Latest news with #RichardThompson
The Independent
a day ago
- General
- The Independent
Consultant should have referred teenager to intensive care, tribunal rules
A senior doctor should have referred a teenager to intensive care when she displayed several 'high-risk indicators' of sepsis days before she died, a medical tribunal has found. Martha Mills, 13, had been an inpatient on the Rays of Sunshine Ward at King's College Hospital in London after she suffered a serious injury to her pancreas when she slipped while riding a bike on a family holiday in Wales in July 2021. Weeks later she experienced a fever, increased heart rate and had a catheter inserted into her vein, which was 'ultimately considered' to be a likely source of the infection that led to her death from sepsis, the Medical Practitioners Tribunal Service (MPTS) hearing was told. More spikes in her temperature followed, before consultant hepatologist Professor Richard Thompson saw Martha on his morning ward round on Sunday August 29 at the hospital, one of three locations in the UK which specialise in the treatment of paediatric pancreatic injuries. The on-call consultant left the hospital at 3pm, but was phoned at home two hours later by a trainee doctor, who gave an update on Martha's condition. Medical records showed she had deteriorated over the course of the afternoon, and into the early evening, with a drop in her blood pressure, the appearance of a new rash and increases in heart rate, respiratory rate and body temperature. Tribunal chairman Robin Ince noted that by 5pm there were 'several high-risk indicators' as set out in the Nice guidelines relating to sepsis. He said: 'These changes collectively indicated a sudden and significant deterioration for no clearly identified reason…it was evident that by around 5pm the clinical condition of Martha justified escalation to PICU (paediatric intensive care unit) and this opportunity was not taken.' The duty registrar called Prof Thompson again at 8.30pm because of ongoing concerns over Martha's fever, but she was kept on the ward despite the continued presence of moderate to high-risk indicators and the absence of meaningful clinical improvement, said the tribunal. Mr Ince said: 'The tribunal notes that Professor Thompson expressed a preference to prearrange any PICU involvement, rather than having PICU clinicians arrive unexpectedly and cause distress to Martha's parents. 'While the tribunal understands the desire to manage the family anxiety sensitively, this did not, in its view, justify withholding or delaying a clinically indicated escalation of care.' He added: 'The tribunal therefore concluded that the GMC (General Medical Council) has proved its case that Professor Thompson failed to take more aggressive intervention from 12 noon onwards in that he did not escalate Martha to the PICU team for a direct clinical review.' The tribunal also ruled that Prof Thompson should have conducted a direct in-person review and assessment of Martha, including the developing rash, from 5pm, which would have been 'beneficial'. Mr Ince said: 'He would no doubt have discovered that no observations had been taken in respect of Martha from 2pm to at least 4.45pm. 'The tribunal notes that one of the advantages of escalating a patient to PICU would have been an increased level of monitoring. 'Although no explanation has been given to the tribunal for the failure to monitor Martha between 2pm and 4.45pm, this absence of monitoring on the ward would no doubt have been a significant factor in justifying such an escalation.' The tribunal cleared Prof Thompson of the GMC's allegations that he gave 'outdated, misleading' information on Martha's condition to a consultant colleague in the intensive care unit, and that he failed to mention her rash. Martha collapsed on August 30 and was moved to intensive care, before she was transferred to London's Great Ormond Street Hospital, where she died in the early hours of August 31. At a 2022 inquest into her death a coroner ruled Martha would most likely have survived if doctors had identified the warning signs and transferred her to intensive care earlier. Martha's mother, Merope Mills, an editor at The Guardian, said she and her husband, Paul Laity, raised concerns about Martha's deteriorating health a number of times but these were not acted on. The couple later successfully campaigned for Martha's Rule to give patients, families and carers the chance to easily request a second opinion from a senior doctor in the same hospital in the event of a suspected deterioration or serious concern. The MPTS hearing in Manchester continues as the tribunal considers whether Prof Thompson's fitness to practise is impaired.
Yahoo
a day ago
- Health
- Yahoo
Consultant should have referred teenager to intensive care, tribunal rules
A senior doctor should have referred a teenager to intensive care when she displayed several 'high-risk indicators' of sepsis days before she died, a medical tribunal has found. Martha Mills, 13, had been an inpatient on the Rays of Sunshine Ward at King's College Hospital in London after she suffered a serious injury to her pancreas when she slipped while riding a bike on a family holiday in Wales in July 2021. Weeks later she experienced a fever, increased heart rate and had a catheter inserted into her vein, which was 'ultimately considered' to be a likely source of the infection that led to her death from sepsis, the Medical Practitioners Tribunal Service (MPTS) hearing was told. More spikes in her temperature followed, before consultant hepatologist Professor Richard Thompson saw Martha on his morning ward round on Sunday August 29 at the hospital, one of three locations in the UK which specialise in the treatment of paediatric pancreatic injuries. The on-call consultant left the hospital at 3pm, but was phoned at home two hours later by a trainee doctor, who gave an update on Martha's condition. Medical records showed she had deteriorated over the course of the afternoon, and into the early evening, with a drop in her blood pressure, the appearance of a new rash and increases in heart rate, respiratory rate and body temperature. Tribunal chairman Robin Ince noted that by 5pm there were 'several high-risk indicators' as set out in the Nice guidelines relating to sepsis. He said: 'These changes collectively indicated a sudden and significant deterioration for no clearly identified reason…it was evident that by around 5pm the clinical condition of Martha justified escalation to PICU (paediatric intensive care unit) and this opportunity was not taken.' The duty registrar called Prof Thompson again at 8.30pm because of ongoing concerns over Martha's fever, but she was kept on the ward despite the continued presence of moderate to high-risk indicators and the absence of meaningful clinical improvement, said the tribunal. Mr Ince said: 'The tribunal notes that Professor Thompson expressed a preference to prearrange any PICU involvement, rather than having PICU clinicians arrive unexpectedly and cause distress to Martha's parents. 'While the tribunal understands the desire to manage the family anxiety sensitively, this did not, in its view, justify withholding or delaying a clinically indicated escalation of care.' He added: 'The tribunal therefore concluded that the GMC (General Medical Council) has proved its case that Professor Thompson failed to take more aggressive intervention from 12 noon onwards in that he did not escalate Martha to the PICU team for a direct clinical review.' The tribunal also ruled that Prof Thompson should have conducted a direct in-person review and assessment of Martha, including the developing rash, from 5pm, which would have been 'beneficial'. Mr Ince said: 'He would no doubt have discovered that no observations had been taken in respect of Martha from 2pm to at least 4.45pm. 'The tribunal notes that one of the advantages of escalating a patient to PICU would have been an increased level of monitoring. 'Although no explanation has been given to the tribunal for the failure to monitor Martha between 2pm and 4.45pm, this absence of monitoring on the ward would no doubt have been a significant factor in justifying such an escalation.' The tribunal cleared Prof Thompson of the GMC's allegations that he gave 'outdated, misleading' information on Martha's condition to a consultant colleague in the intensive care unit, and that he failed to mention her rash. Martha collapsed on August 30 and was moved to intensive care, before she was transferred to London's Great Ormond Street Hospital, where she died in the early hours of August 31. At a 2022 inquest into her death a coroner ruled Martha would most likely have survived if doctors had identified the warning signs and transferred her to intensive care earlier. Martha's mother, Merope Mills, an editor at The Guardian, said she and her husband, Paul Laity, raised concerns about Martha's deteriorating health a number of times but these were not acted on. The couple later successfully campaigned for Martha's Rule to give patients, families and carers the chance to easily request a second opinion from a senior doctor in the same hospital in the event of a suspected deterioration or serious concern. The MPTS hearing in Manchester continues as the tribunal considers whether Prof Thompson's fitness to practise is impaired.
Irish Times
2 days ago
- Entertainment
- Irish Times
Bonnie Raitt in Vicar Street: a healing night of welcome warmth and real soul
Bonnie Raitt Vicar Street ★★★★☆ 'Ireland in any weather is beautiful to me.' Bonnie Raitt is telling Vicar Street about the nine-day break she took here, surrounded by sheep, before playing Belfast on Sunday night. The rest surely did her good because she's in rare form tonight. She hits an early highlight with the rattling, barrelhouse groove of Thing Called Love, a song originally on John Hiatt's Bring The Family. That album featured the slide guitar of Ry Cooder but even he'd have to bow to Raitt's playing as she tosses off an effortless swamp porch solo, knife blade sharp and smooth as molasses, from the battered Stratocaster she apparently bought for $120 back in 1969. And she's got that voice to go with it. Take Mabel John's 1966 classic Your Good Thing (Is About To End). Raitt, brimming over with pleading soul, stretches out vowels, holds notes until her vibrato is on the verge of cracking, and when that voice has finally had enough of the uncaring man in the lyric, her slide guitar takes over to show him the door. An almost supernaturally intuitive interpreter of songs, Raitt delivers an achingly beautiful take on Richard Thompson's Dimming Of The Day, a called-for Angel Of Montgomery by John Prine ('Nobody cut through like John'), and twists Dylan's Million Miles inside out with a glint in her eye as she implores her baby to 'rock me for a couple of months'. Then she bests them all by bringing the house to its feet with the encore's I Can't Make You Love Me, a tale of broken love familiar to every knocked-about heart. READ MORE Raitt makes several bows to old friend Paul Brady , in the audience having the same good time as the rest of us. First she claims she's nervous with him watching, then declares it an honour. When asked to sit in he allegedly replied, 'You can't afford me,' but with the greatest respect to the man from Strabane, she doesn't need him as she commandeers his Not The Only One and Steal Your Heart Away, making them her own. Raitt calls her show 'a healing experience in this suffering, hard-assed world' and that's what it is But Raitt also knows how to write a song. Nick Of Time, the title track from the 1989 album that finally made her an overnight success 18 years after her debut, is one thing with its great lyric about getting on a bit ('Those lines are pretty hard to take when they're staring back at you'). Just Like That is something else entirely. To the surprise of many, including the other nominees and Raitt herself, she won the Grammy for Song Of The Year with it a few years back but the judges were right, for once. A woman who lost her son is visited by the man who lives on thanks to her child's transplanted heart. It's moving on record but it's devastating live. In that inexplicable way a song you've heard before can sneak back up on you, Raitt gets to the line where she lays her head on his chest and she's with her boy again and you're gutted by the lyric's power. 'They say Jesus brings you peace and grace, well he ain't found me yet,' has a similar effect. Raitt calls her show 'a healing experience in this suffering, hard-assed world' and that's what it is, whether she and her superlative four-piece band are transforming the room into a rambunctious roadhouse or a hushed confessional. A night of welcome warmth and real soul. There aren't many like her.
Irish Times
27-05-2025
- Health
- Irish Times
Microplastics: how dangerous are they and how can we reduce our risk?
Recent headlines have raised concerns about microplastics in our bodies and the harm they may be doing. Scientists say it could be years before we have a full understanding of how these tiny plastic particles are affecting human health. But we do know they have been found from the depths of the Mariana Trench in the Pacific to the heights of Mount Everest. And we know that plastic is accumulating in our bodies, too. 'The air we breathe, the water we drink, the food we eat – it's in it,' said Richard Thompson, a marine biologist at the University of Plymouth in England who coined the term 'microplastics' in a 2004 paper. 'We're exposed.' What are microplastics? Scientists generally define 'microplastics' as pieces less than 5mm long. Nanoplastics, which measure less than 1 micrometre, are the smallest of these and the most likely to get into our blood and tissues. READ MORE Microplastics mostly come from larger plastics, which degrade with use or when they aren't disposed of properly, said Jeffrey Farner, an assistant professor of civil and environmental engineering at the Florida A&M University-Florida State University College of Engineering. 'We use plastics in areas or in ways that lend themselves to the production of microplastics or to the breakdown over time,' Farner said – for example, in construction materials that are weathered outdoors; in tubing that generates microplastics when it is cut; and in agriculture, as plastic mulch or in irrigation systems. More than one-third of plastic produced today is for packaging, including single-use items such as food containers that largely end up as waste. A discarded plastic bag or bottle that makes its way to the ocean or a beach gets hit with ultraviolet light, heat and sand abrasion. From there, it 'is going to break down into just an enormous number of micro- and nanoplastics,' Farner said. How do they get into our bodies? These micro- and nanoplastics end up in our air, soil, water and food. The wear and tear on our car tyres, for example, produces particles that pollute the air and water. Microplastics filtered out of wastewater end up in sludge that is then used as fertiliser. Plastic cigarette filters make their way to lakes and oceans, where they degrade over time. Humans breathe in these particles and ingest them. Some research suggests plants directly take them up from the soil and incorporate them into their roots, said Christy Tyler, a professor of environmental science at the Rochester Institute of Technology in New York. The higher up the food chain an animal is, the greater the concentration of microplastics likely to be found inside them. Microplastics are also more common in highly processed foods, potentially because of contamination from processing machinery or even workers' clothing. Scientists have a limited understanding of whether and how microplastics might penetrate the skin, said Tracey Woodruff, director of the programme on reproductive health and the environment at the University of California, San Francisco. But, she said, some evidence suggests we can absorb microplastics – and harmful chemicals within them – from personal care products such as cosmetics and from our clothes, which shed fibres as we move. [ Microplastics are in the heart, lungs, penis, breast milk. Can we keep them out of our bodies? Opens in new window ] Our bodies appear to clear out some of these microplastics, particularly the larger ones. Microplastics have been found in human stool and urine. Jacques Robert, a professor of microbiology and immunology, and of environmental medicine, at the University of Rochester, said his own research on tadpoles fed microplastics has found that about 60 per cent to 70 per cent of the plastic was excreted. (That research has not yet been published.) Other studies have suggested that the plastic not excreted in waste appears to pass out of the gut and into the blood, and from there can migrate to other organs like the liver and brain. What do we know about the health effects? Animal studies indicate that microplastics may harm reproduction, particularly sperm quality. They can also affect lung and gut functioning and may increase the risk for lung and colon cancer, said Woodruff, who conducted a review of the research. Robert's research in tadpoles has also shown that microplastics may weaken the immune system. It can be hard to extrapolate the effects on humans from animal studies, Tyler said, since the type and amount of plastics given to animals in experimental settings often differ from the chronic, low-level exposure to weathered particles that we experience. That said, there is early research in humans showing links between microplastics and preterm births, inflammation and cardiovascular disease. And there is well-established evidence that some chemicals in plastics are harmful to humans. These include per- and polyfluoroalkyl substances, or PFAS, some of which have been labelled known or likely human carcinogens. They also include bisphenol A and phthalates, which disrupt normal hormone function. How can we reduce exposure? One of the most effective steps might simply be not drinking from plastic water bottles, especially if they've been sitting out in the sun, Woodruff said. Another is to avoid heating food in plastic containers. Experts recommended switching to glass or steel containers for food storage, or at least transferring food to a glass or ceramic dish before heating. Eating more fresh fruits and vegetables can help, too. Packaged and highly processed foods contain far more microplastics, and the particles can also be concentrated in fish and meat. Regularly vacuuming your house and using an air purifier with a HEPA filter can reduce the amount of microplastics you inhale, Tyler said, and wiping surfaces with a wet cloth may prevent particles from getting back in the air. [ Do plastic chopping boards shed microplastics into food? Opens in new window ] Washing clothes made of synthetic fibres, such as acrylic or nylon, before wearing them the first time can also help reduce your own exposure, by clearing off microplastics left from the cutting and sewing process. (Doing so, though, also introduces microplastics into wastewater.) Clothes made of natural fibres, such as cotton or wool, sidestep the microplastics problem altogether. These measures have limitations, however. Plastic is ubiquitous and often the most affordable option. 'It shouldn't all be on the consumer to have to make those choices,' Tyler said. It's not entirely clear, either, that avoiding plastic water bottles or cutting boards will meaningfully reduce your lifetime exposure when plastic waste has accumulated in our soil, air and water. Experts said governments would have to regulate and reduce non-essential plastics to stop that accumulation. Some already have. The European Union banned the use of microbeads in cosmetics, for example, and several are phasing out styrofoam in food packaging. And 175 countries have agreed to create a United Nations treaty to end plastic pollution. Compared to 20 years ago, Thompson said, there's now 'a public appetite' for change. – This article originally appeared in the New York Times . 2025 The New York Times Company
Yahoo
22-05-2025
- Business
- Yahoo
Thompson to serve as ECB chair for further year
England and Wales Cricket Board (ECB) chair Richard Thompson has been reappointed until September 2028. The ECB's non-executive directors chose unanimously to extend Thompson's tenure, which had been set to expire in September 2027. Since being appointed in 2022, Thompson has overseen the sale of the franchises in The Hundred and presided over the Independent Commission for Equity in Cricket. The move follows changes made to the body's articles of association last year, which altered the chair's term from five years to three, with a maximum of two terms. "Richard is respected throughout the game," said Katie Bickerstaffe, the ECB's senior independent director, who led the reappointment process. "The board and the wider game is fully supportive of his agenda to become the most inclusive team sport, grow and unite the game, and to lead cricket through a period of global transformation." Thompson will oversee the 2026 Women's T20 World Cup, which is to be held in England, alongside the introduction of overseas ownership in The Hundred next season. The former Surrey chair also sits on the International Cricket Council's Olympics working group, with the sport set to return to the Games in Los Angeles in 2028, and chairs the body's global growth committee. "I'm honoured to be able to continue serving the game I care so passionately about," said Thompson. "Whether it's growing participation and breaking down barriers or supporting our professional game and England teams, I'll continue to work closely with our stakeholders to deliver a game that truly reflects and inspires our communities." Get cricket news sent straight to your phone
