What parents need to know about Tylenol, autism and the difference between finding a link and finding a cause in scientific research

Source: The Conversation – USA (3) – By Mark Louie Ramos, Assistant Research Professor of Health Policy and Administration, Penn State

In cases where associations are found, researchers must consider dosage response, differences between siblings and other factors to determine a cause-and-effect relationship. Ronaldo Schemidt/AFP via Getty Images

Claims from the Trump White House about links between use of the painkiller acetaminophen – often sold under the brand name Tylenol in the U.S. – during pregnancy and development of autism have set off a deluge of responses across the medical, scientific and public health communities.

As a father of a child with level 2 autism – meaning autism that requires substantial support – and a statistician who works with such tools as those used in the association studies cited by the White House, I find it useful to think about the nuances of association versus causation in observational studies. I hope that this explanation is helpful to parents and expecting parents who, like me, are deeply invested in the well-being of their children.

a bunch of white pills are shown with the words tylenol 500 on them in red
The painkiller acetominophen is often sold under the brand name Tylenol in the U.S.
AP Photo/Jae C. Hong

Association is not causation, but …

Most people have heard this before, but it bears repeating: Association does not imply causation.

An often-cited example is that there is a very strong association between ice cream sales and incidents of shark attacks. Of course, it goes without saying that shark attacks aren’t caused by ice cream sales. Rather, in the summertime, hot weather drives more appetite for ice cream and beach time. The increased number of people at the beach does, in turn, cause the likelihood of shark attacks to increase.

Yet pointing this out on its own is neither intellectually satisfying nor emotionally appeasing when it comes to real-life medical concerns, since an association does suggest potential for a causal relationship.

In other words, some associations do end up being convincingly causal. In fact, some of the most consequential discoveries of the past century in public health, like the links between smoking and lung cancer or the human papillomavirus (HPV) and cervical cancer, started out as findings of very strong association.

So when it comes to the issue of prenatal acetaminophen use and autism development, it is important to consider how strong the association found is, as well as the extent to which such an association could be considered causal.

Establishing causal association

So how do scientists determine if an observed association is actually causal?

The gold standard for doing so is conducting what are called randomized, controlled experiments. In these studies, participants are randomly assigned to receive treatment or not, and the environment where they are observed is controlled so that the only external element that differs among participants is whether they received treatment or not.

In doing this, researchers reasonably ensure that any difference in the outcomes of the participants can be directly attributed as being caused by whether they received the treatment. That is, any association between treatment and outcome can be considered causal.

Yet oftentimes, conducting such an experiment is impossible, unethical or both. For instance, it would be highly difficult to gather a cohort of pregnant women for an experiment and extremely unethical to randomly assign half of them to take acetaminophen, or any other medication for no particular reason, and the other half not to.

So when experiments are simply infeasible, an alternative is to make some reasonable assumptions on how observational data would behave if the association was causal and then see if the data aligns with these causal assumptions. This can very broadly be referred to as observational causal inference.

Parsing what the studies mean

So how does this apply to the current controversy over the potential for acetaminophen use during pregnancy to affect the fetus in a way that could result in a condition like autism?

Researchers who try to understand causal roles and links between one variable and potential health outcomes do so by considering: 1) the size and consistency of the association across multiple attempts to estimate it, and 2) the extent to which such association has been established under observational causal inference frameworks.

As early as 1987, researchers have been working to measure possible associations between acetaminophen use during pregnancy and autism. A number of these studies, including multiple large systematic reviews, have found evidence of such associations.

For instance, a 2025 review of 46 studies that examined association between acetaminophen use and an array of neurodevelopmental disorders, including autism, identified papers with five positive associations between acetaminophen and autism.

In one of those studies, which examined 73,881 births, the researchers found that children who were exposed to acetaminophen prenatally were 20% more likely to develop borderline or clinical autism spectrum conditions. Another examined 2.48 million births and reported an estimated association of only 5%.

Both of those are weak associations. For context, estimations of increased lung cancer risk from smoking in the 1950s were between 900% to 1,900%. That is, a smoker is 10 to 20 times more likely than a nonsmoker to develop lung cancer. By comparison, in the two autism studies above, a pregnant woman who takes acetaminophen is 1.05 to 1.20 times more likely than one who does not take the drug to have a child who would be later diagnosed with autism.

It’s also important to keep in mind that many factors can affect how well a study is able to estimate an association. In general, larger sample sizes provide both greater power to detect an association if one does exist, as well as improved precision over estimating the value of the association. This does not mean that studies with smaller sample sizes are not valid, only that from a statistical perspective, researchers like me place greater confidence in an association drawn from a larger sample size.

Once an association – even a small one – is established, researchers then must consider the extent to which causation can be claimed. One way to do this is through what’s called dose-response. This means looking at whether the association is higher among women who took higher doses of acetaminophen during pregnancy.

The study mentioned above that looked at 2.48 million births shows an example of dose-response. It found that pregnant women who reported taking higher doses have higher autism risk.

Another way to examine possible causality in this context is to analyze sibling outcomes, which that same paper did. Researchers looked at whether associations between acetaminophen and autism persisted within families with more than one child.

For example, in a family with two children, if the mother used acetaminophen during one pregnancy and that child was later diagnosed with autism, but she did not use it during the other pregnancy and that child was not diagnosed, then this strengthens the causal claim. Conversely, if acetaminophen was used during the pregnancy of the child who was not diagnosed with autism and not used during the pregnancy of the child who was, then that weakens the causal claim. When this was included in the analysis, the dose-response disappeared, and in fact the overall 5% increased risk mentioned before likewise disappeared. This weakens the claim of a causal relationship.

Consult your doctor

At present, there is clearly not enough evidence to establish a causal association between prenatal acetaminophen use and autism.

Yet as a parent who wonders if my daughter will ever be able to write her name, or hold a job or raise kids of her own, I understand that such explanations may not appease the fears or concerns of an expecting mother who is suffering from a fever.

Naturally, all of us want absolute certainty.

But that’s not possible when it comes to acetaminophen use, at least not at this time.

Your doctor will be able to provide you with much sounder advice than any existing study on this topic. Your OB-GYNs are very likely aware of these studies and have much better judgment as to how these results should be considered in the context of your personal medical history and needs.

Researchers, meanwhile, will continue to dig deeper into the science of this critically important issue and, hopefully, provide greater clarity in the years to come.

The Conversation

Mark Louie Ramos does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

ref. What parents need to know about Tylenol, autism and the difference between finding a link and finding a cause in scientific research – https://theconversation.com/what-parents-need-to-know-about-tylenol-autism-and-the-difference-between-finding-a-link-and-finding-a-cause-in-scientific-research-265946

Who are the worst fathers in literature?

Source: The Conversation – Global Perspectives – By Suzy Freeman-Greene, Books + Ideas Editor, The Conversation

Penguin Books, Goodreads, Harper Collins, Text Publishing

Literature has long portrayed messed-up families. As poet Philip Larkin famously wrote, “They fuck you up, your mum and dad. / They may not mean to, but they do.”

In honour of this rich vein of dysfunction, we asked experts to nominate the worst literary fathers and mothers. Today we delve into dads. Tomorrow, we turn to mothers.

Of course, complex characters – neither wholly good nor bad – are the best sort. Author Andrew O’Hagan has spoken eloquently about striving to humanise even his most unpleasant creations, to fully amplify a novel.

Still, some characters are awfully hard to like. My least favourite dad might be Shug Bain, a cruel, violent man who abandons his wife and kids in Douglas Stuart’s Booker Prize-winning novel. Shug is appalled by his son Shuggie’s feminine mannerisms. “Look how twisted you’ve made him,” he tells his wife.

Here are our experts’ picks.

James Mortmain, I Capture the Castle – Dodie Smith


Penguin Books

Perhaps the worst parent is not an obvious “monster”, but one you can all too easily imagine as your own. In Dodie Smith’s I Capture The Castle, James Mortmain, a once-successful writer in the grip of decade-long writer’s block, threatens his first wife with a cake knife and assaults a neighbour. His younger daughter, Cassandra, softens Mortmain’s awfulness with disarming humour. In court, she writes, everyone was being very funny, but “Father made the mistake of being funnier than the judge … he was sent to prison for three months.” The self-focused Mortmain condemns his family to penury in a crumbling castle, where he reads detective novels in the gatehouse and Cassandra captures their plight in her journal.

– Carol Lefevre


Heathcliff, Wuthering Heights – Emily Bronte


Penguin books

For me, Heathcliff even beats bad-dads King Lear and Agamemnon. Most readers won’t remember that Heathcliff is a dad at all, which is part of what makes him so bad. The sadistic, dysfunctional passion between Heathcliff and Catherine dominates Brontë’s novel, leaving young Linton, the kid Heathcliff has with another woman, Isabella, neglected, abused and dominated by his terrifying father.

Heathcliff doesn’t even meet his son until he’s 13, after Isabella dies. Linton is then forced to live in tormented isolation and tortured into marrying his first cousin, Cathy. All this so Heathcliff can take revenge on Cathy’s father Edgar, who married his beloved Catherine Earnshaw.

– Sophie Gee


Zeus, the Iliad


Penguin Books

Zeus wakes up in book 15 of the Iliad, having been lulled to sleep by Hera with sex and potions. Poor Zeus – with his sneaky wife, bickering, divine siblings and children, all trying to manipulate the war at Troy – and he is only trying to keep the Olympian show on the road. Seriously? Who started the family games? And, if he had canned the swan costume and not raped Leda (or the dozens of other nymphs he “manifested himself” to), no Helen, no war, no problems.

He really is the paterfamilias of toxic patriarchy.

– Robert Phiddian


Reunion – John Cheever

The last time you see your father, I hope he is not drunk on Beefeater Gibsons. I hope he doesn’t clap at the wait staff or demand they speak languages they do not know. I hope he doesn’t get you removed from four restaurants in a single afternoon. Walking away as he curses at a newsstand clerk, I hope you don’t mourn his flaws as “your future and your doom”. But, were this all to occur, I hope it’s happening inside a John Cheever story, where the comic and tragic mix like flesh and blood, or gin and vermouth.

– Alex Cothren


Kev, Last Ride – Denise Young


Harper Collins

I’m not in favour of binaries of any kind, so I’m not comfortable with “best” vs “worst”. Rather, I contribute a father figure from Australian literature who may be both/and best/worst. I’m thinking of Kev, the father in Denise Young’s astonishingly moving novel, Last Ride, who takes his ten-year old son, Chook, with him on the run from the law across outback NSW after committing a brutal murder. Kev is among the worst, because: who would drag a kid into that? But Kev is simultaneously among the best, because his love for Chook, and his deep-seated impulse to protect him from another man’s abuse, is as genuine and moving as the paternal instinct gets. Kev wields fatherhood as double-edged sword. I feel for him.

– Julienne van Loon


Albion Gidley Singer, Dark Places – Kate Grenville


Text Publishing

The worst father in literature is an easy one for me, though it has been decades since I have read his story. I first encountered the incestuous father Albion Gidley Singer in Kate Grenville’s novel Lilian’s Story, in which he is a somewhat shadowy but menacing figure. But it’s in Dark Places that Albion’s evil is brought fully to bear. I can’t remember the details of the book, but I can remember all too well the feeling of suffocation that came from being too close to Albion, to his thoughts and his feelings. A tremendous book I never want to read again.

– Natalie Kon-yu


Sam Pollit, The Man Who Loved Children – Christina Stead


Goodreads

In Christina Stead’s exhilarating and suffocating semi-autobiographical The Man Who Loved Children, the naturalist and patriarch Sam Pollit is nicknamed by his wife Henny “the Great Mouthpiece” for his endless maxims and sickening Pollit-“fambly” patois. He claims to love his many children but mocks, cajoles, and insults them; even has them spy on each other. Family life is so bad that the novel’s heroine, the adolescent Louisa, believes her only hope of escape from the squalor and tyranny is through murder.

– Jane Messer


My pick is a towering figure in Australian fiction: Sam Pollit of Christina Stead’s 1940 masterpiece The Man Who Loved Children. Sam’s oppressive sunniness, his maniacal refusal to look reality in the face, and his demand that his family play along with his ego-fantasy force them to absorb cruelty, mockery and contempt, all the while descending into more and more perilous poverty at his hands. He is a modern day narcissist par excellence, but also a grotesquerie or travesty of optimism as a virtue in the world. In Sam, “positivity” is transformed into dangerous and delusional thinking that steamrolls everything before it and leaves destruction in its wake.

– Edwina Preston


Allie Fox, The Mosquito Coast – Paul Theroux

Charismatic, brilliant and narcissistic, Allie Fox drags his family off to live in an isolated part of Honduras’ Mosquito Coast to escape what he has persuaded himself is the impending end of the world. Like any colonist, he takes over a village and attempts to introduce Western technology and ideas. It all ends in catastrophe of course, and his wife and children barely escape with their lives. Allie is the exemplar of the charming destroyer and is at the top of my “bad dad” list.

– Jen Webb


Captain Ahab, Moby-Dick – Herman Melville


Penguin Books

Herman Melville, a great American author, was a lamentable father and an erratic provider for his family, who drove his son Malcolm to shoot himself in his bedroom in his parents’ house in 1867 after a row about the 18-year-old’s late hours. Melville’s fictional character Captain Ahab in Moby-Dick behaves even more reprehensibly, abandoning his own wife and son to focus obsessively on a doomed quest for a white whale that ultimately leads his whole crew to destruction. Ahab takes his name from the worst king of Israel in the Old Testament, and the author of this epic novel trains his gaze not just on one bad father, but the whole nature of patriarchy.

– Paul Giles


Victor Frankenstein, Frankenstein – Mary Shelley


Penguin books

The worst father in fiction has to be one of the first fathers in the horror genre, the eponymous figure in Mary Shelley’s Frankenstein (1818). Victor, of course, does not beget the monstrous creature via the conventional method of procreating with a female, and he fashions his infamous progeny out of corpses, but he is very much a horrible dad when he denies his ghastly son his love. The Swiss medical genius is the true Gothic monster here, not the hapless and unsightly creature who just wants to be loved.

– Ali Alizadeh


My dear Victor,

I should address you Father, but how can I? I do not have your own creator’s Miltonic power to throw moral injunction at you, as Satan did to God: “Did I request thee … from darkness to promote me?” Was there ever a son whose “being” (your own word) is not named but de-named as monster, dreaded spectre, fiend, vile insect, abhorred devil? I have entered literature as a hideous progeny, as an abortion and an anomaly. You never gave me love but do not forget, Father, that my form is “a filthy type of yours, more horrid from its very resemblance”.

Your son.

– Vijay Mishra


The novel’s horror is set in motion not just by Victor’s transgressive hubris as a scientist, but also by his refusal to accept responsibility. Victor abandons his “monster” at almost the moment after its birth, and repeatedly rejects its appeals for compassion and empathy. Victor’s attempts to disavow his legacy are ultimately futile, as his creation relentlessly pursues his “father” to the end of his days.

– Julian Novitz


Thomas Sutpen, William Faulkner – Absalom, Absalom!


Goodreads

“They feared him and they hated him because of his ruthlessness.” Thomas Sutpen is truly one of William Faulkner’s most terrifying creations: a man who arrives in Mississippi with nothing and wills a dynasty into being. Everything – his marriage, his children, his land – is subsumed by his amoral “design,” which he pursues at any cost and with no concern for those who get in his way.

When a hidden fact about his first marriage comes to light, he casts aside his wife and child, setting in motion a cycle of vengeance that consumes the Sutpen line. In Faulkner’s hands, this ghastly patriarch ultimately becomes a figure for the antebellum South itself – built on inhumanity, colonialism and slavery, unwilling to reckon with the horrors of the reality it has brought into being.

– Alexander Howard

Do you have a nomination for the worst father – or mother – in literature? If so, let us know by scrolling to the end of this article and adding your choice in the comments.

The Conversation

ref. Who are the worst fathers in literature? – https://theconversation.com/who-are-the-worst-fathers-in-literature-263815

Who are the worst mothers in literature?

Source: The Conversation – Global Perspectives – By Suzy Freeman-Greene, Books + Ideas Editor, The Conversation

Goodreads, Penguin Books

The first sentence of Anna Karenina is now a literary cliche, yet contains a nub of truth. “All happy families,” writes Leo Tolstoy, “resemble one another, each unhappy family is unhappy in its own way.”

Literature brims with thwarted parents wreaking havoc in unique ways. We’ve considered the worst fathers. Now we look at troubling mothers.

A recent contender here is Arundhati Roy’s depiction of her tyrannical, infuriating yet seductive mother Mary in her new memoir.

But my choice for worst mother is a fictional character, also a Mary. In US author Sapphire’s arresting 1996 novel, Push, Mary is a violent, jealous woman who follows her husband in sexually abusing their teenage daughter, “Precious”. Amid poverty and deprivation, Mary challenges every maternal stereotype.

Here are our experts’ picks.


Stuff – Joy Williams

Your adult son has just informed you he has terminal lung cancer. Do you:

A) Say, “Oh, well.”

B) Demand he speak quietly so as not to disturb your roommate, Debbie, who is playing dystopian video games.

C) Disagree with the assessment that Gnosticism is a flawed religion incapable of forming any kind of true moral community.

D) Drink a stinger the bright green of antifreeze.

E) Kick him out because your radical silence class is about to begin.

F) Do all of the above: You are a mother in the hilarious void of Joy Williams’ story Stuff.

– Alex Cothren


Medea – Euripides


Goodreads

A princess of Colchis, she betrayed her own people to help Jason, leader of the Argonauts, capture the Golden Fleece, and then ran off with him and started a family. She kept her sorcery under wraps until Jason dumped her in favour of a princess of Corinth. This betrayal sparked a massive overreaction on Medea’s part. Not only did she murder the new bride, and the bride’s father. She slaughtered her own children and then, with the help of her divine granddad (the sun god Helios), skipped off to Athens to start a new life.

– Jen Webb


Daisy Buchanan, The Great Gatsby – F. Scott Fitzgerald


Penguin books

Classic literature is lavishly adorned with bad mums. I’m going with a sleeper hit — Daisy Buchanan in The Great Gatsby, aka the love of Jay Gatsby’s life. Daisy studiously neglects her daughter Pammy, a child of about two, throughout the novel. She says she hopes Pammy will grow up to be a “beautiful little fool”, and so, frankly, do the readers, just so poor Pam won’t ever know her mother cheated on her father with a guy who ends up murdered in his own swimming pool, after being mistaken for Pammy’s own father Tom. And here’s hoping Pammy won’t know her mom Daisy killed her dad Tom’s lover Mabel in a hit-and-run accident, while drunk driving someone else’s car.

– Sophie Gee


May Callaghan, I for Isobel – Amy Witting


Goodreads

The mother in Amy Witting’s I for Isobel simmers with a rage that shapes the whole Callaghan family. But it is the bright, bookish younger daughter, Isobel, who attracts most of May Callaghan’s venom. Isobel feels her mother’s anger as “a live animal tormenting her”. May denies nine-year-old Isobel a birthday celebration; she labels her “a born liar”. Isobel wrests back power by learning to withhold her desire to scream: “She wants me to scream. I do something for her when I scream.”

At her mother’s death, Isobel feels only relief.

– Carol Lefevre


The Piano Teacher – Elfriede Jelinek


Goodreads

Erika Kohut’s Mother intrudes on every aspect of her adult daughter’s life – her movements, her body, her finances. The claustrophobic Viennese apartment they share is a site of domestic interrogation and terror, with Mother looming over Erika like a one-woman tribunal: part inquisitor and part executioner. This is domination, not maternal care, isolating Erika and driving her toward secrecy and spirals of self-harm.

In characteristically relentless and sardonic prose, Jelinek presents this relationship as a miniature of Austria’s refusal to confront its troubling political past. This is a household where desire is policed and traumatic history repressed until it sporadically erupts into terrible violence, shattering the illusions of bourgeois respectability and revealing how repression, left unchecked, becomes cannibalistic.

– Alexander Howard


The Watch Tower – Elizabeth Harrower


Goodreads

Selecting a worst mother from literature has been hard – I know they’re out there, but my brain refuses to decide on one, perhaps subconsciously rejecting the notion. I have settled on a bit-character in a novel with a truly grotesque patriarchal figure at its centre: Elizabeth Harrower’s 1966 novel The Watchtower.

The unnamed mother in this novel abandons her daughters with not a thought for their wellbeing, leaving them in the hands, and financial trap, of the cruel and contemptuous Felix Shaw. I know the world criticises mothers much more harshly than fathers for abandoning their children – in literature as in life – but this abandonment struck a chord in me that I cannot intellectualise. How easily Clare and Laura’s mother wipes her hands of them and how vulnerable they are in the world as a result.

– Edwina Preston


Serena Joy, The Handmaid’s Tale – Margaret Atwood

My pick for worst mother is controversial. Throughout both Margaret Atwood’s The Handmaid’s Tale and its sequel The Testaments we don’t get to see Serena Joy Waterford mothering, which, I think, is a mercy. But I’ve chosen Serena, the wife of a Commander in the republic of Gilead, because she is instrumental in destroying the very notion of what it is to be a mother, which is that of deep and compassionate care. Serena sees children as a right and a prize for religious piety – at the expense of the child and all who care for them. As Sheila Heti has written, “The whole world needs to be mothered.”

Just not by Serena.

– Natalie Kon-yu


Nina, Heartsease – Kate Kruimink


Goodreads

In Tasmanian writer Kate Kruimink’s exquisite novel Heartsease, the twentysomething Ellen (Nelly) is a daughter both made by her mother Nina and trying to remake herself against her. Nelly remembers every childhood slight and hurt, especially the many ways she disappointed her mother as an example of young womanhood: dishevelled, shy, awkward and unlike the elegant, socialite Nina in most ways. Nelly can’t show her mother or ask her questions about incidents from the past, can’t ask why it is she’s never met her maternal grandmother. For Nina died when Nelly was a teenager, and a dead mother really is the worst.

– Jane Messer


Helen, Oh Joseph, I’m so tired – Richard Yates

Richard Yates frequently drew on his personal history in his fiction, and so it’s unsurprising that he repeatedly returns to his turbulent relationship with his own mother, the erratic Ruth “Dookie” Maurer. Dookie appears in various forms in many of Yates’s novels and stories, but is perhaps best realised as the frustrated sculptor Helen in Oh Joseph, I’m so tired from Yates’ collection Liars in Love. The story is unsparing in its depiction of her awful self-centredness and bigotry, but also captures her fragility and desperate need to maintain her delusions of imminent success. Helen’s self-deception is depicted as heart-breaking and absurd, but it also briefly transforms the grim lives of her children into something more privileged and magical.

– Julian Novitz


Maggie, Bodies of Light – Jennifer Down


Goodreads

I can’t entertain a “worst” case scenario for any literary mother because the trope of the monstrous mother is alive and well and continues to cause damage. Rather, I draw attention to the complex, deeply flawed character of Maggie in Jennifer Down’s 2022 Miles Franklin winner, Bodies of Light. The survivor of a childhood marked by drug addiction, grief and abuse, Maggie’s humble attempt at conventional marriage and motherhood fails miserably when three of her babies die in her care. Sound familiar? Down’s achievement here is to show us how the idea of monstrous mothers endures in our culture. The cost is real.

– Julienne van Loon


Mrs Bannerman, The Last House on Needless Street – Catriona Ward


Goodreads

There is no shortage of horrible parents in fiction, but few have horrified me more than Ted’s mother, Mrs Bannerman, in Catriona Ward’s acclaimed The Last House on Needless Street. Her evil is conveyed to the reader via flashbacks that may or may not lead us to conclude that an adult Ted may or may not also be evil. In a suspenseful novel full of ambiguity and uncertainty, there’s nothing vague or uncertain about the abuse that the young mother subjects her son to and the pleasure that she derives from hurting him. Not one for the squeamish.

– Ali Alizadeh


Muriel Cleese, So, anyway … John Cleese


Goodreads

Most accounts of a “bad mother” are complicated by the familiar ambivalence of love-hate relationships. This isn’t the case in John Cleese’s autobiography So, Anyway …. Here the author castigates his mother as “self-obsessed and anxious”, associating this with “her extraordinary lack of general knowledge”, and accusing her of being a person who “had no information about anything that was not going to affect her life directly in the immediate future”. This led to “a constant state of high anxiety” and a desperation to have everything “her own way”. The coruscating nature of Cleese’s unmitigated bile is oddly refreshing.

– Paul Giles


Mrs Skewton, Dombey and Son – Charles Dickens


Penguin books

Dickens’ mothers generally fail by dying romantically or miserably before the action of the novel begins. So it is with the first Mrs Dombey in Dombey and Son. The second Mrs Dombey’s mother, however, is a more durable monster of vanity and manipulativeness. “Cleopatra” (her preferred name) Skewton is the freeze-dried belle of Leamington Spa, decayed and held together by cosmetics. Her aim is to sell her statuesque daughter, Edith, in marriage for the best available price. In succeeding, she finishes the job of destroying Edith’s sense of her own value. Fortunately, Edith has enough hauteur (an Australian might call it mongrel) to fight back.

– Robert Phiddian

Do you have a nomination for the worst mother – or father – in literature? If so, let us know by scrolling to the end of this article and adding your choice in the comments.

The Conversation

ref. Who are the worst mothers in literature? – https://theconversation.com/who-are-the-worst-mothers-in-literature-263816

In swipe at Trump, Brazil’s Lula tells UN that organized crime is not terrorism

Source: The Conversation – Global Perspectives – By Thiago Rodrigues, Professor de Relações Internacionais, Universidade Federal Fluminense (UFF)

Much of Brazilian President Luiz Inacio Lula da Silva’s address at the opening of the 80th session of the United Nations General Assembly was expected.

Condemnation of U.S. interventionism against Brazil and Israeli action in the Gaza Strip have long been part of the rhetoric of the veteran leftist leader. So too has been the need to fight global hunger and speak up for global environmental initiatives.

But, besides those expected major themes, Lula’s speech also embarked on new territory, noticeably on the issue of organized crime and terrorism. “It is worrying to equate crime with terrorism,” Lula noted.

That was a direct reference to U.S. President Donald Trump’s attempts to equate Latin American organized crime groups with terrorist organizations.

Such conflation has been part of Trump’s agenda since the very first day of his second administration. On Jan. 20, 2025, he signed an executive order that ordered the inclusion of Latin American organized crime groups on the list of designated terrorist organizations.

As a result, entities like Venezuela’s Tren de Aragua, Ecuador’s Los Choneros, Mexico’s Cartel de Sinaloa and El Salvador’s Mara Salvatrucha now share space with Boko Haram and the Islamic State group on the State Department’s list of “Foreign Terrorist Organizations.”

Just rhetoric?

The association between drug trafficking and terrorism is not new in U.S. foreign policy. In the 1980s, groups like Sendero Luminoso in Peru and the Medellín Cartel in Colombia were classified as “narco-terrorists” because they fought their own governments using weapons funded by cocaine trafficking.

Ronald Reagan’s administration presented narco-terrorism as a serious threat to American safety. He sent the Army to combat international trafficking and exhorted Andean countries to turn their military into anti-narcotics troops.

The policy left a strong legacy in countries like Colombia, Peru and Mexico, where armies were converted into a de facto military super-police.

In the process, they lost the capacity to act as effective national defense forces.

After the terrorist attacks of Sept. 11, 2001, the relationship between drug trafficking and terrorism was updated. Islamic fundamentalist groups like al-Qaida were accused by the U.S. Department of State of financing their operations through heroin and other drug trafficking.

With the support of a frightened society, President George W. Bush’s government built an anti-terrorist legal and institutional framework that gave the state exceptional powers to repress anyone it deemed to be a “terrorist.”

And in the post-9/11 world, being a “terrorist” held serious consequences in regard to how U.S. authorities could, and would, treat you.

Terrorists were arrested without formal charges. They were tortured and detained in unknown places for an indefinite period of time. Their assets and property were confiscated, their bank accounts interdicted and their resources absorbed by the authorities without accountability.

Today, when Trump extends the classification of “terrorist” to transnational organized crime groups, the tacit understanding is it allows any Latin American accused of international drug dealing to be treated outside the rules of a democratic state of law. That includes to be captured outside the U.S. with no access to any diplomatic aid, to be sent to Guantánamo or to simply disappear.

Geopolitical pressure

Since the 1970s, the so-called “war on drugs” has been an instrument of U.S. diplomatic and geopolitical pressure. It was used to blackmail governments in Latin America, align repressive policies with U.S. guidelines and justify the presence of military personnel, intelligence and military bases in the region, among other forms of intervention.

Since 2001, the “war on terror” has served similar purposes around the world, but with little impact in Latin America. Now, the new classification for Latin American criminal organizations synchronizes the “war on drugs” with the “war on terror.”

More than rhetoric, the U.S. State Department’s updated list allows the government to reinforce the interventionism in Latin America at a particularly sensitive time.

The U.S. is facing a serious domestic political crisis and an unprecedented global challenge posed by China’s consistent and vertiginous rise as a world economic and military power.

The Chinese economic and commercial presence in Latin America poses a concrete threat to the hegemony that the U.S. established on the continent.

Brazil and Mexico – the region’s largest economies – are making Trump’s trade pressure instruments, such as tariffs, much less effective than expected.

In this context, Trump has deployed a military naval force near the Venezuelan coast, reactivating accusations that the regime led by Nicolás Maduro is a “narco-state.”

Trump accuses Maduro of being the head of a group called the Cartel de los Soles, supposedly formed by high-ranking military personnel. The only sources claiming that such a cartel exists are the U.S. itself and voices linked to the ultra-right Venezuelan opposition in exile. However, the accusation is serious and influences U.S. public opinion.

In the same vein, the U.S. government has just “decertified” Gustavo Petro’s Colombia from its list of countries partnering Washington’s effort to fight transnational drugs trafficking – a move that could lead to economic sanctions and cuts in credit lines, loans and military aid.

Following the drug money

Arguing against this logic of unilateral U.S. action, Lula, in his U.N. address, emphasized multilateral cooperation to combat international drug trafficking. And the focus, in his point of view, must be to go after the economic assets of organized crime groups, and their money laundering strategies.

The mention of money laundering refers to the recent actions taken by the Brazilian Federal Police and other local authorities that uncovered huge money laundering schemes from drug trafficking organizations in Brazil’s largest city, São Paulo.

The scheme was carried out through financial institutions, gas stations, hotels and many other “regular” businesses. The initiatives were considered successful because they led to the arrest and indictment of organized crime financial operators, and not the usual low-level streets dealers – who are invariably poor, and Black.

Lula’s talk of international cooperation likely referred to the inauguration of the Center for International Police Cooperation in the Brazilian state of Amazonas. The center is an initiative to coordinate intelligence efforts in the fight against crimes in the Amazon. It brings together representatives of nine Brazilian states and security forces from eight Pan-Amazon countries – and France, on behalf of French Guiana.

The inclusion of the issue of organized crime in Lula’s speech at the U.N. can be seen as an additional front in his opposition to the government of Trump. Like environmental issues, the issue of organized crime is both an internal and international problem for Brazil.

The Conversation

Thiago Rodrigues não presta consultoria, trabalha, possui ações ou recebe financiamento de qualquer empresa ou organização que poderia se beneficiar com a publicação deste artigo e não revelou nenhum vínculo relevante além de seu cargo acadêmico.

ref. In swipe at Trump, Brazil’s Lula tells UN that organized crime is not terrorism – https://theconversation.com/in-swipe-at-trump-brazils-lula-tells-un-that-organized-crime-is-not-terrorism-266125

Even a brief government shutdown might hamper morale, raise costs and reduce long-term efficiency in the federal workforce

Source: The Conversation – USA – By Gonzalo Maturana, Associate Professor of Finance, Emory University

A sign indicates the closing of federal services during the government shutdown in 2013. AP Photo/Susan Walsh

As the federal fiscal year draws to a close, an increasingly familiar prospect is drawing near in Washington, D.C.: a possible government shutdown. And for federal workers, it couldn’t come at a worse time.

In the fractious and polarized political landscape of the United States, Democrats and Republicans have come to rely on short-term, stopgap funding bills to keep the government operating in the absence of elusive longer-term budget deals.

With the parties currently wide apart over the terms of even a short-term budget resolution, the government is set to shut down on Oct. 1, 2025, barring an 11th-hour deal that appears far off. If the shutdown does happen, it would mark another difficult moment this year for a federal workforce that has so far shed more than 300,000 jobs. This is largely due to ongoing Trump administration efforts to downsize parts of the federal government and restructure or largely eliminate certain government agencies with the stated aim of increasing efficiency.

With a government shutdown, hundreds of thousands of federal employees would be furloughed – sent home without pay until funding resumes.

As a team of financial economists who study labor markets and public sector employment and have examined millions of federal personnel records spanning such government shutdowns in the past, we have found that the consequences reach far beyond the now-familiar images of closed national parks and stalled federal services. Indeed, based on our study of an October 2013 shutdown during which about 800,000 federal employees were furloughed for 16 days, shutdowns leave an enduring negative effect on the federal workforce, reshaping its composition and weakening its performance for years to come.

What happens to workers

Millions of Americans interact with the federal government every day in ways both big and small. More than one-third of U.S. national spending is routed through government programs, including Medicare and Social Security. Federal workers manage national parks, draft environmental regulations and help keep air travel safe.

Whatever one’s political leanings, if the goal is a government that handles these responsibilities effectively, then attracting and retaining a talented workforce is essential.

Yet the ability of the federal government to do so may be increasingly difficult, in part because prolonged shutdowns can have hidden effects.

When Congress fails to pass appropriations, federal agencies must furlough employees whose jobs are not deemed “excepted” – sometimes commonly referred to as essential. Those excepted employees keep working, while others are barred from working or even volunteering until funding resumes. Furlough status reflects funding sources and mission categories, not an individual’s performance, so it confers no signal about an employee’s future prospects and primarily acts as a shock to morale.

Importantly, furloughs do not create long-term wealth losses; back pay has always been granted and, since 2019, is legally guaranteed. Employees therefore recover their pay even though they may face real financial strain in the short run.

A cynical observer might call furloughs a paid vacation, yet the data tells a different story.

An empty hallway in the U.S. Capitol.
An American flag is seen inside the U.S. Capitol Building on Sept. 23, 2025, ahead of a looming government shutdown.
Photo by Anna Moneymaker/Getty Images

Immediate consequences, longer-term effects

Using extensive administrative records on federal civilian workers from the October 2013 shutdown, we tracked how this shock to morale rippled through government operations. Employees exposed to furloughs were 31% more likely to leave their jobs within one year.

These departures were not quickly replaced, forcing agencies to rely on costly temporary workers and leading to measurable declines in core functions such as payment accuracy, legal enforcement and patenting activity.

Further, we found that this exodus builds over the first two years after the shutdown and then settles into a permanently lower headcount, implying a durable loss of human capital. The shock to morale is more pronounced among young, female and highly educated professionals with plenty of outside options. Indeed, our analysis of survey data from a later 2018-2019 shutdown confirms that morale, not income loss, drives the exits.

Employees who felt most affected reported a sharp drop in agency, control and recognition, and they were far more likely to plan a departure.

The effect of the motivation loss is striking. Using a simple economic model where workers can be expected to value both cash and purpose, we estimate that the drop in intrinsic motivation after a shutdown would require a roughly 10% wage raise to offset.

Policy implications

Some people have argued that this outflow of employees amounts to a necessary trimming, a way to shrink government by a so-called starving of the beast.

But the evidence paints a different picture. Agencies hit hardest by furloughs turned to temporary staffing firms to fill the gaps. Over the two years after the shutdown we analyzed, these agencies spent about US$1 billion more on contractors than they saved in payroll.

The costs go beyond replacement spending, as government performance also suffers. Agencies that were more affected by the shutdown recorded higher rates of inaccurate federal payments for several years. Even after partial recovery, losses amounted to hundreds of millions of dollars that taxpayers never recouped.

Other skill-intensive functions declined as well. Legal enforcement fell in agencies that became short of experienced attorneys, and patenting activity dropped in science and engineering agencies after key inventors left.

Official estimates of shutdown costs typically focus on near-term GDP effects and back pay. But our findings show that an even bigger bill comes later in the form of higher employee turnover, higher labor costs to fill gaps, and measurable losses in productivity.

Shutdowns are blunt, recurring shocks that demoralize the public workforce and erode performance. These costs spill over to everyone who relies on government services. If the public wants efficient, accountable public institutions, then we should all care about avoiding shutdowns.

After an already turbulent year, it is unclear whether an upcoming shutdown would significantly add to the strain on federal employees or have a more limited effect, since many who were considering leaving have already left through buyouts or forced terminations this year. What is clear is that hundreds of thousands of federal employees are likely to experience another period of uncertainty.

The Conversation

The authors do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.

ref. Even a brief government shutdown might hamper morale, raise costs and reduce long-term efficiency in the federal workforce – https://theconversation.com/even-a-brief-government-shutdown-might-hamper-morale-raise-costs-and-reduce-long-term-efficiency-in-the-federal-workforce-265723

Nicolas Sarkozy condamné à 5 ans de prison : une normalisation démocratique ?

Source: The Conversation – France in French (3) – By Vincent Sizaire, Maître de conférence associé, membre du centre de droit pénal et de criminologie, Université Paris Nanterre – Université Paris Lumières

L’ancien président de la République Nicolas Sarkozy a été jugé coupable d’association de malfaiteurs dans l’affaire du financement libyen de sa campagne présidentielle victorieuse de 2007. Condamné notamment à cinq ans de prison, il sera convoqué le 13 octobre pour connaître la date de son incarcération. Cet événement inédit dans l’histoire de France s’inscrit dans une évolution des pratiques de la magistrature qui s’est progressivement émancipée du pouvoir politique. Elle couronne le principe républicain, proclamé en 1789, mais longtemps resté théorique, d’une pleine et entière égalité des citoyens devant la loi.


Le 25 septembre 2025, Nicolas Sarkozy a été reconnu coupable d’association de malfaiteurs par le tribunal correctionnel de Paris, qui a considéré qu’il avait tenu un rôle actif dans la mise en place d’un dispositif de financement de sa campagne électorale de 2007 par les dirigeants libyens. Comme on pouvait s’y attendre, cette décision a immédiatement suscité l’ire d’une large partie de la classe politique.

Que l’on conteste la décision en soutenant qu’elle est injuste et infondée, cela est parfaitement légitime dans une société démocratique, à commencer pour les principaux intéressés, dont c’est le droit le plus strict – comme, d’ailleurs, de faire appel du jugement. Mais, dans le sillage de la décision rendue dans l’affaire des assistants parlementaires du Front national, cette condamnation est aussi l’occasion, pour une large fraction des classes dirigeantes, de relancer le procès du supposé « gouvernement des juges ».

Certes, la condamnation peut paraître particulièrement sévère : 100 000 euros d’amende, cinq ans d’inéligibilité et surtout, cinq ans d’emprisonnement avec un mandat de dépôt différé qui, assorti de l’exécution provisoire, oblige le condamné à commencer d’exécuter sa peine de prison même s’il fait appel.

Toutefois, si on les met en regard des faits pour lesquels l’ancien chef de l’État a été condamné, ces peines n’apparaissent pas disproportionnées. Les faits sont d’une indéniable gravité : organiser le financement occulte d’une campagne électorale avec des fonds provenant d’un régime corrompu et autoritaire, la Libye, (dont la responsabilité dans un attentat contre un avion ayant tué plus de 50 ressortissants français a été reconnue par la justice), en contrepartie d’une intervention pour favoriser son retour sur la scène internationale…

Alors que la peine maximale encourue était de dix ans de prison, la sanction finalement prononcée ne peut guère être regardée comme manifestement excessive. Mais ce qui est contesté, c’est le principe même de la condamnation d’un responsable politique par la justice, vécue et présentée comme une atteinte intolérable à l’équilibre institutionnel.

Si l’on prend le temps de la mise en perspective historique, on constate pourtant que les jugements rendus ces dernières années à l’encontre des membres de la classe dirigeante s’inscrivent, en réalité, dans un mouvement d’émancipation relative du pouvoir juridictionnel à l’égard des autres puissances et, en particulier, du pouvoir exécutif. Une émancipation qui lui permet, enfin, d’appliquer pleinement les exigences de l’ordre juridique républicain.

L’égalité des citoyens devant la loi, un principe républicain

Faut-il le rappeler, le principe révolutionnaire proclamé dans la nuit du 4 au 5 août 1789 est celui d’une pleine et entière égalité devant la loi, entraînant la disparition corrélative de l’ensemble des lois particulières – les « privilèges » au sens juridique du terme – dont bénéficiaient la noblesse et le haut clergé. Le Code pénal de 1791 va plus loin encore : non seulement les gouvernants peuvent voir leur responsabilité mise en cause devant les mêmes juridictions que les autres citoyens, mais ils encourent en outre des peines aggravées pour certaines infractions, notamment en cas d’atteinte à la probité.

Les principes sur lesquels est bâti le système juridique républicain ne peuvent être plus clairs : dans une société démocratique, où chaque personne est en droit d’exiger non seulement la pleine jouissance de ses droits, mais d’une façon générale, l’application de la loi, nul ne peut prétendre bénéficier d’un régime d’exception – les élus moins encore que les autres. C’est parce que nous avons l’assurance que leurs illégalismes seront sanctionnés effectivement, de la même façon que les autres citoyens et sans attendre une bien hypothétique sanction électorale, qu’ils et elles peuvent véritablement se dire nos représentantes et représentants.

Longtemps, cette exigence d’égalité juridique est cependant restée largement théorique. Reprise en main et placée dans un rapport de subordination plus ou moins explicite au gouvernement, sous le Premier Empire (1804-1814), la magistrature est demeurée sous l’influence de l’exécutif au moins jusqu’au milieu du XXe siècle. C’est pourquoi, jusqu’à la fin du siècle dernier, le principe d’égalité devant la loi va se heurter à un singulier privilège de « notabilité » qui, sauf situations exceptionnelles ou faits particulièrement graves et médiatisés, garantit une relative impunité aux membres des classes dirigeantes dont la responsabilité pénale est mise en cause. Il faut ainsi garder à l’esprit que la figure « du juge rouge », popularisée dans les médias à la fin des années 1970, vient stigmatiser des magistrats uniquement parce qu’ils ont placé en détention, au même titre que des voleurs de grand chemin, des chefs d’entreprise ou des notaires.

La donne ne commence à changer qu’à partir du grand sursaut humaniste de la Libération qui aboutit, entre autres, à la constitution d’un corps de magistrats recrutés sur concours, bénéficiant à partir de 1958 d’un statut relativement protecteur et d’une école de formation professionnelle spécifique, l’École nationale de la magistrature. Ce corps se dote progressivement d’une déontologie exigeante, favorisée notamment par la reconnaissance du syndicalisme judiciaire en 1972. Ainsi advient une nouvelle génération de juges qui, désormais, prennent au sérieux la mission qui leur est confiée : veiller en toute indépendance à la bonne application de la loi, quels que soient le statut ou la situation sociale des personnes en cause.

C’est dans ce contexte que survient ce qui était encore impensable quelques décennies plus tôt : la poursuite et la condamnation des notables au même titre que le reste de la population. Amorcé, comme on l’a dit, au milieu des années 1970, le mouvement prend de l’ampleur dans les décennies suivantes avec la condamnation de grands dirigeants d’entreprises, comme Bernard Tapie, puis de figures politiques nationales, à l’image d’Alain Carignon ou de Michel Noir, députés-maires de Grenoble et de Lyon. La condamnation d’anciens présidents de la République à partir des années 2010 – Jacques Chirac en 2011, Nicolas Sarkozy une première fois en 2021 – achève de normaliser cette orientation ou, plutôt, de mettre fin à l’anomalie démocratique consistant à réserver un traitement de faveur aux élus et, plus largement, aux classes dirigeantes.

Procédant d’abord d’une évolution des pratiques judiciaires, ce mouvement a pu également s’appuyer sur certaines modifications du cadre juridique. Ainsi de la révision constitutionnelle de février 2007 qui consacre la jurisprudence du Conseil constitutionnel suivant laquelle le président de la République ne peut faire l’objet d’aucune poursuite pénale durant l’exercice de son mandat, mais qui permet la reprise de la procédure dès la cessation de ses fonctions. On peut également mentionner la création, en décembre 2013, du Parquet national financier qui, s’il ne bénéficie pas d’une indépendance statutaire à l’égard du pouvoir exécutif, a pu faire la preuve de son indépendance de fait ces dernières années.

C’est précisément contre cette évolution historique qu’est mobilisée aujourd’hui la rhétorique de « la tyrannie des juges ». Une rhétorique qui vise moins à défendre la souveraineté du peuple que celle, oligarchique, des gouvernants.

The Conversation

Vincent Sizaire ne travaille pas, ne conseille pas, ne possède pas de parts, ne reçoit pas de fonds d’une organisation qui pourrait tirer profit de cet article, et n’a déclaré aucune autre affiliation que son organisme de recherche.

ref. Nicolas Sarkozy condamné à 5 ans de prison : une normalisation démocratique ? – https://theconversation.com/nicolas-sarkozy-condamne-a-5-ans-de-prison-une-normalisation-democratique-266101

Not all diabetes is about sugar – understanding diabetes insipidus

Source: The Conversation – UK – By Dan Baumgardt, Senior Lecturer, School of Psychology and Neuroscience, University of Bristol

RA fotografia / Shutterstock.com

Diabetes mellitus – known to many as type 1 and type 2 diabetes – gets all the attention with its rising global prevalence and connection to lifestyle and autoimmunity. Meanwhile, its lesser-known relative – diabetes insipidus – more quietly affects hundreds of thousands of people worldwide, but is an altogether different condition, unrelated to blood sugar.

Both forms share the same defining symptom: excessive urination. The word diabetes comes from ancient Greek meaning “passing through”, which perfectly captures what happens to newly affected patients.

In the more-familiar diabetes mellitus, sugar builds up in the blood because the body either doesn’t make enough insulin or can’t use it properly. When this happens, extra sugar enters the urine, and that sugar pulls water out of the body along with it.

People with diabetes may notice that they need to urinate more often and in larger amounts than usual. Sometimes, the urine can even have a sweet smell. Legend has it that Hippocrates, the “father of medicine”, used to taste his patients’ urine to make the diagnosis. Thankfully, we now use dipstick tests instead.

Diabetes insipidus is very different from diabetes mellitus. It has nothing to do with blood sugar. Instead, the problem is with a hormone called arginine vasopressin (AVP), also known as anti-diuretic hormone (ADH), which normally helps the body control how much water it keeps or loses.

This chemical messenger, produced by the pituitary gland at the base of your skull, acts like your body’s water conservation system. When you need to hold on to fluid – say, when you’re dehydrated – AVP tells your kidneys to reabsorb water rather than letting it escape in urine.

When this system breaks down, the results are dramatic. Without enough AVP, or when the hormone fails to function properly, your kidneys lose their ability to conserve water. No matter how much you drink, you remain perpetually thirsty and dehydrated, producing large volumes of pale, diluted urine. It’s a frustrating cycle that affects around 2,000 to 3,000 people in the UK alone.

The most common culprit is AVP-deficiency (formerly called central diabetes insipidus), where the problem lies in AVP production itself. It’s actually made in a brain region called the hypothalamus before being transported to the pituitary gland, from where it is released.

Brain tumours can damage this delicate system, as can head injuries or brain surgery. Genetics sometimes plays a role, and neurological infections like syphilis or tuberculosis can also disrupt hormone production. In some cases, however, doctors are unable to identify a clear cause.

Pregnancy brings its own unique version called gestational diabetes insipidus. The growing placenta produces an enzyme that breaks down AVP in the bloodstream before it can do its job. Fortunately, this rare condition typically resolves after birth.

For AVP-deficiency, treatment is more straightforward. Patients can take desmopressin, a synthetic version of AVP available as tablets, injections, or even a nasal spray. This replacement therapy effectively restores the body’s ability to conserve water.

Things get trickier with AVP-resistance (formerly called nephrogenic diabetes insipidus), where the kidneys themselves fail to respond to AVP.

Sometimes present from birth, this form can also develop later due to kidney damage from electrolyte imbalances or certain medications. Lithium, commonly used to treat bipolar disorder, is one such example. Since the problem is the kidneys’ inability to respond to AVP, different medications are used. Low-salt diets and careful attention to staying hydrated are also key.

When thirst goes wrong

Perhaps most puzzling is dipsogenic diabetes insipidus, where the brain’s thirst centre goes haywire.

Also located in the hypothalamus, this control centre can be damaged by tumours, trauma, or infections, leading to an insatiable urge to drink water. The excessive fluid intake then suppresses AVP production, creating a vicious cycle. Dangerously, it can dilute blood sodium levels, causing headaches, confusion and even seizures.

The symptoms of this condition sometimes overlap with psychogenic polydipsia, where mental health disorders – particularly schizophrenia – drive compulsive water drinking. The consequences can be severe, as seen in one documented case where a young patient suffered complications after consuming an astounding 15 litres of water per day.

These extreme examples of pathological water intake stand alongside wellness trends promoting excessive hydration as part of a healthy lifestyle. NFL quarterback Tom Brady has famously recommended drinking around two gallons daily – nearly eight litres.

Tom Brady wearing a football helmet.
Tom Brady recommends drinking two gallons of water a day.
Steve Jacobson / Shutterstock.com

While we’re often told to drink more water to avert dehydration, constipation, kidney stones and the like, there’s clearly a dangerous level. Sustained or unexplained high water consumption is not only toxic to the body but may be a sign of an underlying health problem.

Diabetes insipidus reminds us that the term “diabetes” encompasses more than blood sugar problems. This other diabetes may be less common, but for those affected, the consequences of leaving the condition untreated may prove severe. Anyone experiencing persistent excessive thirst, water consumption, and urination should seek medical attention promptly. The cause may turn out to be sugar, hormones, or something else entirely.

The Conversation

Dan Baumgardt does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

ref. Not all diabetes is about sugar – understanding diabetes insipidus – https://theconversation.com/not-all-diabetes-is-about-sugar-understanding-diabetes-insipidus-265108

Why the EU has no choice but to respond to Donald Trump’s bullying on tech regulation with a coercion investigation

Source: The Conversation – UK – By Francesco Grillo, Academic Fellow, Department of Social and Political Sciences, Bocconi University

Back in November 2023 – a time when it wasn’t even clear that Donald Trump would be allowed to run in the upcoming presidential primaries – the European Union approved a tough new “anti-coercion instrument”.

This stated: “Economic coercion exists where a non-EU country applies or threatens to apply a measure affecting trade or investment in order to prevent or obtain the cessation, modification or adoption of a particular act by the EU or a Member State, thereby interfering in the legitimate sovereign choices of the EU or a Member State”.

At the time, the threats were all coming from Russia, which stood accused of interfering in election campaigns, and undermining trust in liberal democracy.

Yet that regulation now seems a perfect fit for the US under a president who is threatening “substantial additional tariffs” against countries he deems to be imposing unfair laws against tech companies. Europe, where those digital regulations were literally invented, is now the clear target of Trump’s ire. Although I would argue that the EU’s approach to regulating in this area has some serious problems, it should not risk bowing to US pressure. The union would lose credibility if it showed that it does not believe in its own rules.

In just eight years, European institutions have approved ten laws in the digital space. The legislation spans 591 articles and covers 1,091 pages. This would have been a monumental effort, with each regulation stemming from the work of potentially hundreds of lawyers, experts and policymakers. That’s even before the EU’s three different institutions (commission, parliament, and council) all had their say.

The problem, though, is that the more articles you have regulating interconnected activities, the more likely you are to find contradictions among them. Paradoxically, the firms that may be more damaged by the necessity to comply tend to be European start-ups, which are generally too small to afford the fees needed to pay lawyers who can help them make sense of such complex legislation.

Added to this is the fact that the phenomena we are trying to govern is extremely radical and unprecedented (especially large language model artificial intelligence). We therefore don’t yet know what the impact of digital change will be and whether the regulations in place are the right ones. Indeed, it’s almost inevitable that such detailed regulation contains what will eventually turn out to be mistakes as circumstances change.

But while EU digital regulation is far from perfect, the bloc cannot allow a third party to bully its way to changing the rules. EU regulation is suboptimal but it is not targeting “incredible American tech companies”, as Trump suggests.

True, elements of the Digital Service Act only apply to “very large platforms” (with over 45 million users in the EU), but while the majority of the 19 giants meeting this threshold are American, the list also includes three Chinese, one Canadian and three European companies.

In fact, some of the comments made by the US president arguably meet the description of actions that the Anti-Coercion Instrument is designed to sanction.

Fighting fire with fire

Trump has put in the bluntest terms that “digital taxes, legislation, rules or regulations are all designed to harm, or discriminate against, American technology”. He has said: “unless these discriminatory actions are removed, I, as President of the United States, will impose substantial additional Tariffs”. This is “threatening a measure affecting trade or in order to obtain the cessation of a particular act by the Union”. Not to open a case to investigate the US on these points would send a dangerous message that competitors (or former allies) can meddle in European sovereign affairs.

The activation of countermeasures would require a qualified majority at the European Council which would not be impossible to reach: 55% of the member states (15 out of 27 would be enough) representing 65% of the population (the sum of Germany and France is one third of the total). In any case, even if a qualified majority is not reached, the exercise is still worthwhile. It would be helpful to know which member states are still serious about being part of a (sovereign) union and which of them would rather go for a union “à la carte”. This latter option is not, logically, good enough for times that require the EU to react quickly to crises.

Trump has taken a similar approach to the EU’s renewable energy policy, calling for member states to dismantle their wind turbines.

The times in which we are living will soon force Europe into a make or break decision. This is what Mario Draghi, former Italian prime minister and author of the report currently guiding the EU’s competitiveness, hinted saying recently when he said: “we have been reminded, painfully, that inaction threatens not only our
competitiveness but our sovereignty”. Europe cannot afford to give the impression that it has lost faith in its ability to be free.

The Conversation

Francesco Grillo is affiliated with Vision, the Italian think tank.

ref. Why the EU has no choice but to respond to Donald Trump’s bullying on tech regulation with a coercion investigation – https://theconversation.com/why-the-eu-has-no-choice-but-to-respond-to-donald-trumps-bullying-on-tech-regulation-with-a-coercion-investigation-265618

Vanishing waters in a warming world

Source: The Conversation – UK – By Will de Freitas, Environment + Energy Editor, The Conversation

In some places, the Caspian Sea has already retreated 50km. S. Melkin / shutterstock

This roundup of The Conversation’s climate coverage was first published in our award-winning weekly climate action newsletter, Imagine.


Around the world, rivers and lakes that sustained civilisations for millennia are vanishing before our eyes. The Caspian Sea – the world’s largest inland body of water – has shrunk dramatically in just a few decades. The Ganges nourishes hundreds of millions of people across India and Bangladesh, yet is drying at a rate scientists say is unprecedented in the past thousand years.

Climate change isn’t solely to blame for the woes of the Caspian or the Ganges, of course. In nearly all cases, what’s going on is some combination of human and climate factors. But there is a trend.

Let’s start with rivers.

Writing in 2022, Catherine E. Russell, then of the University of Leicester, notes that:

“The Loire in France broke records in mid-August for its low water levels, while photos circulating online show the mighty Danube, Rhine, Yangtze and Colorado rivers all but reduced to trickles.”

In her analysis of why rivers worldwide are running dry, she points out that:

“climate change is altering where freshwater is found: such that, in general, places with plenty are getting more while places with little are getting less.”

She says this is making rivers more “flashy”: prone to breaking records for both high and low water levels. The flashiness is exacerbated by humans extracting water and putting rivers in concrete straitjackets.

So what we’re seeing isn’t just a series of droughts. These drying rivers represent a structural change in how water is moving through the land, driven by climate change but also decades of overuse and engineering decisions.




Read more:
Rivers worldwide are running dry – here’s why and what we can do about it


This is particularly apparent in the Ganges, India’s largest and longest river. There, “stretches of river that once supported year-round navigation are now impassable in summer. Large boats that once travelled the Ganges from Bengal through Varanasi now run aground where water once flowed freely.”

That’s according to Mehebub Sahana, a rivers expert at the University of Manchester, who has written about a new study that puts the current drying in historical context. Scientists in India, writes Sahana, gathered 1,300 years of flow data and say the river and its wider system of tributaries has never faced dry spells as severe as it has in the past decade.

Sandbanks
Sandbanks on the shores of the Padma River (the local name for the Ganges) in Bangladesh. Dams upstream in India have meant there is less water flowing into the Padma.
Pavel Vatsura / shutterstock

As the world warms, Sahana notes, “the monsoon which feeds the Ganges has grown increasingly erratic”. But there are other factors at play: “Water has been diverted into irrigation canals, groundwater has been pumped for agriculture, and industries have proliferated along the river’s banks. More than a thousand dams and barrages have radically altered the river itself.”

In Sahana’s words, this results in “a river system increasingly unable to replenish itself”.

To save the Ganges, India will have to extract less groundwater and irrigation water. Upstream India and downstream Bangladesh will have to better coordinate their efforts. And major funding and political agreements “must treat rivers like the Ganges as global priorities”.




Read more:
The Ganges River is drying faster than ever – here’s what it means for the region and the world


‘A relatively new phenomenon’

Something similar is happening with lakes.

While at Keele University, the geographer Antonia Law looked at the climate-related threat to lake wildlife.

She notes there has already been a “staggering decline” in freshwater species diversity since the 1970s, but that “climate change [now] threatens to drive even deeper losses”.

“Lake heatwaves – when surface water temperatures rise above their average for longer than five days – are a relatively new phenomenon. But by the end of this century, heatwaves could last between three and 12 times longer and become 0.3°C to 1.7°C hotter. In some places, particularly near the equator, lakes may enter a permanent heatwave state. Smaller lakes may shrink or disappear entirely, along with the wildlife they contain, while deeper lakes will face less intense but longer heatwaves.”

Needless to say, this is not great news for any person or animal that relies on those lakes. That’s particularly the case as “unlike those living elsewhere, most lake animals cannot simply move to another habitat once their lake becomes uninhabitable”. Many lakes, says Law, are on course for “a sweltering, breathless and lifeless future”.




Read more:
Climate change: world’s lakes are in hot water – threatening rare wildlife


That’s the case even for the biggest lake (sort of) of all: the Caspian Sea.

Here’s Simon Goodman, an ecologist at the University of Leeds who has tracked the seals in the Caspian for more than two decades:

“Once a haven for flamingos, sturgeon and thousands of seals, fast-receding waters are turning the northern coast of the Caspian Sea into barren stretches of dry sand. In some places, the sea has retreated more than 50km. Wetlands are becoming deserts, fishing ports are being left high and dry, and oil companies are dredging ever-longer channels to reach their offshore installations.”

Goodman says variations in the Caspian Sea level were once linked to agricultural irrigation (the same thing that caused the Aral Sea to disappear a few hundred miles to the east), but “now global warming is the main driver of decline”.

That’s because rising temperatures are disrupting the water cycle. Rivers and rainfall are bringing less water, while the hotter sun is evaporating more water than ever. With no link to the wider oceans (aside from a single canal, which is also drying up), the Caspian just can’t keep up.

As things stand, Goodman says, the decline could eventually reach 18 metres, “which is about the height of a six-storey building”. “Even an optimistic ten-metre decline would uncover 112,000 square kilometres of seabed – an area larger than Iceland.”

The five countries around the Caspian Sea have recognised the danger. The world does not need another Aral Sea. But Goodman fears “the rate of decline may outstrip the pace of political cooperation”.




Read more:
Climate change is fast shrinking the world’s largest inland sea


There are many more stories like these. We’ve looked at the Ganges and the Caspian Sea, but this could easily have been a newsletter about Lake Victoria, the world’s second largest freshwater lake, or about drying rivers in Europe making it harder to generate nuclear power (pushing up energy prices in the UK), or about the complete disappearance of Bolivia’s second largest lake.

In all these cases, it’s worth remembering that once a river runs dry or a lake shrivels up, it’s not just water that disappears: it’s entire ecosystems and ways of life.

The Conversation

ref. Vanishing waters in a warming world – https://theconversation.com/vanishing-waters-in-a-warming-world-266001

Why some people are purposefully having their legs broken by cosmetic surgeons

Source: The Conversation – UK – By Michelle Spear, Professor of Anatomy, University of Bristol

Limb lengthening surgery creates an intentional fracture in order to encourage new bone growth. Pixel-Shot/ Shutterstock

Would you willingly have your legs broken, the bone stretched apart millimetre by millimetre and then spend months in recovery – all to be a few centimetres taller?

This the promise of limb-lengthening surgery. A procedure once reserved for correcting severe orthopaedic problems, it has now become a cosmetic trend. While it might sound like a quick fix for those hoping to make themselves taller, the procedure is far from simple. Bones, muscles, nerves and joint all pay a heavy price – and the risks often outweigh the rewards.

Limb lengthening is not new. The procedure was pioneered in the 1950s by Soviet orthopaedic surgeon Gavriil Ilizarov, who developed a system to treat badly healed fractures and congenital limb deformities. His technique revolutionised reconstructive orthopaedics and remains the foundation of current practice today.

While the number of people undergoing cosmetic limb-lengthening surgery each year still remains relatively small, the procedure is growing in popularity. Specialist clinics in the US, Europe, India and South Korea report increasing demand – with procedures costing tens of thousands of pounds.

Reports suggest that in some private clinics, cosmetic cases of limb-lengthening surgery now outnumber medically necessary ones. This reflects a cultural shift, where people are willing to undergo a demanding, high-risk medical procedure to meet social ideals about height.

Surgeons begin by cutting through a bone – usually the femur (thigh bone) or tibia (shin bone). To ensure the existing bone stays healthy and that new bone can grow, surgeons are careful to leave intact its blood supply and periosteum (the soft issue that covers the bone).

Traditionally, the cut bone segments were then connected to a bulky external frame which was adjusted daily to pull the two ends apart. But more recently, some procedures have adopted telescopic rods placed inside of the bone itself.

These devices can be lengthened gradually using magnetic controls from outside the body – sparing patients the stigma of an external frame and reducing the risk of infection. However, they’re not suitable for all patients – especially children – and are considerably more expensive than external systems.

A digital drawing depicting a leg bone with a metal frame screwed into it.
The device is gradually adjusted each day to encourage bone growth.
Love Employee/ Shutterstock

Regardless of whether the device sits outside or within the bone, the process is the same. After a short healing period, the device is adjusted to separate the cut ends very gradually, usually by about one millimetre per day. This slow separation encourages the body to fill the gap with new bone – a process called osteogenesis. Meanwhile, the muscles, tendons, blood vessels, skin and nerves stretch to accommodate the change.

Over weeks and months this can add up to a gain of five to eight centimetres in height from a single procedure – the limit most surgeons consider safe. Some patients undergo operations on both the femur and tibia, aiming to gain as much as 12–15 centimetres in total. However, complication rates rise sharply with each centimetre of additional growth. Complications include joint stiffness, nerve irritation, delayed bone healing, infection and chronic pain.

Intense pain

The underlying challenge of limb-lengthening surgery is the same: the body must constantly repair a bone that is being pulled apart.

When a bone breaks, a blood clot rapidly forms around the fracture. Bone cells (ostoblasts) create a callus (soft cartilage) that stabilises the break. Over weeks, osteoblasts replace this cartilage with new bone that gradually remodels to restore strength and shape.

In limb-lengthening surgeries, however, the fracture is continuously pulled apart. This means the body’s repair process is constantly interrupted and redirected, generating a column of delicate new bone where hardening is delayed.

The process is intensely painful. Patients often require strong painkillers. Physiotherapy is also essential to maintain movement. Yet, even when the surgery succeeds, people may still be left with weakness, altered gait or chronic discomfort.

There’s also the psychological burden that comes alongside the procedure. Recovery can take a year or more – much of it spent with restricted mobility. Some patients report depression or regret, particularly if the modest gain in height does not deliver the hoped-for improvement in confidence.

Muscles and tendons are also forced to lengthen beyond their natural capacity, which can lead to stiffness. Nerves are especially vulnerable. Unlike bone, they cannot regenerate across long distances. Healthy nerves can stretch by perhaps 6–8% of their resting length – but beyond this, the fibres begin to suffer injury and become impaired.

Patients often experience tingling, numbness or burning pain during lengthening. In severe cases, nerve damage may be permanent. Joints, immobilised for months, are at risk of stiffening or developing arthritis because of changes to how force and weight are distributed.

The rise of cosmetic limb-lengthening illustrates a broader trend in aesthetic surgery – where increasingly invasive procedures are offered to people without medical need. In theory, almost anyone could gain a few centimetres of height. But in practice, it means months of broken bones, fragile new tissue, exhausting physiotherapy and the constant risk of complications.

For those with medical need, the benefits can be life-changing. But for those seeking only to add a little height, the question remains whether enduring months of pain and uncertainty is really worth it.

The Conversation

Michelle Spear does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

ref. Why some people are purposefully having their legs broken by cosmetic surgeons – https://theconversation.com/why-some-people-are-purposefully-having-their-legs-broken-by-cosmetic-surgeons-265015