Wednesday, February 12, 2014

A nation of pill poppers?

A nation of pill poppers?

 
statin Around 7 million Britons take statins

A sensible step that will cut deaths and disability or a mistake that will medicalise millions?

There are starkly opposing views of proposals from the health watchdog the National Institute for health and Clinical Excellence (NICE) to dramatically increase the numbers offered statins.

They are already the most commonly prescribed medicines in the UK, which work by lowering the level of cholesterol in blood.

Around seven million people are on the tablets which cost less than 10p a day.

It is estimated they prevent around 7,000 deaths a year from heart attacks or strokes. Add to that the tens of thousands of people who are saved from disabling non-fatal attacks and you can see why health experts are keen on statins.

A generation ago cardiovascular disease was common in early middle age. As a result of statins and treatments for reducing blood pressure, the condition has been delayed by around 20 years.

That means two decades more of healthy life for millions of people.

QRISK2

The current guidance from NICE says adults with at least a 20% chance of having a heart attack or stroke in the next 10 years should be offered statins.

That is being lowered to a 10% chance of cardiovascular disease over 10 years.

So how is the risk calculated? You can work out your individual risk by going online to the QRISK2 calculator.

Input factors like your age, sex (men are at greater risk), ethnicity, blood pressure, Body Mass Index, family history, cholesterol level and so on.

It also includes your postcode: heart disease is strongly linked to poverty and deprivation so that will alter your risk too (though clearly you would expect your doctor to take account of your background, rather than just relying on your address).

My risk was well below the 10% trigger for statins. But any smug feeling was quickly despatched when I added a decade to my age.

Once you hit your sixties you can virtually guarantee that your 10-year risk will place you in the statins category no matter how healthy you are.

The effect of the proposals - which have gone out for consultation in England - would be to add millions to the numbers already on statins.

Mark Baker, from NICE, who helped draw up the guidelines said: "You'd probably need to treat about 60 people with statins for 10 years to prevent one heart attack or stroke."

That might not sound like it is worth it, but let's say you treated another six million people, that would prevent 100,000 heart attacks or strokes over a decade.

Diet & exercise

Estimating the health benefits of statins is difficult, and those figures could be an over-estimate. But you can see that - taken over an entire adult population - the potential health benefits are enormous.

So that's the argument in favour. Now the opposite view.

Putting people onto statins is akin to medicalising them for life. Rather than taking a pill to lower cholesterol, the same effect can be achieved through changing their diet and exercise levels.

Even small modifications to lifestyle - taking the stairs or getting off the bus one stop further from your destination - can make positive changes.

Offering sedentary patients a quick fix may simply store up problems for later.

"It's a very bad idea", said Dr Aseem Malhotra a London cardiologist. "Eighty per cent of cardiovascular disease is due to lifestyle and NICE should be concentrating on that aspect rather than offering pills to millions."

Dr Malhotra believes up to one in five people on statins will suffer side effects such as muscle pains, stomach pains or increased risk of diabetes.

NICE says the figure is far lower and serious problems with statins are rare. NHS Choices says "statins are generally well tolerated and most people will not experience any side effects." It lists the range of possible adverse reactions.

Ultimately it will be up to patients to decide, following consultation with their GP. One likely option for many will be to try statins and see whether they trigger any ill-effects.

Statins are saving lives and preventing disability every day. So they are a powerful tool in promoting good health. But people will need to consider carefully before deciding to take a daily pill for decades to come.


VIDEO: How I recovered The Scream

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The Scream: I found the stolen painting

12 February 2014 Last updated at 00:27 GMT

In 1994 Edvard Munch's famous painting The Scream was stolen from a Norwegian art museum. It was recovered in a daring undercover operation by British detectives. Charles Hill was one of those detectives who posed as an art dealer to trick the thieves into returning the painting.

Witness is a World Service radio programme of the stories of our times told by the people who were there.

Produced by Lucy Burns and Directed by Claire Tailyour


How the car industry outlawed crossing the road

Jaywalking: How the car industry outlawed crossing the road

Road sign in New York

The idea of being fined for crossing the road at the wrong place can bemuse foreign visitors to the US, where the origins of so-called jaywalking lie in a propaganda campaign by the motor industry in the 1920s.

The California Vehicle Code states: "No pedestrian shall start crossing in direction of a flashing or steady "DON'T WALK" or upraised hand symbol." It also forbids crossing between controlled intersections, or "jaywalking".

Late last year, police began a concerted effort to enforce the rules in central Los Angeles. Pedestrians had been "impeding traffic and causing too many accidents and deaths", one traffic police official said. Fines range from $190-$250 (£115-£152).

Then in New York officials responded to several pedestrian deaths last month by issuing a flurry of tickets for jaywalking. The campaign quickly ran into controversy when an 84-year-old Chinese immigrant who had been stopped for jaywalking suffered a gash to his head during an altercation with the police.

Enforcement of anti-jaywalking laws in the US is sporadic, often only triggered by repeated complaints from drivers about pedestrian behaviour in a particular place. But jaywalking remains illegal across the country, and has been for many decades.

The first known reference to it dates to December 1913, says Peter Norton, a history professor at the University of Virginia and author of Fighting Traffic - The Dawn of the Motor Age in the American City. That month a department store in Syracuse hired a Santa Claus who stood on the street with a megaphone, bellowing at people who didn't cross properly and calling them jaywalkers.

"I don't know how this got to Syracuse, but in mid-western slang a jay was a person from the country who was an empty-headed chatterbox, like a bluejay," he says.

The word was first used to describe "someone from the countryside who goes to the city and is so dazzled by the lights and the show windows that they keep stopping and getting in the way of other pedestrians".

The use of jaywalking as a term of ridicule against pedestrians crossing roads took off in the 1920s.

A key moment, says Norton, was a petition signed by 42,000 people in Cincinnati in 1923 to limit the speed of cars mechanically to 25mph (40kph). Though the petition failed, an alarmed auto industry scrambled to shift the blame for pedestrian casualties from drivers to walkers.

Local car firms got boy scouts to hand out cards to pedestrians explaining jaywalking. "These kids would be posted on sidewalks and when they saw someone starting to jaywalk they'd hand them one of these cards," says Norton. "It would tell them that it was dangerous and old fashioned and that it's a new era and we can't cross streets that way."

Image of a card handed to pedestrians in Hartford, Connecticut, in 1921. Reproduced in Street Rivals: Jaywalking and the invention of the Motor Age by Peter Norton, Technology and Culture, Volume 48, Number 2, April 2007 A card handed to pedestrians in Hartford, Connecticut, in 1921

Clowns were commonly used in parades or pageants to portray jaywalkers as a throwback to rural, ignorant, pre-motor age ways.

Another ruse was to provide local newspapers with a free service. Reporters would submit a few facts about local traffic accidents to Detroit, and the auto industry's safety committee would send back a full report on the situation in their city.

"The newspaper coverage quite suddenly changes, so that in 1923 they're all blaming the drivers, and by late 1924 they're all blaming jaywalking," Norton says.

Soon, he adds, car lobby groups also started taking over school safety education, stressing that "streets are for cars and children need to stay out of them". Anti-jaywalking laws were adopted in many cities in the late 1920s, and became the norm by the 1930s.

In the decades that followed, the cultural ascendancy of the car was secured as the auto industry promoted "America's love affair with the automobile". Car makers portrayed them as the ultimate expression of personal freedom, an essential element of the "American dream".

Meanwhile, an overriding goal of city planners and engineers became allowing traffic to circulate unhindered.

"For years, pedestrians were essentially written out of the equation when it came to designing streets," says Tom Vanderbilt, author of Traffic - Why We Drive the Way We Do.

"They didn't even appear in early computer models, and when they did, it was largely for their role as 'impedance' - blocking vehicle traffic."

This made US cities unusually hostile to walkers, says Vanderbilt. Jaywalking became an "often misunderstood umbrella term", covering many situations in which the pedestrian should in fact have the right of way.

Some countries have followed the lead of the US and imposed anti-jaywalking measures. Police in China began a fresh push to stop jaywalking last year, fining offenders and in Shanghai, making them read out traffic regulations aloud.

People cross the road in Beijing, May 2013 Beijing was one Chinese city where police began fining jaywalkers last year

Elsewhere, in Cairo say, or Calcutta, a lack of rules, enforcement and pedestrian infrastructure mean that the only way to cross the road is often by launching oneself into the oncoming traffic.

The UK is among those countries where jaywalking is not an offence. But the rate of pedestrian deaths is half that of the US, at 0.736 per 100,000 inhabitants in 2011 compared to 1.422 per 100,000 in America.

Even in Singapore, where repeated jaywalking offences can lead to a $1,000 fine or a six month jail term, rules are routinely flouted.

There has been resistance in the US too. Newspaper reports from the 1920s show that many were irritated by the cards handed out by boy scouts, says Peter Norton.

In New York, an earlier effort to crack down on jaywalking under former mayor Rudy Giuliani met with opposition from police officers who said they had better things to do. And in Los Angeles, the setting for The Pedestrian, Ray Bradbury's dystopian science-fiction short story from 1951, walkers and cyclists have recently become more common downtown.

When the LAPD advertised the anti-jaywalking campaign on its Facebook page, responses accused the police of seeking an easy source of revenue by fining people with the means to pay, and of wasting their time.

"I love how I see people getting jaywalking tickets everyday at the corner of 5th and Broadway by our loft, and yet I can't walk to my car without getting offered… any variety of hardcore narcotics," wrote one woman in a message that ended "#priorities".

Advocates for walking say drivers are most often to blame for pedestrian deaths and injuries, and that there is no evidence to prove that anti-jaywalking campaigns are effective.

That rings true for John Moffat, a former commander of Seattle's traffic police.

Seattle was known for being especially strict on jaywalking, and Moffat calculated that some 500,000 tickets had been issued there between the 1930s and the 1980s. But he oversaw a change of policy in 1988 after a study in the city showed that the most vulnerable pedestrians were the elderly, children and drunks - not jaywalkers. "Are they the ones ending up in the morgue or in hospital?" he says. "The answer is no, and the reason is that most of them are pretty fleet of foot and agile."

Some think that the success of several projects to make US cities more walkable is a sign of hope for pedestrians.

But there is little experimentation with more radical projects such as shared space, which aims to reduce traffic speed by removing the distinction between streets and pavements. And fines for jaywalking look set to continue, says Ray Thomas, a lawyer in Portland, Oregon, who specialises in pedestrian and bicycle law.

"People in law-enforcement tend to identify with a motorist's perspective", he says. Wherever there's a push to protect the rights of pedestrians, officials feel they also need to enforce limits on them.

"It's their version of being fair," he says. "The difference is that no jaywalking pedestrian ever ran down and killed a driver, and by sheer survival strategy most pedestrians don't jaywalk in front of cars."

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VIDEO: Mums v Guns

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#BBCtrending: US mums fight Facebook policy on guns

12 February 2014 Last updated at 14:15 GMT

A lobby group of American mothers has spoofed Facebook's "Look Back" video to campaign against the site's policy on guns.

Moms Demand Action for Gun Sense in America was formed after 26 children and six adults were killed in a mass shooting at Sandy Hook Elementary School in Newtown, Connecticut in 2012. It says Facebook is allowing users to post pictures of guns for "sale".

Private gun sales are legal in some US states but the group says guns could fall into the wrong hands when offered on Facebook.

A Facebook spokesperson said no financial transactions take place on the platform itself and it urges those promoting an offer of guns to abide by the applicable law.

Anne-Marie Tomchak from #BBCtrending reports.

Produced by Neil Meads

All our stories are at BBC.com/trending. Follow @BBCtrending on Twitter and tweet using #BBCtrending


Why do women murder?

Dennehy murder case: Why do women kill?

Composite of female serial killers Top, left to right: Mary Anny Cotton, Rose West, Myra Hindley. Bottom, left to right: Juana Barraza, Beverley Allitt, Aileen Wuornos

Two men have been found guilty of aiding triple murderer Joanna Dennehy. What makes her case so rare, and why do women kill?

British history is spattered with grim tales of multiple murderers and serial killers.

From the figure of Jack the Ripper, who terrorised Victorian London, to Dr Harold Shipman, who murdered hundreds of his patients without, it seems, any motive - the cases have fascinated as much as they have disturbed.

But they often have one thing in common - the perpetrators are all men.

While serial killings by men or women are rare, the case of 31-year-old Joanna Dennehy, who has admitted stabbing to death three men, appears to be highly unusual.

Smother, strangle or poison

Criminologist Prof David Wilson describes murder as a "man's business".

He says it is usually the preserve of young working class men, who kill other young men of a similar background.

Joanna Dennehy inside a property in Kington, Herefordshire The court heard Dennehy was driven by a thirst "for blood" as she sought further victims

Of suspects convicted of murder in England and Wales over a 10-year period up to 2012 more than 90% were men, Home Office figures show.

And in the rare instances that women do kill, they tend to kill different groups of people to men and use different methods, says Wilson.

"By and large women kill children in their own family - they are intra-familial [killers] - and they tend to smother, strangle and poison, and only occasionally they will stab. That is the pattern generally."

Consultant forensic psychologist Kerry Daynes says women are more "practical and clean" in their killing. They use enough violence to get the job done but nothing more.

"It may be that women are more driven by the end product - of someone being dead and the aftermath of that - [rather] than the actual act of killing itself."

Charts show in a 10 year period 94% of convicted murderers were men and 68% of victims were also male

Wilson says men are more likely to use violent methods, like shooting and stabbing, possibly because they have more access to weapons.

Men's victims tend to be strangers because they are more likely to find themselves in aggressive situations, such as trying to fight or resolve conflicts in nightclubs or in the street, says the professor.

"That kind of confrontational murder is not one that one sees when women are in those social spaces."

But what might make a woman kill in a multiple or serial way?

Wilson says the reasons are as diverse for men as they are for women - but Elie Godsi, a clinical psychologist, says the answer is more straightforward. "Women only behave in really brutal and destructive ways if they have been brutalised."

Daynes says there is generally a history of childhood sexual abuse or trauma.

"They have pathological needs for attention, control or to express their anger," she says.

She adds: "Women serial killers tend to have some form of relationship with their victims - lovers, children, people they are employed to care for. They are more likely to kill at home or their place of work."

'Angel of Death'

Beverley Allitt carried out four deadly attacks on children while working as a nurse at a hospital in Grantham, Lincolnshire, in 1991.

The serial killer, who had Munchausen Syndrome by proxy, where sufferers crave attention, was dubbed the Angel of Death in the aftermath of the case.

Daynes says women are most often Angel of Death-type killers, adding: "We just don't get this with men, probably because typically men do not value or get so much affirmation from being in the role of carer."

The three men Dennehy killed were said to have fallen "under her spell" - but she later went on to select two further men at random to kill.

In some murder cases, there may be a sexual motive, however this is far less common among women. And even then, it may be a man's sexual interests - rather than the woman's - being served.

In Dennehy's case, she was said by a consultant forensic psychiatrist to have paraphilia sadomasochism, in which sexual excitement is derived from the infliction of "pain, humiliation and bondage".

Lone female killers are rare. Women more often kill as part of a couple - a folie a deux, French for "a madness shared by two" - where the murders are shared or the woman becomes infatuated with a more dominant male figure. In this case they kill for much the same reason as men - power, control or financial gain, says Daynes.

Both Rose West and Myra Hindley gained notoriety for the serial killings they carried out with their partners, though West, for example, is known to have killed independently of her husband Fred.

But sometimes power, control and hedonism have nothing to do with serial murder. A so-called comfort killer murders to gain financially or in other ways.

Victorian serial killer Mary Ann Cotton poisoned three of her husbands and 15 children as part of what appears to have been an early insurance scam.

Joanna Dennehy Joanna Dennehy also admitted two attempted murders

It might be surprising to learn then that Cotton, who was hanged for her crimes in 1873, is regarded as Britain's first serial killer, notching up more victims than Jack the Ripper, and yet few people would recognise her name.

'Aberration of nature'

Female serial killers are so rare that it is difficult to compare Dennehy to other notorious cases.

Dr Elizabeth Yardley, senior lecturer at Birmingham City University's centre for applied criminology, says a "loose comparison" might be Aileen Wuornos, who was executed after killing seven men in Florida in 1989 and 1990.

"In terms of the characteristics they displayed, they were both violent drifters who were disconnected from society."

A mental health assessment found Dennehy had psychopathic, anti-social and emotional instability disorders. Prosecutors also told the court she had little capacity for remorse and she was said by one witness to have been driven to kill by a thirst "for blood".

Whatever her reasons for killing, it appears she does fit into the rare bracket of serial killer.

Adam Gregory, behavioural investigative adviser at the National Crime Agency, attended an FBI-led symposium in the US in 2005 where a global definition of the term was drawn up.

It is "the murder of two or more individuals by the same offender on separate occasions" he says, adding: "If this is the case in this trial then I would say that Joanna Dennehy was a serial murderer."

This label, says Wilson, has the power to attract and fascinate as much to cause abhorrence.

But the most shocking element, it seems, is her gender.

"It shakes to the very core our stereotypes and our cultural frameworks about womanhood and femininity. As far as we are concerned women don't do these sorts of things. Women care, women treat and look after and empathise," says Godsi.

Daynes says: "We will always be more shocked by the idea of a female serial killer because women are viewed as nurturers and givers of life. To repeatedly take lives, particularly those of children is seen as an aberration of nature."


VIDEO: Stadium 'rail-seat' design explained

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Safe standing football terraces rail-seat explained

12 February 2014 Last updated at 10:33 GMT

In many European countries, football fans are allowed to stand at top-level games, something which is not allowed at premiership and championship matches in the UK.

All-seater stadiums were introduced in the UK following the Hillsborough disaster in 1989.

But campaigners say they have come up with a system which will make it safe for people to stand on the terraces.

Jon Darch, of the Safe Standing Campaign, demonstrates the "rail seat", which is due to be unveiled at Bristol City's ground on Wednesday.


VIDEO: The 'matter of fact' killer

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Joanna Dennehy: The 'matter of fact' killer

12 February 2014 Last updated at 15:09 GMT

John Rogers met killer Joanna Dennehy and lived to tell his story. While walking his dog near his home in Hereford, Dennehy set upon him with a knife stabbing him multiple times.

He spent weeks in hospital recovering from his wounds. He told the BBC's Ed Thomas that his abiding memory of the attack was how 'matter of fact' Dennehy had been throughout.


VIDEO: British jihadi in Syria suicide attack

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Anti-terror police search house after Syria bomb

12 February 2014 Last updated at 12:07 GMT

Footage has emerged of what is believed to be the first suicide bombing by a Briton in Syria.

Anti-terror police are searching a house in Crawley, in West Sussex, thought to be the home of a man known as Abu Suleiman al-Britani, as part of an investigation into the truck bombing in the city of Aleppo last week.

The attack on a prison in the city resulted in inmates escaping.

The BBC's Security Correspondent Frank Gardner reports.


No penny pinching over floods - PM

UK floods: No penny pinching over help says Cameron

Ed Miliband presses David Cameron on his "money no object" pledge to clean up after the flooding

There will be "no penny pinching" when it comes to funding flood relief efforts, David Cameron has said as he announced extra financial help.

Homeowners and businesses will get grants of up to £5,000 to pay for future flood protection, he told MPs.

The prime minister has said "money would be no object" in the response.

But Labour leader Ed Miliband said he had doubts about this "grand promise" of assistance and said those still at risk needed a "speedier response".

Speaking at Prime Minister's Questions, Mr Cameron said the government would "spend whatever is necessary" on immediate support for flood-affected communities, including providing sandbags, pumping equipment and military assistance where requested.

The flood protection grants will be available to all those whose homes have been affected. More than 5,500 homes have been inundated since December.

Mr Cameron also announced a £10m package of support for waterlogged farms and said other affected businesses would be able to claim 100% tax relief on business rates for three months and be able to defer their tax payments.

"I don't want people to worry about penny pinching when they see the vital work that is needed to help them deal with their houses and help deal with the floods," he said. "That is what this government is doing."

He accused his Labour counterpart of "dividing" the Commons over the issue at a time when the country should be pulling together in the face of adversity.

'One voice'

Mr Miliband urged the government to reconsider planned cuts to the Environment Agency and said it should be spending more on flood defence in the future to make the UK more resilient.

"The government needs to speak with one voice on this issue," he said.

"The response needs to be speedier than it has been in the past and everyone affected needs to feel they are getting the help they need."

The BBC News Channel's chief political correspondent Norman Smith said some of the new assistance schemes are expected to be up and running within days and others by the end of the month.

Earlier on Wednesday, the prime minister chaired a meeting of the Cobra emergency committee on the flood crisis and will lead another meeting at 17:30 GMT.

Cameras were allowed to film a Cobra meeting for the first time

There are still 16 severe flood warnings - meaning a danger to life - in the South East and South West of England.

A No 10 spokesman said he expected the resources to pay for the relief effort to come from contingency funds within departments and elsewhere, drawing a distinction between money for "this relief effort" and the wider costs associated with rebuilding and reconstruction.

'Every resource'

Some £31m is being made available to fund resilience projects on the railway network in the south-west of England - money which has been already been announced.

Damage caused to track near Stonegate, Sussex, following a landslip Network Rail is dealing with damage to parts of the railway network

The BBC understands a further £60m could be taken from an "under-spend" in the Department of Transport's budget to fund repairs.

Transport Secretary Patrick McLoughlin said Network Rail was already spending £38bn on maintaining and enhancing the rail network over the next five years but would not comment on whether any new money would be put at his disposal.

"I don't think it's a blank cheque," he told ITV's Daybreak.

"I think what the prime minister was making very clear is that we are going to use every resource of the government, and money is not the issue while we are in this relief job."

'Bits and bobs'

The BBC's political editor Nick Robinson said Mr Cameron had used a "big phrase" to demonstrate his commitment to do whatever was necessary to help those affected but, in reality, there did not seem to be a "big cheque".

The scale of the potential economic outlay is illustrated by the fact that the floods which struck large parts of England and Northern Ireland in 2007 cost business £740m.

The committee on climate change, which advises the government on emissions targets, has suggested £500m would need to be spent to make the UK's flood defences ready for future challenges.

The UK Independence Party has called on the prime minister to give more details of where the money will come from, saying that the sums needed could run to hundreds of millions of pounds.

Nigel Farage, the party's leader, has called for money to be temporarily taken from the foreign aid budget to deal with the immediate challenges - a proposal rejected by the prime minister.

"If David Cameron is only talking about utilising a £60m transport underspend and one or two other bits and bobs from across Whitehall then he still clearly does not appreciate the terrible scale of this crisis," he said.


VIDEO: First video from Algeria crash scene

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Algeria mourns dozens killed in military plane crash

12 February 2014 Last updated at 10:16 GMT

Algeria has begun three days of national mourning for the 77 people killed in a military passenger plane crash in the north-east of the country.

One person survived when the Hercules C-130 crashed into a mountain in Oum al-Bouaghi province, en route to Constantine, in bad weather conditions.

Most of the passengers were military personnel and their family members.


VIDEO: No touching or clicking required

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Gesture recognition software: No touching or clicking required

12 February 2014 Last updated at 13:18 GMT

BBC technology correspondent Rory Cellan-Jones talks to Tal Krzypow, VP of Product Management of Eyesight Technologies in Tel Aviv, about the company's gesture recognition software.

He demonstrates how it allows you to swipe through a presentation or view a document without touching a keyboard or a screen.


VIDEO: Pacific castaway met by media crowds

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Castaway returns home to El Salvador after 13 months adrift

12 February 2014 Last updated at 12:40 GMT

The castaway who spent 13 months adrift in a boat is back in his home country, El Salvador.

Jose Alvarenga was found two weeks ago in the Marshall Islands.

He said he got lost in a storm while fishing off the coast of Mexico in December 2012.

Miranda Hurst reports


VIDEO: UN concern for people in Homs

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Syria crisis: UN concerned for men and boys in Homs

12 February 2014 Last updated at 00:07 GMT

The United Nations says it is "deeply concerned" about the fate of hundreds of men and boys who have been detained by the Syrian authorities after trying to escape from the besieged city of Homs.

A temporary ceasefire has enabled some to leave the city but there is concern about what will happen when the current humanitarian operation ends.

More than 1,000 civilians, mostly women, children and the elderly have been evacuated since an agreement was reached last week.

Before the humanitarian operation began, the UN estimated there were more than 2,500 people trapped in Homs.

Around 190 other men were still being questioned.

Lyse Doucet reports.


PM's flood pledge and Temple mourned

Newspaper review: Cameron's floods pledge and Temple mourned

Independent front page The Independent leads with Prime Minister David Cameron's warning that the current flooding in England will get worse before it gets better - perhaps lasting several more months. The picture lead is of flooded Shepperton, Surrey, but the paper says parts of Worcester are also under water.
Daily Telegraph front page The Daily Telegraph says David Cameron has "declared the floods a national emergency" and staked his personal authority on rebuilding damaged regions and making them more resilient. The Duchess of Cambridge is the picture lead - she is seen wearing a necklace borrowed from the Queen, says the paper.
The Guardian front page The Guardian says Mr Cameron's personal involvement in the flooding crisis and his promise that money would be no object "may come back to haunt him". The paper also features the views of a flooded resident from Somerset who says until flooding came close to London, they felt the government wasn't listening.
I front page The I says the prime minister's commitment is a "promise to restore normal life" to those parts of England coping with flooding. It also reflects the line from its sister paper the Independent that there may not be any respite from the rising waters until as late as May.
Daily Express front page The Daily Express agrees with the prime minister's contention that things will get worse before they get better: its front page predicts a "new Atlantic 'super-storm'" will cause chaos across the UK and will bring gusts of 90 mph and "more flood misery for thousands".
Daily Mail front page The Daily Mail launched a campaign on Tuesday to have some of the UK's foreign aid budget diverted to help flood victims at home, and says 100,000 have signed its petition. David Cameron has ruled out such a move, which the Mail says goes against "powerful evidence of what the public thinks".
The Sun front page The Sun is also in active mode, launching "Operation Sunbags", delivering 1,500 sandbags to residents in Wraysbury and Colnbrook in Berkshire. The paper notes the prime minister's decision to put "Iraq War hero" Maj Gen Patrick Sanders in charge of the military's aid to civilian authorities.
The Times front page The Times leads with claims the Police Federation "hijacked" the "plebgate" affair "for its own political ends". It quotes from one of the officers on duty at Downing Street when ex-Chief Whip Andrew Mitchell became embroiled in a row about riding his bike through the vehicle gates..
Daily Mirror front page The Daily Mirror's front page leads with a picture of 11-month-old Ava-Jayne Corless, who died after being mauled by a pit bull terrier-type dog in Blackburn, Lancashire. The girl's mother and her boyfriend are being questioned on suspicion of manslaughter.
FT front page The Financial Times says efforts to clean up Barclays Bank by its chief executive Antony Jenkins have suffered a setback after criticism of his decision to raise bonuses by 10% amid falling profits. The bank's £2.38bn bonus pool "drew the ire of MPs", the FT reports.
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Flood waters at door of couple's home in Wraysbury Many of the papers report from flooded Wraysbury in Berkshire

All the national papers devote multiple pages to the continuing flood crisis, especially after Prime Minister David Cameron's prognosis - delivered at a news conference on Tuesday - that the situation will get worse before it gets better.

The Daily Telegraph says Mr Cameron has "staked his personal authority on rebuilding damaged regions" by promising that money will be no object when it comes to tackling the problem.

Reviewing Wednesday's front pages on the BBC News Channel, Pippa Crerar of the London Evening Standard said some commentators had called into question Mr Cameron's leadership and he "had to establish he is capable of leading".

"David Cameron is scarred by what happened in 2007 when his [Witney] constituency flooded and he did not come back immediately from a shadow cabinet trip to Rwanda," she said.

Her co-reviewer, the comedian and writer David Schneider, said people in Somerset may be wondering why - after five weeks of flooding there - how money is being made available.

The Independent gives little cause for hope of any early relief for flooded homeowners and businesses. Under the headline "Britain's water torture: here to stay until May", it reports a warning from the British Geological Survey that some parts of central-southern England remain at risk of flooding for weeks to come because the ground is so saturated.

The Sun heralds its own efforts to deliver 1,500 sandbags to people living near the flooded River Thames - and happily takes a swipe at politicians visiting the floods.

The Daily Mail says its petition urging the government to divert money from the UK's multi-billion pound overseas aid budget reached 100,000 signatures in one day.

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Putting the boot in
(l-r) David Cameron, Nick Clegg, Nigel Farage and Ed Miliband Politicians covered a lot of ground on Tuesday - much of it in their gumboots

It is hard to pick up a Wednesday paper without finding a picture of a welly boot-clad politician. Leaders of the main parties, plus UKIP, are all seen surveying the floods while appropriately shod.

"Dave and Co, the 'flood tourists'" is the Daily Mail's description of their appearance in Surrey and Berkshire on Tuesday. The appearance of politicians "in their spotless and even designer Wellington boots was simply too much to bear" for some residents, it says.

"What a shower!" is the Daily Mirror's banner headline (albeit across pages six and seven). While accusing the politicians of looking "way out of their depth", the paper says David Cameron "finally took personal charge of the national emergency".

The Express also goes with the "out of their depth" line. The politicians were trying to negotiate the "twin perils of rising waters and growing anger amid flood-hit voters", it says. It singles out Labour leader Ed Miliband because he was "powerless to take action".

The Thames Valley "saw a surfeit of political leadership", says the Daily Telegraph. One reason for the steady flow of politicians heading upriver from Westminster may be a lesson of history, it adds: Clement Attlee's Labour government's failure to deal with flooding in 1947 cost it crucial seats and the loss of power in the 1950 general election.

(For those taking notes, the paper without a single picture of a politician in wellies is the Guardian).

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Profits down, bonuses up
Antony Jenkins Barclays boss "St Antony" provides headlines for both tabloid and broadsheet

Water of a slightly hotter nature is lapping at the desk of Barclays chief Antony Jenkins, after he signed off on a 10% rise in the bank's bonus pot, bringing it to a total of £2.38bn.

The Times considers an intervention by the bosses' group the Institute of Directors as "unprecedented" after it accused institutional investors of being "supine" for failing to block the bonus rise.

A simple graphic on the Guardian's story tells of why this is causing ructions at the higher levels of British business: it shows bonuses up 10% and annual profits down 32%. "That performance demands a cut in bonuses, not a rise", says the paper's Nils Pratley. Mr Jenkins is not taking his bonus this year.

"Union fury at 10% hike for bosses" declares the left-leaning Daily Mirror. "Fatcats", according to Trades Union Congress chief Frances O'Grady, were being "rewarded with tens of billions of pounds in bonuses" despite having got off "scot-free" after the 2008 financial crash.

The Financial Times says Mr Jenkins, "dubbed St Antony by some commentators in the City", had been seen at Westminster "as a fresh start for the banking industry after the excess associated with his predecessor Bob Diamond".

The Daily Mail puts the story on page two, saying the bonus announcement comes from a bank which wants to cut 7,000 UK jobs, generating fears "a quarter" of its 1,560 branches will close.

The Daily Express calls the boosted bonuses an "obscenity" and in its leader column declares bankers "must be punished for their failures".

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Temple tributes
Shirley Temple Temple's mother always ensure there were exactly 56 ringlets in her hair, many papers note

The papers unite in marking the passing of US actress and diplomat Shirley Temple - the girl who became a star at the age of three.

"Farewell to America's little darling", is the Independent's obituary headline. Unlike Tatum O'Neal and Macaulay Culkin, Temple "was, and will always remain, the quintessential child star", it says.

"Her smiling face lifted the spirits of the American people during the Great Depression", eulogises the Sun, adding how US President Franklin D Roosevelt dubbed her "Little Miss Miracle" for her effect on morale.

The Daily Telegraph's Hannah Betts says Temple "not only created the role of child star; she finessed it" before "moving on from it with grace, wit and intelligence".

Her life after Hollywood, as US representative to the UN and later ambassador to Ghana and Czechoslovakia, is considered by the Guardian's Peter Bradshaw in his obituary. "Shirley Temple didn't twerk", he writes, noting how she sensed her recognition could be "parlayed into a career in politics".

"In these less innocent days", writes the Daily Mail's Michael Thornton, "it seems certain that never again will the world know a child star with the magic of Shirley Temple."

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Statin island?
Cholesterol-lowering drugs People with a 10% risk of developing cardiovascular disease in 10 years should get statins, the guidance says

The medical watchdog NICE's recommendation that millions more people in England should be put on cholesterol-lowering drugs known as statins does not get an easy ride from the Daily Telegraph.

The drugs are the most-commonly prescribed in Britain, it says, "amid increasing obesity and aggressive prescribing by GPs, whose pay is linked to take-up of the pills". It quotes public health professor Shah Ebrahim, who tells of his "concern" at mass-medicalising "the whole of the British public in this way".

The Times provides an alternative view from Prof Rory Collins of Oxford University, who believes it is not "mass-medicalisation" but provides "more choice", although he warns the benefit to people at lower risk of cardiovascular disease must be balanced against potential side effects.

The Guardian says there are fears doctors will "hand out pills instead of tackling the root causes of heart attacks and strokes" by dealing with smoking, drinking, poor diet and a lack of exercise.

But the Daily Express reports NICE's guidance would require doctors to help patients improve their lifestyle before offering "high intensity statin therapy".

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Making people click

The Times - Months of misery as floods set to last

Daily Telegraph - Is intelligence written in the genes?

The Independent - George Clooney hits back at claims he does not understand Britain's right to the Elgin Marbles

Daily Mail - Baby girl is mauled to death by pitbull

The Guardian - Donald Trump loses legal challenge to wind farm near his Scottish golf resort

Daily Mirror - Teenager stabs girl in the face and beats another black and blue because they called him Harry Potter


US faces 'catastrophic' ice storm

US 'catastrophic' ice storm rolls north

A pedestrian battled the snow and wind in Sanford, North Carolina on 11 February 2014 Residents in North Carolina may face up to 1ft (30cm) of snow

A "catastrophic" ice storm wreaking havoc in the American South is now poised to pummel the eastern seaboard, say forecasters.

Nearly 100,000 people are without power in Georgia, Texas and North and South Carolina and 2,600 flights have been cancelled due to ice and strong winds.

Nearly empty roadways were reported as many heeded warnings to stay indoors.

North Carolina and Virginia are bracing for up to 1ft (30cm) of snow as the storm rolls north.

Two Alabama department of transportation employees worked to free a sand truck from highway 176 around Little River Canyon on 11 February 2014 Workers struggle to free a sand truck in Alabama amid heavy snow and ice

It is predicted to drop up to 8in of snow in Washington DC and up to 10in in New York overnight.

At least five traffic accident deaths were blamed on ice in Texas and Mississippi.

The National Weather Service said it was an event of "historical proportions", drawing comparisons with similar weather systems that struck the Atlanta area in 2000 and 1973.

A woman walked down a snowy street in Greenville, Mississippi, on 11 February 2014 A woman braves the snow and ice in Greenville, Mississippi
A woman pulled her dog through the snow in Cullman, Alabama on 11 February 2014 A woman pulls her dog through the snow after bringing lunch to her husband in Alabama
Jordan Larson-Horstman and her daughter Jane, 4, build a snowman in Charlotte, North Carolina, on 11 February 2104 A mother and her four-year-old daughter build a snowman in Charlotte, North Carolina

Hollande honoured at US state dinner

Francois Hollande honoured at US state dinner

The two presidents' toasts were the highlights of the evening

French President Francois Hollande has been honoured at a lavish White House state dinner, capping a visit to the US aimed at renewing the partnership between the two long-standing allies.

His was the first official state dinner at the White House since 2011.

At the party, Mr Hollande and US President Barack Obama toasted the nations' centuries-old friendship.

They have suggested the bad feelings over US spying and French opposition to the Iraq War have been soothed.

First Lady Michelle Obama (left), French President Francois Hollande (centre) and US President Barack Obama at a State Dinner at the White House on 11 February 2014  Guests at the state dinner were treated to rib-eye beef and salad from the White House garden

Among the guests at Tuesday's state dinner were diplomats and dignitaries from both governments, as well as leaders in the media and business.

Hollywood luminaries in attendance included Bradley Cooper, Mindy Kaling, Stephen Colbert, Julie Louis-Dreyfus and director JJ Abrams.

The roughly 300 guests dined on caviar, quail eggs and rib-eye steak, later listening to a performance from singer Mary J Blige.

After being welcomed to the White House by Mr Obama and First Lady Michelle Obama, Mr Hollande was seated between the couple at the dinner table in a heated tent on the South Lawn.

The move was seen as a tactful way to handle the fact that Mr Hollande arrived alone after a widely publicised split from long-time partner Valerie Trierweiler following reports he had an affair with an actress.

Comedian Stephen Colbert and his wife Evie Colbert arrive for the State Dinner being held for French President Francois Hollande at the White House in Washington 11 February 2014 Political satirist Stephen Colbert, shown with his wife Evie, sat beside First Lady Michelle Obama at the dinner
US President Barack Obama and First Lady Michelle Obama welcome French President Francois Hollande as he arrives for a state dinner at the White House in Washington, DC, 11 February 2014 The US president and first lady met Mr Hollande for a traditional greeting on the White House steps
US first lady Michelle Obama (L), French President Francois Hollande (C) and US President Barack Obama pose in front of the Grand Staircase for an official photo before a State Dinner at the White House 11 February 2014 Mr Hollande is the first French president to be honoured with a state dinner since Jacques Chirac

The highlights of the evening were toasts given by the two presidents.

With a glass of white wine in his hand, Mr Obama opened by quoting French writer Alexis de Tocqueville's impressions of 19th Century America, recalling to humorous effect his bafflement with American cuisine and his underwhelming impression of the White House.

"We Americans have grown to love all things French - the films, the food, the wine," Mr Obama continued. "But most of all, we love our French friends because we have stood together for our freedom for more than 200 years.

"Vive la France, God bless America, and long live the alliance between our great nations."

'We love Americans'

Speaking first in English, Mr Hollande acknowledged the sacrifice of the US soldiers who fought in France during World War Two and said that France felt America's pain at the terrorist attacks of 11 September 2001.

Continuing in French, he praised French-US diplomatic and military co-operation in the Middle East and Africa, and said the two countries would work jointly for economic growth and to combat climate change.

Mr Hollande said relations between the two countries had reached "an exceptional level of closeness and confidence" because they shared the "universal values" of freedom, democracy and respect for the law.

"We love Americans, although we don't always say so," the French president said, "and you love the French, but you are sometimes too shy to say so."

At a news conference after bilateral talks earlier on Tuesday, Mr Hollande said he and Mr Obama had resolved their issues over digital eavesdropping by the US National Security Agency.

"Mutual trust has been restored," said Mr Hollande.

Mr Obama also announced he had accepted Mr Hollande's invitation to go to France in June to commemorate the 70th anniversary of the invasion of Normandy during World War Two.

On Wednesday, Mr Hollande will travel to San Francisco and meet chiefs of Silicon Valley giants including Facebook, Twitter and Google.

Mary J Blige (centre) performed at the state dinner at the White House in Washington DC on 11 February 2014 Guests witnessed a performance by musician Mary J Blige (centre)
Actress Julia Louis-Dreyfus (left) and her father William Louis-Dreyfus arrived to a state dinner at the White House in Washington DC on 11 February 2014 Actress Julia Louis-Dreyfus brought her father, William, as her guest to the state function
US ambassador to the United Nations Samantha Power (right) and her husband Cass Sunstein arrived to a state dinner at the White House in Washington DC on 11 February 2014 US ambassador to the United Nations Samantha Power (right) and her husband Cass Sunstein partook in the evening's festivities
Entrepreneur Elon Musk (right) and his wife Talulah Musk arrived for the State Dinner at the White House in Washington on 11 February 2014 PayPal, Space X and Tesla entrepreneur Elon Musk (right) and his wife Talulah also attended the soiree