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Why I Support the Fortification of Flour with Folic Acid

From the end of 2026, the UK government will require the addition of folic acid to non-wholemeal flour. This is an important step forward in public health; an intervention that could prevent up to 200 cases of neural tube defects annually as well as improving the health of pregnant women and their babies.  Why Folic Acid Matters Folic acid is essential for healthy cell growth and development. For pregnant women, folic acid plays a critical role in the early stages of foetal development, particularly in forming the neural tube, which develops into the brain and spinal cord. An insufficient folic acid intake during pregnancy can lead to neural tube defects such as spina bifida and anencephaly—serious conditions that can result in lifelong disability for the child or even loss of life. While women planning to become pregnant are encouraged to take folic acid supplements, about half of pregnancies in the UK are unplanned. This means that many women may not be taking supplements at the cruc
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Bridging the Digital Divide in Healthcare: Understanding the Use of the NHS App

The NHS App, launched in 2019, was designed to revolutionise how patients engage with their healthcare, offering features such as booking appointments, viewing medical records, and ordering prescriptions. While the app has seen substantial uptake—with millions registering and engaging—it appears that the benefits of this digital innovation are not evenly distributed across the population as we report in our article in the Journal of Medical Internet Research . The Promise of the NHS App Digital health tools like the NHS App hold the potential to empower patients, improve self-management of health, and increase access to care. From March 2020 to June 2022, millions of users logged into the app, ordered prescriptions, and accessed medical records. However, a closer look at the data reveals disparities in who is using these features. The Digital Divide in Action Our recent study highlights how sociodemographic factors influence app engagement. Key findings include: Socioeconomic Disparit
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Improving Migrant Healthcare: An Evaluation of of Health Catch-UP!

In today's interconnected world, migration is a key feature of modern societies. The UK has become home to a significant number of migrants seeking new opportunities or fleeing difficult circumstances. Yet, this group often faces unique healthcare challenges, including the risk of undiagnosed infectious and non-communicable diseases and incomplete vaccination records. Addressing these issues is crucial not only for individual well-being but also for broader public health. In a recent article published in the journal BMC Medicine , we evaluated Health Catch-UP!, a digital tool designed to bridge these healthcare gaps. Understanding the Need Migrants when compared to local populations are more vulnerable to certain health conditions that are common in their countries of origin. These range from infectious diseases like hepatitis and latent tuberculosis (TB) to non-communicable conditions like diabetes and high cholesterol. Unfortunately, current healthcare services in the UK often ov
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Understanding the limitations of non-pharmaceutical interventions (NPIs) during the Covid-19 pandemic

The UK and many other countries saw the implementation of numerous non-pharmaceutical interventions (NPIs) during the Covid-19 pandemic. Policy-makers, clinicians and public health specialists need to be more aware of the limitations of observational studies in evaluating non- NPIs. The lack of high-quality randomised controlled trials (RCTs) during the Covid-19 made it difficult to isolate the specific effects of individual NPIs and disentangle them from the complex interplay of different interventions. While observational studies provided rapid insights in an evolving crisis, they also presented challenges due to confounding factors and the concurrent implementation of multiple NPIs. Prioritising adaptive frameworks for real-time RCTs, particularly cluster-randomized trials, in future health crises could strengthen the evidence base and provide more robust insights for policymakers. Although the UK has a good public health data infrastructure compared to many other countries, it can
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Cardiovascular risks in people with long-term conditions

People with many long-term conditions are at increased risk of cardiovascular disease. If you or someone you care about is living with a long-term condition, here are some practical steps people can take to reduce their risk: 1. Attend for Scheduled Check-Ups: Make sure you attend for any scheduled check-ups. For example, to check your blood pressure, weight, blood sugar levels and cholesterol; or to review your medication. 2. Healthy Lifestyle Choices: Focus on a healthy diet, regular physical activity and avoiding smoking; all of which can reduce the risk of cardiovascular disease. For exercise, you should aim for at least 150 minutes of moderate intensity activity a week or 75 minutes of vigorous intensity activity a week. But even small changes – such as a modest increase in the amount of exercise you take each day – can have positive benefits. A diet rich in fruits, vegetables and whole grains and with less intake of processed foods and sugary drinks is also helpful for your hea
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Understanding Vascular Risks in People with Multiple Sclerosis (MS)

Multiple sclerosis (MS) is a complex neurological condition that affects the central nervous system. While much of the focus on MS is often on the symptoms related to the nervous system, recent research has shed light on another important aspect: the increased risk of vascular diseases, such as diabetes and hypertension, in people living with MS (PwMS). Let's take a closer look at what this means and how it impacts overall health based on the findings of a recent paper from my team published in the Multiple Sclerosis Journal . What the Research Shows A large study conducted between 1987 and 2018 looked at the health records of over 12,000 people with MS and compared them with over 70,000 individuals without MS. The findings were significant: Increased Risk of Diabetes : People living with MS have a higher risk of developing type 2 diabetes after being diagnosed with MS. Over 10 years, the incidence rate of diabetes was notably higher in people with MS compared to those without. Wom
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Preparing for Future Health Shocks: Lessons from the COVID-19 Pandemic

The COVID-19 pandemic was a profound global health crisis that exposed vulnerabilities in our public health systems and forced rapid adaptations worldwide. In the absence of effective pharmaceutical solutions at the pandemic's onset, non-pharmaceutical interventions (NPIs) such as physical distancing, mask-wearing, and lockdowns became essential tools to mitigate the spread of SARS-CoV-2. While NPIs were crucial in reducing transmission and preventing healthcare system overload, their implementation came with significant social, economic, and psychological costs. Reflecting on these measures - as we do in our recent article in the British Medical Journal - offers valuable insights into preparing for future health shocks. Evaluating the Effectiveness of Non-Pharmaceutical Interventions NPIs aim to limit person-to-person contact and control the spread of infectious diseases, but they are not without challenges. The simultaneous application of multiple interventions during the pandem
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