Category: English

Source: The Conversation – UK – By Sally Pearse, Strategic Lead for Early Years and Director of the Early Years Community Research Centre, Sheffield Hallam University

The government has announced its strategy for “giving every child the best start in life”, laying out proposals covering early years care, education and support in England.

The strategy builds on the current local family hub model of services, which offer a range of support aimed at babies and young children. Best Start family hubs will further bring together early years and family services in a similar way to the previous Sure Start programme. The government’s commitment includes £1.5 billion in investment to implement these reforms.

The Best Start Hubs will be a one-stop shop to support families with their child’s early development, from breastfeeding advice to speech and language support and stay and play sessions. The hubs will also support families with wider challenges such as housing and benefits, and provide courses for parents.

The attempt to bring services together to deliver local, holistic support to families is understandable given the impact of the original Sure Start initiative, introduced by Tony Blair’s Labour government.

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The Sure Start Local Programmes that were established from 1999 onwards had a significant positive effect on those families who had access to them. From 2010, though, when the Conservative-Liberal Democrat coalition came into power, funding was cut and many Sure Start centres closed.

In May 2025 the Institute for Fiscal Studies published a summary report on the short- and medium-term effects of Sure Start on children’s lives.

They found that the impact of the Sure Start services for under-fives was remarkably long-lasting, with improvements during their teenage years in educational attainment and behaviour in school, and reductions in hospital admissions. The Institute for Fiscal Studies estimates that these long-term benefits significantly outweigh the cost of the Sure Start programme.

Like Sure Start, the Best Start strategy has the potential to be transformational for young children and their families.

However, the current range of challenges faced by families and the depth of child poverty in the country will make bringing about this transformation challenging. A 2023 report from charity the Joseph Rowntree Foundation estimates that there are one million children growing up destitute in the UK, without the means to stay warm, dry, clean and fed.

The challenge of poverty

The day after the Best Start strategy was launched, the children’s commissioner for England published a research report on children’s experience of growing up in a low-income family. Based on interviews with 128 children, the report outlines the “almost-Dickensian” levels of poverty experienced by children whose basic needs are not being met. Children described poor housing conditions, mouldy food and lack of hot water.

The significant impact that poverty has on children’s educational attainment, health and future lives will be difficult for the benefits that the Best Start programme may provide to negate.

I have witnessed these financial challenges and the wider range of issues families are dealing with on a daily basis in my own role as the director of the Early Years Community Research Centre at Sheffield Hallam University, and through my wider research with families.

In March 2024 I was part of a team of researchers who were commissioned by the Ministry for Housing, Community and Local Government to explore how multiple insecurities, such as financial difficulties, health problems, precarious work, poor housing and lack of support networks affected people’s lives.

Parents described the difficulties of making ends meet. They talked about having to deal with many different national and local agencies, the stress this created within their family and the toll on their health and wellbeing.

Even working full-time did not necessarily make families more secure. In one family, the working pattern the parents had to adopt to make ends meet meant that they only had one day a fortnight to be together.

We have to do stupid hours. I mean my partner, she works nights. I work mainly days … we’re kind of like passing ships in the night.

The places these families turned to were local community centres run by a range of organisations. The common themes about why they accessed these centres were the warm, welcoming, non-judgemental approach taken by staff, trusting relationships with staff and the range of services and support that were offered.

This bodes well for the Best Start strategy – if it is able to deliver the full range of services the government has outlined in a local trusted space. However, this will be a significant challenge in communities that have lacked support over recent years, are suffering the hardships of poverty and that may have lost trust in government services.

Sally Pearse received funding from the Ministry for Housing, Communities and Local Government

– ref. England’s family hubs plan aims to build on Sure Start’s success – but may struggle to overcome today’s child poverty levels – https://theconversation.com/englands-family-hubs-plan-aims-to-build-on-sure-starts-success-but-may-struggle-to-overcome-todays-child-poverty-levels-260630

Source: The Conversation – UK – By Christian Heiss, Professor of Cardiovascular Medicine, Head of Department of Clinical and Experimental Medicine, University of Surrey

Imagine having blocked arteries in your legs and not knowing it. At first, there may be no symptoms at all. Just occasional fatigue, cramping or discomfort – symptoms easy to dismiss as ageing or being out of shape.

But as blood flow worsens, a small cut on your foot might not heal. It can turn into an ulcer. In the worst cases, it can lead to amputation. This condition is called peripheral artery disease (PAD) – and it’s far more common than many realise.

PAD affects around one in five people over the age of 60 in the UK, and is especially prevalent in people with diabetes, high blood pressure or kidney disease.

PAD is rarely an isolated issue: it’s usually a sign of widespread atherosclerosis, the build-up of fatty deposits that can also narrow arteries in the heart and brain.

It also significantly increases the risk of heart attacks, strokes and other conditions linked to poor blood flow to vital organs. Research shows that a large proportion of people diagnosed with PAD will die within five to ten years, most often due to these complications.

Early detection is key to reducing the impact of PAD, and I’ve been working with colleagues to develop a faster, simpler way to diagnose it.

PAD testing

Doctors can check circulation in the feet by comparing blood pressure in the toe with that in the arm. The result is known as the toe–brachial index (TBI). The trouble is that the test needs a toe-sized cuff, an optical sensor and a doctor who knows how to use the equipment.

Many GP surgeries and foot clinics don’t have this kit. And in many people, especially those with diabetes or stiff arteries, the test doesn’t always give a clear or reliable, result.

Our research team asked a simple question: could we turn a routine ultrasound scan into a quick, reliable way to measure blood flow in the foot?

Most hospitals, and many community clinics, already have handheld ultrasound probes, which use Doppler sound to track how blood flows through vessels.

This works through the Doppler effect: as blood moves, it changes the pitch of the sound waves. Healthy blood flow creates a strong, steady “swoosh”, while a narrowed or blocked artery produces a faint or disrupted sound. Doctors are trained to hear the difference and use these sound patterns to spot circulation problems, especially in conditions like PAD.

But my research team wondered whether a computer could do more than listen: we wanted to know whether it could convert the shape of that Doppler “wave” into a number that mirrors the TBI.

To investigate, we scanned the feet of patients already being treated for PAD – 150 feet in all. For each artery, we used Doppler ultrasound to measure how quickly blood surged with each heartbeat, a pattern known as the acceleration index. We then compared these results to the standard toe–brachial index, the traditional test that measures blood pressure in the toe.

A one-minute scan, a nearly perfect match

The acceleration index alone was able to predict the standard toe–brachial index with 88% accuracy. Using a simple formula, we converted that Doppler reading into an “estimated TBI” – a number that closely mirrored the conventional result. It needed no toe cuff, no optical sensor and it took under a minute to perform.

Even more encouraging, estimated TBI rose in tandem with traditional TBI results after treatment. When patients underwent angioplasty – a procedure to reopen blocked arteries – their estimated TBI increased almost identically to the measured TBI. That means this scan doesn’t just help diagnose PAD; it could also be used to track recovery over time.

Crucially, our approach works with equipment that’s already widely available. We repeated the experiment using a basic pocket Doppler: the kind many GPs and podiatrists have tucked in a drawer.

While it wasn’t quite as precise as hospital-grade ultrasound, the results were still strong. With some additional software refinement, doctors could soon assess foot circulation quickly and accurately using tools they already own, without adding time to a busy clinic schedule.

Why early detection matters

Because early diagnosis of PAD changes everything. It can mean the difference between losing a foot, keeping your mobility and living longer with a better quality of life. It can shorten hospital stays and reduce the risk of heart attack and stroke.

But right now, too many people with PAD aren’t diagnosed until they already have chronic limb-threatening ischaemia – the most severe form of the disease. This condition occurs when blood flow to the legs or feet becomes critically low, depriving tissues of oxygen. It can cause constant foot pain (especially at night), wounds that won’t heal and, in advanced cases, tissue death (gangrene) and the risk of amputation. Without urgent treatment to restore circulation, chronic limb-threatening ischaemia can be life-threatening.

Part of the problem is that the tools used to diagnose PAD are often slow, expensive or too complicated for routine use. That’s why a simple, cuff-free Doppler scan that provides a reliable estimate of toe–brachial index is so promising. It uses equipment that many clinics already have, takes less than a minute and delivers immediate results – offering a faster, easier way to spot poor circulation before serious damage is done.

We’re now looking at ways to automate the measurement so that it can be used even by non-specialists. We’re testing it in various clinics with different patient groups and exploring its performance over time. But the evidence so far suggests that this could become a key part of vascular care – not just in hospitals, but in GP surgeries, diabetes clinics and anywhere else early intervention could save a limb.

Blocked arteries don’t need to stay hidden. With the right tools, we can find them earlier, treat them faster and protect people from the devastating consequences of late diagnosis.

Christian Heiss has received funding from Lipton Teas & Infusions, Ageless Science, iThera, the Medical Research Council, the ESRC, European Partnership on Metrology, co-financed from European Union’s Horizon Europe Research and Innovation Programme and UK Research and Innovation. He is member of the board of the European Society of Vascular Medicine, president of the Vascular, Lipid and Metabolic Medicine Council of the Royal Society of Medicine, and chairperson-elect of the ESC WG Aorta and Peripheral Vascular Diseases.

– ref. A one minute scan of your foot could help prevent amputation – here’s how – https://theconversation.com/a-one-minute-scan-of-your-foot-could-help-prevent-amputation-heres-how-260847

Source: The Conversation – UK – By Charikleia Sinani, Senior Lecturer in Physiotherapy, School of Science, Technology and Health, York St John University

When a child struggles to tie their shoelaces, write legibly or stay upright during PE, it can be dismissed as clumsiness or lack of effort. But for around 5% of UK children, these challenges stem from a neurodevelopmental condition known as developmental coordination disorder (DCD), also known as dyspraxia. And new findings reveal how deeply it’s impacting their lives – at home, in school and in their future.

Alongside colleagues, we conducted a national survey of more than 240 UK parents. The findings reveal a stark reality for families of children with developmental coordination disorder (DCD).

Despite affecting around 5% of children – making it as common as ADHD – DCD remains underdiagnosed, misunderstood and insufficiently supported. Families reported an average wait of nearly three years for a diagnosis, with almost one in five children showing clear signs of DCD but not yet having begun the diagnostic process.

The diagnosis, when it comes, is often welcomed: 93% of parents say it helped explain their child’s difficulties and offered clarity. But many also expressed frustration that this recognition didn’t change much in practical terms, particularly in schools. One parent summarised the prevailing sentiment: “It is helpful for us at home but not at school.”

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Our survey showed that the movement difficulties associated with DCD can ripple through everyday life, mental health and wellbeing.

Children with DCD face daily physical struggles with eating, dressing, cutting with scissors and handwriting. These aren’t just inconveniences. They translate into fatigue, frustration and often social exclusion. Compared to national averages, children in this survey were less active, with only 36% meeting recommended physical activity levels. Many parents worry that early disengagement from sport is cultivating lifelong habits that will undermine their children’s health.

The emotional impact is just as severe. A staggering 90% of parents expressed concern about their child’s mental health. Anxiety, low self-esteem and feelings of isolation are common. Children with DCD are significantly more likely than their peers to show signs of emotional and peer-related difficulties.

One parent recalled their child asking, “Why do I even try when I’m never picked?” Others shared heartbreaking worries: a child who felt “he doesn’t belong here” or another who had internalised the idea that they are “stupid” or “terrible”.

DCD is a lifelong condition: it doesn’t go away with age, and there’s currently no “cure.” However, with the right support, many children can develop strategies to manage their difficulties and thrive. Early intervention, tailored therapies, especially occupational therapy, and appropriate classroom accommodations can make a significant difference to a child’s confidence, independence and quality of life.

Schools are often unprepared

Despite 81% of teachers being aware of a child’s motor difficulties, fewer than 60% had individual learning plans in place. Support was inconsistent: some children benefited from teaching assistants or adaptive tools like laptops, while others found themselves struggling alone. Physical education posed particular challenges, with 43% of parents saying their child wasn’t supported in PE lessons, often facing teachers who didn’t understand DCD at all.

The consequences are significant: 80% of parents felt that movement difficulties negatively impacted their child’s education, and the same number feared it would affect their future employment.

Therapy helps but is hard to access. Most families had sought therapy, with occupational therapy proving transformative for some. Yet many faced long waits or had to pay out of pocket, with some families spending thousands annually. Even when therapy was available, 78% felt it wasn’t sufficient.

And it’s not just the children who suffer – 68% of parents reported constant emotional concern, and nearly half said the condition restricted their ability to take part in normal family activities.

What needs to change

To improve outcomes for children with DCD, we need urgent, coordinated action across five key areas. Parents and experts involved in the report outlined clear recommendations:

Awareness: A nationwide effort is needed to educate the public, schools and healthcare professionals about DCD as a common yet currently poorly understood condition.

Diagnosis: GPs and frontline professionals need clear, step-by-step guidance and referral routes to help them identify early motor difficulties and connect families with the right support quickly.

Education: All teachers should receive mandatory training in DCD and practical strategies for supporting affected pupils in the classroom.

Mental health: Support systems must recognise the deep connection between movement challenges and emotional wellbeing, ensuring that physical and psychological needs are treated together.

Support: Crucially, children shouldn’t have to wait for a formal diagnosis to get support. Early intervention is vital to preventing long-term harm – and must be available as soon as difficulties emerge.

Children with DCD are bright, capable and full of potential. But as one parent warns, “If she can’t write her answers down quickly enough in exams, she won’t be able to show her knowledge.” The cost of neglect is high, not just in lost grades or missed goals, but in the wellbeing of a generation of children struggling in silence.

Charikleia Sinani has received funding from The Waterloo Foundation.

Greg Wood has previously received funding from The Waterloo Foundation.

Kate Wilmut has in the past received funding from ESRC (Economic and Social Research Council), The Leverhulme Trust and The Waterloo Foundation

– ref. Dyspraxia: why children with developmental coordination disorder in the UK are still being failed – https://theconversation.com/dyspraxia-why-children-with-developmental-coordination-disorder-in-the-uk-are-still-being-failed-260853

Source: The Conversation – UK – By Robert Eaglestone, Professor of Contemporary Literature and Thought, Royal Holloway University of London

Raynor Winn, author of the award-winning memoir The Salt Path, which was recently adapted into a film, has been accused of “lies, deceit and desperation”. Writing in The Observer, reporter Chloe Hadjimatheou claims that Winn left out significant facts and invented parts of the story.

The Salt Path follows a transformative 630-mile trek along England’s South West Coast Path that Winn took with her terminally ill husband Moth after they lost their home and livelihood.

The Observer article claims that aspects of both the story of losing their home and Winn’s husband’s illness were fabricated. In a statement on her website, Winn has defended her memoir, calling the claims “grotesquely unfair” and “highly misleading”.

There’s a long list of memoirs which have been shown to be problematic. James Frey’s recovery memoir A Million Little Pieces (2003) was allegedly exaggerated. In 2006, he apologised for fabricating portions of the book. Worse, Binjamin Wilkomirski’s feted Holocaust survivor memoir Fragments: Memories of a Wartime Childhood (1995) was completely fake. Wilkomirski’s real name was Bruno Dössekker and he was not a Holocaust survivor, he had simply invented his “memories” of a death camp, though he seemed to believe they were true.

But, for readers, how much does this matter? Novelist D.H. Lawrence wrote that readers should: “Never trust the artist. Trust the tale.” As readers of The Salt Path, we fear for Raynor and Moth as they desperately try to escape drowning from a freak high tide at Portheras Cove. We are relieved when we hear that Moth’s terminal disease was “somehow, for a while, held at bay”.

The origin of the word fiction is from the Latin fingere, which means not to lie, but to fashion or form. All memoirs – indeed, all texts, from scientific articles to history books to bestselling novels – are “formed” or “shaped”. Writing doesn’t just fall from a tree, we make it, and it reveals the world by mediating the world.

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But this idea, that writing is a “shaping”, is why this case matters. Writing, done by oneself, or by a ghostwriter (or even by AI) has conventions, not-quite-rules that underlie its creation and reception. Some of these are in the text (the enemies eventually become lovers); some are outside the text itself (you really can judge a book by its cover). But most conventions are both inside and outside at the same time.

Works by historians have footnotes to sources, so you (and other historians) can check the claims. Each scientific article refers to many others, because each article is just one tiny piece of the whole puzzle on which a huge community of scientists are working, and the extensive references show how this piece fits (or doesn’t). Non-fiction follows conventions, while novelists can do whatever they want, of course, to challenge or obey the conventions (that’s one reason why novels are exciting).

Memoir has a particularly important convention, revealed most clearly by the historian Stefan Maechler’s report on Wilkomirski’s fraudulent memoir. Maechler argued that Wilkomirski broke what the French critic Philippe Lejeune called the “autobiographical pact”, a contract of truth between the author and the reader.

For Lejeune, however, this pact is not like a legal agreement. A memoir, unlike a scientific article, need only put forward the truth as it appeared to the author in that area of their life. While the information needs to be accurate to some degree, its level of verifiability is less than a legal document or work of history. Much more important for Lejeune is the harder-to-pin-down fidelity to meaning.

After all, many meaningful things – falling in love, for example, or grief – happen mostly inside us and are hard to verify. Even more, the developing overall shape of our life as it seems to us is not really a historical fact, but our own making of meaning. For Lejeune, in a memoir, this emotional truth is more significant than the verifiable truth.

Playing with ‘emotional truth’

The author of The Salt Path seems to have leaned into this idea. In her first statement after The Observer’s piece she claims that her book “lays bare the physical and spiritual journey Moth and I shared, an experience that transformed us completely and altered the course of our lives … This is the true story of our journey”. How, after all, could one verify a “spiritual journey”?

However, I don’t fully agree with Lejeune. Perhaps our inner and outer worlds are not as separate as he supposes. Our public actions, including sharing facts, show who we are as much as our words describing our inner journeys.

In a memoir, the verifiable truth and the emotional truth are linked by a kind of feedback loop. As readers, we allow some degree of playing with verifiable truth: dialogue is reconstructed, not recorded; we accept some level of dramatisation; we know it’s from one person’s perspective. But we also make a judgment about these things (there’s no fixed rule, no science to this judgment).

If there’s too much reconstruction, too much dramatisation, we begin to get suspicious about the emotional truth too: is this really how it felt for them? Was it honestly a spiritual journey? And, in turn, this makes us more suspicious of the verifiable claims. By contrast, the novelist’s pact with the reader admits they fake emotional truth, which somehow makes it not fake at all: that’s one reason why novels are complicated.

This is why defending a memoir’s “emotional truth” is a high-risk strategy. We know from our own lives that people who are unreliable in small (verifiable) things are often unreliable in large (emotional, meaningful) ones.

So, for readers, the facts behind The Salt Path matter less in themselves and more because each question points to a larger issue about the book’s meaning. When you call someone “fake”, you don’t really mean that “their factual claims are inaccurate”, but that they are somehow inauthentic, hollow or – it’s a teenager’s word, but still – phoney. Once the “autobiographical pact” looks broken in enough small details, the reader no longer trusts the teller or the tale.

In a lengthy statement published on her website in which she addresses the allegations in detail, Winn said that the suggestion that Moth’s illness was fabricated was an “utterly vile, unfair, and false suggestion” and added: “I can’t allow any more doubt to be cast on the validity of those memories, or the joy they have given so many.”

This article features references to books that have been included for editorial reasons, and may contain links to bookshop.org. If you click on one of the links and go on to buy something from bookshop.org The Conversation UK may earn a commission.

Robert Eaglestone 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. The Salt Path scandal: defending a memoir’s ‘emotional truth’ is a high-risk strategy – https://theconversation.com/the-salt-path-scandal-defending-a-memoirs-emotional-truth-is-a-high-risk-strategy-260937

Source: The Conversation – UK – By John Caro, Principal Lecturer, Film and Media, University of Portsmouth

Superman was the very first superhero. He debuted in Action Comics issue #1 which was released in June 1938. Over time, the character has been assigned multiple nicknames: “The Man of Steel”, “The Man of Tomorrow” and “The Big Blue Boy Scout”. However, in his first appearance in ravaged Depression-era America, the byline used to announce Superman’s debut was: “The Champion of the Oppressed”.

Created by the sons of Jewish immigrants, writer Jerry Siegel and artist Joe Shuster, Superman is an example of youthful male wish fulfilment: an all-powerful figure dressed like a circus strong man, who uses brawn to right wrongs. However, Siegel and Shuster’s initial version of the character was a more flawed character.

Appearing in a 1933 fanzine, Siegel’s prose story The Reign of the Superman with accompanying illustrations by Shuster, featured a reckless scientist whose hubris is punished when he creates the telepathic “super man” by experimenting on a drifter plucked from the poverty lines. Echoing Mary Shelley’s Frankenstein, the creator is dispatched by his creation.

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Siegel and Shuster had some early success selling stories to National Allied Publications, the forerunner of DC Comics. At this time, comic books were mainly collections of newspaper cartoons – the “funnies” – pasted together to create more portable anthologies. They featured the escapades of characters like Popeye and Little Orphan Annie.

Inspired by the heroic tales of derring do of pulp fiction adventurers such as Johnston McCulley’s Zorro (1919) and Philip Wylie’s 1930 science fiction novel Gladiator, Siegel and Shuster further developed their Superman character. They transformed him into a hero and added the now familiar cape and “S” logo.

Having no luck selling their superhero to the newspapers, they eventually sold the rights to Superman to DC Comics, where Superman achieved huge success. Within a year, there was a syndicated newspaper strip and a spin-off Superman comic book featuring the first superhero with their own exclusive title. Along with extensive merchandising, there was a 1940 radio show, followed by an animation series in 1941, with the inevitable live action serial in 1948.

In this early example of a property crossing multiple media platforms, Superman’s apparent appeal lay with the fantastical aspects, as he battled mad scientists, criminal masterminds and giant dinosaurs.

But in the early issues, Superman’s enemies were noticeably more earthbound and reflected the concerns of an audience reeling from the effects of the Great Depression. In an early story, War in Sante Monte, Superman confronts a corrupt Washington lobbyist, Alex Greer, who is bribing a greedy senator. It transpires that Greer represents an arms dealer who is profiteering by manipulating both sides in an overseas war.

In a later tale, Superman Battles Death Underground, our hero challenges the owner of a dangerous mine who is cutting corners with safety precautions.

In 1932 Siegel’s father, a tailor, died following the attempted robbery of the family shop – so it is no surprise that Superman had a low tolerance for crime and its causes. In the story Superman in the Slums, dated January 1939, the social commentary is plain. When teenager Frankie Marello is sentenced to reform school, Superman acknowledges the impact of the boy’s social environment:

It’s these slums – your poor living conditions – if there was only some way I could remedy it!

His solution is to raze the dilapidated buildings to the ground, forcing the authorities to replace them with modern cheap-rental apartments. In creating new construction work, here is Superman’s extreme version of President Franklin D. Roosevelt’s New Deal.

In the 1998 forward to Superman: The Action Comics Archives Volume 2, former DC Comics editor Paul Kupperberg comments this is a Superman “who fought (mainly) guys in suits out to screw over the little guy”. The form that the fight took is of interest, for this Superman has no time for niceties or due process, as he gleefully intimidates and bullies anyone who gets in his way.

A man caught beating his wife is thrown into a wall and warned that there is plenty more where that came from. The corrupt lobbyist is dangled over power cables until he reveals who he is working for. Any police officers that attempt to obstruct Superman’s personal quest for justice are brushed aside with annoyance.

Refining Superman

Through his appearances on mainstream radio and cinema, Superman softened and became more patient. In popular culture, concerns about the depression and social injustice shifted to efforts to encourage a national consensus as the United States moved to a war footing in the early 1940s.

Post-war, there were occasional returns to the more radical interpretations of Superman, but generally it is the clean cut, fantastical Big Blue Boy Scout perception of the character that has dominated.

The new Superman film appears to be maintaining that image. In the trailer, actor David Corenswet’s Superman tackles various super-villains and a destructive Kaiju (a Godzilla-like skyscraper-sized monster) – although there is the suggestion that behind them all is the corrupt industrialist, Lex Luthor.

Fittingly, it is in the pages of comic books that a more progressive, militant representation of Superman has emerged. In 2024 DC rebooted its familiar superheroes with its new grittier “Absolute” universe.

Jason Aaron and Rafa Sandoval’s Absolute Superman comic (2024) emphasises the character’s status as an isolated blue-collar immigrant from the doomed planet of Krypton. This is a youthful, less seasoned Superman who is quick to anger and less likely to pull his punches. Their interpretation is closer to Superman’s early vigilante roots, including a storyline where he liberates the workers in a Brazilian mine from the clutches of exploitative big business.

Perhaps – in the comic books at least – the Champion of the Oppressed has finally returned.

This article features references to books that have been included for editorial reasons, and may contain links to bookshop.org. If you click on one of the links and go on to buy something from bookshop.org The Conversation UK may earn a commission.

John Caro 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. Superman wasn’t always so squeaky clean – in early comics he was a radical vigilante – https://theconversation.com/superman-wasnt-always-so-squeaky-clean-in-early-comics-he-was-a-radical-vigilante-260721

Source: The Conversation – UK – By Divya Venkatesh, BBSRC Discovery Fellow, University of Oxford

Cambodia’s Ministry of Health recently confirmed the country’s twelfth human case of H5N1 avian influenza so far this year. The patient, a five-year-old boy from Kampot province, is currently in intensive care with severe respiratory symptoms.

The announcement, on July 3, came just days after a 19-month-old child in neighbouring Takeo province died from the same virus.

To date, there is no evidence of human-to-human transmission. But the steady increase in cases has renewed attention to the risks posed by H5N1. This highly pathogenic bird flu virus spreads rapidly among poultry and occasionally jumps to humans – often with deadly consequences.

Since 2003, there have been at least 954 reported human infections globally, nearly half of them fatal, according to the World Health Organization (WHO). Experts have long considered H5N1 a serious pandemic threat due to its high mortality rate and potential to evolve.

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The recent Cambodian cases are linked to the 2.3.2.1e lineage of H5N1 (previously known as 2.3.2.1c), a strain that has circulated for decades in poultry across Cambodia, Laos and Vietnam. From 2005 to 2014, Cambodia saw sporadic but severe human infections – then almost a decade passed without new cases.

That changed in 2023 when six human cases were reported. The numbers have since climbed: ten in 2024, and now 12 in the first half of 2025. Of these recent infections, at least 12 – about 43% – have been fatal. A troubling pattern is also emerging: seven of this year’s cases occurred in June alone, according to the WHO’s latest Disease Outbreak News update.

Animal pandemic

Globally, however, a different H5N1 lineage – 2.3.4.4b – has dominated in recent years. This strain sparked a devastating wave of avian outbreaks starting in 2021, sweeping across continents and decimating wild bird and poultry populations. It also spread to mammals, leading scientists to label it an “animal pandemic”.

Although it no longer causes mass die-offs, 2.3.4.4b remains widespread and dangerous, particularly because of its capacity to infect mammals. It has been linked to about 70 human cases in the US alone, with only one death recorded so far, and is under investigation for suspected mammal-to-mammal transmission in species, including US dairy cattle and seals.

Influenza viruses are notoriously prone to genetic reassortment – a process by which two or more strains infect the same host and exchange genetic material. These events can sometimes generate new, more transmissible or deadly variants. In April 2024, the UN Food and Agriculture Organization reported the emergence of a reassortant virus in Vietnam. This new strain combines surface proteins from the long-standing 2.3.2.1e virus with internal genes from the globally dominant 2.3.4.4b.

Evidence suggests that this reassortant virus may be driving the rise in Cambodian human infections.

A 2024 study, which has not yet undergone peer review, found that the new virus carries genetic markers that could enhance its ability to infect humans – although it is not yet considered human-adapted. According to the study’s authors, this reassortant form has become the predominant strain found in poultry across the region in recent years.

So far, all confirmed human cases in Cambodia have been linked to direct contact with infected or dead poultry – often in small, rural backyards. This suggests that the country’s “one health” strategy, which aims to integrate human, animal and environmental health responses, is functioning as intended. Although some gaps clearly remain.

Food safety and food security remain serious concerns across much of Cambodia and south-east Asia. Limited veterinary oversight, informal poultry markets, lack of compensation for poultry losses due to disease, and poor biosecurity may offer the virus opportunities to persist and evolve – and potentially reach more people.

Since the COVID pandemic, advances in disease surveillance and reporting have made it easier to detect and confirm human infections, Dr Vijaykrishna Dhanasekaran, head of the Pathogen Evolution Lab at Hong Kong University, told me over email. However, he notes that surveillance remains heavily concentrated in urban areas and the commercial poultry sector, while rural settings and interactions with wild birds are poorly monitored.

Expanding surveillance to these overlooked areas will be vital, he says, if the world hopes to better understand – and prepare for – the next potential influenza pandemic.

Divya Venkatesh receives funding from BBSRC.

– ref. Child hospitalised as bird flu cases climb in Cambodia – https://theconversation.com/child-hospitalised-as-bird-flu-cases-climb-in-cambodia-260565