prison food

Prison food 'beats NHS hospitals'

Researchers say hospital patients do not consume enough good food

Researchers have claimed the food provided in prisons is better than in NHS hospitals.

Experts from Bournemouth University examined the quality of food offered to prisoners and NHS patients.

They say people in hospital are losing out on nutrition because they are not being helped with eating or having their diet monitored.

A Department of Health spokesman said most patients were "satisfied with the food they receive in hospitals".

Professor John Edwards said about 40% of patients entering hospital were already malnourished, and this did not tend to improve during their stay.

"If you are in prison then the diet you get is extremely good in terms of nutritional content," he said.

"The food that is provided is actually better than most civilians have.

It's incredible that so many hospitals are failing to serve healthy meals. If prisons can serve good food then so can hospitals Norman Lamb, Liberal Democrat

"There's a focus on carbohydrates. Then there's the way they prepare the food; it's very healthy. They don't add salt and there's relatively little frying of food - if you have a burger then it goes in the oven.

"Hospital patients don't consume enough. If you are using food as a means of treatment then it's not working.

"And from the work we've done we know that people who sit round a table eat a lot more, but this doesn't happen in hospitals."

Professor John Edwards: ''People often need help with eating''

His fellow researcher Dr Heather Hartwell said fruit and vegetables were made available in hospitals "but this doesn't mean it's eaten".

She also said that patients suffered because they may have no appetite as a result of their illness, and might also not get help with eating and drinking.

The research suggests further problems are caused because meals are likely to be at a set time, when patients may be having tests or treatment.

"Hospital cutbacks are also seen in areas like catering budgets, rather that elsewhere," Dr Harwell said.

"Hospital food services also need to be less fragmented and more joined up."

'Improve services'

Liberal Democrat shadow health spokesman Norman Lamb said: "This study highlights the experience of too many patients in NHS hospitals.

"While there is excellent care in many places, there are a lot of examples of what is in effect neglect of vulnerable people.

"It's incredible that so many hospitals are failing to serve healthy meals. If prisons can serve good food then so can hospitals."

A Department of Health spokesman said: "Good quality food for patients improves their health and their overall experience of services.

"The majority of patients are satisfied with the food they receive in hospitals, and we are working to improve services further."

"Clinicians have a duty to ensure patients get the appropriate treatment for any condition, including malnutrition.

"We have also introduced the concept of 'protected mealtimes' where all non-urgent activity on the ward stops, so that patients can enjoy their meals."

food surprises ?

Cost of food: Global roundup

Full coverage: The cost of food

CHRIS MORRIS, DELHI, INDIA

Ordinary Indians are facing significantly increased hardship because of the rise in the cost of food. The rate of price increases seems to have slowed, but many basic foodstuffs like rice and lentils are far more expensive than they were a year ago.

'Alarming' hunger in Indian states

And that means people on or below the borderline - hundreds of millions of people - are struggling to make ends meet.

In the most extreme cases, severe malnutrition is a life-threatening condition. There are about eight million children under the age of five in India who are in urgent need of therapeutic feeding and nutritional treatment.

But there are also tens of millions of children who suffer from chronic malnutrition which may not be immediately visible. They are deprived of many of the nutrients they need to lead healthy productive lives.

In India, the rise in the cost of food has not created a crisis, it has simply made a bad situation worse.

Rising inflation has received considerable attention in the Indian media, but the recent focus has been on the global financial turmoil, and its impact on Indian markets.

Chris Morris discovers why India's young people are the hardest hit by high food prices

That is of little immediate relevance, though, to the vast majority of people in this country. What matters is the price of vegetables, the price of flour, and whether there is any work to be had to buy the food they need.

Two thirds of India's population are forced to get by on less than two dollars (£1.15; 1.47 euros) a day. And the little money they do make now buys less food than it used to. Something has to give.

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CHRISTIAN FRASER, CAIRO, EGYPT

Inflation in Egypt is at a 16-year high with soaring food prices triggering violent protests in some areas of the country this year, prompting the government to raise public sector salaries by 30%.

But the pay rise was soon followed by increases in prices of fuel, which sent the cost of goods and services even higher.

An Egyptian family can spend as much as 80% of its income on food

Egyptian economist Samir Radwan says that while the levels of salaries and subsidies may have risen, "the government's liberalizing of some other commodity prices means the poor are actually worse off than they were before May".

Many poorer families in Cairo - some of whom spend 80% of their household income on food - have been making savings by cutting their meals from three a day to just two.

Egypt is also the world's largest importer of wheat, which explains why the country has been hit so hard by these international price rises. Finance Minister Youssef Boutros-Ghali says a large part of the inflation in his country stems from the higher prices of imported goods. But he believes that, as the year progresses, things will start to look better.

Egypt is the world's largest importer of wheat, which explains why the country has been hit so hard by these international price rises

The wheat Egypt has, in the past, bought from Russia and Ukraine now looks much cheaper.

"Look at international commodity prices," he says. "Wheat used to be $480 a tonne, it has now fallen to around $200 a tonne. Corn is the same. Soybean the same. Edible oils the same. All of this is bound to translate here. We will see prices fall."

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JULIA CAESAR, LONDON, UK

Despite the UK's wide variety of shops competing for custom, many here are feeling the pinch. But, after nine long months of price rises, food inflation seems to be slowing down.

According to the BBC's Food Price Index compiled by Verdict, which tracks the cost of a typical trolley of UK food items, meat and fish products rose by 22.9% from January to August.

World Service food price index Global Hunger Index in full

General store-cupboard items, such as tinned foods, registered a 15% increase and seven items in the survey leapt in price by more than 40%. A pack of four croissants, for example, was 47.4% more expensive and a 125g packet of ham went up by 45.4%.

Another survey shows that fruit and vegetables have seen the biggest price rises - up by 30% at leading supermarket chains in the UK over the past year. Retailers are blaming poor crop harvests and high supply chain costs.
But at least the shoppers in the UK have choice and they are making the most of it, according to consumer research.

In the last 12 months, 41% of shoppers have switched to cheaper brands, with two-thirds searching for promotions and deals more often than a year ago. Hard discounters have become more popular too, forcing big-name supermarkets to compete more on price than they used to.

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MICHAEL BRISTOW, BEIJING, CHINA

Those in charge of the Chinese economy received some welcome news this summer - inflation fell to its lowest level in more than a year.

Earlier in 2008, prices - particular for basic food items such as pork and eggs - had been rising faster than at any time in the past decade.

Chinese people are sensitive to price rises for everyday items

Shoppers across the county complained that they had cut back on the kind of food purchases they make every day.

It was a worrying time for the Chinese leadership. As in other countries, inflation has sometimes led to street protests in China. In a keynote speech given to China's parliament, Premier Wen Jiabao said tackling inflation was top of the government's agenda.

But even in the midst of this bad news, Chinese officials said they were confident that they would get inflation under control.

They claimed the food price rises were the result of temporary supply problems and not because of long-term shortages.

That confidence now seems to have been well-placed. Beijing shoppers say prices are still going up, but more slowly than before.

A senior finance official recently predicted that inflation in China would slow to 3% in 2009 from a high of 8.7% earlier this year.

Having largely escaped the worst effects of the global financial crisis, economists are urging China to concentrate on turning that prediction into a reality.

And the government will need to, because Chinese people remain acutely sensitive to price rises, particularly for everyday items.

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LIZ BLUNT, ADDIS ABABA, ETHIOPIA

It is easy to tell when one of the local "kebeles" in Addis Ababa is selling wheat - residents cluster outside hoping to be able to buy a sack of half-price grain and unemployed youngsters hang around hoping to earn a little money by carrying their sacks.

Wheat prices in Addis are higher than in other capitals

The "kebeles" are a leftover from communist times - part local government offices, part community centres, part instruments of social control. Now the Ethiopian government is using them to distribute subsidised wheat.

Food prices have more than doubled in the past year here.

It was easy at first to blame world prices, market forces and globalisation. But, with wheat prices in Ethiopia much higher than world prices, it looked as if there would be a lot of profit to be made by importing wheat, yet market forces show no sign of bringing down the price.

The government's attempts to flood the market have cost a lot but have had little effect. If you are lucky enough to be at the front of the queue when the wheat arrives, you can buy a 100 kilo sack for 350 birr (around $35; 25 euros).

But the markets are still selling wheat for 600 or even 700 birr per sack. Not surprisingly, much of the subsidised wheat is taken straight down the road to the market where it is sold for twice the price.

Perhaps merchants and farmers are being greedy, but more likely there is just not enough food in the country.

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JONATHAN HEAD, BANGKOK, THAILAND

Rice - the staple crop in this part of Asia - reached record prices this year. Even after falling back from highs of around $1000 (735 euros; £573) for a tonne of good quality rice, to $600-800, it is still double what was being paid last year.

Rising rice prices have not generated more cash for farmers

Yet the majority of farmers - who farm small plots of land of three hectares or less - have taken home very little of this bonanza. The reasons are complex, and vary from country to country, but they underline a simple fact: whereas driving up the price of other smallholder agricultural commodities such as coffee or rubber often does enrich those who work the land, it rarely works that way in the case of rice.

Many small rice farmers do not actually grow enough for their families to eat so they still have to buy rice at market prices. In Cambodia, for example, despite the government's pride in becoming one of the world's ten largest rice exporters, only a third of rice farmers produce any surplus they can sell - and one fifth of the population does not get enough to eat.

Farmers usually have no storage facilities, so they need to sell their rice the moment it is harvested World food prices: What happened?

This lead to a bizarre situation where the government planned to sell 1.6m tonnes of locally grown rice on world markets this year, but was also forced to ask the Asian Development Bank for a $38m food security aid package for Cambodians who could not feed themselves.

Thailand - the region's largest exporter - has done well out of rising prices, but its farmers have not as most of the profits have gone to the middlemen. Farmers usually have no storage facilities, so they need to sell their rice the moment it is harvested.

As prices started to ease from their highs in May, almost everyone in the region breathed a sigh of relief.

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DANIEL SCHWEIMLER, BUENOS AIRES, ARGENTINA

There is no doubt that food prices in Argentina are rising - you just need to ask any shopper. But to get an idea of just how much will depend on who you talk to.

Argentina's official statistics office, the INDEC, says inflation is under control, at around nine percent a year. But shoppers, independent economists, newspapers and even some staff at the INDEC say those figures do not reflect the reality. Prices, they say, are rising at more than 20% annually.

Government measures to control food prices have sparked strikes

About one third of the Argentine wage goes on food, and meat takes up a fair amount of space in the basket. Argentines are the biggest per capita consumers of beef in the world and the government has worked hard to keep the price down - negotiating with producers and restricting exports.

But soya has become the new Argentine beef. They aren't eating it but exporting it - mostly to China and India. The little cream bean was, until recently, fetching high prices on world markets and has been the driving force behind Argentina's economic recovery from the crisis it suffered seven years ago.

More and more land previously used for other crops or for pasture is being turned over to the lucrative soya crop, reducing supplies and pushing up prices.

Earlier this year farmers nationwide protested against government plans to increase export taxes, mostly on soya. The four-month protest and the worst drought in a century in Argentina's northern provinces have both had an effect in a country which produces nearly all its own food and imports little

population consequences ?

Food crisis hits developing world farms

By James Melik Business Reporter, BBC World Service

Roses have proved to be a particularly successful export for Kenyan farmers

Farmers in developing countries are struggling despite recent rises in the price of commodities they produce, the Fairtrade Foundation says in a new report.

The report, which interviewed farmers' groups in Uganda, Malawi, Nicaragua, India, Sri Lanka and the Caribbean, reveals that many families are spending up to 80% of their entire household budget on basic food items.

The rocketing cost of food, fuel and fertiliser prices have had a devastating effect on their livelihoods.

In some cases, families have been forced to cut out meals, take children out of school and reduce the amount of land they plant, the report says.

WHAT IS FAIR TRADE? Fair trade aims to address the injustices of conventional trade, which may discriminate against the poorest, weakest producers. It enables farmers to improve their position by receiving guaranteed prices for their goods Source: Fairtrade Foundation

Some farmers have even sold their land because they can no longer afford to farm it or buy fertilisers to keep up production.

But the report says that fair trade schemes could help ease their plight, with demand for Fairtrade products remaining strong despite the economic downturn.

'Hard times'

Some 450 million small farms around the world are home to one third of all humanity.

They are vital for producing food for local and national consumption, as well as earning crucial export income to boost wider economic growth and development.

These are hard times for consumers, but even harder times for producers Tomy Mathew, Indian farmer

But for many farmers, rises in the price of export commodities such as vanilla, coffee, tea or sugar have been outstripped by the dramatic increase in the cost of staple food.

Tomy Mathew, a farmer and founder of the Fair Trade Alliance of Kerala in India who represents more than 3,000 small farmers growing coffee, peppers, and spices, says the last few months have been very difficult.

"The price of rice has gone up 40% while the amount we receive for crops has remained the same or in some cases come down," he says.

Mounting debt means that farmers have to cut back on the type schooling or healthcare they can afford for their families.

"These are hard times for consumers, but even harder times for producers and Fairtrade is needed more than ever," he says.

Sainsbury's saves money by selling Fairtrade bananas and no other kind

Some critics however, maintain that offering a guaranteed premium for goods will deter farmers from implementing better production facilities and cost-effective measures.

Ian Bretman of the Fairtrade Foundation disputes that assumption.

"Unlike the European Union's agricultural subsidies, we only pay an agreed price for a product as long as there is a demand from the consumer," he says.

"Providing the demand is upheld, farmers are guaranteed an income regardless of volatile prices and that enables them to conduct their business better by planning ahead."

Growth market

In the UK, demand for Fairtrade product has bucked the global economic downturn by increasing 43% in the last 12 months.

Products selling under similar banners have been equally successful in Europe, Japan and the United States, but Mr Bretman is more excited about what has been happening in the southern hemisphere.

"South Africa has an established consumer market and the launch of Fairtrade goods sets a precedent for the rest of the continent," he says.

Peppers are among 4.500 items licensed to use the Fairtrade logo

Dismissing the idea that people who support Fairtrade objectives tend to be largely middle-class, middle-income shoppers, Mr Bretman says that the Co-op is not one of the most upmarket retailers, yet they stock 230 Fairtrade products.

There is also less difference in the premium price a customer pays for Fairtrade products than there once was.

"That is largely due to greater sales, which means savings can be made because of the cost efficiencies of higher volumes.

"Supermarkets also save money by only having one line of a particular product," Mr Bretman explains.

"Sainsbury's only sells Fairtrade bananas and some supermarkets only sell Fairtrade coffee," he says.

He agrees, however, that in the current economic climate, people might start looking to save money by switching to cheaper products.

"Public awareness has grown and more businesses have become involved, but we cannot be complacent," he insists.

Pointing out that Fairtrtade empowers both the producer and the consumer, he adds: "We have to state our case more strongly."

New product

One thing which has resonated with consumers is the choice of produce now available.

Apart from the more established and familiar products such as Fairtrade coffee, tea and chocolate, cotton has seen the greatest increase in sales recently along with nuts, honey and spices.

A farmer's cooperative in Palestine is the first to produce Fair Trade olive oil

More than 4,500 items are licensed to carry the Fairtrade logo and at the start of the Fairtrade Fortnight another was added - in the form of Palestinian olive oil.

It is the first olive oil to bear the logo and the first produce which originates in Palestine.

Almost 75% of Palestinians live below the poverty line as described by the United Nations.

Initially, 265 olive growers will benefit from the Fairtrade status, but the intention is to bring as many people as possible into the scheme.

Mahmoud Issa is typical of the olive grove owners who believe their lives will improve.

His family has been growing olives for five or six generations.

He hopes to earn enough money to ensure his children have a good education.

"But I hope they retain an attachment to the farm," he says, "so the tradition of growing olives continues in our family."

evolution formula

Mouse set to be 'evolution icon'

Matt Walker Editor, Earth News

Pale-coated deer mice usually live on sandy soils

A tiny pale deer mouse living on a sand dune in Nebraska looks set to become an icon of biology.

Within just a few thousand years, generations of the mice have evolved a sandy-coloured coat camouflaging themselves from predators.

Most striking is that these mice acquired the mutation for pale fur naturally, then rapidly passed it on.

That makes the fast-evolving deer mouse one of the best examples yet studied of "true" natural selection in action.

Deer mice are one of the most abundant and widespread mammals in North America.

Ours is a very complete story. We've been able to connect changes at DNA level to the ability of deer mice to survive in nature Dr Catherine Linnen

Usually the mice have a dark coat, which enables them to blend in with dark soils and avoid being seen by predators such as owls and hawks.

But at Sand Hills in Nebraska, pale-coated mice abound.

"We decided to investigate the striking contrast between mice living on the pale Sand Hills and mice living on darker soils just a few miles outside," says Dr Catherine Linnen of Harvard University in Cambridge, Massachusetts, US.

"We were also intrigued by the fact that Sand Hills had formed within the last 8,000 to 15,000 years, which implies the light colour of the Sand Hills mice became advantageous only recently."

Fair gene

Linnen and colleagues at Harvard and the University of California at Berkeley have now worked out exactly how the mice evolved so quickly.

They have published the details in the journal Science.

They discovered that the light coat colour is coded by a single gene, dubbed Agouti. This is expressed at a higher amount, and for longer, than the genes that code for dark hair.

Most animals known to quickly evolve new features do so by expressing a variation of a gene that already exists, rather than evolving a new type of gene altogether.

But the researchers found that the Agouti gene only appeared among wild deer mice in Sand Hills around 4,000 years ago, just a few thousand years after dark mice colonised their new home. That means it first evolved 8000 generations of mice ago.

The darker, more usual coat colour

They also ascertained that this new gene has since become very common among the Sand Hills mice.

"The light gene wasn't in existence, so the mice had to "wait" until a particular mutation occurred and then selection had to act on that new mutation," says team member Professor Hopi Hoekstra, also of Harvard University.

"It's a two part process. First the mutation has to occur and second, selection has to increase its frequency."

The researchers say it is the first time that it has been possible to document the appearance of a gene, its selection and subsequent spread through a population of wild animals.

And that has allowed them to estimate the "strength" of the natural selection pressure.

Having light coloured fur gives the paler Sand Hills mice a 0.5% survival advantage.

"It doesn't seem that much, but multiplied over thousands of individuals over hundreds of years, it makes a huge difference," says Prof Hoekstra.

"Ours is a very complete story," adds Dr Linnen.

"We've been able to connect changes at DNA level to the ability of deer mice to survive in nature."

Rival icon

In some respects, the dune-living deer mice are similar to the famous peppered moths of northern England.

For decades, the peppered moths (Biston betularia) have been heralded as one of the best-examples known of a wild animal adapting to its environment due to natural selection.

Originally, most peppered moths were lightly coloured, to blend with the lightly coloured bark of trees.

Due to widespread pollution caused by the Industrial Revolution, soot blackened the trees and newly conspicuous lightly coloured moths were picked off by predators, a selection pressure that triggered the rise of more dark coloured moths.

"In both species, changes in colour evolve rapidly due to selection by visually-hunting predators," says Prof Hoekstra.

But the study by Dr Linnen and Prof Hoekstra's team takes our undertaking of natural selection to a much deeper level.

The selection pressure on the moths was technically artificial, caused by pollution produced by people. Whereas the selection causing the pale mice is truly natural.

What is more, the scientists have found the gene responsible, and worked out exactly how long it took to evolve and take hold in the population.

"Despite the fact that the peppered has been an icon of 'evolution in action', we do yet know the genetic changes involved," says Prof Hoekstra.

"Once researchers find the pigmentation gene responsible for moth colour change, they can do the same types of analyses we have done. It will be really interesting to compare these estimates between mice and men."

aspergers syndrome

Reid was sitting at the bar in Castro's Lounge, a Beaches watering hole where he's a regular, when he noticed the new guy a few seats down.

The stranger was wearing jeans, a Chelsea soccer jersey, and a thick woollen coat - a bit much for the April weather. The two solo bar-sitters started talking. The stranger said he'd earned his doctorate at the prestigious Massachusetts Institute of Technology, and Mr. Reid, a well-spoken 41-year-old with a doctorate in sciences himself, was intrigued.

Introducing himself as Giancarlo Dinatale, the acquaintance apparently worked for Goldman Sachs, where he had developed a differential calculus model for stock markets. He also told Mr. Reid he planned on buying a $750,000 home in the Beaches (with cash) and flying in a designer from New York. But there was a glitch.

"He told me this story about how he'd been in Starbucks a few days earlier and his wallet and passport had been stolen, along with his laptop," Mr. Reid remembered him saying as they went outside for a smoke that night, around four months ago. "He asked if I could help him out a bit. I thought he sounded pretty legitimate."

Mr. Reid lent the man $300.

The next day, they met again and Mr. Dinatale said he'd spent the cash on applying for new documents. He asked for another $160, which Mr. Reid provided, as well as a sofa to crash on. Mr. Reid also bought him dinner. They played chess and poker, and Mr. Dinatale was skilled at both. Yet over the week or so they knew each other, the man wore the same clothes and "obviously wasn't showering."

When they met to settle the loans, Mr. Dinatale didn't show up, but later called and apologized. He'd miss another scheduled meet. Mr. Reid never saw him, or his $460, again.

Mr. Reid wasn't his only alleged mark. In fact, there is a website devoted to people who claim to have been duped by this man, whom police have identified as someone named Simon Gann. A homeless, about-to-be-deported gambler who says he has Asperger's Syndrome, Mr. Gann now sits in a Toronto jail, facing 20 charges, including 14 for fraud and two each of harassment, theft and threatening damage.

He is alleged to have worked across Toronto, bilking his marks of sums that seldom exceeded a few hundred dollars. He did not go to M.I.T. And he is not to be confused with his identical twin brother, Jordan, who once posed as a doctor and also wound up in custody.

an awkward man of many talents

About a year ago, Michelle Inder was travelling in Tegucigalpa, Honduras, when a man approached her in her hotel. Initially she brushed him off, but when the stranger, Samir Benzema, pinned down her accent - she was a New Zealander and travel buff living in England - they started talking. Mr. Benzema spoke several languages, some to her, others into his BlackBerry.

"I was like, 'Wow, this guy is really interesting. He speaks 10 different languages, and is telling me he works for Goldman Sachs in New York,' " says Ms. Inder, 33. He told her he was a card whiz, though she then watched him throw away $5,000 at a blackjack table.

He also carried a bag of American money, which he said had as much as $50,000 in it. A day later, he claimed he'd misplaced it and began asking her for cash.

"You look back and you think, 'How could I be so stupid?' It was very dubious. So many red flags."

In the end, Michelle lent or spent about $4,500 (U.S.) on the man. After she left him to rejoin her tour in nearby Costa Rica, she asked for it back.

"He's like, 'All you cared about was money, you never cared about me,' " she says, sighing. "It was insane."

The inconsistencies occurred to her only later. At one hotel they checked into, a key was waiting under a different name: Gann, which Mr. Benzema dismissed as a mistake. Days later, the name Simon Gann popped up in an e-mail. When she asked, he said it was one of his six names. Unconvinced, she Googled him.

Which brought her to Meredith Gavin.

A 33-year-old who lives in Albany, N.Y., Ms. Gavin is the Erin Brockovich of alleged Gann victims.

About six years ago, she had a run-in with either Simon or Jordan - but isn't sure which.

One of the twins stayed for a few days, stole about $300 from her and another $700 from her friend, and got her pregnant, Ms. Gavin says. Her son, Liam, is now five. She isn't sure which Gann twin is his father, but she leans toward Jordan, whose nose is smaller than Simon's.

Jordan's situation, however, is more grave - at least for now. Posing as a wealthy obstetrician-gynecologist in Tampa, Fla., he told a woman he'd give her $100,000 towards her student loan if she fronted him $750, according to local reports. Jordan wound up charged with theft and sentenced to 30 months in a state prison. He is due out next year.

Liam's birth, the trial of Jordan, the claims against Simon and her frustration with being duped led Ms. Gavin to launch theganntwins.com, a Gann-related website.

"Because the police weren't going to do anything, I was like, 'Well, somebody needs to put something out there,' and I just did it. For me it was anger. Not angry at him, but angry at the people who were conned by him that didn't put out something," she said.

Without Ms. Gavin's site, it's hard to imagine investigations taking place. She's spoken with dozens of purported victims, including some of the eight that police have identified in Toronto.

Between accounts from Ms. Gavin and Ms. Inder, it appears Mr. Gann entered the Vancouver area last fall, and moved to Toronto earlier this year.

Sarah, a 19-year-old University of Toronto student, was among those he allegedly met. A man claiming to be Mr. Dinatale stole $500 from her after replying to an ad she'd posted on Craigslist.

Sarah and "Mr. Dinatale" spoke on the phone, and he convinced the young woman that he needed to trust her before investing $20,000 in a venue she hoped to develop. He claimed to have written a music-software program she knew about. She says Mr. Dinatale wasn't a smooth speaker and "didn't have any charm." Awkward, he used language that few might understand in order to confuse his marks.

They met at the bank, where she gave him her banking information, and he eventually made off with the cash. She now calls it a life lesson.

"I think I was lucky," she said. "I figured it out in 24 hours. I could have been a lot more devastated if it had been a week-long affair."

Gann's big gambit

"Hey, Speakman!"

Detective-Constable Robert Speakman twists around, turning to another officer who called his name. He has just entered Courtroom 112 of Toronto's Old City Hall courthouse.

The young detective, whose suit doesn't quite hide his gun, goes to the back of the court and shakes the hands of his buddies. Following Det.-Const. Speakman's investigation, which involved claims from Sarah, Mr. Reid, and others, Mr. Gann is set to appear in this room, a guilty-plea court. It's a catch-all, quickly paced courtroom used for brief appearances.

Mr. Gann makes no plea, speaking up from a whisper only to say his name and consent to further detention - a move so unusual that the judge asked if he knew what he was doing. He might.

On May 29, the Canadian Border Service Agency had intercepted Mr. Gann at the Ottawa airport. Furnished with a Toronto warrant, they arrested him. He has been in pre-trial custody ever since. Once he is acquitted or finished completing the terms of any sentence, the CBSA says he'll be deported. He faces a minor charge in his home state of Massachusetts of failing to appear for 2001 jury duty.

If convicted in Toronto, Mr. Gann would likely be sentenced to around two years in prison.

While he faces another court appearance next Friday. Ms. Gavin will be awaiting word from Albany, as will Mr. Reid and Sarah in Toronto and Ms. Inder in London. Each regrets being duped, but agree on one thing - the man they met was able to gain the trust of men and women, many of them well educated.

"If I wasn't ever conned by them, and I read an article, I would think, 'This is ridiculous. Who are these people? How do they not know?' " Ms. Gavin says. "You'll be amazed at the things they're capable of, reading your movements. They are intelligent boys, those Gann boys. They're very, very smart, which is why they've been able to get away with it for so long, and do it to so many people.

irritable bowel

Irritable bowel syndrome

IBS can cause repeated long-term bouts of pain

Irritable bowel sydrome (IBS) is a condition which causes pain and misery to millions of people worldwide.
However, it remains something of a mystery to medical science.
What is it?
As the name suggests, IBS is a disorder which affects the lower digestive tract.
The contents of the bowel are moved along by a rhythmic tightening and relaxation of the muscles of the intestinal wall - a process called peristalsis.
It appears that peristalsis is stronger and more frequent in people with IBS.
This can cause a wide range of symptoms, including regular abdominal pain, diarrhoea and constipation.
Who gets it?
The condition is thought to affect up to one in five of the population.
However, it may be even more common because it is thought that many people never seek a medical opinion.
It is particuarly common among people aged 20 to 30, and twice as common in women than men.
What are the symptoms?
The main symptoms of IBS are:

• Repeated abdominal pains and tenderness
• Diarrhoea
• Constipation
• A bloated feeling
• Headache

Other symptoms can include:

• Burping
• Bad breath
• Tiredness
• Nausea
• A sense of incomplete emptying after going to the toilet

What causes IBS?
Nobody knows for sure.
Scientists believe that part of the problem is likely to be a fault in the way that the body uses serotonin, a chemical which coordinates contractions of the muscles.
The bowel can over-react to all sorts of things, including food, exercise and hormones.
There is evidence to suggest the condition may be related to stress in some people. Up to 60% of IBS patients show signs of anxiety or depression.
In some instances, the condition develops after a gastrointestinal infection.
There may also be a link to increased sensitivity or intolerance to certain foods.
How is IBS diagnosed?
Pinning down the condition can be difficult, and sometimes IBS is only considered after other conditions have been ruled out.
Tests which may be carried out include X-rays, and an endoscopy, in which a thin tube housing a camera is inserted into the bowel.
Doctors sometimes work on the rule of thumb that a patient must have suffered significant abdominal pains for at least 12 weeks in the last 12 months, along with two of the following three symptoms:

• Pain which is relieved by defecation
• Pain associated with a change in the frequency of bowel movement
• A change in the form of the stool

Is there any treatment?
A healthy diet with plenty of fresh fruit and vegetables, and lots of water is a good idea.
Avoiding certain foods and drink can also help. These include: spicy and fatty foods, gas producing vegetables, such as beans, alcohol, tea and coffee.
Several drugs can help:

• Antispasmodics can slow contractions in the bowel, which helps with diarrheoa and pain.
• Laxatives can tackle constipation

There also is some evidence that complementary therapies such as acupuncture, and Chinese herbal medicine may be helpful.
For some relaxation techniques, and hypnosis may be useful.

bacterial gastroenteritis

'Perfectionism' bowel pain link

Women are more prone to IBS

Perfectionists are more prone to developing irritable bowel syndrome (IBS) after an infection, a study has suggested.
University of Southampton researchers asked 620 people with gastroenteritis about stress and their illness.
Those who pushed themselves or were particularly anxious about symptoms were more likely to develop IBS.
Experts said the study, published in Gut, may explain why only some people develop IBS after a gut infection.

These are people who have high expectations of always doing the right thing Dr Rona Moss-Morris

About 5% of the UK population have IBS.
Up to one in 10 people develop it after a having a bacterial gut infection, having previously been healthy.
Such infections cause inflammation and ulceration in the bowel and can cause severe vomiting and rectal bleeding.
'Not hypochondriacs'
In this study, each person was checked three and six months after their initial bout of bacterial gastroenteritis to see if they had developed IBS symptoms such as diarrhoea, constipation, abdominal pain and bloating.
In all, 49 people had IBS at both points. Women were more than twice as likely to have IBS as the men.
Those with IBS were significantly more likely to have reported high levels of stress and anxiety and psychosomatic symptoms than those who did not develop the condition.
They were also significantly more likely to be "driven", carrying on regardless until they were forced to rest, which the researchers say simply makes the initial condition worse and longer-lasting, potentially leading to IBS.
Dr Rona Moss-Morris, who led the research, said: "We found people's beliefs about their symptoms, how anxious they got and their behaviour were all important.
"These people were not hypochondriacs. But they did have a negative attitude towards their symptoms."
She added: "These are people who have high expectations of always doing the right thing - and going off work goes against their beliefs."
Such people try to remain active and may go back to work too soon, she said.
"They keep going - but then collapse in a heap.
"They are 'all or nothing' people who have high expectations of themselves."
Trigger
Dr Moss-Morris said people who appear to have problems recovering from a bout of gastroenteritis could be investigated to see if they have a particularly anxious or perfectionist personality.
She suggested cognitive behavioural therapy might be an effective treatment.
But she added there was no suggestion that IBS was "all in the mind".
Professor Robin Spiller, an IBS expert from University Hospitals Nottingham and the editor of Gut, said: "There is probably a complicated mechanism at work here."
He said there were two potential explanations.
"It might be that stress and anxiety affects the immune system.
"But it could also be that if you don't rest, it might do you more harm."

Soluble fibre 'effective for IBS

Irritable bowel syndrome is a common condition

A soluble fibre supplement should be the first line of attack in treating irritable bowel syndrome, experts say.

Researchers from Utrecht University in the Netherlands compared adding bran, a soluble supplement called psyllium and a dummy supplement to sufferers' diets.
They found psyllium was the most effective, warning that bran may even worsen the symptoms of the condition, the British Medical Journal reported.
As many as one in 10 people is estimated to have the condition.
It is characterised by abdominal pain and an irregular bowel habit.

I think adding psyllium to the diet is the best treatment option to start with Dr Niek de Wit, researcher

Its exact cause is unknown and recommendations for treatment include dietary advice, antidepressants and drug treatments.
Many relying on dietary adjustments still turn to bran in a bid to help improve the way the intestines work.
But the Dutch study of 275 patients questions the wisdom of this approach.
The team gave patients 10g of either psyllium, bran or rice flour twice a day for 12 weeks.
Symptom severity
At the end of the study, those on psyllium, a naturally occurring vegetable fibre, reported symptom severity had been reduced by 90 points using a standard scale of rating problems.
For bran it was 58 points and for the placebo group, 49.
The report also showed that patients seemed less tolerant of bran, with more than half of the group dropping out during the trial, mostly because their symptoms worsened.
Soluble fibre can also be found in fruit such as apples and strawberries, as well as barley and oats.
But Dr Niek de Wit, one of the researchers, said: "It is unlikely that people with IBS would get enough from fruit and other foods to help them.
"I think adding psyllium to the diet is the best treatment option to start with. In the study, people did this by adding it to things such as yoghurt and it had a real effect."
Dr Anton Emmanuel, medical director of Core, the charity for diseases of the gut, said bran was being over-used.
He said the study was "helpful" and "reasonably robust", adding: "Putting it all together, patients should tolerate this form of fibre well and it may help some, especially those with a tendency to constipation."

nhs profit themselves

Drug export warning to NHS trusts

Drugs are more expensive outside the UK

NHS hospital trusts in England have been warned against any attempt to cash in by exporting medicines intended for NHS patients.

The Health Service Journal reports some trusts have considered taking advantage of the weak pound to make a profit.

But the government's chief pharmaceutical offer Dr Keith Ridge has written to all NHS trusts, calling the practice irresponsible.

Dr Ridge warned it could threaten the quality of patient care.

It is shocking and disgraceful that some NHS managers are said to be considering plans to export medicine Norman Lamb Liberal Democrat health spokesman

He said it was particularly irresponsible to export pharmaceuticals at a time when the supply chain was threatened by the swine flu pandemic.

The low value of the pound means drugs could be bought in sterling, then sold on in countries where prices are higher.

This, combined with the Department of Health's pharmaceutical price regulation scheme, which keeps UK medicine prices low, has presented trusts in theory with a chance to make substantial financial gains.

Commenting on the report, a Department of Health spokesperson said: "Exporting medicines for short term financial gain is an unacceptable practice.

"We are confident that the vast majority of hospital pharmacists are behaving responsibly.

"However, Dr Ridge has written to all hospital pharmacists to underline that such practices are contrary to acceptable professional behaviour."

Naming and shaming

Norman Lamb, Liberal Democrat health spokesman, said pharmacists had been warning for some time that medicine shortages were having a negative impact on patient care.

He said: "It is shocking and disgraceful that some NHS managers are said to be considering plans to export medicine, rather than addressing this serious problem.

"With concerns about swine flu already putting the NHS under pressure, we must ensure that we do not run short of vital drugs in the UK.

"There is a strong case for naming and shaming those trusts involved and taking appropriate disciplinary action."