The team tested ‘BabyBreathe’ – a programme designed to help women who quit smoking before or during pregnancy stay smoke-free after giving birth, funded by the National Institute for Health and Care Research (NIHR).

The BabyBreathe scheme provides one-to-one support from trained health visitors with digital tools, text message support, a dedicated website and app, and a relapse-prevention kit sent to families after birth.

A major study published today in the BMJ shows that women who received this intervention as intended, with support from trained health visitors, were significantly more likely to remain smoke-free 12 months after giving birth compared to those without health visitor support.

Lead researcher Prof Caitlin Notley, Professor of Addiction Sciences at UEA’s Norwich Medical School, said: “Quitting smoking during pregnancy is an incredible achievement, but staying smoke-free after a baby is born can be just as challenging.

“Too often, support ends once a woman has quit, even though the stressful months after birth are when many women are most at risk of returning to smoking.

“Our research shows that when health visiting services are trained and supported to deliver specialist relapse prevention advice, they can make a real difference by significantly improving women’s chances of staying smoke-free. That means better health for mothers, babies and entire families.”

How the research happened

A total of 886 women from England and Scotland who had successfully stopped smoking before or during pregnancy took part in the study, as part of a large-scale randomised, controlled trial.

Participants were randomly assigned to receive either the BabyBreathe intervention or usual care – the latter of which offered no advice or support to prevent smoking relapse.

Although BabyBreathe was not delivered as intended for around one in five participants during the trial, either due to health visitor workforce pressures, missed appointments or administrative issues, health visitors provided one-to-one tailored advice and support to women in the intervention group. This was delivered at the end of pregnancy and immediately after the baby was born.

This support included advice on alternatives to try if they experienced urges to go back to smoking, as well as advice for partners and family members, and access to specially designed digital resources including the BabyBreathe app and website.

A relapse prevention ‘kit’ was also posted to women immediately after the birth of their baby and support continued for up to 12 months postpartum, at all routine health visitor appointments.

The intervention was the result of more than a decade of research and development involving women, families, health professionals and researchers – who worked together to co-design, develop and test this practical support package.

‘Health visitors play an important role’

When researchers looked at participants who received the intervention as intended, 57.6 per cent remained smoke-free at 12 months in the BabyBreathe group – compared to 49.9 per cent for those with usual care.

These findings suggest that health visiting services could play a significant role in ensuring the consistent delivery of relapse-prevention support, therefore also supporting the health of the entire family by helping more mothers to remain smoke-free after giving birth.

Prof Notley said: “Women of childbearing age who quit and stay non-smoking can reduce their risks of developing a smoking-related disease to almost the same level of risk as non-smokers.

“There are also great benefits for babies and children brought up by parents who do not smoke- in avoiding exposure to second-hand smoke, and in helping to prevent the next generation from taking up smoking.

“Until now, health visitors had no training on smoking relapse prevention. This meant that when women had made the extremely important – and difficult – health behaviour change of quitting smoking during pregnancy, no one picked up on this and gave them positive praise and support.

“This new approach extends the intensive support for initially quitting smoking that pregnant women are offered, going one step further to help women to stay smokefree in the long term,” she added.

The researchers note several limitations of the study that impacted the primary analysis, including incomplete delivery of the BabyBreathe programme and low engagement with some of its components. The participant group was also more highly educated and less socioeconomically deprived than the wider population, which may have affected the programme’s overall effectiveness and limit how broadly the findings can be applied.

The Institute of Health Visiting (iHV) worked collaboratively with UEA on the BabyBreathe study.

Vicky Gilroy, Director of Innovation and Research at the iHV, said: “Health visitors and their teams are uniquely placed to support women in preventing smoking relapse as part of their universal offer.

“It has been a privilege to contribute to the BabyBreathe study and help develop the evidence of the importance of their role. The findings reinforce the need for all health visitors to receive training in this important area.”

This research was led by UEA in collaboration with the University of Edinburgh, City St George’s, University of London, the University of Exeter, the University of Stirling, Glasgow Caledonian University, the Institute of Health Visiting (iHV) and the Norfolk 0-19 Healthy Child Service.

Prof Richard Holland, Professor of Public Health Medicine and Dean at the University of Exeter Medical School, said: “Our BabyBreathe study enrolled pregnant women who had quit smoking and showed great promise that a postpartum health visitor support package, if delivered as intended, could make a real difference to supporting them to stay off cigarettes. This is so important to improve their own health whilst protecting their baby too.”

‘Effectiveness of the BabyBreathe intervention for maintaining postpartum smoking cessation: multi-centre pragmatic randomised controlled trial’ is published in the BMJ.

1/ For more information, or to arrange interviews, please contact the UEA Communications office at: communications@uea.ac.uk.

2/ An embargoed copy of the paper is available via Dropbox link: https://www.dropbox.com/scl/fo/kkvto7owvcnb568wzhwrx/ADvTh36Lm77rkiUlRD1iS1k?rlkey=mlun95plxtvaulbm5ze0suvr8&st=8lnvumr2&dl=0

3/ The University of East Anglia (UEA) is a UK Top 25 university for research quality (Times Higher Education Rankings 2026) and UK 26th in the Complete University Guide. It also ranks in the World Top 60 (QS World Rankings for Sustainability 2025), World Top 9 for reduced inequalities (Times Higher Education Sustainability Impact Ratings 2026), and World Top 180 (TIME Magazine 2026). Known for its world-leading research and good student experience, its 360-acre campus has won 10 Green Flag awards in a row for its high environmental standards. The University is a leading member of Norwich Research Park, one of Europe’s biggest concentrations of researchers in the fields of environment, health and plant science. www.uea.ac.uk.

4/ The mission of the National Institute for Health and Care Research (NIHR) is to improve the health and wealth of the nation through research.

NIHR do this by:

• funding high quality, timely research that benefits the NHS, public health and social care

• investing in world-class expertise, facilities and a skilled delivery workforce to translate discoveries into improved treatments and services

• partnering with patients, service users, carers and communities, improving the relevance, quality and impact of our research

• attracting, training and supporting the best researchers to tackle complex health and social care challenges

• collaborating with other public funders, charities and industry to help shape a cohesive and globally competitive research system

• funding applied global health research and training to meet the needs of the poorest people in low and middle income countries.

NIHR is funded by the Department of Health and Social Care. Their work in low and middle income countries is principally funded through UK international development funding from the UK government.

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The landmark review, published in JAMA Internal Medicine, provides general practitioners and physiotherapists with an updated roadmap for managing shoulder pain.

It suggests that simple supportive care delivers better patient outcomes in most cases, rather than unnecessary scans and invasive procedures.

Shoulder pain affects nearly one in six adults each year, making it the third most common musculoskeletal complaint in primary care, trailing only behind back and knee conditions.

For most of these patients, the review emphasises that routine scans (X-rays, ultrasounds or MRIs) are not recommended because what appears on a scan often does not explain a person’s pain.

Instead, clinicians should focus on understanding the patient’s symptoms and history, conducting a physical examination, providing reassurance about their expected recovery, and recommending activity modifications, symptom relief or a wait-and-see approach where appropriate.

Lead author Dr Romi Haas, Research Fellow at the Monash School of Public Health and Preventive Medicine, said initial assessments should focus on ruling out serious underlying causes, such as infections, tumours or broken bones, and distinguishing localised shoulder pain from referred pain, such as pain originating from the neck or heart.

“The traditional approach has been to look for a structural flaw by scanning the shoulder, assuming that if you can identify the source of the pain, you can fix it,” Dr Haas said.

“However, global evidence shows these findings are often just normal signs of ageing, akin to grey hair or wrinkles.

“Unwarranted imaging can wrongly attribute a person’s pain to these normal age-related changes, causing undue worry, overdiagnosis and treatments they don’t need. Importantly, early scans don’t improve long-term recovery.”

Subacromial pain is the most common presentation of shoulder pain. It’s usually felt around the top and outside of the shoulder, and can worsen when lifting or reaching with the arm, or when sleeping on that side.

“Structural labels like ‘bursitis’ or ‘tendon tears’ make people think their shoulder is damaged and needs fixing,” Dr Haas said.

“Shifting to location-based labels, such as ‘subacromial pain’, helps reassure patients that it’s safe to keep moving while they manage their symptoms and recover.”

Co-author Dr Thomas Ibounig, a shoulder and elbow surgeon at Helsinki University Hospital in Finland, said the evidence is just as relevant for surgeons as it is for other clinicians.

“High-quality evidence has found that a common shoulder operation, which removes bone and tissue to create more space for the tendons, provides no meaningful benefit over a dummy procedure, where incisions are still cut into a patient, but nothing has been repaired,” Dr Ibounig said.

“It’s a reminder that pain isn’t always caused by an anatomical or structural problem we can simply fix with surgery.

“This guidance helps clinicians explain that clearly, so patients aren’t unnecessarily worried or pushed toward treatments they don’t need.”

Dr Haas said the same principle applies to corticosteroid injections.

“They can provide short-term pain relief, but they don’t routinely need to be guided by imaging,” Dr Haas said.

“Evidence shows an injection given by a doctor using the patient’s physical anatomy as a guide works just as well, without the additional cost or inconvenience of imaging.”

Senior author, Professor Rachelle Buchbinder, a rheumatologist and clinical epidemiologist from the Monash School of Public Health and Preventive Medicine, said most people recover from shoulder pain within one year, although often much sooner.

“Based on a long-term study of 526 adults with new shoulder concerns, followed for more than 10 years, almost 80 per cent experienced satisfactory improvement, through watchful waiting or anti-inflammatory medication,” Professor Buchbinder said.

“Our new guidance is a practical tool and a reassuring reminder for clinicians.

“It gives GPs, physios and surgeons the evidence base they need to reassure patients that self-management, time, and targeted advice are usually the safest and most effective path to recovery.”

Read the research paper: https://doi.org/10.1001/jamainternmed.2026.3135

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Seizures are among the more common in-flight medical events, and benzodiazepines are the standard first-line treatment for a seizure that does not stop on its own. The authors argue that the current contents of airline emergency medical kits leave clinicians who volunteer to assist during a flight without access to the medication they would ordinarily reach for.

The Viewpoint sets out the case for adding the drug class to standard kits and discusses the practical considerations involved, including which formulations would be appropriate at altitude and in a confined cabin setting, and how a controlled substance would be stored and accounted for on board.

Emergency medical kit contents are set by regulators, so any change to what airlines carry would require action at that level rather than by individual carriers.

The corresponding author is Joseph I. Sirven, MD, of the Department of Neurology at Mayo Clinic, Scottsdale, Arizona.

Read the full article: A Call for Benzodiazepines in Airline Emergency Medical Kits

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In a Rutgers-led study published in the Journal of Exposure Science & Environmental Epidemiology, researchers conducted a survey of product usage among 143 students at Princeton High School in New Jersey. They found that more time on social media and greater engagement with beauty-related content predicted more usage. After researchers accounted for gender, grade, race, ethnicity and parents’ education, they found students who followed influencers with product lines reported using 30% more products in the previous 24 hours. Those who watched hair or beauty tutorials used 40% more.

It was a novel finding that researchers on the study team credited a pair of then-high school students, Gabrielle Kaputa and Vita Moss-Wang, who helped design and conduct the survey and suggested it include questions about social media usage.

“Social media turned out to be the most interesting part of our results,” said Emily Barrett, the George G. Rhoads Endowed Legacy Professor and vice chair of the Department of Biostatistics and Epidemiology at the Rutgers School of Public Health and the lead author of the study.

“We often hear that social media may hurt kids’ mental health and socioemotional development,” she added. “This study suggests another cause for concern: social media’s potential to increase the use of personal care products that often include hormone-disrupting and potentially carcinogenic chemicals.”

Barrett and her colleagues, who have conducted several studies of adult product use, see much need for more information about student usage patterns.

“Teenagers are a particularly interesting population to study because they are undergoing rapid changes, including in their hormone systems,” Barrett said. “It may be a sensitive period in which better product choices could reduce chemical exposure.”

Such products include soap, toothpaste, shampoo, deodorant, sunscreen, skin care products, fragrance and makeup. Some contain phthalates, parabens, phenols or other chemicals that may affect hormone signaling and cancer risk. Previous research has found that people who use more products tend to have higher levels of some of these chemicals in their bodies.

In this study, girls reported using a median of 14 products in the previous day, twice as many as boys. In addition to near universal reports of using soaps and toothpaste in the past day, 57% reported the use of fragrances, which often use endocrine-disrupting phthalates without reporting them on labels. Overall product use among the students was comparable to levels reported in adult studies.

The students voiced some concern about potential chemical exposure, but few took the necessary steps to minimize it. Nineteen percent regularly read ingredient lists, and 5% regularly used an app or website intended to identify healthier products.

“Teenagers don’t read labels, it turns out,” said Moss-Wang, who was a sophomore at Princeton High School when the project began and is now a sophomore at Wellesley College.

The unusual collaboration began when investigators from the Rutgers Center for Environmental Exposures and Disease approached the Princeton High School research program in 2023. Moss-Wang and Kaputa joined the team, helped design the survey and urged the researchers to explore social media. They also prepared research ethics materials, created a recruitment video and flyers, visited classes and tracked responses. A second recruitment wave reached high school students in Rutgers summer programs.

“Dr. Barrett allowed us to manage the high school population outreach and data collection,” said Kaputa, now a junior at the University of Connecticut. “We identified interesting aspects of social media exposure within our student questionnaires.” Both students used the data for a three-year research project and became coauthors of the scientific paper.

The professional researchers, meanwhile, are now doing follow-up research with focus groups to learn which accounts, messages and influencers shape teenagers’ choices.

Larger studies across more diverse communities could test whether the pattern holds and could pair product inventories with urine samples that measure chemical exposure. Researchers also want to learn whether trusted online voices can steer adolescents toward safer choices.

The study was supported by the National Institute of Environmental Health Sciences through the Rutgers Center for Environmental Exposures and Disease.

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The editorial, “Unanticipated Effects of GLP-1 Receptor Agonists: A Net Positive,” was published in the journal Obesity and highlights additional benefits that were not fully anticipated when the drugs were initially developed.

“Most of the unanticipated side effects of GLP-1 receptor agonists have been positive,” the authors wrote.

The researchers highlight evidence suggesting GLP-1 medications may reduce inflammation and lower the risk of certain cardiovascular and musculoskeletal conditions. Emerging studies also suggest the medications may reduce alcohol consumption and the risk of certain substance use disorders, although additional clinical trials are needed to confirm these effects.

At the same time, questions remain about the medications’ effects on lean body mass and nutritional health. Weight loss associated with GLP-1 medications can include reductions in lean mass, including muscle, making it important to understand how to preserve muscle through exercise and appropriate nutrition. Reduced appetite may also increase the risk of micronutrient deficiencies in some patients.

“GLP-1 receptor agonists have already transformed the practice of medicine in the United States, and this change will continue as more medications come onto the market,” the authors wrote.

The researchers identify three key priorities for future GLP-1 research:

• Understanding the mechanisms behind potential reductions in inflammation,
• Conducting randomized trials to better understand changes in lean body mass and ways to preserve muscle,
• Conducting larger randomized trials to determine whether these medications can reduce alcohol use disorders.

Despite the remaining questions, the authors conclude that the evidence available to date supports a favorable overall risk-benefit profile for GLP-1 receptor agonists and dual agonists.

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However, by reviewing clinical data from thousands of bariatric surgery candidates and applying new obesity definitions, the researchers were able to better understand their underlying health – which could have important implications for patient treatment and surgery prioritisation in the future.

Led by Professor Francesco Rubino, Chair of Metabolic and Bariatric Surgery at King’s College London, the researchers reviewed retrospective clinical data from 2,316 surgical candidates across four specialist centres – King’s College Hospital in the UK, and centres in France, Spain and Brazil.

They applied the new obesity definitions: clinical obesity, where there is clear evidence that excess fat, or adiposity, is causing organ damage, and preclinical obesity, where organ function is preserved despite excess adiposity.

From the surgical candidates, 73.8% had clinical obesity and 26.2% had preclinical obesity. Despite both groups of patients having similar BMI, patients with clinical obesity had far greater surgery-related and cardiovascular risks. They also had an overall high chance of death.

These findings suggest that distinguishing between clinical and preclinical obesity reveals key information about the health status and risks to surgery candidates that BMI alone cannot capture.

“This study shows that the distinction between clinical and pre-clinical obesity is clinically meaningful even among surgical candidates with very high BMI levels, because BMI alone cannot tell us who has active disease,” said Professor Francesco Rubino, senior author and Chair of Metabolic and Bariatric Surgery at King’s College London.

He continued: “It is now essential that future surgical studies and registries systematically report patients’ clinical or pre-clinical obesity status, so that surgical safety, effectiveness and cost-effectiveness can be interpreted in the appropriate clinical context.”

Traditionally, obesity has been classified primarily using BMI, a measure of weight relative to height that provides limited information about whether excess fat is actually affecting a person’s health. BMI levels have historically played a central role in determining eligibility and priority for metabolic bariatric surgery – operations of the stomach that help people lose weight and fix health issues, such as type 2 diabetes.

In 2025, the Lancet Diabetes & Endocrinology Commission on Clinical Obesity proposed a new diagnostic framework. This distinguished between clinical obesity, where there is clear evidence that excess fat, or adiposity, is leading to organ dysfunction, from preclinical obesity, where organ function is preserved but future health risk is increased.

In the latest study, the researchers found that these differences in disease status were not reflected in BMI. In the UK centre, for example, BMI was roughly 47.5 among patients with clinical obesity and 48.5 among those with preclinical obesity. Yet those with clinical obesity were approximately 10 years older and had substantially higher risk of death, cardiovascular risk and operation-related risk.

The researchers argue that for patients with clinical obesity, surgery primarily represents treatment of established disease. On the other hand, for those with preclinical obesity, its key goal may instead be to reduce future health risk. Recognising this distinction could help clinicians plan surgery, as well as select and prioritise surgical candidates.

Read the full study here: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2852615

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“Always finish your antibiotics” is no longer considered medical best practice for all conditions.

Surprised? You’re not alone.

A new study has found that almost 90% of Americans believe that it’s always best to take the full course of antibiotics, even when you feel better—consistent with long-running but now outdated health campaigns. The reality is more complicated. Sometimes shorter courses are safer, and sometimes longer courses are best.

The survey demonstrates a need for better communication between doctors and patients about what’s healthiest.

“Historically, there was very strong guidance by major health organizations and clinicians that you must always finish the course,” says Alistair Thorpe, PhD, research assistant professor of population health sciences at University of Utah Health and first author on the study. “Now, we’re seeing a growing body of evidence saying that that is not always the case. And oftentimes, shorter durations of antibiotics are as effective and safe as longer alternatives.”

The results are published in Open Forum Infectious Diseases.

A complex reality

The research team surveyed 1,475 people across the country on their attitudes about antibiotic course length. They asked participants whether they’d feel more comfortable taking a three- to five-day course of antibiotics if they had pneumonia, as is recommended by current guidelines, or if they’d prefer an antibiotic course of a week or more, which is recommended by outdated guidelines. While shorter courses of antibiotics are as effective and safer for pneumonia than longer ones, about 60% of people said they’d rather take the longer course.

One of the main reasons people gave for preferring longer antibiotic courses was that they had been told to “always finish their antibiotic course”—88% of respondents had heard of, and agreed with, this common mantra. Most had been told this by their clinician, and many had also heard it via a public health campaign.

A strong body of scientific evidence shows that, for many common infections, shorter courses of antibiotics work as well as longer courses and are less likely to cause side effects. Still, there are some cases, like tuberculosis, where longer courses are most effective.

The study authors suggest that doctors and public health campaigns use several evidence-informed strategies to better communicate the complex reality of antibiotic course length—for instance, avoiding overly simplistic claims that either shorter or longer courses are universally better, and acknowledging that as scientific evidence accumulates over time, health recommendations can change.

To patients who have been prescribed antibiotics, Thorpe recommends having an open conversation with your doctor about the appropriate course length and adherence plan to get health advice that’s specific to your situation.

“Discuss with your clinician what the right duration is for you and when the right time is to stop your course,” Thorpe says. “Getting advice directly from a clinician on a one-to-one basis about what is most appropriate for you in that situation is the right way to go.”

Thorpe emphasizes that the changing recommendations are a positive outcome of increasing knowledge.

“Evidence is growing and guidance is evolving on antibiotic use, which is a normal process and a good sign that we are working to improve how we provide care,” he says. “Our knowledge about how best to use antibiotics has changed, but it has changed because we’re learning more, and it’s important that we make sure we are communicating this well to the public.”

This research is published in Open Forum Infectious Diseases as “US Adults’ Perspectives on Antibiotic Durations and Adherence to Therapy for Common Bacterial Respiratory Infections: A National Survey.”

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Researchers at the University of Waterloo and the Global Tobacco Control Program at the U.S. Centers for Disease Control and Prevention (CDC) conducted the study, which is the largest of its kind.

Tobacco use is the leading preventable cause of disease and death worldwide. Up to two-thirds of people who smoke throughout their lives die from a smoking-caused disease, and lose more than a decade of life, on average.

The research team analyzed data from more than 240,000 adult smokers across 46 countries over two decades. While more than 90 per cent knew that smoking causes lung cancer, only about 80 per cent knew it causes heart disease or heart attack and 70 per cent knew it causes stroke. In several high-income countries — including Australia, Germany, England, the U.S., New Zealand, and Canada — fewer than half of adults who smoke knew that second-hand smoke causes heart disease or heart attack. China, a country of 300 million smokers, was among the countries where awareness was lowest.

“Knowledge gaps about the major health effects of smoking and second-hand smoke are deeply concerning,” said Dr. Janet Chung-Hall, Research Scientist for the International Tobacco Control Policy Evaluation Project (ITC Project) at Waterloo and the lead author of the study. “The low awareness of the cardiovascular harms of smoking and second-hand smoke is particularly troubling given that smoking causes more than 2 million cardiovascular deaths worldwide each year. Increasing public awareness of these risks should be a greater public health priority.”

Across two decades, the study found almost no progress in knowledge of the health risks of smoking and second-hand smoke. Although knowledge about the cardiovascular risks of smoking and second-hand smoke increased in some countries, including Bangladesh, India, Thailand and Vietnam, knowledge of those second-hand smoke risks actually decreased in the majority of high-income countries studied, including Canada, the U.S., New Zealand, England, and Japan.

The study also examined knowledge about lung cancer, finding that although about 90 per cent knew that smoking causes lung cancer, fewer knew that secondhand smoke does, with little progress over time.

“Knowledge is an important first step toward quitting smoking and protecting others from second-hand smoke,” said Dr. Geoffrey T. Fong, Principal Investigator of the ITC Project and University Professor of Psychology and Public Health Sciences at Waterloo. “Our findings highlight the need for governments to implement stronger, sustained public education about the cardiovascular as well as cancer risks of smoking and second-hand smoke. Policies such as large pictorial warnings and sustained media campaigns can increase awareness, encouraging quitting among those who smoke and discouraging young people from starting to smoke.”

Those policies are part of the global tobacco control treaty, the WHO Framework Convention on Tobacco Control, to which more than 180 countries are signatories.

The study appears in BMJ Open.

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Researchers at Semmelweis University analyzed data from 566 women with endometriosis and 447 women without the condition. Using internationally validated questionnaires, they assessed work productivity, absenteeism, and work ability. Women with endometriosis lost an average of 12.7 work hours over a four-week period because of health-related problems, compared with 5.7 hours among women in the control group. Based on the hours missed, the researchers estimated an average annual income loss of €1,757 per affected woman.

“The impact of endometriosis is not only a health issue but also a major social and economic one. The condition affects women during one of the most active stages of their lives, meaning it can influence employment, career development, and long-term financial security,” said Dr. Dóra Balogh, Assistant Professor in the Department of Obstetrics and Gynecology at Semmelweis University and senior author of the study.

Endometriosis affects about 10% of women of reproductive age worldwide. In this chronic gynecological condition, tissue similar to the lining of the uterus grows outside the uterus, causing chronic pelvic pain, painful periods, fatigue, and, in some cases, infertility. Symptoms often persist for many years before the condition is diagnosed.

The study found that 42% of women with endometriosis had poor work ability, compared with 17.9% of women in the control group. Poor work ability means that a person’s health makes it harder to perform their job and increases the risk of prolonged work disability or leaving the workforce.

“The most surprising finding was that nearly half of the women with endometriosis fell into this category. Without appropriate support, the condition may not only make day-to-day work more difficult but also threaten women’s ability to remain in the workforce over the long term,” said Dr. Dominika Miklós, a resident physician in the Department of Obstetrics and Gynecology at Semmelweis University and first author of the study.

The researchers also found that many workplaces are not adequately prepared to support employees with endometriosis. Fifty-four percent of respondents said their employer had little or no knowledge of the condition, while only 17% believed their workplace was sufficiently informed about it. Participants said they would most value menstrual leave, flexible work hours, remote or hybrid work options, and greater understanding and support from employers. Some European countries, including Spain and Portugal, already allow menstrual leave under certain circumstances.

Part of a larger research program
The study was conducted as part of the international FEMaLe (Finding Endometriosis with Machine Learning) research program, launched in 2020. At Semmelweis University, the project is led by Dr. Attila Bokor, Associate Professor in the Department of Obstetrics and Gynecology. Its aim is to improve understanding of endometriosis, promote earlier diagnosis, and investigate the health, social, and economic impact of the disease.

This is the first comprehensive study in Central and Eastern Europe to examine the effects of endometriosis on work productivity, work ability, and workplace support simultaneously. Its findings are consistent with studies from Western Europe and Australia, suggesting that the impact of endometriosis on working life is similar across regions. The researchers conclude that flexible work arrangements and better-informed employers could help women with endometriosis remain in the workforce.

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“We found undisclosed harmful chemicals in products claiming to be free of them,” said Jenna Hua, PhD, MPH, senior author of the study and founder of the Million Marker Research Institute. “That means someone can carefully read ingredient lists, choose ‘clean’ products, and still end up exposed to the very chemicals they were trying to avoid. The label can’t protect you when it doesn’t show what’s really in the bottle.”

The researchers tested 113 personal care and cleaning products across 12 categories. On average, each product contained 51 detected chemicals, more than three times the average of 16 ingredients listed on the label. Overall, 98% of products contained at least one unlabeled chemical, and 85% contained at least one unlabeled chemical with known or suspected health hazards. The specific brands and items will be revealed in an upcoming report.

These undisclosed chemicals included endocrine-disrupting compounds such as phthalates and parabens, fragrance chemicals, silicone contaminants, and butylated hydroxytoluene (BHT). Previous research has linked some of these chemicals to infertility, miscarriage, breast cancer, obesity, diabetes, allergies, and other health problems. Others are classified as potential carcinogens, endocrine disruptors, reproductive or developmental toxicants, or skin sensitizers.

Undisclosed harmful chemicals were found across product categories, price points, company sizes, and marketing claims. Products advertised as “natural,” “non-toxic,” or “organic” frequently contained undisclosed chemicals linked to health harm.

More than one-quarter of the products contained chemicals that contradicted claims made on labels or company websites. Researchers found synthetic chemicals in some products marketed as “100% natural,” as well as fragrance, phthalates, parabens, silicones, or oxybenzone in products claiming to be specifically free of those substances. Some products labeled “hypoallergenic” contained known allergens or sensitizers.

The researchers note that this does not necessarily mean manufacturers intentionally added these chemicals. Contaminants can enter products through raw materials, processing equipment, chemical reactions, storage or packaging. Changes in suppliers may also alter a product’s chemical composition without a corresponding change to its label.

The study used nontargeted analysis, an advanced laboratory method that can screen for thousands of chemicals without relying on a predefined list of substances. Researchers detected 3,141 chemical signals and identified 303 compounds with confirmed, probable, or tentative confidence.

Most product safety ratings and certifications programs rely heavily on disclosed ingredient lists. According to the authors, that approach can miss contaminants, impurities, breakdown products, and chemicals introduced during manufacturing or packaging. The researchers recommend making nontargeted analysis of finished, packaged products a standard part of product safety and quality control, alongside existing checks such as stability, microbial, and preservative testing.

The authors also argue that current U.S. oversight remains too dependent on ingredient disclosure and manufacturer reporting. Although the 2022 Modernization of Cosmetics Regulation Act expanded the U.S. Food and Drug Administration’s authority over cosmetics, routine testing of finished products for undisclosed chemical contaminants is still generally not required.

“People shouldn’t need a chemistry lab to know what they’re bringing into their homes or putting on their skin,” Hua said. “The next generation of product safety must look beyond the label and test what is actually there.”

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Clearer public health messaging and a review of government legislation are urgently needed, in light of the findings, say the researchers.

E-scooters have become an increasingly popular form of transport worldwide, because they are cheap, fast, and convenient. And in July 2020, during the COVID-19 pandemic, the UK government launched e-scooter rental trials in England, which are due to complete in 2028, explain the researchers.

Since 2019, e-scooters have been involved in 59 reported deaths in the UK, where riding privately owned e-scooters is illegal unless on private land, and with the owner’s permission, they add.

But unlike rental use, which isn’t legally permitted until at least the age of 16, private use is unregulated, they point out.

While these vehicles are designed for adults, they are often used by children and teens, who are likely to be novice road users and to take more risks, say the researchers, prompting them to try and gauge the numbers and severity of injuries involving e-scooters in this age group.

They focused on emergency care data spanning January 2019 to December 2024 from 3 children’s major trauma centres in the cities of Liverpool, Manchester, and Sheffield. Liverpool and Manchester are part of the government’s e-scooter rental pilot; Sheffield isn’t.

Between 2019 and 2024, the 3 trauma centres dealt with 477 patients with e-scooter injuries, with the overall numbers of cases rising from fewer than 10 in 2019 to nearly 150 in 2024.

The average age of the injured children was 12; half were aged between 10 and 13. And nearly two thirds (64.5%) were boys.

Most (95%) injuries were sustained by the rider, and 80% of all the incidents involved a private e-scooter.

The most common cause was a fall from the e-scooter (75%), but nearly 11.5% were caused by a collision with a vehicle; 5% were pedestrians hit by an e-scooter.

Over half (52%) of the incidents happened on public land: nearly 1 in 4 (22%) occurred on public roads, and nearly 1 in 3 (30%) on public footpaths/parks.

Injuries to the arms and legs were the most common (36%-40%), but around 1 in 4 (24%) were head injuries and nearly 1 in 5 (18.5%) were facial injuries.

Less than 2% of riders were reported to be wearing a helmet at the time of the incident. And 1 in 10  head injuries were sufficiently severe as to warrant imaging, hospital admission, and in some cases, surgery.

Among the most seriously injured, around half (48%) were the result of a collision with a car or stationary object.

Overall, the level of hospital care required was substantial: nearly two thirds of the injured children (64.5%) required some form of imaging (x-rays, computed tomography, or ultrasound scans); 13.5% were admitted; and 7% required surgery.

Three out of four injured children (74%) lived in areas of greatest social and economic disadvantage.

The researchers acknowledge that their study was based on data from only 3 children’s trauma centres, so the findings might not be more widely applicable. But they suggest that because a change in software limited data collection to 2023-4 at the trauma centre in Manchester, the actual numbers of e-scooter injuries may be higher than reported.

“Clearly, reporting these accidents is important to influence and change policy, but there must also be an onus on retailers to clearly advise customers of the law, and policymakers to regulate private e-scooters, such as with speed limiters, or mandate helmet use,” write the researchers.

“As well as legislative changes, schools, local councils, youth groups and road safety campaigns could all have a role in helping to reduce the burden of this emerging public health challenge. Utilising approaches like educational campaigns, such as bicycle safety schemes targeted to e-scooter riders, could be beneficial and have been shown to improve riders’ safety behaviour,” they suggest.

“We urgently need to increase public and clinician awareness, have clearer public health messaging, and a review of government legislation to prevent further injuries and deaths,” they conclude.

The post Nearly 500 kids injured by e-scooters since 2019, 3-centre study in England shows appeared first on Pharmacy Update Online.

In a newly published study, researchers found that high doses of clomiphene citrate – accumulated over multiple fertility treatment cycles – could increase the risk of pregnancy loss.

Supported by the NHMRC and conducted in partnership with Boston University and the Centers for Disease Control and Prevention, the study analysed 21,004 IVF embryo transfer cycles in the United States, finding that women receiving cumulative doses of 500-749 mg clomiphene citrate had a 12% higher risk of miscarriage; while women who received 750-999 mg had a 38% higher risk of miscarriage.

Women receiving cumulative doses of 750 mg or more were also more than twice as likely to have twins or other multiple births.

Spontaneous abortion rates increased as dose increased, but the researchers caution that the greater than tripling of stillbirth at the highest dose was not statistically significant as the dose was rare, and larger studies are needed to confirm the association. The observation is, however, consistent with a previous publication from Adelaide University showing a doubling of neonatal death in pregnancies involving clomiphene citrate.

Importantly for the new study, higher cumulative doses of the drug did not improve the chance of a live birth, but did increase twinning, which increases the risk of adverse outcomes for both mother and child.

Clomiphene citrate is one of the world’s most widely prescribed fertility drugs. It has been prescribed to millions of women worldwide since 1967 and remains a recommended first-line treatment for ovulation induction.

Recognised as an essential medicine by the World Health Organization, clomiphene citrate works by stimulating the ovaries to release eggs, thereby increasing the chance of pregnancy.

Women who do not respond to lower doses, or who require multiple treatment cycles, may receive progressively higher cumulative doses over time.

Lead author Associate Professor Sheree Boulet said the findings demonstrated a clear dose-response relationship.

“Women who received higher cumulative doses of clomiphene citrate experienced progressively greater risks of adverse pregnancy outcomes,” Assoc Prof Boulet said.

“We examined more than 21,000 embryo transfer cycles across four cumulative dose categories and found that increasing the dose did not significantly improve the chance of a live birth.

“Our findings suggest there may be a point where increasing the dose offers little additional benefit while exposing women to greater risk, highlighting the importance of carefully balancing effectiveness with safety when making treatment decisions.”

The findings build on a series of studies from Adelaide University’s Robinson Research Institute that linked clomiphene citrate with increased risks of pregnancy loss, stillbirth, perinatal death and some birth defects.

Experimental studies in mice supported these findings, showing that higher doses reduced successful pregnancies and were associated with pregnancy loss, impaired fetal growth and developmental abnormalities.

Senior researcher and co-author of all studies, Professor Michael Davies, said the study builds on more than two decades of Adelaide-led research examining the safety of fertility treatments.

“Clomiphene citrate has been used by many women since 1967, but it has never been comprehensively evaluated in large prospective clinical trials,” Prof Davies said.

“Our studies indicate that women respond differently to clomiphene citrate and that increasing cumulative doses may increase the risk of adverse pregnancy outcomes without improving the likelihood of a live birth.

“The findings confirm and extend our previous studies in both human and mouse models which highlight the need to better understand the dose-response relationship and whether more personalised dosing strategies could improve safety.

“Until we can better understand these differences, it remains important that clinicians rigorously follow manufacturer’s safety recommendations and avoid unnecessarily increasing cumulative doses.

“The same questions are now being asked of newer ovulation-inducing medications, so any move away from clomiphene citrate should also be guided by robust evidence rather than assumptions about safety.”

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