The pathway aligns regulatory review by the Medicines and Healthcare products Regulatory Agency (MHRA) with the National Institute for Health and Care Excellence (NICE) health technology appraisal process, so that decisions are reached simultaneously.

But Huseyin Naci at the London School of Economics and Political Science notes that these two bodies require different forms of evidence. The MHRA focuses on a product’s clinical effectiveness and safety, while NICE assesses its comparative effectiveness and long term value for money against current NHS treatments.

Rather than aligning evidentiary standards, the pathway runs two independent processes in parallel with the aim of synchronising their conclusions, he explains, offering companies earlier revenue and a longer rebate-free window, while benefits for patients and the NHS are less clear.

He acknowledges that earlier access to effective new drugs can matter for patients with significant unmet needs, but says, unlike the patient-focused Innovative Licensing and Access Pathway (ILAP), the new pathway expedites all new medicines regardless of added therapeutic benefit.

The pathway will also impose timelines to ensure that MHRA and NICE decisions are reached simultaneously. Yet Naci points out that fixed drug evaluation deadlines have historically been linked to higher rates of adverse events, and fast-tracked medicines are more prone to post-marketing safety issues than those approved through standard routes.

A further problem is that NICE committees may be asked to assess products on evidence not yet fully vetted by the MHRA, compounding the uncertainty under which they already operate, he writes.

Earlier adoption of expensive, potentially low-value medicines will also extend the period over which they divert NHS resources from more cost-effective interventions, a problem exacerbated by the 2025 US-UK trade agreement committing NICE to a 25% higher cost-effectiveness threshold, he adds.

Naci urges the government to ground medicines access policy in patient need and population health, calling for clarification on the assumptions underpinning the pathway and assessment of its anticipated benefits and harms for all stakeholders, not just industry.

NICE’s focus on synchronisation of decisions risks overlooking whether the NHS will be adequately protected from the earlier adoption of medicines that prove harmful, ineffective, or poor value, he concludes.

The study examined the facilitators and challenges of so-called tobacco endgame policies in Europe. These policies refer to goals and measures aimed at reducing the use of tobacco products in the population to such a low level that it no longer places a significant burden on public health. Tobacco causes more than seven million premature deaths worldwide each year.

The EU’s Tobacco-Free Generation target was launched in the 2021 Cancer Plan and was recently reinforced in the Safe Hearts Plan. The aim is to reduce the use of tobacco products among the European population to below five per cent by 2040.

EU support is decisive for achieving the targets

According to the study, achieving the targets is particularly supported by broad political commitment, effective and long-term cooperation between different actors, and an active civil society that keeps the issue visible and brings public opinion to light.

In contrast, tobacco industry influence on decision-making, the visible marketing of new nicotine products, and the slowness of regulation make progress towards the targets more difficult.

The interviewees saw the EU’s role as central in reducing the use of tobacco and nicotine products. Common EU regulation and examples from other countries can accelerate national measures and encourage countries to set more ambitious targets for reducing the use of tobacco and nicotine products.

“The ongoing revision of EU tobacco legislation provides an important opportunity to strengthen Member States’ actions and accelerate progress towards the Tobacco-Free Generation target,” says Senior Specialist Hanna Ollila from the Finnish Institute for Health and Welfare.

Finland has been a forerunner

In some countries, the target has been extended to cover nicotine products as well. Finland has been a forerunner in this respect. In Finland, the objective of the Tobacco Act is to end the use of tobacco and nicotine products. In practice, the aim is to achieve a prevalence below five per cent by 2030.

“It is important for Finland to continue its active role and ensure that national regulation remains up to date, particularly with regard to new nicotine products. The rapid increase in the use of nicotine pouches among young people requires swift additional measures, such as raising the age limit,” Ollila states.

The study is based on interviews with 23 experts in eight European countries. The interviewees included officials, researchers and representatives of non-governmental organisations. It was carried out as part of the Joint Action on Tobacco Control 2 -project, within a work package led by THL.

Rates of depression and anxiety have increased worldwide since the COVID-19 pandemic, and more people are pursuing mental health treatment as a result. However, there is limited up-to-date data describing how these individuals seek out and receive care. Detailed, population-level information can help healthcare systems meet this growing population’s needs.

To make a start on gathering this data, Kruk and her colleagues surveyed 32,419 adults in 18 high-, low-, and medium-income countries. More than 1,000 people from each country responded. Participants self-reported data via the People’s Voice Survey in 2022 and 2023.

First, survey respondents self-assessed their physical and mental health (the latter including “poor,” “fair,” “good,” “very good,” and “excellent”). Then, they quantified their overall confidence in the healthcare system, their own use of healthcare services, the typical quality of care received, and their ability to manage their own mental health (a metric called patient activation).

Across all countries, respondents reporting poor mental health were more likely to report chronic illness, poorer overall health, lower patient activation, worse care quality and lower confidence in the healthcare system. Between 0.9% (Lao PDR) and 52.4% (UK) of these respondents reported receiving mental health care in the last year. Respondents in Nigeria reported the best overall mental health (4.7% people reported the lowest proportion of “poor” or “fair” mental health (4.7%), while respondents in China had the highest proportion (39.6%).

The researchers hope these results can help the countries in question — and individual healthcare systems — better serve the needs of those with poor mental health. While this is a descriptive study, the researchers posit patient activation as a potential target for elevating overall health and wellness.

The authors acknowledge that big-picture data doesn’t describe individuals’ specific experiences within the healthcare system. They suggest comparison across similar health systems and tracking system performance over time to continuously improve health services.

The authors add, “What stands out from this study is that poor mental health doesn’t exist in isolation. People reporting poor mental health were nearly twice as likely to have a chronic illness and far less likely to feel empowered to manage their own health. Health systems need to stop treating mental health in a silo and recognize that these patients are showing up across all areas of care — and often with more complex needs.”

Kruk adds, “As a research consortium working across very different health systems, we expected to find variation, and we did, in treatment access. But the experience gap was remarkably consistent: people with poor mental health had worse care, more unmet needs, and less trust in the system, regardless of where they lived. Health systems globally need to rethink how they serve this growing group, not just whether they can reach them.”

Freely available paper in PLOS Medicine: https://plos.io/3O045Xd

Citation: Kruk ME, Kapoor NR, Arsenault C, Carai S, Daray FM, Doubova SV, et al. (2026) Health system use and experience among people with poor mental health: A cross-sectional analysis of the People’s Voice Survey in 18 countries. PLoS Med 23(5): e1004745. https://doi.org/10.1371/journal.pmed.1004745

Author countries: United States of America, Greece, Argentina, Mexico, Peru, Ethiopia, India, South Africa, Republic of Korea, United Kingdom, Nigeria, Italy, China

Funding: This work was supported by the Bill & Melinda Gates Foundation (https://www.gatesfoundation.org/ INV-005254) to MEK; the Swiss Agency for Development and Cooperation (https://www.eda.admin.ch/deza/en/home.html; 81067262) to MEK; Merck Sharp & Dohme LLC (https://www.merck.com) to MEK; the Inter-American Development Bank (https://www.iadb.org/en; Project No. RG-T3768) to EGE; and the Taejae Research Foundation (https://taejaefoundation.or.kr/en) to JO. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

The warning label currently required on alcohol containers in the United States has not changed since its adoption in 1988, despite new evidence linking alcohol to several diseases. The label states the risks of drinking during pregnancy and while driving or operating machinery and warns generally that drinking alcohol “may cause health problems.” The label often goes unnoticed and unremembered by consumers.

“We wanted to test whether new warnings could better inform consumers about alcohol’s harms and better encourage people to consider cutting back on their drinking,” says lead author Anna H. Grummon, Ph.D., M.S.P.H., assistant professor at the Stanford University School of Medicine. The study was conducted as part of a larger project co-led with Marissa G. Hall, Ph.D., associate professor at the University of North Carolina.

Designed to compare the effects of differently worded and designed warning labels, the study recruited a nationally representative sample of 1,036 adults of legal drinking age (21 and older) who reported drinking at least once a week.

Participants viewed 10 messages — one control, eight new warning labels, and the current U.S. warning label — in random order. They then rated each message on how well it encouraged them to drink less alcohol, reminded them of alcohol’s harms, and informed them of something new.

“Each participant rated multiple warnings covering a range of health harms — such as cancer, liver disease, hypertension, and dementia, among others — so we could make direct, apples-to-apples comparisons between them,” says Grummon.

All the new alcohol warnings in the study outperformed the current U.S. warning label, but those highlighting cancer risk were particularly effective. This finding is notable as policymakers in the United States and abroad debate whether to adopt a cancer warning on alcohol products.

“Ireland, for example, is set to require cancer warnings on alcohol containers in the coming years, and Alaska already requires a cancer warning to be posted in bars, restaurants, and liquor stores where alcohol is sold,” says Grummon. “Our findings suggest these policies could help people understand the risks of drinking and potentially reduce consumption.”

Study participants also rated the effectiveness of warning icons and label design. Triangles and octagons were perceived as more effective and attention-grabbing than other icons, such as a magnifying glass.

More research is underway. Grummon and Hall are currently running a randomized trial to test whether new alcohol warnings effectively lead people to drink less. The study will also measure whether the warnings improve knowledge of alcohol-related harms over time.

“We know from tobacco control that well-designed warnings can inform consumers and encourage healthier choices,” says Grummon. “Given that alcohol-related deaths are increasing, we hope policymakers will consider whether updating alcohol warnings should be part of a broader strategy to address alcohol-related harms.”
—–
Grummon, A. H., Lee, C. J. Y., Campos, A. D., Lazard, A. J., Brewer, N. T., Whitesell, C., Ruggles, P. R., Greenfield, T. K., & Hall, M. G. (2026). New alcohol warnings outperform the current U.S. warning in a national survey experiment. Journal of Studies on Alcohol and Drugs, 87(3), 433-443. https://doi.org/10.15288/jsad.25-00226

By W.B. Kagan

image: “Government warning” alcohol label

View more Credit: Journal of Studies on Alcohol and Drugs

The purchasing and consumption of foods high in energy, saturated fat, free sugars, and salt, is associated with an increased risk of obesity and diet-related non-communicable diseases. In recent years, the UK Government has set a series of voluntary targets for manufacturers, retailers, and restaurants to reduce the sugar, salt, and calorie content of food. The sugar targets were intended to be met by 2020, the salt targets by 2024, and the calorie targets by 2025. Few studies have assessed the nutritional quality of foods in the restaurant sector, despite an increasing percentage of weekly food intake coming from takeaway or restaurant meals.

In the new study, researchers gathered nutritional information from the 21 highest-grossing restaurant chains in the UK in 2024, using PDF menus or nutritional information on restaurant websites. They calculated the proportion of menu items from each restaurant and food subcategory that met the nutritional targets. Nine of the 21 restaurants had more than half of their menu items meeting all applicable targets. Menu items from Papa John’s were the lowest adhering to the calorie (35%) and salt (8%) targets, while menu items from Burger King, KFC, Nando’s, and Vintage Inns had zero adherence to the sugar targets.

Food within the same subcategory varied in adherence to the targets, with salads and breakfast items having the highest overall adherence, and desserts and pizzas the lowest. However, there were examples of companies across all subcategories performing well, indicating that performance is not constrained by the type of cuisine being offered.

“Our findings demonstrate that there was low adherence to the UK Government’s sugar, salt, and calorie reduction targets in 2024,” the authors say. “This is consistent with other research that finds limited effectiveness of voluntary regulation on reformulation, suggesting that mandatory regulation may be a more effective approach to improving the nutritional quality of out-of-home food.”

Alice O’Hagan adds, “Our study shows that the UK Government’s voluntary sugar, salt, and calorie reduction targets were not being met consistently across the highest-grossing UK restaurant chains, in 2024. Only 43% of menu items met all of the targets they were eligible for, and adherence to the targets varied widely between restaurants and food categories, showing that healthier menus are achievable but are not yet the norm.”

“Interestingly, restaurants with similar menu styles performed quite differently in meeting the targets. This shows the nutritional quality of menus is not fixed by cuisine type, making the shift towards healthier menus a more attainable goal for food companies.”

Co-author Lauren Bandy adds, “Voluntary targets alone are not delivering consistent improvements in the salt, sugar or calorie content of food items on offer in UK restaurants. Our findings highlight the potential value of stricter regulation in the out-of-home sector, and show that improving transparency and accountability of individual food companies will be key in supporting healthier food provision for the UK population.”

Freely available paper in PLOS Medicine: https://plos.io/4bNeHl9

Citation: O’Hagan A, Pechey R, Forde H, Bandy L (2026) Adherence to voluntary UK sugar, salt, and calorie reduction targets in the highest-grossing restaurant chains: A cross-sectional study. PLoS Med 23(5): e1004681. https://doi.org/10.1371/journal.pmed.1004681

Author countries: United Kingdom

Funding: AOH and RP are supported by the NIHR Oxford Health Biomedical Research Centre (https://oxfordhealthbrc.nihr.ac.uk/). RP is also supported by the Royal Society and Wellcome Trust (Sir Henry Dale fellowship; 222566/Z/21/Z; https://www.royalsociety.org/grants/henry-dale/). HF is funded by the SHIFT: Sustainable and Healthy Interventions for Food Transitions project, which is funded by the Wellcome Trust (grant reference 227132/Z/23/Z; https://wellcome.org/research-funding/funding-portfolio/funded-grants/shift-sustainable-and-healthy-interventions-food), and by the COPPER project, which is funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme (grant reference NIHR133887; https://fundingawards.nihr.ac.uk/award/NIHR133887). LB is supported by the NIHR Applied Research Collaboration (ARC) Oxford and Thames Valley (https://www.arc-oxtv.nihr.ac.uk/). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Image: Dan Gold, Unsplash (CC0, https://creativecommons.org/publicdomain/zero/1.0/)

In an expert commentary titled ‘AI can reason like a physician; what comes next? published in Science, Flinders researchers caution that while new AI systems show impressive capabilities, strong results in controlled studies do not mean they are ready for routine use in hospitals or clinics.

The authors say there is an urgent need to understand how emerging AI tools can be safely integrated into everyday clinical practice, with patient outcomes remaining the central focus.

Despite these warnings, the researchers acknowledge that recent advances in AI create genuine opportunities to support doctors, particularly in busy and high-pressure care settings.

The commentary reviews new research showing that advanced reasoning-based AI systems can work through diagnostic scenarios step by step and, in some cases, closely match or even exceed the diagnostic performance of experienced doctors.

Erik Cornelisse, a PhD candidate at Flinders University and co-author of the commentary, says this shift marks a move from simple question answering tools towards algorithms capable of seemingly human-like clinical reasoning on text-based tasks.

However, the Flinders team stresses that real world medical care involves far more than text-based reasoning or test performance.

They say clinical practice depends on physical examination, listening to patients, understanding medical and social context, and taking responsibility for outcomes, elements that current AI systems cannot safely provide on their own.

“Health care decisions are complex, high stakes, and deeply human, and accuracy alone, particularly on just text-based cases, does not make a system safe for patients,” says Mr Cornelisse from the College of Medicine and
Public Health.

Senior author Associate Professor Ash Hopkins, an NHMRC Investigator and leader of Flinders’ Clinical Cancer Epidemiology Lab, says modern healthcare relies on judgement, accountability, and ethical oversight.

“AI systems have demonstrated that they can reason through clinical problems with similar performance to doctors, notably on the same scenarios used to train clinicians themselves. This presents genuine opportunities to support clinicians in the future,” says Associate Professor Hopkins.

“Multiple stakeholders are currently working on the frameworks for AI in terms of legal, professional, or moral responsibility for its decisions, and presently there is a critical need for deliberate and controlled integration into clinical care.”

The commentary highlights known risks linked to poorly evaluated systems, including bias, inequitable care, and unintended patient harm.

“History shows that algorithms can worsen outcomes when deployed without sufficient safeguards and can amplify problems as easily as they solve them, particularly when systems are trained on incomplete or unrepresentative data,” says Mr Cornelisse.

Looking ahead, the Flinders researchers argue that enthusiasm for medical AI must be matched by strong governance and clearer standards for evaluation.

“We do not allow doctors to practise without supervision and evaluation, and AI should be held to comparable standards,” says Mr Cornelisse.

The researchers stress that improvement in real patient outcomes, not exam scores, benchmarks, or demonstrations, must be the true measure of success.

Associate Professor Hopkins says AI holds enormous promise but must be applied responsibly.

“Patients deserve technology that improves care in the real world, not systems that only look impressive in studies,” he says.

“With careful design, strong oversight, and rigorous evaluation, AI could become a powerful tool to deliver safer, fairer, and more effective care across health systems worldwide,” concludes Associate Professor Hopkins.

The paper, ‘AI can reason like a physician; what comes next?’, by Ashley M. Hopkins and Erik Cornelisse is published in SCIENCE.  DOI 10.1126/science.aeg8766 (link live after embargo lifts)

The paper published online today highlights that ^99mTc-maraciclatide has potential as:

• A novel non-invasive diagnostic test, particularly for superficial peritoneal endometriosis (SPE), which cannot be reliably detected by conventional imaging techniques and currently requires laparoscopic surgery for definitive diagnosis
• A tool to enable disease monitoring, eliminating uncertainty around disease recurrence
• A marker of treatment response, empowering the development of novel therapies

^99mTc-maraciclatide is a gamma-emitting radiotracer that binds to αvβ3 integrin, which is upregulated during angiogenesis (new blood vessel formation), a cardinal feature of inflammatory diseases. The DETECT study describes, for the first time, the use of ^99mTc-maraciclatide as a potential tool for the visualisation and diagnosis of endometriosis.

Key findings:

• The DETECT study demonstrated a high correlation between locations of maraciclatide uptake and laparoscopy across all types of endometriotic lesions, including superficial peritoneal endometriosis (SPE). SPE is the earliest stage of endometriosis, which is found in 80 per cent of all laparoscopically diagnosed disease
• Imaging with ^99mTc-maraciclatide visualised endometriosis, detecting disease missed by conventional imaging methods
• Imaging results were concordant with the surgical presence or absence of endometriosis in 16/19 cases, with endometriosis imaged in 14/17 surgically positive participants, including two cases of thoracic endometriosis
• No false positives were reported in this study
• ^99mTc-maraciclatide imaging was able to detect lesions across all endometriosis subtypes supporting the applicability of the scan to various patient groups
• ^99mTc-maraciclatide was well tolerated and patient acceptability was high

Dr Tatjana Gibbons, lead author on the paper and investigator on the study from the Nuffield Department of Women’s and Reproductive Health, University of Oxford added, 

“These exciting findings indicate that maraciclatide offers a highly promising diagnostic and monitoring tool, particularly for superficial peritoneal endometriosis, which is the most common and yet the hardest type of endometriosis to identify.

“We are hugely grateful to the patients who have participated in the DETECT study without whom investigating this diagnostic approach would not have been possible.”

Professor Christian Becker, Co-Director of the Endometriosis CaRe Centre in Oxford, co-lead on the study and joint senior co-author on the paper, added:

“Novel, non-invasive diagnostic tests for endometriosis are a global research priority. The diagnostic challenge of endometriosis, which presents with varied and non-specific symptoms, is exacerbated by an absence of clinically validated biomarkers and the limitations of currently available imaging techniques. If these Phase II results are reproduced in the Phase III studies, maraciclatide has the potential to be an extremely valuable tool, as it could both reduce diagnostic delays and provide a validated endpoint for the development of new therapeutics.”

David Hail, CEO of Serac Healthcare, commented:

“The completion and publication of this clinical study marks a pivotal achievement for Serac Healthcare. These data, from a representative patient population, including women receiving hormone therapy, provide  evidence of maraciclatide’s anticipated real-world performance.

“With FDA Fast Track Designation and agreed Phase III study designs, we are now advancing to validate these findings in larger trials and progress to regulatory submission.”

Professor Krina Zondervan, Co-Director of the Endometriosis CaRe Centre, Head of Department at the Nuffield Department of Women’s and Reproductive Health, Co-theme Lead for the NIHR Oxford Biomedical Research Centre’s Surgical Innovation Theme, co-lead on the study and joint senior co-author on the paper, said:

“Superficial peritoneal endometriosis, the most prevalent subtype of endometriosis, currently evades reliable detection, leaving women no choice for diagnosis other than invasive surgery. If these results are confirmed in larger Phase III studies, imaging with maraciclatide could transform clinical research and practice and potentially empower the development of treatments for women across the globe.”

The study was co-led by Professor Christian Becker, Co-Director of the Endometriosis CaRe Centre in Oxford, together with Professor Krina Zondervan, Co-Director of the Endometriosis CaRe Centre and Head of Department at the Nuffield Department of Women’s and Reproductive Health at the University of Oxford. The study was funded by the  NIHR Oxford Biomedical Research Centre and Serac Healthcare. Scans were performed at the Royal United Hospital, Bath.

About the Phase 2 trial:

This was an exploratory, open-label, single-centre, phase 2 study evaluating preoperative imaging in 20 individuals with suspected or confirmed pelvic or thoracic endometriosis using a SPECT-CT, with intravenous ^99mTc-maraciclatide. The primary outcome was alignment of radiological and surgical findings in those patients completing both imaging and surgery. The surgical report on lesion type and location was compared to images for alignment.

Ten of the participants with SPE had prior imaging with traditional modalities (transvaginal (TV) ultrasound and/or MRI) in the last 12 months, none of which had detected SPE.

Phase III multi-centre international studies are due to start later this year.

But there are few evidence-based interventions to help this age group problem-solve and reduce stress. To address the gap, Rutgers University researchers tested the efficacy of Bright IDEAS, a problem-solving skills training intervention based on cognitive-behavioral therapy, in reducing depression and anxiety and improving their overall health-related quality of life in people ages 18 to 39, which the National Cancer Institute defines as “young adults.”

Their study, published in JAMA Network Open, found young adults who participated in the Bright IDEAS program showed significant reductions in depression and anxiety symptoms and improvements in their quality of life compared with members of the control group.

“Bright IDEAS participants felt less overwhelmed and more empowered,” said Katie Devine, Associate Director of the New Jersey Pediatric Hematology and Oncology Research Center of Excellence at Rutgers Cancer Institute, New Jersey’s only National Cancer Institute-designated Comprehensive Cancer Center together with RWJBarnabas Health. “This shows that a relatively brief intervention delivered by trained professionals can have a profound impact on patient well-being.”

Bright IDEAS teaches a five-step tactical approach to problem solving (IDEAS is an acronym standing for the steps of problem-solving: Identify the problem, Define your options, Evaluate options, Act and See if it worked) in a positive context (as in “bright”).

“The goal is by improving problem-solving skills, young adults will be better equipped to identify and act on problems and thus reduce symptoms of distress and improve quality of life,” said Devine, an author of the study who also is an associate professor at Rutgers Robert Wood Johnson Medical School.

The Bright IDEAS intervention is completed over six video sessions by licensed mental health professionals or supervised trainees who are trained to deliver the Bright IDEAS program.

“In each session, they address challenges and walk through the problems to identify solutions,” Devine says. “Instead of feeling overwhelmed about how to manage what is happening to them, they become empowered to manage their stressors.”

The study included 344 young adults between 18 and 39 who were within four months of a first cancer diagnosis and who were undergoing systemic therapy such as chemotherapy, radiation, immunotherapy or stem cell transplant at Rutgers Cancer Institute in New Brunswick, N.J., Memorial Sloan Kettering Cancer Center in New York, and Moffitt Cancer Center in Tampa.

Researchers conducted a randomized controlled trial, with half the participants receiving Bright IDEAS and the other half receiving usual psychosocial care of visits with a social worker and provided resources. The participants were surveyed to measure their symptoms at three and six months after enrollment.

“We are next planning a trial in community oncology settings, where most young adults receive their treatment, to make Bright IDEAS more accessible to patients who may not have access to large urban cancer centers,” Devine said.

Other Rutgers authors involved in the study are Sharon Manne, Kristine Levonyan-Radloff, Shengguo Li and Pamela Ohman Strickland.

“Rates of colorectal cancer are rising, but many eligible people are unscreened, especially in community health centers,” said corresponding author Jennifer Haas, MD, MSPH, of the Division of Internal Medicine in the Mass General Brigham Department of Medicine. “CHCs are an important source of care in the United States, especially for under- or uninsured people. Since many CHCs are under-resourced, the goal of our research was to help design an intervention to specifically benefit people who receive care in these settings.”

Haas and colleagues are members of the Stand Up To Cancer (SU2C) Colorectal Cancer Health Equity Dream Team that brings together leading researchers, patient advocates, community leaders, and clinicians to accomplish several goals, including improving colorectal cancer screening in medically underserved communities.

In previous studies, mailing stool-based tests to patients increased CRC screenings at CHCs, but, with multiple mail-in tests now available, it was unclear which test and which forms of patient outreach were most effective. In the current study, researchers compared completion rates for participants who received either a mailed fecal immunochemical test (FIT) or FIT-DNA kit. Both are noninvasive, at-home tests that detect blood in the stool. However, the newer FIT-DNA test also identifies abnormal DNA indicative of cancer or pre-cancerous polyps and is repeated every three years (rather than every year). Whereas CHCs bear the costs of mailing FIT tests and conducting patient outreach, the manufacturer of FIT-DNA coordinates mailing for these tests and offers a wrap-around assistance program to support patients through screening test completion.

Participants in the randomized study included adults aged 45-75 years at eight CHCs in Boston and LA.

who were due for CRC screening. Patients were predominantly Hispanic (75%) and on Medicaid (50%). Ultimately, 28% of patients who received FIT-DNA kits completed screening after 90 days, which was significantly higher than the completion rate in those who received FIT kits and automated English or Spanish text-message reminders (23%). The researchers suggest that FIT-DNA screening may have had a higher completion rate due to stronger outreach support through the patient assistance program and the potential for reduced testing frequency.

In a separate, associated study in a tribal site in South Dakota, FIT-DNA kits were associated with an increase in participation in CRC screening. Improving screening is especially important in Native American populations due to their high CRC incidence and low screening rates.

The researchers emphasize the urgency of improving access to diagnostic colonoscopy, which is necessary after a positive stool or blood test. In this study, despite participants with abnormal stool tests receiving phone calls to help educate them about and schedule their colonoscopy, completion rates were only 36% in both the FIT and FIT-DNA groups and were lower in LA than in Boston, perhaps related to access to colonoscopy or differences in insurance coverage.

“Effective screening is essential because it allows us to catch and treat cancer early,” Haas said. “There are evidence-backed, preventive interventions for CRC, but they need to be implemented systematically in a way that addresses barriers for both the CHCs and the patients they are serving. The best screening test will always be the one that people are able to complete.”

Authorship: In addition to Haas, co-authors include Folasade P. May, Suzanne Brodney, Jessica J. Tuan, Sapna Syngal, Andrew T. Chan, Beth Glenn, Gina Johnson Yuchiao Chang, David A. Drew, Beverly Moy, Nicolette J. Rodriguez, Erica T. Warner, Adjoa Anyane-Yeboa, Chinedu Ukaegbu, Anjelica Q. Davis, Kimberly Schoolcraft, Susan Regan, Kelley Le Beaux, Ellen T. Lee, Roopa Bhat, Alexis Gordon, Linh K. Phan,  Andrea Fernanda Cortés Chirino, Caylin J. Marotta, and Rachel G. Z. Kindermann.

Disclosures: May reported being a member of scientific advisory boards with Exact Sciences, Natera, Geneoscopy, and Medtronic during the conduct of the study. Syngal reported grants from Exact Sciences, personal fees from GlaxoSmithKline and Natera outside the submitted work; in addition, Syngal had a patent for PREMM model with royalties paid from Myriad Genetics and Ambry Genetics. Chan reported

personal fees from Pfizer Inc and Boehringer Ingelheim, and grants from Freenome Holdings outside the submitted work. Rodriguez reported grants from Robert A. Winn Excellence in Clinical Trials: Career Development Award during the conduct of the study. Warner reported grants from Pfizer Inc and AstraZeneca, and nonfinancial support from Guardant Health outside the submitted work. Anyane-Yeboa reported personal fees from Exact Sciences advisory board during the conduct of the study and personal fees from Takeda Pharmaceuticals advisory board outside the submitted work.

Funding: Authors were supported by a research grant from Stand Up to Cancer, a division of the Entertainment Industry Foundation. Haas also received support from the American Cancer Society (CRP-22-0800-01-CTPS).

Paper cited: May FP et al. “Mailed Outreach for Colorectal Cancer Screening in Community Health Centers” JAMA Internal Medicine DOI: 10.1001/jamainternmed.2026.1170

The team analyzed data from the 2024 National Survey on Drug Use and Health (NSDUH). This was the first year the large‑scale, nationally representative survey asked psilocybin‑specific questions, enabling the researchers to gain a more accurate picture of past‑year use among the 58,633 respondents. Previous national surveys have grouped psilocybin with other hallucinogens and have focused on lifetime use rather than its use during the past 12 months.

“Prior surveys only captured lifetime use, which tells us little about current use patterns; someone who tried psilocybin once in college a decade ago and someone using it regularly today look identical in that data. Past-year gives us a much more clinically relevant picture of who is using psilocybin right now and what factors are associated with their use,” said first author Kevin Yang, MD, resident physician in the Department of Psychiatry at UC San Diego School of Medicine.

The research found:

• 18–25 year-olds had 1.4x the odds of psilocybin use compared to those ages 35–49, while those over 50 had about one-third lower odds
• Males had 1.7x the odds compared to females and white respondents had 2.5x the odds of Black respondents and 1.4x the odds of Hispanic respondents
• The use of cannabis and hallucinogens like LSD, MDMA and ketamine was strongly associated with past-year psilocybin use.
• Alcohol use disorder and prescription stimulant misuse were also correlated with psilocybin use.
• Individuals with a major depressive episode in the past year had higher odds of psilocybin use.

The findings have implications for clinical practice. Over the past decade, clinical trials have revealed that psilocybin has promising therapeutic effects for depression and treatment‑resistant depression, but the safety profile of unsupervised, naturalistic use remains unclear. Unlike controlled clinical settings where participants are carefully screened, doses are standardized, and psychological support is provided, naturalistic use lacks these safeguards.

“When psilocybin is used outside of a clinical setting, the risks look very different. We’ve seen reports of anxiety, paranoia and prolonged psychological distress, and there are also potential interactions with antidepressants that clinicians need to look out for,” said Yang.

He says the findings highlight the need for clinicians to be aware of psilocybin use among their patients, particularly those with depression.

“With 8 million Americans using psilocybin in the past year, this is something that psychiatrists and other clinicians should be asking about, including why patients are using it and what benefits they perceive, as well as being prepared to counsel them on harm reduction and potential risks,” said Yang.

Looking forward, Yang says longitudinal studies that track the mental health of people over time as they use psilocybin are needed, as well as increased public health surveillance as de‑criminalization and potential FDA approval of the substance progress.

Additional co-authors on the study include: Avery Eun, UC San Diego School of Medicine; Joseph J. Palamar, NYU Grossman School of Medicine.

Read the full study here.

These services are frequently hosted on digital platforms which can be inaccessible to disabled people, the consequences of which can be life-altering.

Blind people, for example, have reported being unable to book vaccinations during the pandemic due to websites that block screen readers. Wheelchair users report having to give their secure card details to strangers when they cannot reach a payment kiosk.

Disabled voters may face challenges accessing online voter registration systems or digital voting platforms that are not designed with accessibility in mind, effectively excluding them from participating in democratic processes.

The new book Digital Accessibility Ethics: Disability Inclusion in all Things Tech, with contributions from a global coalition of experts and advocates, calls for urgent action.

“Digital accessibility is not a luxury, it’s a civil and human right,” the editors Lainey Feingold, Reginé Gilbert and Chancey Fleet argue. “Without it, disabled people are excluded from participating in society, and the digital world cannot be ethical.”

Inequity in the digital age

The team of 39 expert authors demonstrate how the digital accessibility gap, a component of the digital divide, harms disabled people, who make up over 1 billion of the global population according to the World Health Organisation.

The experts argue that inaccessibility is pervasive and a daily challenge. As more services move online and technology continues to advance, without digital accessibility the digital divide will continue to widen.

“Increasingly, everything is digital,” the editors explain. “Our devices help us find our next job, our next love, our community gathering places. Learning and teaching happen online – in and out of the classroom, the workplace, the library. We depend on computers for work, entertainment, shopping, civic participation, and connection. Digital tools allow us to withdraw our own money, listen to music, play games, follow our favourite teams, and participate in local government.

“Legal problems are increasingly handled online. Daily, we look to our phones to find our way. In an emergency, the digital devices in our pockets offer critical safety information and unite us with loved ones.

“None of this is possible for people with disabilities when digital tools and content are not accessible.”

Inaccessibility has economic and social consequences for disabled people, who are more likely to live in poverty, face higher unemployment rates and lack access to critical services due to systemic barriers. Employers also miss out on the skills and creativity of a large section of society when disabled people are blocked from leadership potential by inaccessible workplace tools.

Systemic exclusion

One example where the stakes could not be higher is in emergencies and crises. According to the United Nations, only 20% of disabled individuals can evacuate without support, but less than 40% of emergency plans mention disability at all.

“These statistics are not coincidences,” explains Erin E. Brown, a Bahamian Disability Inclusion Consultant. “They are symptoms of structural ableism, where emergency preparedness frameworks fail to incorporate basic accessibility, digital or otherwise. And in a world increasingly reliant on technology to issue warnings, give directions, and provide services, the absence of digital accessibility is more than a design flaw. It’s an ethical breach.”

Emergency alerts and news updates often fail to include captions, sign language interpretation or screen-reader-friendly formats, leaving deaf, blind and neurodivergent individuals without critical emergency information.

A roadmap for change

The authors introduce a Digital Accessibility Ethics Framework, a tool designed to guide governments, corporations and people in creating inclusive digital environments.

The authors call for immediate action in several key areas, including introducing the Ethics Framework into organisational decision-making before exclusion happens, calling for more government accountability and enforcing compliance with the growing number of digital accessibility legal requirements across the globe.

The authors also suggest organisations should focus on creating digital tools and content that disabled people can use just as easily and independently as everyone else. This means adopting policies to ensure all technologies, whether purchased, licensed, or free, provide equal access to everyone.

They also suggest organisations should provide accurate and current accessibility information about their products and services, including a clear roadmap for addressing accessibility gaps. A robust feedback loop should be established to capture, remediate, and report on issues identified by disabled individuals, ensuring their voices are heard and acted upon, they advise.

“While technology and law are rapidly changing, one thing remains constant: the continued growth of the digital world. In the coming years, more decisions will be made about digital tools and content that impact ever-increasing aspects of our lives. Digital accessibility ethics must be part of that decision‑making,” the editors conclude.

DOI: 10.1201/9781003616702 

In 2024, the FDA updated the definition of the term “healthy” as it relates to how manufacturers can use the word on food packages. The new definition replaced one from 1992 and is consistent with current nutrition science and federal dietary guidance.

Also for the first time, the agency proposed an “FDA healthy” label icon for food packages, which is still undergoing approval.

The new study, led by researchers at Oregon State University and Tufts University, examined consumer purchasing preferences for snack products with and without healthy labels, focusing on the new FDA definition and healthy symbol to understand how endorsement from a regulator, such as the FDA, shapes consumer choices.

“Our main finding is that trust in government was an important part for people and that they were willing to pay more for that label,” said lead author Katherine Fuller, an assistant professor at Oregon State University who studies consumer behavior, particularly in the context of food and sustainability.

Fuller noted that the finding mirrors past research related to the USDA “organic” label, which has also been associated with a premium price.

For the new study, published in Food Quality and Preference, the researchers conducted an experiment in 2023 with 267 shoppers in person at six grocery stores in the Boston area. In the stores, participants were given tablets and shown pictures of 15 real-world products, nine of which were considered healthy and six that were not.

Participants first viewed products without any special healthy label and then viewed the same products, with those products meeting the new FDA “healthy” standards bearing either a generic healthy label or the FDA-healthy label. Participants received $5 in cash and a $10 gift card from the store. They were informed that the $5 could be applied toward the purchase of a product they selected in one of the scenarios they were presented. This procedure ensured the participants’ decisions had real economic consequences.

“Giving study participants purchasing power in a setting that mirrored a real shopping experience let us better observe how the labels might influence behavior,” said senior author Sean Cash, chair of the Division of Agriculture, Food and Environment at the Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy at Tufts University and an economist studying food policy and consumer behavior.

Each participant also completed a survey providing information about their demographics, knowledge of healthy food options and levels of generalized trust and trust in government.

Research findings from the study included:

• Consumers were more likely to choose the healthy snacks over unhealthy options.
• Consumers’ preference for healthy snacks increased when products were labeled with healthy icons. While the FDA and generic labels were associated with higher selection of healthy snacks, only the FDA label had a statistically significant effect.
• Prior findings that consumers are willing to pay more for labeled healthy foods were confirmed, and, additionally, the new results showed that adding a healthy label increases this premium further. For example, consumers were willing to pay 59 cents more on average for a healthy product with an FDA-endorsed label compared to a product with no label.
• The stronger effect of the FDA label reflects the role of perceived institutional credibility. These results are consistent with previous studies that demonstrate institutionally credible labels more effectively shape consumer decisions.
• The effectiveness of the FDA’s healthy label varied with the degree to which consumers indicated they trusted the government.

“Our findings demonstrate that labels act as signals for consumers, and policy can shape how well those signals work,” said Cash. “When labels are viewed as credible, such as when they have the endorsement of a government agency, they are more likely to influence eating patterns and purchasing habits.”

“Right now, there is a lot of misinformation about what is healthy and what isn’t healthy,” Fuller added. “Having a clear label, supported by scientific research, saying this is healthy because we checked, is important.”

Co-authors of the paper are Julia Reedy Sharib, Bingbing Fan and Dariush Mozaffarian, of the Friedman School at Tufts University, and Jennifer L. Pomeranz, of New York University.

Citation and Disclaimer: Research reported in this article was supported by the National Institutes of Health’s National Heart, Lung, and Blood Institute under award number R01HL115189. Complete information on authors, funders, limitations, methodology and conflicts of interest is available in the published paper. The content is solely the responsibility of the authors and does not necessarily represent the official views of the funders.