in a referendum to repeal the eighth amendment to its constitution, which bans abortion in almost all circumstances.

The song’s lyrics include: “You’re just a small bump unknown, you’ll grow into your skin/With a smile like hers and a dimple beneath your chin/Finger nails the size of a half grain of rice, and eyelids closed to be soon opened wide/ A small bump, in four months you’ll open your eyes.”

In his Instagram post, Sheeran, who is currently playing a series of concerts in Ireland, said: “I’ve been informed that my song Small Bump is being used to promote the pro-life campaign, and I feel it’s important to let you know I have not given approval for this use, and it does not reflect what the song is about.”

Ireland’s referendum has attracted interest from groups from around the world seeking to influence the vote. A significant proportion of Facebook posts aimed at influencing voters were shown to have come from pages managed partly or entirely outside Ireland. Even some groups registered with Ireland’s ethics watchdog, the Standards In Public Office Commission, had Facebook pages managed from abroad.

Facebook said it was blocking all foreign spending on advertising around Ireland’s referendum on abortion in an effort to adhere to the “principles” of the country’s election spending laws.

Poorest and brightest girls more likely to be depressed – UK study

Brighter girls and girls from poorer families are more likely to be depressed by the time they enter adolescence, according to a study triggering fresh concern about soaring rates of teenage mental illness.

The government-funded research identified the two groups as being most at risk of displaying high symptoms of depression at the age of 14. In contrast, more intelligent boys and boys from the most deprived backgrounds appear not to suffer from the mental troubles that affect their female peers, the academics discovered.

The findings are based on detailed questionnaires filled in by 9,553 boys and girls aged 14 across the UK as part of the Millennium Cohort Study (MCS), which is tracking the progress of people born in 2000 into adulthood.

They add to growing evidence that teenage girls are particularly vulnerable to mental health difficulties. NHS figures show there were sharp increases between 2005/06 and 2015/16 in the number of girls under 18 admitted to hospital in England because they had self-harmed by cutting (up 285%), poisoning (42%) or hanging themselves (331%).

The researchers, led by Dr Praveetha Patalay, also found that being overweight, a history of being bullied and not getting on with peers were the three most common causes of depression in boys and girls aged 14. Their previous finding, that 24% of 14-year-old girls and 9% of boys that age were depressed, stirred widespread debate last year.

Dr Nihara Krause, a consultant clinical psychologist, said the findings about brighter and poorer girls were worrying, given the known links between depression and self-harm, and self-harm and risk of suicide.

“Some children who are depressed will self-harm. Some people say that physical pain is easier to tolerate than emotional pain,” she said. “What’s very concerning, in those who are depressed, is the link with suicide, because more and more studies show that self-harm is a predictor of suicide. Someone who self-harms is more likely to try to take their own life, especially if they are depressed. So these new findings are a concern from that point of view.”

Patalay said girls from families in the bottom two quintiles of household income were 7.5% more likely to be depressed at 14 than girls from the highest income families, but the same pattern was not found in boys.

Cleverer girls also had a significantly higher risk of having high depressive symptoms at 14, she said, and she was doing further research to calculate that risk more precisely among those with “higher childhood cognitive scores”.

Krause said: “Part of it could be that [brighter girls] have a ‘hyper brain’, a more active brain, which often means they have a much higher emotional reaction to things and they are constantly overthinking things.

“For example, if there’s a friendship situation that might be a concern to them, children of higher intelligence might think about all sorts of reasons why this situation has developed and get stressed about it.”

She pinpointed pressure on children to succeed at school – from their parents, schools and themselves – and competition for university places and jobs as a key cause of anxiety and depression in teenagers. In addition, some bright pupils are pushed too much, and those children can develop academically but be less adept at forming friendships, she suggested.

Children of either sex who have been bullied are 5.5% more likely to be depressed at 14, and boys or girls who do not get on well with their peers are 1.5% more likely to exhibit depressive symptoms.

The researchers also found that overweight boys and girls were 5% more likely to be depressed. This has prompted speculation as to whether the huge recent increase in childhood obesity is helping to drive what experts say is a growing mental health crisis in young people.

“We found a substantial link between being overweight and being depressed. Rates of overweight and mental ill-health are increasing in childhood, and they both have enormous consequences through our lives. Tackling these two health issues should be a public health priority,” Patalay said.

Emla Fitzsimons, a co-author of the findings and director of the MCS, said: “The study highlights a sharp increase in mental health problems among girls between ages 11 and 14. We certainly need to be looking at how the use of social media and cyberbullying may affect girls and boys differently.”

Dr Nick Waggett, chief executive of the Association of Child Psychotherapists, said it was unhelpful to highlight bright or poor girls as being at particular risk “when we already now there is a significant burden of mental illness in children and young people, including adolescent girls, and that there is a substantial shortfall in specialist services for them.”

Claire Murdoch, NHS England’s national mental health director, said: “After decades in the shadows, children’s mental health is finally in the spotlight, with more young people seeking help and years of unmet need being addressed. The NHS has responded, with 70,000 more young people set to get help, £1.4bn of extra funding and eating disorder and perinatal mental health services covering the whole country.

“But if the NHS is to meet fully the scale of the challenge then government, schools and councils need to work with us and our patients over the long-term.”

Trump administration to revive Reagan-era abortion ‘gag’ rule

Donald Trump’s administration will reinstate a decades-old policy that will strip federal funds from family planning clinics providing abortion or related services, marking its latest salvo to curtail women’s reproductive rights.

The Department of Health and Human Services will announce the proposal on Friday, an administration official confirmed to the Guardian. The move would revive a policy first implemented by Ronald Reagan in 1988, which effectively barred reproductive health organizations that received federal grants from providing or even discussing abortion with patients.

The policy has been derided as a “gag rule” by abortion rights supporters and medical groups, and it is likely to trigger lawsuits that could keep it from taking effect.

“This is an attempt to take away women’s basic rights, period,” Dawn Laguens, the executive vice-president of Planned Parenthood Federation of America, said in a statement.

She added: “Everyone has the right to access information about their health care – including information about safe, legal abortion – and every woman deserves the best medical care and information, no matter how much money she makes or where she lives. No matter what. They won’t get it under this rule.”

The Reagan-era rule never went into effect as written, although the US supreme court ruled that it was an appropriate use of executive power. The policy was rescinded under Bill Clinton, and a new rule went into effect that required “nondirective” counseling to include a range of options for women.

Federal funds are already barred from being used for abortion services under current US law.

The move will galvanize activists on both sides of the abortion debate ahead of the congressional midterm elections.

Doctors’ groups and abortion rights supporters say a ban on counseling women trespasses on the doctor-patient relationship. They also believe such rules would prevent patients from being able to obtain birth control or other preventive care from reproductive health care providers, and undermine access to safe, legal abortion, particularly among low-income women.

Abortion opponents have long argued that a taxpayer-funded family planning program should have no connection whatsoever to abortion.

“The notion that you would withhold information from a patient does not uphold or preserve their dignity,” said Jessica Marcella of the National Family Planning & Reproductive Health Association, which represents family planning clinics. “I cannot imagine a scenario in which public health groups would allow this effort to go unchallenged.”

She said requiring family planning clinics to be physically separate from facilities in which abortion is provided would disrupt services for women across the country.

Kristan Hawkins of Students for Life of America also backed the move. She said: “Abortion is not healthcare or birth control and many women want natural healthcare choices, rather than hormone-induced changes.”

Abortion opponents claim the federal family planning program in effect cross-subsidizes abortion services provided by Planned Parenthood, whose clinics are also major recipients of grants for family planning and basic preventive care. Hawkins’s group is circulating a petition to urge lawmakers in Congress to support the Trump administration’s proposal.

Known as title X, the nation’s family-planning program serves about 4 million women a year through clinics, at a cost to taxpayers of about $ 260m. Planned Parenthood clinics also qualify for Title X grants, but they must keep the family-planning money separate from funds used to pay for abortions.

The Republican-led Congress has unsuccessfully tried to deny federal funds to Planned Parenthood, and the Trump administration has vowed to religious and social conservatives that it would keep up the effort.

In one of his first acts as president, Trump reinstated a “global gag rule” policy that restricted the US government from providing funds to international family-planning organizations offering abortion-related services or information about the procedure.

Global health advocates have since bemoaned the closure of abortion facilities overseas, with developing areas the most acutely impacted. Trump later expanded upon the action, affecting nearly $ 9bn in funding to combat global health issues such as HIV/Aids, Zika and malaria.

The Associated Press contributed to this report

Capita’s NHS deal was founded on guesswork. It was doomed to fail | Richard Vize

The massive problems that have beset NHS England’s primary care support services deal with Capita, now dissected by the National Audit Office, are a textbook example of how to set up an outsourcing contract to fail. Pretty much everything that could have gone wrong went wrong, with both parties grossly underestimating the size and complexity of the task and the risks involved.

The £330m, seven-year contract delivers vital support services to around 39,000 people working in primary care, including GPs, opticians and pharmacists. Each year it includes delivering more than 240,000 orders for supplies, sending out more than nine million invitations for cervical screenings, processing around £9bn of payments to GPs and pharmacists – and moving six million patient records between GP practices. It is the engine powering primary care.

When NHS England inherited the services from primary care trusts in 2013 they were a mess, run out of 47 local offices with no common service standards or processes, an archaic IT system running 82 databases and many paper-based records.

Meanwhile the government’s first mandate to NHS England required the organisation to deliver deep cuts in administrative costs to focus resources on the frontline – as if the two were separate. NHS England decided to cut the cost of primary care support by 40% by outsourcing to an organisation that could transform it.

The Capita deal was a classic outsourcing contract. The winning bidder was expected to make massive losses in the first two years – £64m – in return for later riches. It was not scheduled to break even until year six.

Problems began before the contract was let, because NHS England knew little about the shape and scale of services being provided. As the National Audit Office has said repeatedly over the years, if the public sector tries to let a contract without knowing what it wants or what it will cost, it will end badly.


Capita needed to cut costs quickly, so by the end of 2016 it had shut nearly all the local offices and halved the staff

Capita got to work, setting up a centralised customer support centre, opening an online portal, introducing new payment processing systems and trialling a new way of moving patient medical records. The folly of relying on something approaching guesswork to estimate the scale of likely demand now became apparent. The orders flooding into the online portal far exceeded the vehicles available to make deliveries, stock shortages in the NHS supply chain created further delays, and the customer support centre could not cope with the ensuing flood of complaints.

In April 2016 a new system for moving patient records was finally introduced, which involved them all being routed via Capita’s Darlington depot. Yet more calls to the customer service centre followed.

With a big upfront loss, Capita had a massive incentive to cut costs quickly, so by the end of 2016 it had shut virtually all the local offices it had inherited and halved the staff. Vital local knowledge was lost.

Sticking closely to the script for an outsourcing contract failure, everyone started arguing rather than focusing on fixing the problem. Capita maintained that since there was no reliable performance data, NHS England could not prove it was failing. NHS England countered that Capita could not prove it was succeeding. Default notices were served, rectification plans were written, senior managers moved on, additional staff and vehicles were mobilised.

Capita lost £125m in the first two years – double the target. The two parties are still arguing over the contract.

The biggest unknown is whether there has been serious harm to patients. No specific cases have been identified, but it seems hard to believe that no one has suffered.

NHS England was too focused on achieving the savings, and failed to assess whether Capita had the skills to deliver such ambitious transformation at such a low cost.

With careful planning and good data you might just about be able to do any two of centralise, outsource, slash costs and improve services. Trying to do all four simultaneously was never going to work.

  • Richard Vize is a public policy commentator and analyst

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Suffer hay fever? Don’t blow your nose | Brief letters

It’s not just trees (We can’t chop down all these trees and not harm ourselves, 15 May). The railway ecosystem includes many other types of plant. On my trips from Winchester to Waterloo in the 1960s, I saw everlasting peas (Lathyrus latifolius) in full flower, cascading down the banks. There are still pockets of plant diversity on the route between Cambridge and King’s Cross, thanks to Margaret Fuller, wife of the crossing keeper at Shepreth, as recorded in The Illustrated Virago Book of Women Gardeners (ed Deborah Kellaway; 1995).
Margaret Waddy
Cambridge

David Cox offers some good advice (Seven ways to deal with hay fever, G2, 14 May) but misses out the real game-changer. Hay fever sufferers must not blow their noses. Everyone seems to know not to rub an irritated eye, but not that blowing has much the same effect on the nasal passages – congestion, irritation, and more discharge.
Dr Stuart Handysides
(Retired GP), Ware, Hertfordshire

Woody Guthrie’s words of long ago apply: Some rob you with a six-gun and some with a fountain pen (Carillion fall blamed on hubris and greed, 16 May). Why no prosecutions?
Huw Kyffin
Canterbury

Is it my imagination or is the royal romance, and lead-up to the wedding, beginning to sound a little like the plot of Notting Hill Part II (Markle’s father ‘may miss her wedding after surgery’, 16 May)?
Tony Hart
Formby, Merseyside

Who is giving Prince Harry away?
Marion McNaughton
Warburton, Cheshire

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