Category: Academic Reportage

Source: The Conversation – USA (3) – By Jill Inderstrodt, Assistant Professor of Health Policy and Management, Indiana University

It’s a rare occasion when my worlds of biomedical informatics and serialized lesbian melodrama fandom collide.

But that’s exactly what happened earlier this summer when two of my favorite actresses appeared on a popular podcast. I was excited to hear them talk about their new book and their history of working together, so I was confused but delighted when their conversation took a turn toward my area of expertise – electronic health records.

One actress noted that on a recent trip to the optometrist, she was asked about her ethnicity. “And I was like, what difference does it make?” she said.

The host chimed in with her experience of being asked similarly personal questions before a mammogram. “Like, it doesn’t matter if I’m married or not. It doesn’t matter if I’m white or Asian, you know?” she remarked.

Listening to the host and actresses question a process that, to me, seems straightforward and purposeful served as a stark reminder of the chasm that often exists between how researchers like me use patient data and a patient’s actual experience of clinical data collection.

For those of us who use demographic data collected during health care encounters to conduct research and design interventions, it does matter whether patients answer their doctor’s demographic questions. But as a patient myself, I can see how these questions might seem unnecessary and even invasive.

So it may help to understand why your doctors collect this data, how researchers use it and what medical discoveries might be possible when we know more about who patients are.

Why your data matters

When you answer the demographic questions your doctor logs in your electronic health record, you’re doing more than disclosing personal information. You’re adding one small piece to a giant puzzle of data that allows researchers like me to see a bigger picture.

Your health information can help us understand who gets sick and why. It might even be used to design real health interventions.

As a researcher focused on improving health and health care for moms and their babies, I consider myself lucky to live in Indiana, a state with one of the nation’s most comprehensive health information exchanges. These exchanges are interconnected networks of hospital system electronic health record databases from all over the state that allow researchers like me to learn about how individuals and groups experience health and medical care.

For example, my colleagues and I in the Indiana University Better AI for a Strong Rural Maternal and Child Health Environment Lab use this data to train machine learning models that predict preeclampsia, a life-threatening condition of high blood pressure during pregnancy, before a mom gets really sick.

We could use only clinical data: diagnoses, labs and vital readings like blood pressure that contribute to the outcome of preeclampsia. But for conditions like preeclampsia, Black moms are diagnosed at higher rates than their white counterparts. Research shows that race and racism can be major contributing factors to this disparity.

In order to predict preeclampsia accurately and use these predictions to help doctors monitor, diagnose and treat the condition, my team needs to factor in other information that can illuminate these different outcomes, called social determinants of health.

Social determinants of health are the parts of ourselves and our environments that drive our health status. Race itself isn’t a social determinant of health, but racism is. This includes structural racism, like a ZIP code’s history of school segregation or redlining. If available, we also include information you might have given at your doctor’s visit, like if you haven’t had enough food to eat in the past month, or if you have a history of intimate partner violence or homelessness.

Because there is more variation within races than between them, race alone actually tells us very little. Including social determinants of health in our datasets provides added context as to how you move about the world, what resources you have access to and how your environment might shape your health.

Putting the pieces together

This is why your cardiologist asks about your marital status. Your response might help researchers understand why single moms are more likely to have cardiovascular disease than their married counterparts. And telling your optometrist your race is one of the only ways to learn what role race might play in patients using weight loss drugs experiencing vision loss.

Other researchers have used data from electronic records to determine how many people in a geographic area or of a certain demographic group have diabetes, to predict dementia and even to track gum disease.

During the COVID-19 pandemic, researchers used data from electronic health records to determine what types of people were getting sick. They investigated COVID-19 patients’ race, geography and insurance status. Researchers continue to use this data to track long COVID, a condition that health professionals still don’t completely understand.

Honoring patient privacy

Of course, these health information exchanges are careful about how and with whom they share patient data. The data is tailored to the needs of the study and shared in compliance with the Health Insurance Portability and Accountability Act, or HIPAA.

For instance, for my most recent preeclampsia study, the health care system sent a dataset that contained limited pieces of personal information, like the baby’s birth date, the mom’s birth date – since we often need to know how old she was when she gave birth – and their ZIP code so we can see trends in preeclampsia across geographic areas.

The data wasn’t allowed out of the health system’s virtual private network, so the data remains within our firewall. This ensures that the data remains safe. And all of this must be approved by our university’s institutional review board, a rigorous process that ensures our research can’t harm participants.

Improving health care for everyone – including you

All of this research drives innovation and serves as a basis for the programs, protocols and policies that improve health – from you as an individual all the way to the national and even global level.

Your doctor can use the information you provide to recommend services or therapies for you. For instance, if your doctor finds out through check-in questioning that you haven’t had enough food in the past month, they can refer you to a nutrition program, sometimes run by the hospital system itself. If you were married at your last appointment but now list your marital status as “separated,” your doctor can check in with you to see if you need any additional mental health or social services.

While it’s normal for these personal questions to feel a little uncomfortable, it helps to remember that there is a good reason your doctor is asking them. Your data can help move medical research forward.

Jill Inderstrodt receives funding from US Centers for Disease Control and Prevention and National Institutes of Health.

– ref. ‘Are you married?’ Why doctors ask invasive questions during treatment – https://theconversation.com/are-you-married-why-doctors-ask-invasive-questions-during-treatment-268268

Source: The Conversation – USA (3) – By Loveline Chizobam Phillips, Ph.D. Candidate, George Mason University

One in 10 babies in the U.S. – nearly 374,000 infants – were born preterm in 2023, meaning before 37 weeks of pregnancy. More than 15% were very preterm, meaning they were born before 32 weeks. A full-term pregnancy lasts 40 weeks.

Florida’s rate is slightly higher, at about 1 in 9 babies born preterm. In an average week, 456 of the 4,257 babies born in the state will be preterm, and 75 of those will be very preterm.

According to the March of Dimes, preterm birth and low birthweight-related health complications cause 37.5% of infant deaths nationwide. This makes preterm birth the second-leading cause of infant deaths, after birth defects. Preterm babies who survive infancy are susceptible to health complications later in life, including cerebral palsy and learning disabilities.

Preterm and low-birthweight babies – those weighing less than 5.5 pounds (2,500 grams) – are far more likely to go to the neonatal intensive care unit, or NICU. Very preterm infants tend to have the longest NICU stays, averaging around 43 days.

Beyond the emotional toll this takes on a family, preterm births and their resulting health complications carry substantial financial costs. The average NICU admission in 2021 cost around US$71,000. And economists estimated the lifetime societal cost of all preterm babies born in 2016, from birth to subsequent disability care, at $25.2 billion.

We are a public policy Ph.D. student and public policy researcher focusing on health policy and population health outcomes.

Recently, we were sifting through the data on preterm and low birthweight rates in the U.S., in search of places that are doing better than average at preventing preterm births. And that is what we found in the Central Hillsborough Healthy Start program, which serves a cluster of Tampa ZIP codes with roughly 177,000 residents.

In 2008, this program published records showing 30% lower preterm and low-birthweight rates among families at highest risk. Peer-reviewed evaluations link participation in the program to substantial reductions in preterm and low-birthweight outcomes.

These remarkable improvements remained consistent through 2020.

When we looked at what this program is doing, we found a set of practices that can serve as a model for other counties in Florida and around the U.S. to lower preterm birth rates, saving money and, more importantly, lives.

Screening for risk factors

The program does early screening for risk factors of preterm birth using Florida’s Healthy Start prenatal risk screen at the pregnant person’s first prenatal visit. This screening has been proven to correctly flag a good share of higher-risk pregnancies, while avoiding many false alarms, helping scarce services reach families who need them most.

This is key, because the risk of preterm birth isn’t spread out evenly across all pregnancies. The neighborhoods that Central Hillsborough Healthy Start serves include many young, Black, unmarried, low-income families that are eligible for Medicaid. All of these factors place them at high risk for preterm birth.

Early screening allows the Healthy Start program to identify mothers at highest risk and tailor its resources to assist them.

Measuring against the rest of the state

The Florida Healthy Start prenatal risk screen is available throughout the state. Florida created Healthy Start in 1991 precisely to reduce infant deaths and low birthweight through universal prenatal and infant risk screening, community coalitions and coordinated services.

While Florida’s preterm birth rate in 2023, the most recent year for which there is data, was 10.7%, Hillsborough County tracked slightly below the U.S. average of 10.4% at about 10.2% of the county’s 16,900 births.

That difference may seem small, but it represents 85 fewer preterm babies in Hillsborough County, and at the average rate of $71,000 per NICU admission, that’s about $6 million in hospital spending avoided in a single year.

In addition, statewide, 14.8% of Black infants were born preterm in 2023, slightly higher than the 14.65% average across the U.S. In Hillsborough County in the same year, it was 13.9%.

Among pregnant women without a partner, participation reduced very preterm births by 52% and halved the rate of very low-birthweight babies – that is, babies weighing less than 3.3 pounds (1,500 grams).

Obese mothers in the program had a 61% lower chance of extremely preterm birth, which means birth before 28 weeks of pregnancy, than comparable women elsewhere in Florida. Even exposure to air pollution, a known risk factor for preterm birth, was less harmful among women in the program.

So what has Central Hillsborough Healthy Start been doing differently?

The Central Hillsborough Healthy Start model

The model used by Central Hillsborough Healthy Start is practical and straightforward.

After early screening, nurses make home visits and help coordinate patient care for mothers in the program.

Central Hillsborough Healthy Start also provides prenatal education, depression screening and programs to help pregnant mothers improve their health and decrease harmful practices such as smoking or substance abuse. These programs are critical, because obesity, diabetes, hypertension and smoking during pregnancy are significant risk factors for preterm births.

The program also helps to connect patients to resources they may need during and after pregnancy by making personal introductions to community partners such as women and infant resource specialists in women, infants and children, or WIC, clinics.

Healthy Start workers also connect patients to interconception care for healthy birth spacing between pregnancies, which can help prevent future preterm births. Studies show that more than 30% of U.S. mothers who give birth preterm conceived their baby less than 18 months after having their previous child.

The Healthy Start staff use Florida’s coordinated intake and referral approach to track referrals and follow up across partners. This is vital to helping the program’s staff see who has been contacted, which services were delivered and whether referrals took place. They can then follow up if necessary.

Stability and sustainability

Central Hillsborough Healthy Start operates through a local nonprofit, REACHUP Inc., in partnership with the University of South Florida and the Hillsborough Healthy Start Coalition.

Its funding comes primarily from the federal government through the Health Resources and Services Administration’s national Healthy Start program. The program’s current federal funding extends into 2029. But proposed changes to the federal budget threaten to eliminate this funding altogether.

The program’s budget is supplemented by local partners, including Hillsborough County, which helps sustain operations despite federal uncertainty.

Locally, the Hillsborough coalition’s portfolio includes programs that work together like one team, sharing information so families keep getting help even when one grant ends. These partnerships with local community organizations allow the program to remain stable.

A model for others

Looking at the data, we believe Central Hillsborough Healthy Start has succeeded by using the same basic approach for everyone, then customizing. Everyone gets screened early and set up with nurse visits. Then, its adds what each family needs so that support fits real life.

The Central Hillsborough story shows that health disparities are not inevitable. And this model can serve as a feasible blueprint for other communities. With early identification, consistent support and sustained investment, the outcomes for mothers and babies can improve dramatically.

Read more stories from The Conversation focused on Florida.

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. How one Florida program reduced preterm births – and how it could serve as a model for other communities – https://theconversation.com/how-one-florida-program-reduced-preterm-births-and-how-it-could-serve-as-a-model-for-other-communities-268058

Source: The Conversation – USA (2) – By Kent Jones, Professor Emeritus, Economics, Babson College

The U.S. Supreme Court is currently reviewing a case to determine whether President Donald Trump’s global tariffs are legal.

Until recently, tariffs rarely made headlines. Yet today, they play a major role in U.S. economic policy, affecting the prices of everything from groceries to autos to holiday gifts, as well as the outlook for unemployment, inflation and even recession.

I’m an economist who studies trade policy, and I’ve found that many people have questions about tariffs. This primer explains what they are, what effects they have, and why governments impose them.

What are tariffs, and who pays them?

Tariffs are taxes on imports of goods, usually for purposes of protecting particular domestic industries from import competition. When an American business imports goods, U.S. Customs and Border Protection sends it a tariff bill that the company must pay before the merchandise can enter the country.

Because tariffs raise costs for U.S. importers, those companies usually pass the expense on to their customers by raising prices. Sometimes, importers choose to absorb part of the tariff’s cost so consumers don’t switch to more affordable competing products. However, firms with low profit margins may risk going out of business if they do that for very long. In general, the longer tariffs are in place, the more likely companies are to pass the costs on to customers.

Importers can also ask foreign suppliers to absorb some of the tariff cost by lowering their export price. But exporters don’t have an incentive to do that if they can sell to other countries at a higher price.

Studies of Trump’s 2025 tariffs suggest that U.S. consumers and importers are already paying the price, with little evidence that foreign suppliers have borne any of the burden. After six months of the tariffs, importers are absorbing as much as 80% of the cost, which suggests that they believe the tariffs will be temporary. If the Supreme Court allows the Trump tariffs to continue, the burden on consumers will likely increase.

While tariffs apply only to imports, they tend to indirectly boost the prices of domestically produced goods, too. That’s because tariffs reduce demand for imports, which in turn increases the demand for substitutes. This allows domestic producers to raise their prices as well.

A brief history of tariffs

The U.S. Constitution assigns all tariff- and tax-making power to Congress. Early in U.S. history, tariffs were used to finance the federal government. Especially after the Civil War, when U.S. manufacturing was growing rapidly, tariffs were used to shield U.S. industries from foreign competition.

The introduction of the individual income tax in 1913 displaced tariffs as the main source of U.S. tax revenue. The last major U.S. tariff law was the Smoot-Hawley Tariff Act of 1930, which established an average tariff rate of 20% on all imports by 1933.

Those tariffs sparked foreign retaliation and a global trade war during the Great Depression. After World War II, the U.S. led the formation of the General Agreement on Tariffs and Trade, or GATT, which promoted tariff reduction policies as the key to economic stability and growth. As a result, global average tariff rates dropped from around 40% in 1947 to 3.5% in 2024. The U.S. average tariff rate fell to 2.5% that year, while about 60% of all U.S. imports entered duty-free.

While Congress is officially responsible for tariffs, it can delegate emergency tariff power to the president for quick action as long as constitutional boundaries are followed. The current Supreme Court case involves Trump’s use of the International Emergency Economic Powers Act, or IEEPA, to unilaterally change all U.S. general tariff rates and duration, country by country, by executive order. The controversy stems from the claim that Trump has overstepped his constitutional authority granted by that act, which does not mention tariffs or specifically authorize the president to impose them.

The pros and cons of tariffs

In my view, though, the bigger question is whether tariffs are good or bad policy. The disastrous experience of the tariff war during the Great Depression led to a broad global consensus favoring freer trade and lower tariffs. Research in economics and political science tends to back up this view, although tariffs have never disappeared as a policy tool, particularly for developing countries with limited sources of tax revenue and the desire to protect their fledgling industries from imports.

Yet Trump has resurrected tariffs not only as a protectionist device, but also as a source of government revenue for the world’s largest economy. In fact, Trump insists that tariffs can replace individual income taxes, a view contested by most economists.

Most of Trump’s tariffs have a protectionist purpose: to favor domestic industries by raising import prices and shifting demand to domestically produced goods. The aim is to increase domestic output and employment in tariff-protected industries, whose success is presumably more valuable to the economy than the open market allows. The success of this approach depends on labor, capital and long-term investment flowing into protected sectors in ways that improve their efficiency, growth and employment.

Critics argue that tariffs come with trade-offs: Favoring one set of industries necessarily disfavors others, and it raises prices for consumers. Manipulating prices and demand results in market inefficiency, as the U.S. economy produces more goods that are less efficiently made and fewer that are more efficiently made. In addition, U.S. tariffs have already resulted in foreign retaliatory trade actions, damaging U.S. exporters.

Trump’s tariffs also carry an uncertainty cost because he is constantly threatening, changing, canceling and reinstating them. Companies and financiers tend to invest in protected industries only if tariff levels are predictable. But Trump’s negotiating strategy has involved numerous reversals and new threats, making it difficult for investors to calculate the value of those commitments. One study estimates that such uncertainty has actually reduced U.S. investment by 4.4% in 2025.

A major, if underappreciated, cost of Trump’s tariffs is that they have violated U.S. global trade agreements and GATT rules on nondiscrimination and tariff-binding. This has made the U.S. a less reliable trading partner. The U.S. had previously championed this system, which brought stability and cooperation to global trade relations. Now that the U.S. is conducting trade policy through unilateral tariff hikes and antagonistic rhetoric, its trading partners are already beginning to look for new, more stable and growing trade relationships.

So what’s next? Trump has vowed to use other emergency tariff measures if the Supreme Court strikes down his IEEPA tariffs. So as long as Congress is unwilling to step in, it’s likely that an aggressive U.S. tariff regime will continue, regardless of the court’s judgment. That means public awareness of tariffs ⁠– and of who pays them and what they change ⁠– will remain crucial for understanding the direction of the U.S. economy.

Kent Jones 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. Tariffs 101: What they are, who pays them, and why they matter now – https://theconversation.com/tariffs-101-what-they-are-who-pays-them-and-why-they-matter-now-271576

Source: The Conversation – USA (2) – By Chao Guo, Professor of Nonprofit Management, University of Pennsylvania

Long-term care for older people is challenging for everyone. The costs are high and the quality of care is unpredictable at best, often falling short.

The U.S. health care system is so hard to navigate that experts can find it aggravating. Even when people who need help with activities of daily living – a list that includes getting dressed, preparing meals and bathing – receive the care they need, they may still experience social isolation. And it can take a relentless emotional toll on caretakers, be they family members or trained professionals.

We are researchers of government, business and nonprofits. Together, we are seeking innovative solutions to pressing social problems such as the aging population and the growing need for long-term care.

In our ongoing research, we’re exploring a promising concept that could potentially ease some of these burdens: time banking, a community-based mutual aid system that treats everyone’s time as equally valuable.

A global demographic shift

By 2050, 1 in 6 people around the world will be over 65, up from 1 in 11 in 2019, the United Nations projects. By the late 2070s, older adults could outnumber children under 18 for the first time in human history.

Caring for a growing number of older people with a shrinking number of younger people is expensive and complicated. A 2022 Kaiser Family Foundation survey found that 90% of respondents could not afford the estimated US$100,000 annual cost of nursing home care, and even the roughly $60,000 cost of in-home assistance was beyond the reach for most U.S. families.

These high costs are compounded by a growing shortage of professional caregivers. The U.S. Bureau of Labor Statistics estimates that nearly 9 million new direct-care workers, such as nursing assistants, home health aides and personal care aides, will be needed in the next decade to care for the people who will need their services.

Yet a 2023 survey by the American Health Care Association found that 77% of nursing homes face staffing shortages, and 95% report difficulty hiring.

Time banking origins

Time banking emerged in Japan in 1973 through the work of Teruko Mizushima, a housewife who became a social activist. It was later popularized in the United States by Edgar Cahn, a lawyer who dedicated his life to making society more fair.

The idea is simple: One hour of help equals one time credit, regardless of the task or its market value.

Members earn time credits by assisting others. The options are endless, but here are some examples: They can drive someone to an appointment, prepare a meal or teach basic skills, such as how to knit or change a tire. After they’ve earned credits, participants can spend them when they need support themselves. So, if you dedicated a total of 60 hours helping others, you could then redeem 60 hours at a future date in the form of someone caring for you.

Mizushima’s Volunteer Labor Bank in Osaka, the world’s first time bank, used a time-based complementary currency known as “love currency,” which members could save for later use or transfer to their relatives.

Hour Exchange Portland, one of the longest-running time banks in the U.S., is a system where neighbors have traded services using time credits for nearly three decades. It’s among hundreds of time banks operating in the country.

Resonating with the realities of aging

We have designed our research to facilitate a comparative investigation of time-banking practices across countries and regions. In the past two years, we have conducted interviews and convened focus groups with dozens of time bank participants and adults who were either middle-aged or over 65 in the U.S. and China.

Our findings suggest that time banking might be particularly helpful in solving three problems associated with aging that conventional systems fail to address: the affordability of care, the scope of care, and social isolation.

First, as the cost of paid care rises, time credits offer a new way to obtain basic assistance without spending more money. For many families, the ability to pay with their time instead of their money could make caring for their loved ones more affordable.

Time banking also brings visibility to types of labor that market-based systems routinely overlook or undercompensate: emotional support, companionship, help with small daily routines, and patient explanations for how new technologies work. These forms of care are rarely paid for, yet they are central to maintaining independence and dignity.

Perhaps more importantly, time banking fosters connections because it doesn’t simply reward transactions. Instead, it assigns value to many kinds of human interactions.

Our interviews indicated that services are exchanged through a wide range of activities: practicing calligraphy with someone else, teaching Tai Chi, reading aloud to someone who is visually impaired, or checking in with a neighbor to remind them to take their medication.

These exchanges are less about specialized skills and more about showing up for one another. They broaden the caregiving ecosystem and remind older adults that they remain essential members of their communities.

As we learned, when older adults engage in time banking, they feel seen, useful and woven into the fabric of community life.

A path forward

Creating time banks that can make it easier for families to handle their elder care responsibilities would require meeting numerous challenges.

Some are inherent in time banks. For example, it’s hard to sustain high levels of participation, meet the diverse needs of a time bank’s members, reduce the risks of some members exploiting the system, and pay for administrative costs.

Other challenges are more specific to elder care. For example, it might not be feasible to maintain reciprocity among members, as those who are frail tend to be on the receiving end of time-banked services and can’t easily give back.

But by analyzing the pros and cons of various designs, our research team hopes to develop a time-banking model tailored to elder care.

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. Time banks could ease the burden of elder care and promote connection – https://theconversation.com/time-banks-could-ease-the-burden-of-elder-care-and-promote-connection-264541

Source: The Conversation – USA (2) – By Nora Gilbert, Professor of Literary and Film Studies, University of North Texas

Along with millions of others, I’ll soon be taking 2 hours and 10 minutes out of my busy holiday schedule to sit down and watch a movie I’ve seen countless times before: Frank Capra’s “It’s a Wonderful Life,” which tells the story of a man’s existential crisis one Christmas Eve in the fictional town of Bedford Falls.

There are lots of reasons why this eight-decade-old film still resonates, from its nostalgic pleasures to its cultural critiques.

But when I watch it this year, the sequence where Bedford Falls transforms into the dark and dystopian “Pottersville” will resonate the most.

In the film, protagonist George Bailey, who’s played by Jimmy Stewart, is on the brink of suicide. He seems to have achieved the hallmarks of the American dream: He’s taken over his father’s loan business, married the love of his life and fathered four excessively adorable children. But George feels stifled and beaten down. His Uncle Billy has misplaced US$8,000 of the company’s money, and the town’s resident tyrant, Mr. Potter, is using the mishap to try to ruin George, who’s his last remaining business competitor.

An angel named Clarence is tasked with pulling George back from the brink. To stop him from attempting suicide, Clarence decides to show George what life would have been like if he’d never been born. In this alternate reality, Bedford Falls is called Pottersville, a place Mr. Potter runs as a ruthless banker and slumlord.

Having previously written about “It’s a Wonderful Life” in my book on literary and film censorship, I can’t help but see parallels between Pottersville and the U.S. today.

Think about it:

In Pottersville, one man hoards all the financial profits and political power.

In Pottersville, greed, corruption and cynicism reign supreme.

In Pottersville, hard-working immigrants like Giuseppe Martini who were able to build a life and run a business in Bedford Falls have vanished.

In Pottersville, homeless addicts like Mr. Gower and nonconformist “pixies” like Clarence are scorned and ostracized, then booted out of the local watering hole.

In Pottersville, cops arrest people like Violet Bick while they’re at work and haul them away, kicking and screaming.

But what horrifies George the most about Pottersville is how desensitized the people living in it seem to be to its harshness and cruelty – how they treat him like he’s the crazy, deranged one for wanting and expecting things to be different and better.

This is what the current political moment feels like to me. There are days when the latest headlines feel so jarringly unprecedented that I find myself thinking, “Can this be happening? Can this be real?”

If you think these comparisons are a bit of a stretch, consider when “It’s a Wonderful Life” was made, and the frame of mind Capra was in when he made it.

Frank Capra, anti-fascist

In 1946, Capra was just returning to Hollywood filmmaking after serving for four years in the U.S. Army, where the Office of War Information had tasked him with producing a series of documentary films about World War II and the lead-up to it. Even though Capra hadn’t been on the front lines, he’d been immersed in the sounds and images of war for years on end, and he had become acutely familiar with Germany, Italy and Japan’s respective rises to fascism.

When deciding on his first postwar film, Capra recalled in his autobiography that he specifically “knew one thing – it would not be about war.” Instead, he chose to adapt a short story by Philip Van Doren Stern, “The Greatest Gift,” that Stern had originally sent to friends and family as a Christmas card in 1943.

Stern’s story is certainly not about war. But it’s not exactly about Christmas, either.

As Stern writes in his opening lines:

“The little town straggling up the hill was bright with colored Christmas lights. But George Pratt did not see them. He was leaning over the railing of the iron bridge, staring down moodily at the black water.”

The protagonist contemplates suicide because he’s “sick of everything” in the small-town “mudhole” he’s stuck in – until, that is, a “strange little man” gives him the chance to see what life would be like if he’d never been born.

It was Capra and his team of screenwriters who added the sinister Henry F. Potter to Stern’s short, simple tale. The Potter subplot encapsulates the film’s most trenchant, still-resonant themes: the unfairness of socioeconomic injustices; the pervasiveness of corporate and political corruption; the threat of monopolized power; the need for affordable housing.

These themes had, of course, run through many of Capra’s prewar films as well: “Mr. Deeds Goes to Town,” “You Can’t Take It with You” ““Meet John Doe” and “Mr. Smith Goes to Washington,” the last of which also starred Jimmy Stewart.

But they take on a different kind of weight in “It’s a Wonderful Life” – a weight that’s especially visible on the weathered face of Stewart, who himself had just returned from a harrowing four-year tour of duty as a fighter pilot in Europe.

The idealistic vigor with which Stewart had fought crooked politicians and oligarchs as Mr. Smith is replaced by the bitterness, exhaustion, frustration and desperation with which he battles against Mr. Potter as George Bailey.

Life after Pottersville

By the time George has begged and pleaded his way out of Pottersville, the lost $8,000 is no longer top of mind. He’s mainly just relieved to find Bedford Falls as he had left it, warts and all.

And yet, the Bedford Falls that George returns to isn’t quite the same as the one he left behind.

In this Bedford Falls, the community rallies together to figure out a way to recoup George’s missing money. Their pre-digital version of a GoFundMe page saves George from what he’d feared most: bankruptcy, scandal and prison.

And even though his wife, Mary, tries to attribute this sudden wave of collectivist, activist energy to some sort of divine intervention – “George, it’s a miracle; it’s a miracle!” – Uncle Billy points out that it really came about through more earthly organizing means: “Mary did it, George; Mary did it! She told some people you were in trouble, and they scattered all over town collecting money!”

But the question of whether George actually wins his battle against Potter is a murky one.

While the typical Capra protagonist triumphs by defeating vice and exposing subterfuge, George never even realizes that Potter is the one who got hold of his money and tried to ruin his life. Potter is never held accountable for his crimes.

On the other hand, George is able to learn, from his time in Pottersville, what a crucial role he plays in his community. George’s victory over Potter, then, lies not in some grand final act of retribution, but in the incremental ways he has stood up to Potter throughout his life: not capitulating to Potter’s bullying or intimidation tactics; speaking truth to power; and running a community-centered business rather than one guided by greed and exploitation.

In recent months, there have been similar acts of protest, large and small, in the form of rallies, boycotts, immigrant aid efforts, subscription cancellations, food bank donations and more.

That doesn’t mean the U.S. has made it out of Pottersville, however.

Each day, more head-spinning headlines appear, whether they’re about masked agents terrorizing immigrant communities, the dismantling of anti-corruption oversights, the consolidation of executive power or the naked display of political grift.

Zuzu’s petals are still missing. Clarence still hasn’t gotten his wings.

But this holiday season, I’m hoping it will feel helpfully cathartic to go with George Bailey, for the umpteenth time, through the dark abyss of his dystopian nightmare – and come out with him, stronger and wiser, on the other side.

Nora Gilbert 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. The dystopian Pottersville in ‘It’s a Wonderful Life’ is starting to feel less like fiction – https://theconversation.com/the-dystopian-pottersville-in-its-a-wonderful-life-is-starting-to-feel-less-like-fiction-270759

Source: The Conversation – USA (3) – By Joshua Shanes, Emanuel Ringelblum Professor in Jewish History, University of California, Davis

Friends and family will come together to celebrate, share gifts and eat traditional foods as the eight-day Jewish festival of Hanukkah begins on Dec. 14, 2025.

Hanukkah commemorates the rededication of the Second Temple in Jerusalem, the center of ancient Judean worship, in 164 B.C.E. It had been defiled by the Seleucid king Antiochus IV Epiphanes and was recaptured by Judean forces. Judean culture had been transformed by Greek influence for centuries, but Antiochus attempted to quash Judean religious distinctiveness altogether. This led to a rebellion by the Hasmonean family, known also as the Maccabees. They established a dynasty that lasted until the conquest by Rome in 63 B.C.E.

The story is preserved in the Books of the Maccabees, written during the second and first centuries B.C.E. Some Christians consider the texts part of the Bible, though Jews today do not. The first rabbis working 2,000 years ago left it out of the Jewish Bible.

As a scholar of modern Jewish religion and politics, I have always been fascinated by the ways in which modern Jews pick and choose from the well of tradition to construct a form of Jewishness they feel is authentic.

Hanukkah serves as a prime example of this process.

What does the holiday celebrate?

The eight-day holiday has two traditional components. On the one hand, its liturgy gives thanks to God for the military victory. This reflects the original pre-rabbinic core of the holiday, which was declared by the new Hasmonean dynasty to celebrate its triumph.

The primary ritual of the holiday, however, is the lighting of the Hanukkah menorah. It celebrates the legend of a single flask of pure oil found in the Temple that was sufficient for just one day, but miraculously burned for eight.

The earliest version of this story appears in the Talmud – the main collection of rabbinic laws and commentary – some 500 years after the story occurred. The founders of Rabbinic Judaism – the Judaism of the past 2,000 years – were apparently uncomfortable with its military message and reshaped the holiday to give it new meaning.

In the words of historian Malka Simkovich, “Instead of glorying military prowess, the holiday instead glorifies the unconditional and miraculous divine light that Jews can depend on, even in the gloomiest of darkness.” This reflects Rabbinic Judaism’s tendency to reread biblical and other texts about land and power as metaphors for spiritual growth and faith.

Though popular today, Hanukkah is traditionally a minor holiday on which work is permitted. Over time, it developed into a celebration emphasizing family and children, games and gifts and special foods.

Modernity brings new meanings

In the 19th century, this shared meaning of the holiday changed. In America and parts of Europe, Jews experienced emancipation and economic mobilization and sought ways to integrate into their local national communities.

As Jews became more integrated into wider society, Hanukkah served as an opportunity to celebrate at a time of year when their Christian neighbors were doing the same. They continued to celebrate the holiday in its rabbinic, spiritual meaning, however. As the pioneering European Hebrew newspaper Hamagid wrote in 1857: “More than we recall the physical valor of the Maccabees, we understand the war as a struggle for spiritual deliverance from Greek culture.”

Then came Zionism, the Jewish nationalist movement born in the 1880s in Europe, that defined Jews as a modern nation rather than just a religion. It hoped one day to establish a home in Palestine, the site of the ancient Israelite kingdoms. They used Jewish traditions, especially pre-rabbinic biblical traditions about Jews living in that land, to prove the validity of their worldview.

Zionists quickly adopted Hanukkah as their most important holiday. They did this for a variety of reasons, but most important was its easy reformulation into a secular nationalist festival.

Zionism remakes Hanukkah

Hanukkah was not merely repackaged by Zionists in Europe; it was totally transformed from a relatively minor holiday into the central annual celebration of the movement.

Moreover, while the miracle of the oil defined traditional celebrations, it was specifically the military victory that defined Zionist ones. For the fledgling nationalist movement, the ancient story gave a historical example of Jewish heroes who successfully fought to expel foreign invaders from their homeland.

They exemplified the “new Jew,” the “Jew of muscle” that their leaders promoted, in contrast to the European stereotype of Jews as weak or bookish.

The role of God and even the Temple was limited; the story was refocused on the nation and its military struggle for freedom and independence. Hanukkah offered weapons, heroes and victories, writes historian Francois Guesnet: “It was an occasion to confront the glorious past with the needs of the contemporary national re-awakening.”

At the same time, Zionist Hanukkah celebrations also connected the movement to Jewish religious observance, thereby appealing to traditional groups without alienating its secular core. After all, Hanukkah was a traditional Jewish celebration, and since work is allowed, they were not violating any ritual laws with their events.

Orthodox leaders did not buy it.

In Sanz, for example – a city today in Poland – the Zionists’ first Hanukkah celebration in 1900 raised a storm of protest by local Hasidic leaders. They accused the Zionists of desanctifying the holiday and defiling the Hanukkah miracle. They even complained that the Zionists defiled the Star of David by using it in their signage and directed that the emblem be torn off the Holy Ark in the synagogue.

Over time, the Zionists’ version of Hanukkah largely won, especially in Israel. Zionists brought these values into the new Jewish state that they succeeded in creating in 1948. But it has also been embraced by many Jews in the diaspora.

Other meanings persist

The rabbinic tradition has not disappeared. There are still ultra-Orthodox Jews who reject the Zionist return to pre-rabbinic traditions of the Book of Maccabees, for example. There are also many liberal Jews, especially young Jews, who reject the infusion of Zionism into their Jewish identity.

These numbers have grown in recent years due to Israel’s actions in the Gaza Strip and the West Bank.

The Book of Maccabees describes the battle against Antiochus being preceded by a battle against Jews who sided with him. As a result, it has become almost an annual tradition for Jews to accuse each other of representing that traitorous group and to claim that one’s own camp represents the true Jews.

Some Jews will write editorials and social media posts about how Hanukkah “proves” that Zionism is the authentic interpretation of Jewish tradition. Some even question why non-Zionist or anti-Zionist Jews bother lighting candles. Their opponents respond with articles about Hanukkah’s history as a rabbinic holiday and how it has been reinterpreted since the start of the Zionist movement.

Each argues that their own interpretation is the correct one.

In truth, Judaism is constantly being made and remade. Is Hanukkah’s “real” meaning the Zionist return to pre-rabbinic sources? Or is it the rabbinic spiritualization of the holiday and its metaphor of bringing light into darkness? There is no clear answer.

In other words, both sides have sources to support their interpretation. Zionists can draw on the military imagery featured in the First Book of Maccabees and other sources. For those who prefer the holiday as presented by the rabbis who founded Rabbinic Judaism 2,000 years ago, there is an equal wealth of material, including in the prayers recited in synagogues.

The rabbis assigned a special reading from the later biblical books for each Sabbath and holiday. Their choice for the Sabbath of Hanukkah – Zechariah 2:14-4:7 – is revealing: “This is the word of the Lord to Zerubbabel, saying: ‘Not by military might and not by physical power, but by My spirit,’ says the Lord of Hosts.”

Joshua Shanes 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. Hanukkah celebrates both an ancient military victory and a miracle of light – modern Jews can pick from either tradition – https://theconversation.com/hanukkah-celebrates-both-an-ancient-military-victory-and-a-miracle-of-light-modern-jews-can-pick-from-either-tradition-271624

Source: The Conversation – USA – By Carlos Gershenson, Professor of Innovation, Binghamton University, State University of New York

In the past decade, AI’s success has led to uncurbed enthusiasm and bold claims – even though users frequently experience errors that AI makes. An AI-powered digital assistant can misunderstand someone’s speech in embarrassing ways, a chatbot could hallucinate facts, or, as I experienced, an AI-based navigation tool might even guide drivers through a corn field – all without registering the errors.

People tolerate these mistakes because the technology makes certain tasks more efficient. Increasingly, however, proponents are advocating the use of AI – sometimes with limited human supervision – in fields where mistakes have high cost, such as health care. For example, a bill introduced in the U.S. House of Representatives in early 2025 would allow AI systems to prescribe medications autonomously. Health researchers as well as lawmakers since then have debated whether such prescribing would be feasible or advisable.

How exactly such prescribing would work if this or similar legislation passes remains to be seen. But it raises the stakes for how many errors AI developers can allow their tools to make and what the consequences would be if those tools led to negative outcomes – even patient deaths.

As a researcher studying complex systems, I investigate how different components of a system interact to produce unpredictable outcomes. Part of my work focuses on exploring the limits of science – and, more specifically, of AI.

Over the past 25 years I have worked on projects including traffic light coordination, improving bureaucracies and tax evasion detection. Even when these systems can be highly effective, they are never perfect.

For AI in particular, errors might be an inescapable consequence of how the systems work. My lab’s research suggests that particular properties of the data used to train AI models play a role. This is unlikely to change, regardless of how much time, effort and funding researchers direct at improving AI models.

Nobody – and nothing, not even AI – is perfect

As Alan Turing, considered the father of computer science, once said: “If a machine is expected to be infallible, it cannot also be intelligent.” This is because learning is an essential part of intelligence, and people usually learn from mistakes. I see this tug-of-war between intelligence and infallibility at play in my research.

In a study published in July 2025, my colleagues and I showed that perfectly organizing certain datasets into clear categories may be impossible. In other words, there may be a minimum amount of errors that a given dataset produces, simply because of the fact that elements of many categories overlap. For some datasets – the core underpinning of many AI systems – AI will not perform better than chance.

For example, a model trained on a dataset of millions of dogs that logs only their age, weight and height will probably distinguish Chihuahuas from Great Danes with perfect accuracy. But it may make mistakes in telling apart an Alaskan malamute and a Doberman pinscher, since different individuals of different species might fall within the same age, weight and height ranges.

This categorizing is called classifiability, and my students and I started studying it in 2021. Using data from more than half a million students who attended the Universidad Nacional Autónoma de México between 2008 and 2020, we wanted to solve a seemingly simple problem. Could we use an AI algorithm to predict which students would finish their university degrees on time – that is, within three, four or five years of starting their studies, depending on the major?

We tested several popular algorithms that are used for classification in AI and also developed our own. No algorithm was perfect; the best ones − even one we developed specifically for this task − achieved an accuracy rate of about 80%, meaning that at least 1 in 5 students were misclassified. We realized that many students were identical in terms of grades, age, gender, socioeconomic status and other features – yet some would finish on time, and some would not. Under these circumstances, no algorithm would be able to make perfect predictions.

You might think that more data would improve predictability, but this usually comes with diminishing returns. This means that, for example, for each increase in accuracy of 1%, you might need 100 times the data. Thus, we would never have enough students to significantly improve our model’s performance.

Additionally, many unpredictable turns in lives of students and their families – unemployment, death, pregnancy – might occur after their first year at university, likely affecting whether they finish on time. So even with an infinite number of students, our predictions would still give errors.

The limits of prediction

To put it more generally, what limits prediction is complexity. The word complexity comes from the Latin plexus, which means intertwined. The components that make up a complex system are intertwined, and it’s the interactions between them that determine what happens to them and how they behave.

Thus, studying elements of the system in isolation would probably yield misleading insights about them – as well as about the system as a whole.

Take, for example, a car traveling in a city. Knowing the speed at which it drives, it’s theoretically possible to predict where it will end up at a particular time. But in real traffic, its speed will depend on interactions with other vehicles on the road. Since the details of these interactions emerge in the moment and cannot be known in advance, precisely predicting what happens to the the car is possible only a few minutes into the future.

Not with my health

These same principles apply to prescribing medications. Different conditions and diseases can have the same symptoms, and people with the same condition or disease may exhibit different symptoms. For example, fever can be caused by a respiratory illness or a digestive one. And a cold might cause cough, but not always.

This means that health care datasets have significant overlaps that would prevent AI from being error-free.

Certainly, humans also make errors. But when AI misdiagnoses a patient, as it surely will, the situation falls into a legal limbo. It’s not clear who or what would be responsible if a patient were hurt. Pharmaceutical companies? Software developers? Insurance agencies? Pharmacies?

In many contexts, neither humans nor machines are the best option for a given task. “Centaurs,” or “hybrid intelligence” – that is, a combination of humans and machines – tend to be better than each on their own. A doctor could certainly use AI to decide potential drugs to use for different patients, depending on their medical history, physiological details and genetic makeup. Researchers are already exploring this approach in precision medicine.

But common sense and the precautionary principle
suggest that it is too early for AI to prescribe drugs without human oversight. And the fact that mistakes may be baked into the technology could mean that where human health is at stake, human supervision will always be necessary.

Carlos Gershenson 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. AI’s errors may be impossible to eliminate – what that means for its use in health care – https://theconversation.com/ais-errors-may-be-impossible-to-eliminate-what-that-means-for-its-use-in-health-care-251036

Source: The Conversation – USA – By Lisa Fazio, Associate Professor of Psychology, Vanderbilt University

Zohran Mamdani as a creepy trick-or-treater, Gavin Newsom body-slamming Donald Trump and Hakeem Jeffries in a sombrero. This is not the setup to an elaborate joke. Instead, these are all examples of recent AI-generated political videos. New easy-to-use tools – and acceptance of those tools by politicians – means that these fake videos are quickly becoming commonplace in American politics.

Perhaps the most interesting thing about many of the videos is how clearly fake they are. Rather than trying to deceive the viewer into thinking a depicted event actually happened, the videos serve a different purpose. President Trump didn’t post a video of himself wearing a crown in a fighter jet dumping feces on a group of protesters because he wanted people to believe that the flight actually happened. He likely did it to express his feelings about the protest and to create an in-joke with his followers.

Fears about the political implications of AI-generated videos have been around since the term deepfakes was coined in 2017. Steady improvements in the technology mean that distinguishing real from fake could become a significant threat. But today’s use of AI imagery is largely about making memes and making money – in other words, typical social media content.

Getting a rise out of people

Internet platforms use algorithms designed to keep people engaged, and that typically means promoting content that stirs emotions. AI-generated political videos often provoke an emotional response – amusement or outrage.

People are more likely to share information when it is emotionally arousing. For example, people are more likely to pass along urban legends that elicit feelings of disgust, and news articles that are emotionally charged are more likely to make the New York Times list of most emailed articles. Similar patterns occur online, where emotional content is much more likely to go viral than nonemotional content.

In addition, strong emotions can interfere with people’s ability to detect false information. People are worse at distinguishing between true and false political news headlines when they are experiencing stronger emotions – for instance, enthusiasm, excitement or fear. Thus, emotionally appealing AI-generated videos are both more likely to spread and reduce people’s ability to judge whether they are real or fake.

Online politics

Creating and sharing AI videos is also a powerful way for people to demonstrate their allegiances and show their political identities. “I am a Trump supporter, so I post AI videos of ICE detainees crying to own the libs” or “I am a Democrat and so I share Governor Newsom’s AI-video of JD Vance talking about couches to show that I’m in on the joke.”

What’s new in recent months is that campaigns and politicians are using AI-created videos, not just their supporters. An analysis from The New York Times showed that Trump commonly uses AI imagery to “attack enemies and rouse supporters”.

These new tools also allow for active participation in the political process. Rather than simply watching politicians and voting, citizens can play an active role in shaping the conversation between elections.

Information and technology researcher Kate Starbird has written about similar dynamics in the ways that everyday Americans found “evidence” for voter fraud in the 2020 election. Politicians told the public that voter fraud was going to occur, and then when voters saw things that they did not understand when voting, such as the use of Sharpie pens to mark ballots, they interpreted that action as evidence of voter fraud. Politicians then circulated that evidence online to support the false narrative.

New AI tools make this cycle of participatory disinformation even simpler. Instead of reinterpreting actual events as evidence for a false claim, people can easily generate that evidence themselves.

AI video at volume

AI video creation tools make it incredibly easy for people to churn out hundreds of videos, post them online and simply see what content becomes popular and goes viral. In fact, that’s exactly what seems to have happened with recent AI-generated videos of raids by Immigration and Customs Enforcement. According to an investigation by 404 media, Facebook user “USA Journey 897” used to post a variety of real videos of police activity as well as absurd AI videos of people carrying whales and riding tigers.

However, after the release of a new version of OpenAI’s Sora video generator on Sept. 30, 2025, the account switched entirely to posting multiple fake videos of deportations every day. Most of the videos accumulated hundreds of thousands of views, and one fake video of a Walmart employee being detained had over 4 million views.

Typically these accounts are hosted overseas and exist to earn money through creator incentive programs. These incentives create an environment where social media no longer informs people about the world, but instead serves as a fun-house mirror, presenting back to us the world that we want to see – or at least the version of the world that will capture our attention and outrage.

Flowing into the internet

It’s not always easy for people to detect which videos are real and which are AI-generated. A recent audit by the publication Indicator found that platforms regularly fail to properly label AI content. Researchers posted over 500 AI-generated images and videos across Instagram, LinkedIn, Pinterest, TikTok and YouTube. Less than one-third were properly labeled as AI-generated, and even posts generated by the platform’s own AI tools were often missed.

For years, the great fear concerning political deepfakes was that they were going to fool people into believing something happened that didn’t. They still might, but at the moment, AI-generated political videos are a mix of entertainment and memes, legitimate attempts at persuasion, and ways of capturing attention for money.

In other words, they are now just like the rest of the internet. Most of what we see and share is meant to entertain, some is meant to inform and persuade, and a great deal exists solely to monetize our attention.

Lisa Fazio 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. AI-generated political videos are more about memes and money than persuading and deceiving – https://theconversation.com/ai-generated-political-videos-are-more-about-memes-and-money-than-persuading-and-deceiving-268977