A range of new services will be available without the need to go to a GP, from December, in England.
Most NHS maternity units not safe enough, says regulator
The NHS watchdog says the findings are the worst in England since focused inspections began in 2018.
Scientists piece together DNA repair pathway implicated in breast, ovarian, and prostate cancers

Our DNA is not indestructible. Throughout the course of our lives, DNA can break in response to natural and environmental factors. Thankfully, our bodies have dedicated enzymes and pathways which can glue our broken DNA back together through several different mechanisms, known as DNA repair pathways.
Some cancers, however, can hijack these pathways for their own benefit. Susanna Stroik, PhD, and Dale Ramsden, PhD, both researchers in the Department of Biochemistry and Biophysics in the UNC School of Medicine and the UNC Lineberger Comprehensive Cancer Center, have pieced together the lesser-known DNA repair pathway, called polymerase theta-mediated end joining (TMEJ).
The pathway — which has been found to be upregulated in many patients with hereditary breast cancer, ovarian cancer, and prostate cancer, specifically those involving BRCA1 and BRCA2 mutations — has been laid out step by step in a published article in Nature, and the new knowledge could lead to new therapies for cancer.
“People with these breast cancer mutations, their cancers rely on polymerase theta’s repair pathway to keep the tumors alive and repair DNA damage in the cancerous tissue,” said Stroik, a postdoctoral researcher in Ramsden’s lab. “Now that we know more about this pathway, scientists could, in theory, produce a drug that could disrupt key pieces of the pathway in cancer cells, as opposed to using conventional chemotherapies that destroy healthy cells along with the cancer.”
Polymerase Theta’s Discovery
Out of all DNA repair pathways, TMEJ has been the most elusive. Richard Wood, PhD, a distinguished professor at University of Texas MD Anderson Cancer Center played a key role in the first characterization of polymerase theta in 2003.
Over the next 15 years, multiple labs, including the Wood, Ramsden, and Gupta labs (also at Lineberger Comprehensive Cancer Center), were able to link polymerase theta to DNA repair (TMEJ) and cancer. Sylvie Doublié, PhD, an alumnus of UNC-Chapel Hill and professor of microbiology and molecular genetics at the University of Vermont, then solved the first structure of polymerase theta.
Together, and with other scientists from Penn State and New York University, these researchers were dedicated to understanding precisely what steps are involved in TMEJ, and which of those steps polymerase theta does and does not perform.
With the help of these collaborators, Stroik was able to use a wide variety of cutting-edge experimental approaches to fill in the gaps in our understanding of the TMEJ pathway. Critically, she discovered that another polymerase, called polymerase delta, uses a buddy system with polymerase theta to assist it in this repair pathway.
A Unique Buddy System
Stroik’s research showed that polymerase theta is good at some things, but not others.
“It makes a lot of errors and it’s not capable of creating large swaths of DNA at once,” said Stroik. “What was so beautiful and kind of elegant about the whole discovery is that there are two different enzymes alternating between pathway steps and helping each other out.”
When a double stranded break occurs, both strands of DNA are cut at the same spot, much like scissors severing a braid of hair. Polymerase theta acts quickly, grabbing the two single strands of DNA, matching up the closest base pairs to the break, and holding them together.
However, this often leaves some residual flaps of single stranded DNA at the ends. Polymerase delta jumps in to cut the extraneous flaps, giving polymerase theta enough room to start synthesizing new DNA to fill in gaps in the DNA strands. Finally, polymerase delta jumps in one last time to help polymerase theta complete synthesis.
Stroik had another breakthrough finding: polymerases theta and delta are physically attached to one another. This new information could prove to be especially useful to drug developers hoping to create a new cancer treatment by drugging this interaction.
Cancer Treatment Potential
Since many cancers make use of the TMEJ pathway to keep tumors alive, many researchers have investigated creating drugs that can interfere with the pathway, essentially preventing cancer from repairing itself, leading to its eventual demise.
“Anytime you find new pieces of the pathway, you can ‘drug’ it,” said Ramsden.
Stroik and Ramsden’s new research will contribute to ongoing basic studies in polymerases theta and delta, while also aiding new cancer drugs called polymerase theta inhibitors, which are currently in clinical trials.
People with obesity burn less energy during day

Weight influences how and when bodies burn energy, new research indicates.
An Oregon Health & Science University study published in the journal Obesity found people who have a healthy weight use more energy during the day, when most people are active and eat, while those who have obesity spend more energy during the night, when most people sleep. The study also found that during the day, those with obesity have higher levels of the hormone insulin — a sign that the body is working harder to use glucose, an energy-packed sugar.
“It was surprising to learn how dramatically the timing of when our bodies burn energy differed in those with obesity,” said the study’s first author, Andrew McHill, Ph.D., an assistant professor in the OHSU School of Nursing and the Oregon Institute of Occupational Health Sciences at OHSU. “However, we’re not sure why. Burning less energy during the day could contribute to being obese, or it could be the result of obesity.”
Obesity is defined as having a Body Mass Index, or BMI, of 30 or more. Being overweight or obese increases the risk for health conditions such as high blood pressure and Type 2 diabetes.
Schedules and when people sleep, eat and exercise can also affect health, by either complementing or going against the body’s natural, daily rhythms. Every 24 hours, people experience numerous changes that are triggered by the human body’s internal clock. These changes normally occur at certain times of the day in order to best serve the body’s needs at any given hour.
McHill and the study’s senior author, Steven A. Shea, Ph.D., director of the Oregon Institute of Occupational Health Sciences at OHSU, focus their research on how circadian rhythms and sleep impact the human body. McHill leads theOHSU Sleep, Chronobiology and Health Laboratory.
While previous research has suggested circadian rhythm misalignment affects energy metabolism and glucose regulation, those studies have largely involved participants who have a healthy weight. To explore this further, McHill, Shea and colleagues organized a study that included people of different body sizes.
A total of 30 people volunteered to participate in the study, which involved participants staying at a specially designed circadian research lab for six days. The study followed a rigorous circadian research protocol involving a schedule designed to have participants be awake and sleep at different times throughout each day.
After each period of sleep, volunteers were awakened to eat and participate in a variety of tests for the remaining time of each day. One test had participants exercise while wearing a mask that was connected to a machine called an indirect calorimeter, which measures exhaled carbon dioxide and helps estimate energy usage. Blood samples were also collected to measure glucose levels in response to an identical meal provided during each day.
Next, the research team plans to explore eating habits and hunger in people who are obese, as well as those who have a healthy weight. That new study will also follow up on a 2013 study, led by Shea, that found circadian clocks naturally increase food cravings at night.
Exposure to air pollution in utero may affect reproductive system development

From invisible wafts of diesel exhaust to sun-choking plumes of orange smoke, air pollution is known to damage respiratory well-being. Now, research from Rutgers suggests another reason to hold our breath: Polluted air also may hurt reproductive health.
In a study of air pollution data in relation to markers of reproductive development in infancy, Rutgers researchers found certain pollutants may negatively alter anogenital distance, a measure of prenatal exposure to hormones.
“These findings suggest air pollution may interfere with normal hormone activity during critical periods of prenatal and early infant development, and we suspect that disruption may have long-term consequences for reproductive health,” said Emily Barrett, a professor in the Department of Biostatistics and Epidemiology at the Rutgers School of Public Health and lead author of the study published in the journal Environmental Health Perspectives.
Cross-sectional studies in adult men and women have shown that alterations in anogenital distance — the length between genitals and the anus — may be related to hormone levels as well as semen quality, fertility and reproductive disorders.
In animal studies, anogenital distance is used to determine developmental toxicity of pollutants. One measurable impact is on the reproductive system. When anogenital distance is reduced in male offspring, it’s a sign that a toxic exposure is interfering with fetal testosterone production, Barrett said.
Researchers have speculated that a similar relationship may exist in humans. To test their hypothesis, Barrett and colleagues used data from The Infant Development and Environment Study (TIDES), an ongoing longitudinal study of pregnant women and their children launched in 2010 in four U.S. cities: Minneapolis; Rochester, N.Y.; San Francisco; and Seattle. Anogenital distance at birth in children, and at one year for boys, was measured as part of the TIDES program.
These data were then compared with levels of nitrogen dioxide and fine particulate matter (PM2.5) — particle pollution 2.5 micrometers or smaller released during the burning of gasoline, oil, diesel and wood. An air pollution monitoring system administered by the University of Washington tracked pollution levels in the residential areas of TIDES participants during pregnancy.
By comparing these two measures, the researchers identified a link between exposure to air pollution during key developmental windows and anogenital distance.
For instance, higher PM2.5 exposure during the so-called male programming window at the end of the first trimester, when the male fetus typically receives a surge of hormones, was associated with shorter anogenital length at birth.
The researchers also observed that higher PM2.5 during mini puberty (a period in early infancy when hormone production is high) was associated with shorter anogenital distance in males at age one. These findings suggest there may be multiple points during early development that the reproductive system may be vulnerable to the impacts of air pollutants.
“PM2.5 is like a trojan horse,” said Barrett, adding that particulate matter can carry metals such as cadmium and lead, known endocrine disruptors. “When these disruptors interfere with the body’s hormones, the result could be lifelong impacts on our health, from cancer risks to impaired ability to conceive a child.”
Sorry But You Need To Stop Eating This 1 Thing Before Exercise

Exercise seems so simple, but it can feel like there’s a lot of prep behind-the-scenes to hit those fitness goals. Whether it’s sourcing the right equipment, finding the right time to do it or even whether the exercise you’re doing is actually beneficial for you, it feels like half the work is simply… getting ready to exercise.
Thankfully, it turns out choosing what to eat before you get started and what to refuel with is a lot less complicated.
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What you shouldn’t eat before a workout
According to Kerry Beeson, a nutritional therapist at Prep Kitchen, the focus of eating before a workout is to provide you with heightened energy, prevent fatigue, and support muscle maintenance and growth.
“As a general rule, you should aim to eat between one and three hours before your session,” she says.
Beeson adds that if you’re eating between one and two hours before your workout, you should keep the quantity small to avoid indigestion.
As for what not to eat, the nutritional therapist recommends steering away from nuts. This is because they are too slow to digest which could lead to discomfort and bloating. She also advises against tucking into cheese and fatty meats.
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Instead, it’s recommended that people eat complex carbohydrates which release energy gradually such as sweet potato and brown rice.
Surprisingly, Beeson also advises against high-fibre foods saying: ”Foods which are too high in fibre can cause gas and bloating which isn’t ideal before a high intensity workout. Interestingly, we don’t actually digest fibre, it’s indigestible which can lead to bloating and stomach discomfort if you exercise too soon after.”
What to eat after a workout
While it may be tempting to reach for a sugary snack after a workout (guilty), your body will refuel more effectively with nutritious foods. Beeson recommends tucking into spinach, eggs, lean meats or wholegrain pasta.
Sadly, after a workout still isn’t the greatest time to tuck into nuts and cheese – so it might be worth giving those a miss for now.
As Beeson says: “Try to avoid high fat foods for the first couple of hours following a workout as this can put unnecessary strain on your digestion while your body recovers.”
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‘He’s Extraordinary’: Daniel Radcliffe Honours His Paralysed Harry Potter Stunt Double

Daniel Radcliffe is celebrating the man who made him fly.
The Harry Potter star, who became famous at 12 years old for portraying the fictional character, produced a new documentary about his stunt double from the films. David Holmes: The Boy Who Lived, chronicles the titular 42-year-old’s journey after being paralysed on set.
“I used to fly,” he says in the film, according to People. “Not so much anymore.”
Holmes is eight years older than Radcliffe but served as his stunt double for all eight “Potter” films. He suffered an on-set spinal injury in 2009, however, breaking his neck after being propelled backward into a wall while test filming for the final two instalments.
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The Deathly Hallows incident left Holmes paralysed from the waist down.
“I wanted to make something about Dave for years because he’s extraordinary and I wanted to share that with the world,” Radcliffe told People for a story published Tuesday. “I was trying to do it myself. We shot some stuff and I didn’t really know what I was doing.”
“I thought I might know how to direct a documentary,” he added. “I absolutely didn’t.”
Radcliffe ultimately hired Potter video operator Dan Hartley to direct the film.
The documentary opens with Holmes as Harry Potter performing in mid-air on a broomstick, showing just how essential he was to bringing J.K. Rowling’s literary vision to the screen.
Radcliffe was initially intent on making a documentary about stunt men and their invaluable work in general, but it shifted to a focused look at Holmes before and after his accident. For Radcliffe, it also served as a trip down memory lane.
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“Dave, still, is one of the most important people in my life,” he told the BBC this week.
”He was somebody that was so incredibly fun to hang with when I was young,” Radcliffe added. “But then as I grew up he became a real guide to me, and kind of mentor and someone who really looked out for me, and that really has just continued as we’ve grown.”
Radcliffe forged ahead as a daring journeyman actor to shed his Potter fame with more risqué work.
Holmes became an ambassador for the RNOH Charity. He’s also a producer, including for the podcast Cunning Stunts, which featured other stunt professionals discussing the art.
Holmes told People he’s “not ready to watch” the documentary yet, but knows it was made “with love and sensitivity.”
“I have a team of Avengers that are wheelchair users or people from all different aspects of the disability spectrum that have seen this thing and said, ’No, it’s really empowering and it’s really positive and you’re going to do a good thing for the world,’” he said.
“Those opinions are the ones that matter to me,” Holmes concluded.
David Holmes: The Boy Who Lived is now available on HBO Max in the US and NOW in the UK.
People With Suspected ADHD Are Facing A Crisis In The UK

While the UK ADHD population is still grappling with ongoing medication shortages, new research from Mamedica has found that not only are the 2.6 million people diagnosed being left behind but a further 4.5 million Brits believe that they have undiagnosed ADHD.
Undiagnosed ADHD can come with a myriad of complications which leads to a reduction in quality of life for neurodivergent people. According to ADDitude Magazine, undiagnosed ADHD can lead to impulsivity, emotional instability ,and feelings of anger and worthlessness.
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How long are NHS waiting lists for ADHD diagnosis?
Of course, throughout the UK, waiting list times differ but a report by ITV released in October found that in some areas of the UK, adults could be waiting up to 10 years for a diagnosis.
Speaking to ITV, a Department of Health and Social Care spokesperson said: “We know how vital it is to have timely diagnoses for ADHD, and we are committed to reducing diagnosis delays and improving access to support.”
Additionally, Sheffield magazine Now Then has reported that in the 12 months between June 2022 and June 2023, only 21 adults received an assessment from The Sheffield Adult Autism and Neurodevelopmental Service (SAANS), which resulted in nine diagnoses.
Now Then stated that with 5,481 service users on the waiting list at the end of the same period, with current assessment rates, it would take 261 years to get through the current waiting list.
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How this crisis is affecting women
According to the ADHD Foundation, 50-75% of the women in the UK with ADHD are undiagnosed, and as a result may be experiencing poor health and socio-economic outcomes.
While awareness of ADHD in women and girls has improved in recent years, ADDitude Magazine warns that there is still a lot of information gaps with professionals such as teachers and gynaecologists.
They said: “We now know that fluctuating female hormones worsen ADHD symptoms, yet this important issue is largely neglected. Gynaecologists are not educated about ADHD; psychiatrists don’t study the effects of female hormones on the condition; and many females feel minimised and mistreated.”
How is the ADHD diagnosis crisis being tackled?
The shortage in medication has led to doctors in England being told to not prescribe new patients with ADHD medication but this is expected to be resolved by December. From there, it is up to individual health boards to tackle backlogs.
However, back in May of this year, MPs on the All Party Parliamentary Group (APPG) for Attention Deficit Hyperactivity Disorder (ADHD) called on the government to prioritise tackling NHS waiting lists to assess people who could have the disorder.
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Tory MP James Sunderland, a vice chair on the APPG, said to PoliticsHome that he wants the government to “throw the kitchen sink” at tackling NHS backlogs relating to ADHD, particularly for school-aged children.
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Researcher helps solve 60-year mystery inside heart

One University of Kentucky researcher has helped solve a 60-year-old mystery about one of the body’s most vital organs: The heart.
Kenneth S. Campbell, Ph.D., the director of translational research in the Division of Cardiovascular Medicine in the UK College of Medicine, helped map out an important part of the heart on a molecular level. The study titled “Cryo-EM structure of the human cardiac myosin filament” was published online in the journal Nature earlier this month.
The heart is made up of billions of cells. Each cell contains thousands of smaller structures, called sarcomeres. These are the building blocks of muscle. Within each block, are hundreds of myosin filaments. To put this microscopic level into perspective, if the heart is a continent, Campbell and fellow researchers are looking at single strands of hair.
“Each filament has roughly 2,000 molecules arranged in a really complicated structure that scientists have been trying to understand for decades,” said Campbell. “We knew quite a lot about the individual molecules and people thought the myosins could be arranged in groups of six that were called crowns, but not much beyond that.”
Campbell explained the most interesting discovery in the paper is that there are three different types of crowns. The interactions between them are shown in the second photo below.
“We think this means that heart muscle can be controlled more precisely than we had realized. We were also excited to see how myosin binding protein-C, another protein that is linked to genetic heart disease, sits within the structure. It gives us a new level of information about how the molecules are arranged in the heart,” said Campbell.
Working with researchers at the University of Massachusetts Chan Medical School, the group produced single-particle 3D reconstructions of the cardiac thick filaments. The pictures provide a new framework for interpreting structural, physiological and clinical observations.
“This study is important for discovering new drug therapies for heart disease which Kentucky desperately needs,” said Campbell. “It gives us a much better understanding of how the molecules in our hearts interact.”
Heart disease is the leading cause of death in Kentucky and puts the Commonwealth among the top 10 states with the highest death rate from the disease, according to the Centers for Disease Control and Prevention (CDC).
“We’re interested in therapies for different kinds of heart failure and myopathies, where the heart muscles don’t work very well,” said Campbell. “Our research is one of many projects underway at the university to help come up with better therapies for heart disease.”
The research team collected heart samples from the Gill Cardiovascular Biorepository, of which Campbell is the director. Samples are donated for research purposes from patients who receive cardiovascular care at UK.
“We started the Gill Cardiovascular Biorepository in 2008. With the help of a surgeon at UK HealthCare, we started collecting samples of myocardium from organ donors and from patients who were getting cardiac transplants,” said Campbell. “Now we’ve built a huge resource with roughly 15,000 samples from nearly 500 people.
“We also share these samples with research groups around the world. This study in Nature comes from one of those collaborations.”




