Thursday, July 16, 2026

Epidurals not linked to increased harm for newborns or children

Study provides strong evidence that epidural analgesia in labour is safe for newborns, say researchers

DECADES OF USE BEFORE THIS STUDY

BMJ Group

Having an epidural during labour is not associated with clinically significant increased risks of harm to newborn babies, including brain injury, severe breathing problems, sepsis and death, or cerebral palsy later in childhood.

The researchers say these findings “support widening availability and equitable access to epidural analgesia as a safe component of intrapartum care.”

Epidural analgesia in labour provides effective pain relief and may help reduce complications in mothers after giving birth, but evidence of its effect on newborn and child health is limited.

To address this, researchers analysed data for 495,695 births in Scotland over a 13 year period (2007-2019) to examine whether epidural analgesia during labour was associated with serious neurological conditions occurring within 28 days of birth.

Only women who delivered a single baby vaginally or via unplanned caesarean section between 24 and 42 weeks of pregnancy were included in the analysis.

Further measures included other severe newborn illness, sepsis, low Apgar score (a routine test of a baby’s health) five minutes after birth, death within 28 days of birth, and cerebral palsy diagnosed at any point during childhood.

Factors such as mother’s age, ethnicity, weight, existing pre-eclampsia or diabetes, smoking history, birth location and gestational age at birth, were also taken into account.

Of nearly 500,000 women included in the study, around one in four had an epidural during labour. Overall, serious neurological conditions were rare, affecting fewer than 1 in 1,000 babies. These conditions occurred at the expected rate and were no more common among babies whose mothers had an epidural compared with those who did not.

No association was found between epidural analgesia in labour and serious neurological conditions, other severe newborn illness, sepsis, low Apgar score at five minutes, death at 28 days, or cerebral palsy in childhood.

This is an observational study so no firm conclusions can be drawn about cause and effect, and the authors acknowledge that the study was limited to women delivering in Scotland, a predominantly white population, so the findings may not apply to more ethnically diverse populations or other healthcare settings.

However, this was a large study with long term follow-up of newborn and childhood outcomes, and results were consistent after additional analyses across various groups including women considered to have high risk pregnancies and preterm births, supporting the reliability of the findings.

As such, the authors conclude: “These results should reassure parents and clinicians that epidural analgesia use in labour is safe for babies and support informed, evidence based decision making about analgesic options in labour.”

DOI

10.1136/bmj-2026-343320

Method of Research

Observational study

Subject of Research

People

Article Title

Epidural analgesia in labour and neonatal and childhood outcomes: national population based cohort study

Article Publication Date

15-Jul-2026

COI Statement

: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare: support form NHS Greater Glasgow and Clyde, Wellbeing of Women, Chief Scientist Office (Scotland), UK Medical Research Council, and British Heart Foundation; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work. Outside of the submitted work, RK is a board member of the Obstetric Anaesthetists’ Association. RK has declared funding from Wellbeing of Women (for research unrelated to this work in the past 36 months). SMN has participated in advisory boards and received speakers or consultancy fees from Access Fertility, Beckman Coulter, Ferring, Finox, Merck, MSD, Roche Diagnostics, and The Fertility Partnership. SMN has declared funding from the Chief Scientist Office, Wellbeing of Women, and National Institute of Health and Care Research (NIHR), for research unrelated to this work in the past 36 months. All funds for these grants go to and are managed and audited by the University of Glasgow. DAL has declared funding from the NIHR, Diabetes UK, and US National Institute of Research, for research unrelated to this work in the past 36 months. All funds for these grants go to and are managed and audited by the University of Bristol. DAL is a member of the UK Biobank strategic oversight committee, chair of the scientific advisory board for the Bradford Health Research Institute public health “ActEarly” Programme, and chair of the NIHR and BHF (British Heart Foundation) partnership working group on maternal cardiovascular health. She does not receive any payment for these activities. MS, AK, and SS certify they have no affiliations with or involvement in any organisation or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript. The authors declare no other relationships or activities that could appear to have influenced the submitted work.

Adolescent social media restrictions may reduce some harms while shifting others, warn experts

Effects are not simple and need to be considered within social, technological, commercial, and political contexts to avoid unintended harms

BMJ Group

Amrit Kaur Purba and colleagues argue that social media restrictions operate within a wider system of adolescents, families, schools, governments, and commercial actors - and therefore should be treated as complex systems interventions rather than isolated behavioural policies.

Without this broader approach, they warn that “governments risk introducing highly visible policies that are poorly understood and may cause unintended harm while leaving root causes unchanged.”

They outline how lessons from other commercial determinants of health such as the tobacco and alcohol industries can help predict how social media companies may adapt politically, scientifically, technologically, and economically after regulation.

For example, companies may try to redefine what counts as “social media” so that it falls outside new regulations, invest more in related or less regulated spaces, and shape policy through lobbying, public messaging, research funding, and marketing.

Adolescents themselves may also adapt by moving to more private or harder to monitor spaces, such as encrypted messaging apps or AI based chat systems.

The authors also note that restrictions may not affect all young people in the same way, suggesting that those with supportive families, strong digital skills, access to high quality educational resources, and opportunities for safe offline activities may benefit more than those facing isolation, unsafe environments, or limited support.

One young person’s perspective, who is also an author on the paper, seems to support this view. While acknowledging that social media can be both helpful and harmful, they describe it as “a place where friendships are made, where people can find communities, express themselves, learn new things, and sometimes a place to escape difficult situations.”

They add: “I have had friends reach out to me on social media about things they aren’t comfortable talking to family members about, and I have done the same. Without social media, what could we have done?”

The authors suggest using systems mapping to anticipate these effects and design more balanced, evidence informed approaches.

While this approach cannot predict exactly what will happen, it helps show how different parts of a system connect, how these parts may respond to change, and where effects may feedback on one another, they write.

As such, they recommend that evaluations move beyond standalone measures like screen time or short term changes in mental health to capture wider factors such as school engagement, social connections, industry and platform responses, and longer term effects.

And they conclude that taking this broader view need not delay action. Instead, “it will help ensure policies are balanced, flexible, evidence informed, and improve over time.”

Journal

The BMJ

DOI

10.1136/bmj-2026-100084

Method of Research

Commentary/editorial

Subject of Research

People

Article Title

Adolescent social media restrictions: are we missing the bigger picture?

Article Publication Date

15-Jul-2026

COI Statement

All authors have read and understood the BMJ policy on declaration of interests and declare the following interests: AKP is funded by the Wellcome Trust and leads the Digital Determinants of Health Hub at the London School of Hygiene and Tropical Medicine. She has provided unpaid advisory input to the UK government and regulatory bodies, including the Home Office, the Department for Science, Innovation and Technology (DSIT), Ofcom, the Metropolitan Police, and No 10 Downing Street on issuesrelated to online harms, digital regulation, youth violence, and adolescent health. She previously served as deputy director of a DSIT commissioned programme on social media and youth health. She also holds unpaid advisory roles with the Alliance 4 Children and the UK Department for Education’s Technical Advisory Board (Education and Outcomes Panel) and has contributed to advisory activities related to youth digital technology use and public health through WHO and United Nations initiatives. She has received honorariums from academic institutions, government bodies, and public health organisations for invited talks relating to social media, online harms, and adolescent health. None of these organisations had any role in the preparation of this paper. MP is director of the NIHR Public Health Policy Research Unit. SVK served on the academicconsortium for the DSIT commissioned programme on social media and youth health. MM and JM declare no conflicts of interest.

Black and Asian doctors up to 30 times less likely to get training posts in some specialties

Data reveals a pattern that has been 'hiding in plain sight' for years, warns expert Report comes as latest NHS staff survey shows racism remains rife in health service

BMJ Group

Black and Asian doctors in the UK are up to 30 times less likely to be offered medical training posts in some specialties than white candidates, shows data published exclusively by The BMJ today.

The findings - based on 2024 NHS England (NHSE) data via a Freedom of Information request - highlight the ongoing barriers that applicants from ethnic minorities face when applying for jobs in medicine, as highlighted in The BMJ’s racism in medicine issue in 2020.

Across all specialties, Black doctors are four times less likely to be offered a training place than white applicants, official NHSE figures show.

But in some specialties the gap is much wider. The starkest example was core training 1 (CT1) in anaesthetics. Black applicants for CT1 in this speciality stood less than 1 in a 100 chance of being offered a place in 2024 - and were 30 times less likely to be offered a place than white counterparts. Only 10 of 1,158 Black applicants received an offer, compared with 7% of Asian applicants (111 of 1,696) and a third of white doctors (556 of 1,668).

In general practice, all ethnicities stood a similar chance of being shortlisted but Black doctors only got offered a place 20% (1,328 of 6,487) of the time, and Asian doctors 23% (2,378 of 9,221) of the time, compared with 64% (2,162 of 3,076) of white applicants.

Core psychiatry also saw just 5% (171 of 3,133) of Black applicants placed, and 9% (320 of 3521) of Asian candidates compared with 41% (402 of 981) of white applicants.

In obstetrics and gynaecology, white applicants were nearly 11 times more likely to be offered a specialty training (ST1) place than Black candidates, and in acute care common stem (ACCS) emergency medicine 7% (39 of 522) Black applicants were offered a place, versus 48% (316 of 660) white applicants.

While the picture was generally less stark for Asian applicants than Black applicants, they were still five times less likely than their white counterparts to be offered places for ACCS and public health CT1.

Across all specialties, Black or Asian candidates were often shortlisted at a similar rate to white candidates, but were then much less likely to be offered posts, the data show.

Report author Sheila Cunliffe, a senior human resources professional and independent researcher into racism in the NHS, argues that NHSE currently does not appear to be complying with legislation to eliminate discrimination in selection processes on the basis of protected characteristics.

Anton Emmanuel, consultant gastroenterologist, head of Workforce Race Equality Standard (WRES) for Wales – and former WRES director at NHSE, says the data reveals a pattern that has been 'hiding in plain sight' for years — and one that the current WRES process has not been equipped to expose.

The report also suggests that for many non-white applicants, there can be cultural challenges in the recruitment process which may disadvantage them.

Speaking to The BMJ, a Black trauma and orthopaedics consultant, who asked not to be named, described this as “an unwritten curriculum” where some applicants may have had very different life experiences to others and find it harder to build relationships which help them through the process and provide mentoring.

Cunliffe’s report acknowledges the limitations of the available dataset, including that it does not allow adjustment for factors such as whether a doctor is UK-trained or an International Medical Graduate (IMG) their gender, or whether they have disability.

Journal

The BMJ

DOI

10.1136/bmj-2026-100228

Method of Research

News article

Subject of Research

People

Article Title

Exclusive: Black and Asian doctors are up to 30 times less likely to be offered medical training posts in some specialties, data show

Article Publication Date

15-Jul-2026

Black women need more help in accessing breast cancer screening

University of Surrey

Black African and Black Caribbean women in the UK want clearer and more accessible information about breast cancer screening, according to a study from the University of Surrey.

Surrey researchers sought to understand why Black women are less likely to attend breast cancer screening than their white female counterparts. Focus groups and interviews were conducted with 47 Black African and Caribbean women aged between 50–71, the age group routinely invited for NHS breast screening, to learn why only 45 percent of Black women take part in screening compared to 63 percent of white women.

 Lead author of the paper Anietie Aliu, a Postgraduate Researcher at the University of Surrey and a Registered Nurse, said: 

 “Diagnosing breast cancer early can dramatically improve a person’s chance of survival. Breast cancer screening plays an important role in this by identifying the cancer and ensuring a person receives speedy treatment. 

 “Despite the importance of screening, Black women are less likely to attend appointments than white females. This puts them at risk of a potential cancer being diagnosed late and spreading to other areas of the body. We need to understand what is preventing Black women from attending these appointments and help identify ways to remove such barriers.” 

The study found a need to increase awareness of breast cancer screening, especially for women who are less familiar with this service. Some women, particularly those born outside the UK, had limited knowledge of breast screening before receiving their first invitation. Others questioned why screening was needed when they had no symptoms.

The importance of trusted conversations amongst this group was also identified.

Researchers found that some Black women expected their GPs to talk to them about breast screening, particularly before they reached screening age. Although breast screening is organised through national screening services, researchers note that GPs often have established relationships with patients and may be better placed to provide brief, opportunistic advice about preventive care, including breast screening information to women.

To improve knowledge and attendance at screening appointments, participants suggested stronger links between GP practices, breast screening services and Black community champions, so women can receive trusted information, ask questions and feel reassured.

Researchers also found that faith and religious beliefs influenced the decision-making of some of the women. For instance, some Black African Christians maintained that illness, including cancer, was not permitted by God in their bodies, whilst, in contrast, others saw screening as a personal choice that does not conflict with Christian faith.  

Women from the Muslim faith noted the importance of indicating their religion in the medical appointment form to guarantee a female mammographer highlighting that religious beliefs can play a role in a woman’s decision to attend screening. 

Anietie Aliu added:

“Breast screening can save lives, but our findings show that attendance is shaped by multiple factors, not just awareness, although awareness remains important. Women need relatable screening information, reassurance, flexible appointments and services that are accessible within their communities. Many felt that invitation letters were too formal, and that leaflets and media imagery did not reflect them, making it harder to relate to screening.”

Dr Afrodita Marcu, a Senior Research fellow at the University of Surrey and member of the research team added:

“We need a more collaborative approach, where primary care, screening services and community voices work together to support women before, during and after the invitation.”

Researchers note that future interventions for breast cancer screening need to be designed with Black women, rather than for them. They emphasise that user-friendly, culturally relevant resources developed in partnership with communities, healthcare professionals and screening services could help improve understanding, reduce fear and make breast screening feel more accessible and reassuring.

Dr Robert Kerrison, Associate Professor of Cancer Care at the University of Surrey, also part of the research team, said:

“There is no question that breast screening can be lifesaving, but we need to make it easier for women to understand, access and feel reassured by the programme. This means improving communication, addressing practical barriers and making sure healthcare professionals and community partners are supported to provide clear and trusted information.”

Building on these findings, the research team has also explored healthcare professionals’ perspectives and worked with stakeholders to develop user-friendly intervention materials with Black women. Researchers believe this kind of co-designed approach is important because it ensures that breast screening messages are culturally relevant, practical and shaped by the people they are intended to support.

This study was published in the British Journal of Cancer 

Notes to editors

For more information or to request an interview with Anietie Aliu, please contact: mediarelations@surrey.ac.uk

Journal

British Journal of Cancer

DOI

10.1038/s41416-026-03551-6

Article Title

Black women’s decisions about participating in breast cancer screening in the UK: A qualitative study

Weight loss drugs could help with binge eating disorder

University College London

Drugs commonly used for weight loss, known as GLP-1 receptor agonists, have been found to reduce the key symptoms of binge eating disorder, in a new review of evidence led by University College London (UCL) researchers.

The systematic review and meta-analysis, published in eClinicalMedicine, found that weight loss drugs can reduce binge eating episodes, loss-of-control eating and emotional eating, and highlights its potential role to treat binge eating disorder as well as obesity.

Lead author Dr Ilaria Costantini (UCL Psychiatry) said: “Binge eating disorder, where people regularly eat an excessive amount of food while feeling they have lost control, is common and highly impairing, affecting over 17 million people worldwide.

“But treatment options are limited and there are currently no approved medications, so there remains a need for better ways to help people living with this condition. We found evidence that weight loss drugs may help to manage some key symptoms of binge eating disorder.”

In the largest study to date on the subject, the researchers pulled together evidence from 25 randomised controlled trials that took place in 12 countries on four continents, including data from 8,069 participants.

The studies were testing the effects of drugs targeting the appetite-regulating hormone GLP-1 such as semaglutide (often marketed under brand names Ozempic or Wegovy), tirzepatide (also known as Mounjaro) or liraglutide.

These drugs can suppress appetite by targeting the central nervous system and insulin secretion, and they can delay stomach emptying, while also potentially influencing brain processes of reward and impulse control.

The researchers found that the drugs yielded benefits beyond weight loss, including reducing binge eating, loss of control eating and emotional eating.

Participants also reported increased cognitive or dietary restraint (which relates to how much people intentionally limit their eating), but the researchers say more research is needed to understand this link.

The study’s first author, PhD candidate Izzy Emptage (UCL Psychiatry), said: “From the evidence available, we cannot say whether the increase in dietary restraint reflects a positive and helpful form of self-regulation or if it is a more dysfunctional pattern of eating. We hope that future research can clarify whether or not taking weight loss drugs might contribute to more pathological forms of eating restriction such as meal skipping.”

The researchers say their findings demonstrate that weight loss drugs could be an important part of treatment plans for people with binge eating disorder, alongside psychological therapies and social support.

Izzy Emptage added: “Many people with binge eating disorder cannot access weight loss drugs through their public healthcare providers, so many have to seek treatment privately at considerable personal cost.

“We hope that by highlighting the potential of weight loss drugs to help with binge eating symptoms, our findings will lead to further funding of larger high-quality studies in this area, to better understand how this medication could be used in practice and improve treatment options.”

Dr Costantini said: “One strength of our study is the involvement of a lived experience panel, who shared important insights into their views and concerns about the use of these medications for binge eating, as well as the challenges many people face in accessing treatment for binge eating disorder. Importantly, they emphasised that sustainable recovery is likely to depend not only on medication but also on psychological therapies and social support, as well as policy or community-level approaches to tackle societal norms and weight bias.”

The researchers note limitations of their study, as most of the trials included in the review had a high risk of bias and were funded by pharmaceutical companies, and they rarely included participants with a clinical diagnosis of binge eating disorder, which the researchers say limits the certainty of the findings.

They say that robust, independently-funded randomised controlled trials with long follow-up times that include people diagnosed with binge eating disorders are still needed to clarify the potential clinical role of these drugs to help treat binge eating disorder, and to determine whether the observed short-term benefits translate into meaningful and sustained improvements.

The study involved researchers in the UCL Faculties of Brain Sciences, Population Health Sciences and Medical Sciences alongside colleagues in the Universities of Exeter, Oxford, North Carolina and Karolinska Institute, and was supported by Wellcome, the Medical Research Foundation and the National Institute for Health Research (NIHR).

Journal

EClinicalMedicine

DOI

10.1016/j.eclinm.2026.104007

Method of Research

Meta-analysis

Subject of Research

People

Article Title

The effectiveness of glucagon-like peptide-1 receptor agonists (GLP-1RAs) on binge eating in patients with obesity: a systematic review and meta-analysis

Article Publication Date

15-Jul-2026

KAIST develops robot that judges its surroundings and walks, runs, and jumps like an animal

Professor Hae-Won Park's team in the Department of Mechanical Engineering generated 15.5 hours of gait training data in just eight minutes using computer simulations, implementing walking, running, jumping, and other locomotion skills

The Korea Advanced Institute of Science and Technology (KAIST)

KAIST Develops Robot That Judges Its Surroundings and Walks, Runs, and Jumps Like an Animal — image:
Figure 1. KAIST HOUND demonstrates its ability to overcome various obstacles using the newly developed control technology.
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Credit: KAIST

An era in which robots decide "how to walk" on their own has arrived. A four-legged robot has been developed that, much like a person or an animal, autonomously chooses the appropriate gait strategy for its surroundings — changing its gait on stairs, leaping over gaps, and keeping its balance on forest trails.

KAIST (President Choongsik Bae) announced on the 16th of July that a research team led by Professor Hae-Won Park from the Department of Mechanical Engineering has developed a core control technology for four-legged robots that lets a single controller select and switch in real time among walking, running, jumping, and other locomotion skills, allowing the robot to move quickly and stably, even in real outdoor environments.

Four-legged robots move on four legs, giving them an advantage over wheeled robots on rough terrain. But in real outdoor settings, obstacles such as stairs, ledges, stepping stones, gaps, and tree branches appear one after another in different forms, meaning the ability to simply walk and run fast is not enough.

Existing four-legged robots have excelled at running quickly across flat ground or clearing simple obstacles, but they have struggled to maintain both speed and stability in real-world environments where obstacles combine in complex ways. Because walking, running, jumping, and other gaits had to be controlled individually, the robots were also limited in how naturally they could switch between them as conditions changed.

To overcome these limitations, the research team developed a new learning-based control technology called APT-RL (Action Pretrained Transformer-based Reinforcement Learning).

APT-RL is a control technology designed to enable a robot to first learn a range of locomotion skills — such as walking, running, and jumping — and then freely combine and transition among them in real-world environments as the situation demands.

Rather than filming the movements of real people or animals, the team generated 15.5 hours of training data covering a variety of gaits using computer simulations alone, in just eight minutes. That data was used to teach the robot basic movement capabilities, drawing on robot dynamics (a mathematical model of how a robot moves) and trajectory optimization (a technique for calculating the efficient path of movement). The approach is far faster and more efficient than earlier methods that relied on motion capture, a technology that records human or animal movement using sensors.

The team then applied reinforcement learning — an artificial intelligence technique in which an agent learns optimal behavior through repeated trial and error — so the robot could autonomously select and switch gaits suited to complex three-dimensional terrain such as stairs, ledges, and gaps. Finally, the team combined a depth camera (which measures the distance to objects in order to obtain three-dimensional information) with LiDAR (Laser Detection and Ranging, a sensor that uses lasers to measure the distance and shape of the surrounding environment in three dimensions), enabling the robot to recognize its surroundings and target speed in real time and choose the most appropriate walking strategy.

The team tested the control technology on its own four-legged robot, 'KAIST HOUND.' The experiments were conducted not only on an indoor obstacle course but also in real outdoor environments, including KAIST’s campus and forest trails.

KAIST HOUND moved stably across urban terrain that included stairs, grass, and slopes, as well as irregular natural terrain such as fallen trees, exposed roots, and paths covered in fallen leaves, switching gaits in real time to match the conditions. In rugged terrain with obstacles, the robot reached a peak instantaneous speed of six meters per second (about 22 kilometers per hour), demonstrating that it can achieve both fast movement and stability in real outdoor environments.

The experiments showed that KAIST HOUND autonomously selected and switched between a trot (alternating diagonal legs) and a bound (a leaping gait using the front and back leg pairs together) depending on the terrain and target speed, and that it could integrate walking, running, jumping, and ledge-clearing into a single controller.

Professor Hae-Won Park said "We expect this to become a foundational technology that expands the potential uses of physical-AI-based walking robots in rugged environments such as disaster sites, defense missions, and industrial facility inspections."

Jun-Gill Kang (affiliated with the Agency for Defense Development (ADD) at the time of the research) and Jaehyun Park, a Ph.D. candidate in KAIST's Department of Mechanical Engineering, are co-first authors of the study. Professor Hae-Won Park and Professor Seungwoo Hong from Korea University are co-corresponding authors. The research was selected as the cover paper for the July issue of Science Robotics, the world's leading academic journal in robotics, and was published on July 15 (U.S. Eastern time).

※ Paper title: "Agile perceptive multi-skill locomotion for quadrupedal robots in the wild“

※ DOI: 10.1126/scirobotics.adz7397

※ Authors: Jun-Gill Kang (the Agency for Defense Development at the time of the research, co-first author), Jaehyun Park (KAIST, co-first author), Hae-Won Park (KAIST, corresponding author), Seungwoo Hong (Korea University, corresponding author)

This research was supported by funding from the Ministry of Trade, Industry and Resources (MOTIR) and the Korea Planning & Evaluation of Industrial Technology (KEIT) (RS-2024-00427719), as well as by the Agency for Defense Development's Future Challenge Defense Technology R&D program (912768601).

Journal

Science Robotics

DOI

10.1126/scirobotics.adz7397

Method of Research

Experimental study

Article Title

Agile perceptive multi-skill locomotion for quadrupedal robots in the wild

Article Publication Date

15-Jul-2026

Figure 2. Overview of the developed control technology

People. The research team. From left: Ph.D. candidate Jaehyun Park (KAIST, co-first author); Professor Hae-Won Park (KAIST, corresponding author); Professor Seungwoo Hong (Korea University, corresponding author); Researcher Jun-Gill Kang (Agency for Defense Development at the time of the research, co-first author).

Credit

KAIST