Category: English

Source: The Conversation – UK – By Laurence Roope, Senior Researcher, Health Economics, University of Oxford

Imagine a stark choice. You can save one person who is likely to live another 30 years. Or you can save several people who may each live another ten years.

Should we prioritise saving more lives – or more years of life? This kind of trade-off sits at the heart of how health systems make decisions.

Yet do people actually agree with that principle? A new international study – based on what people told us during the COVID pandemic – suggests the answer is more complicated than this simple trade-off suggests.

Across many countries, decisions about healthcare spending are guided by a concept known as the quality-adjusted life year, or Qaly. In simple terms, this approach aims to maximise the total number of years of healthy life generated by a healthcare system.

That often means prioritising treatments that deliver more life-years overall. Saving someone with more years ahead of them is typically seen as creating more value than saving someone with fewer remaining years. In practice, this can mean prioritising younger patients over older ones.

This kind of reasoning is used by Nice in the UK – and other healthchare advisory agencies, globally – to decide which medicines should be funded. But it rests on an implicit ethical assumption: that maximising total life-years is the right goal.

Our research asked a simple question: do ordinary people actually agree?

To find out, we conducted a large survey experiment with more than 14,000 people across 12 countries, including the UK, US, China, Brazil and Uganda.

Participants were asked to imagine a life-saving vaccine that could only be given to one group. They had to choose between vaccinating a 55-year-old person (with about 30 years left to live) or one or more 75-year-olds (with about ten years left each).

The scenarios were framed around COVID, but the underlying question was broader: how should we trade off saving lives versus saving life-years?

By varying the number of older people, we could estimate how many lives participants were willing to “trade” to save one younger person.

The results reveal a clear pattern – and one not entirely consistent with the Qaly-based values that underpin many healthcare funding decisions.

People don’t think in purely mathematical terms

Most people did favour saving the younger person. Around two-thirds of respondents chose to vaccinate the 55-year-old rather than a single 75-year-old.

However, when forced to make tougher trade-offs, people did not behave as if they were trying to maximise life-years. If they were, they would have been willing to sacrifice about three 75-year-olds to save one 55-year-old (since 30 years versus ten years is a 3:1 ratio). In practice, they were willing to trade fewer.

On average, across countries, people were willing to trade about two and a half older lives to save one younger life. In other words, public preferences sit somewhere between treating all lives as equal, and strictly maximising total life-years. They don’t fully align with either.

The story becomes even more interesting when we look beyond age. In some versions of the experiment, we also varied whether the hypothetical people were working. This turned out to matter a lot. When both people had the same employment status, one 55-year-old was considered roughly equivalent to just over two 75-year-olds.

Yet when the younger person was working and the older person was not, the trade-off shifted dramatically – people were willing to sacrifice more than three older lives to save the younger worker. And when the situation was reversed – the older person working and the younger not – many respondents preferred saving the older person.

This suggests that people are not just thinking about life expectancy. They are also considering broader social factors, such as contribution, perceived need or fairness.

A gap between policy and public values

These findings raise an uncomfortable question. If health systems are designed to maximise life-years, but the public values something more nuanced, is there a mismatch between policy and societal preferences?

Our results suggest there is. People do care about life expectancy – younger lives are generally prioritised. However, they also place weight on fairness, context and social roles. Their preferences are more nuanced than the strict “maximise life-years” rule embedded in many healthcare decision frameworks.

This doesn’t mean that healthcare decisions should simply follow public opinion. These are complex ethical choices, and expert judgment remains essential.

Nevertheless, ignoring public values entirely may also be problematic. Policies that feel intuitively unfair can undermine trust, which is essential for the sustainability of policies and institutions.

Rather than abandon existing approaches like Qalys, one option may be to complement them. Decision-makers could more clearly include the public’s views by using things like discussion groups, citizen panels or other methods that balance efficiency with fairness.

Another possibility is to recognise that there is no single correct answer. Different societies may reasonably draw the line in different places – and even within countries, views vary by age, politics and experience.

Our study shows that people do not see these decisions in simple mathematical terms. When faced with real trade-offs, they weigh lives, years and social context together. Ultimately, that may be a more realistic reflection of the ethical complexity at the heart of healthcare.

Laurence Roope is supported by the NIHR Oxford Biomedical Research Centre and the NIHR Oxford Health Biomedical Research Centre.

Philip Clarke receives funding from the NIHR, UKRI and the British Academy.

Fiorella Parra-Mujica 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. Would you save more lives or more years of life? A global study reveals how people really think – https://theconversation.com/would-you-save-more-lives-or-more-years-of-life-a-global-study-reveals-how-people-really-think-280338

Source: The Conversation – UK – By Melanie Ramdarshan Bold, Professor of Youth Literature and Culture, University of Glasgow

For many children, Paddington is now primarily the star of three movies and a hit west end musical. However, that is not where the bear in a red hat whose adventures involve high-speed chases and marmalade-based slapstick began.

In writing our book on the bear, we have found that the Paddington British writer Michael Bond created in 1958 is a rather different creature from that which we now know. Film Paddington is a slapstick innocent abroad, propelled by plot and peril. Book Paddington is slower, odder, funnier: a small figure of polite chaos who wreaks havoc not because the world is against him, but because he takes it entirely at its word. He is, in the gentlest possible way, a satirist.

Paddington is incredibly popular with children and adults alike. Paddington in Peru broke UK box office records last autumn, the West End musical at the Savoy Theatre triumphed at the Olivier awards this week and is already booking into 2027, and a fourth film is in development. So if you or your children are eager for more we would highly recommend you try Bond’s books.

The books are also ideally structured for reading aloud. Each chapter works as a self-contained episode – around ten to 25 minutes, just right for bedtime – and the comedy builds through repetition and familiarity. Children who already love Paddington from the screen will find a quieter version of him on the page. And the pleasure of reading these together is that parent and child will both be laughing, just not always at the same things.

Here are five places to start.

1. A Bear Called Paddington (1958): the one to begin with

This is where Paddington arrives at the station with his label and his suitcase and his jar of marmalade, and the Browns (somewhat impulsively and definitely against Mr Brown’s better judgement) take him home. What follows is a series of gentle domestic catastrophes: a bath that floods the bathroom, a trip on the Underground that goes spectacularly wrong, an attempt at painting that produces an accidental masterpiece.

Start here because it establishes how Paddington works. He is never naughty. He is meticulous, earnest, and operating from a logic that is entirely reasonable if you happen to be a bear from Peru who has only recently encountered escalators. The chapter “A Visit to the Theatre”, in which Paddington cannot distinguish between drama and reality and nearly causes a riot from the stalls, is Bond at his best: a small bear taking the world seriously and the world not quite knowing what to do about it.

2. Paddington Helps Out (1960): the funniest one to read aloud

Paddington attempts DIY, enters a painting competition, and tries to help with the laundry. His intentions are commendable and the results are catastrophic.

What makes this book especially good for shared reading is its rhythm. Bond writes set-pieces with the timing of a comedian: slow build, moment of realisation, glorious mess. Children adore the predictability: they can see the disaster coming before Paddington can, and that anticipatory pleasure is one of the great rewards of series fiction.

3. Paddington Goes to Town (1968): the one with the best stories

Several chapters here are quietly brilliant. Paddington serves as a wedding usher and interprets the role as requiring him to keep everyone silent. He is mistaken for a waiter at a society dinner and ends up serving the guests something he believes to be baked Alaska but which turns out to be baked elastic.

For parents, the pleasure is in Bond’s comedy of social embarrassment. Paddington moves through the adult world with total sincerity, and the comedy arises from the gap between his good manners and the chaos he leaves behind.

4. Paddington Abroad (1961): the one that opens the world up

The Browns take Paddington on holiday to France. His encounters with French food, French customs, and French plumbing are some of the funniest passages Bond ever wrote.

This is a good choice if your child is about to go on a family holiday. It captures the comedy of being somewhere unfamiliar and trying very hard to get things right, which is Paddington’s permanent condition. He is always a visitor, always slightly out of place, and always managing to belong anyway.

Paddington Abroad also addresses some of the questions parents might have begun to ask themselves about Paddington’s paperwork – the Browns’ encounter with border control is both comic and discomfiting. Bond was inspired to create the character partly by the sight of wartime evacuee children arriving at London stations with labels round their necks. That quiet thread of displacement runs through the books without ever becoming too heavy. For children who have felt like the odd one out, there is real comfort in it – adults may see more.

5. Love from Paddington (2014): the one to read together, slowly

Published when Bond was 88, this is unlike the others. Written as letters from Paddington to Aunt Lucy in Peru, it retells many of his adventures in his own voice: warm, slightly bewildered, full of small asides. The letter format means each entry is short and self-contained, and Paddington’s voice is a pleasure to read aloud.

It is also, in the quietest way, a book about what it means to make a home somewhere new, to miss where you came from, and to feel grateful for the people who took you in. Younger children will enjoy the stories. Older children, and their parents, may catch something else underneath: a gentleness about love and distance and belonging that is never sentimental but always keenly felt.

The films have given a new generation the hat and the marmalade and the hard stare. The books will give them something more: the bear himself, in all his polite, disruptive, irreplaceable glory. Our main advice is: start anywhere. But start together.

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.

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

– ref. Five Paddington books to read with your child, and why the bear on the page is different and worth meeting – https://theconversation.com/five-paddington-books-to-read-with-your-child-and-why-the-bear-on-the-page-is-different-and-worth-meeting-280617

Source: The Conversation – UK – By Richard Gregory, Honorary Professor of Genetics, Evolution & Environment, UCL

The outbreak of a mysterious and deadly disease in finches in British gardens in 2005 set alarms bells ringing for conservationists. A decade later, the extent of that disease in greenfinches and chaffinches was reported. And now, bird scientists are beginning to understand how feeding birds in our gardens might be linked to their health and survival.

Major new guidance on bird feeding released by the UK’s largest nature conservation charity, the Royal Society for the Protection of Birds (RSPB), asks that we feed birds seasonally and safely.

Feeding birds in gardens is helpful, especially during winter when birds might be facing food shortages. But summer feeding should be paused because this is a time when natural food sources such as caterpillars, bugs and flies are much more abundant. In summer, the benefits of feeding the birds are less obvious. Limiting summer bird feeding also limits the spread of disease, which happens more prominently when birds gather in numbers to share food and water.

Scientists now know that the disease detected in finches in the 2000s is trichomonosis, caused by a microscopic parasite called Trichomonas gallinae. It typically infects the bird’s throat and has been known for many years to affect pigeons and doves, along with birds of prey. Birds can act as carriers or succumb to the disease. Quite how this parasite spilled over into finches is uncertain, but probably happened through the sharing of food or water.

Studies show that this parasite can persist in moist bird feed for up to five days and in water up to 30 hours, especially in milder conditions. July to October is the peak time for disease outbreaks in finches.

The disease causes lesions in the bird’s throat that interfere with its ability to swallow. This causes the bird to regurgitate food and water, and eventually die. It can spread between birds when they feed one another during courtship, when feeding chicks or through regurgitation at food or water sources in gardens. Poorly birds appear fluffed up and lethargic. Some may have messy or wet feathers around their beak and often shake their heads as they try to swallow. It’s a sad sight.

Trichomonsis has had devastating consequences in bird populations across the UK and into mainland Europe. Greenfinches and chaffinches have been hit hardest. Greenfinch numbers are down by 65% and chaffinch down by 36% since 1995.
Bullfinches also catch this disease and die, and a range of other birds may contract the disease – some of which are already declining in numbers.

Without urgent action, the situation will probably get worse for these and other birds, especially when facing a myriad of other pressures. These include the loss of natural habitats, limited food availability, plus accelerating climate change.

The new guidance from the RSPB comes on the back of a detailed review of the effects of bird feeding that includes both bird survival from one year to the next and their breeding success. The review also considers the human benefits to bird feeding, and takes into account recent field studies of the disease and how to curb its spread. Most research has been conducted in natural settings such as woodlands, rather than residential, urban or suburban settings. But the key insights are clear.

The review found that feeding can boost bird populations. But there are two big concerns for conservation around garden bird feeding. First, increased disease transmission (as shown by trichomonosis and other diseases). Second, while many bird species have benefited from garden feeding, this may have come at the cost to others.

A 2009 study found that an estimated 12.6 million UK households (48%) provided supplementary food for birds of which 7.4 million used specially designed bird feeders. As demand increases, so too does the range of different bird food and feeders.

This popularity has upsides and downsides for different birds, but probably has strong benefits for our own connection to nature, wellbeing and health.

Birds that use feeders, such as greater spotted woodpeckers, wood pigeons, collared doves, great tits and blue tits have all increased their numbers dramatically in the long term. Yet, as their numbers have grown there is an increasing nervousness from conservationists that they might outcompete or predate more vulnerable species. Blue and great tits often take over and evict the endangered willow tit from their nest holes, and willow tits are preyed upon by great spotted woodpeckers. Further research will shed light on these complex interactions.

How to help

Two simple shifts can ensure we feed birds seasonally and safely.

During summer and autumn, there’s a higher risk of disease spreading. It’s also when there are more natural foods available to birds, so pause feeding any seeds or peanuts between 1 May and 31 October. You can continue to offer small amounts of mealworms, fat balls or suet, as they pose less risk of transmitting disease. Also consider bird-friendly planting to provide natural food sources, such as sunflowers, teasels and ivy.

Between 1 November and 30 April, you can feed with a full range of bird foods, including seeds and peanuts, but feed in moderation so food doesn’t spoil and large flocks of birds are not attracted to one location. Little and often is good.

Other guidance encourages good hygiene to minimise the risk of disease. Ideally, clean bird feeders and water baths at least once a week. You can change the water in bird baths every day and move bird feeders to different spots every week. Instead of using bird feeders with flat surfaces, such as bird tables, window feeders and feeders with trays, opt for hanging bird feeders to reduce the risk of spreading infections.

Richard Gregory works for the Royal Society for the Protection of Birds (RSPB) as the Head of Monitoring Conservation Science.

– ref. How to feed your garden birds without spreading disease – https://theconversation.com/how-to-feed-your-garden-birds-without-spreading-disease-280409

Source: The Conversation – UK – By Michael A. Lewis, Professor of Operations Management, University of Bristol; University of Bath

Around the world, countries are seeking to build greener, more circular economies. Steel is central to that ambition. It is still one of the most widely used materials – but producing it is one of the largest industrial sources of carbon emissions worldwide.

The UK domestic steel industry is the smallest it has been since the 1930s. Production fell to 4 million tonnes in 2024 and 70% of the country’s steel is imported. Despite this, the government’s new steel strategy is hugely important for the country’s future prosperity.

The UK is decisively moving from blast furnaces to electric arc furnaces (EAF), producing “circular steel” from scrap. On the face of it, the plan is compelling. It should align with UK strategies for its economy, national security and progress towards net zero.

Read more:
New industrial strategy brings Rachel Reeves’ securonomics to life – but will it protect Britain from more supply chain shocks?

The strategy requires the state to take an active role – buying more domestic steel, reducing import quotas and subsidising the UK’s high electricity costs. Perhaps above all, it rests on the assumption that scrap steel, most of which is exported, can be redirected to feed this new generation of EAFs.

Making this shift will require significant changes to pricing and processing systems. The UK generates around 10-11 million tonnes of steel scrap each year and exports roughly 80% of it. Per capita, it is the world’s largest scrap exporter. Only about 2.6 million tonnes is consumed by domestic steelmakers.

The new strategy relies on far more of this scrap staying in the country. But this would mean disrupting a business model that generates an estimated £9 billion a year in gross value added. A 2025 EU analysis noted that China’s plans to increase scrap-based production could require an additional 45 million tonnes of scrap globally. Rising international demand will push scrap prices up, making export even more attractive.

Ultimately, it is this scrap flow (where scrap is stored and treated) that will determine whether the economic and environmental potential of the strategy can be realised.

The power problem

A 2025 industry report uncovered a perplexing challenge: it is cheaper to export steel scrap and re-import finished steel products than to process and manufacture in the UK. The report called for investment in UK processing infrastructure: advanced scrap sorting, shredding, and refining to remove contaminants, as well as updated rules and oversight across the recycling supply chain.

European steelmakers such as Voestalpine and recyclers like TSR have already invested in the scrap sorting and processing infrastructure to meet the requirements of electric arc furnaces.

Using scrap steel might appear to be an obviously sustainable option, but there are complications. EAF steelmaking produces around 75% fewer direct carbon emissions than via a blast furnace but it uses vast amounts of electricity.

The sector’s electricity consumption is expected to double – and UK industrial electricity prices are 27%-38% higher than in France or Germany. Environmental and economic performance depends on the whole scrap chain – sorting, processing, removal of contaminants – not just the furnace technology.

For example, in separating different types of scrap, workers are potentially exposed to hazards from mixed materials such as batteries. Not only that, but poorly sorted scrap can result in lower-quality steel and generate hazardous residues in the slag.

Intriguingly, many of the assumptions of the new steel strategy can be tested against history. In 1972, the Sheerness steelworks in Kent became Britain’s first scrap-fed EAF mini-mill. By early 1980, the Financial Times reported this private steelmaker had productivity four times that of the publicly owned British Steel Corporation (BSC). More than half of its output was exported.

Then came the 1980 steel strike and other industrial relations challenges, market liberalisation and globalisation. Ownership at Sheerness passed from Co-Steel International of Canada to Allied Steel & Wire (ASW) in 1998, a company that was already in debt.

By 2002, ASW was in administration and Sheerness closed. A Saudi-backed company, Thamesteel, reopened the site in 2003 and installed a high-capacity EAF. But by 2012, Thamesteel was also in administration. The EAF was dismantled and shipped to Newport in south Wales.

But despite this conclusion, the fact remains that the technology worked. The plant was productive and profitable for many years. What kept shifting was the system beyond the furnace – electricity costs, scrap supply, government policies, UK market structures and global competition. Today the site is a car park for imported vehicles.

Whether the UK steel strategy succeeds will be determined by the unglamorous work of closing this scrap gap – better sorting, processing infrastructure and logistics. Meanwhile, the UK is competing in a global market where scrap prices are set by forces well beyond its control. Facing that fact, and not just the shiny furnaces, is where the strategy will be won or lost.

Michael A. Lewis currently receives funding from the AHRC.

Annika Skoglund received funding from the Swedish Foundation for Strategic Research.

– ref. The UK wants a cleaner steel industry – but its plan rests on a supply chain that doesn’t exist yet – https://theconversation.com/the-uk-wants-a-cleaner-steel-industry-but-its-plan-rests-on-a-supply-chain-that-doesnt-exist-yet-280308

Source: The Conversation – UK – By Basil Germond, Professor of International Security, School of Global Affairs, Lancaster University

A US-sanctioned tanker with links to China, the Rich Starry, has transited the Strait of Hormuz, despite the US blockade of the waterway. According to the respected maritime news and intelligence agency Lloydslist, the Rich Starry is falsely registered in Malawi, but is Chinese owned and carrying a Chinese crew. It is subject to US sanctions for carrying Iranian goods. It is not known what the vessel is currently transporting.

Having been anchored off the UAE, the Rich Starry is not technically in breach of the blockade, but the incident has raised fears of a potential confrontation between the US and China in the region. Other vessels are reported to be waiting to transit the Strait, despite the US blockade.

The decision to impose a blockade on Iranian ports in the vicinity of the Strait was announced by the US president, Donald Trump, following the breakdown of US-Iran peace talks in Islamabad on April 11. Trump’s announcement was clarified by a statement on April 12 from US Central Command, which stipulated that the operation would prevent ships entering and exiting Iranian ports and coastal areas while not impeding vessels transiting the Strait to and from non‑Iranian ports.

Trump also announced that: “I have also instructed our Navy to seek and interdict every vessel in International Waters that has paid a toll to Iran. No one who pays an illegal toll will have safe passage on the high seas.” It remains unclear as to whether this will be implemented.

The Strait of Hormuz has been as good as closed since shortly after the US and Israel launched their attacks on Iran at the end of February. Most ship owners, charterers and insurers are unwilling to accept the financial risk – and risk to human life – that transiting the Strait under threat of Iranian attack would entail.

Blockades are used to convert naval dominance into advantage on land by preventing imports and exports of goods, in Iran’s case oil, to put pressure on an adversary’s population and government by hurting their economy. Likewise, Iran’s strategy of closing down the Strait after it was attacked intended to disrupt the global economy in order to put international pressure on the Trump administration.

Iran has long threatened to use its geographical proximity to the Strait of Hormuz to close it down. Having demonstrated how effective this can be in disrupting oil and liquid natural gas prices, Tehran has been flexing its muscles by demanding that ships wanting to transit the waterway pay a tariff of up to US$2 million (£1.5 million). Lloydslist reported on March 25 that “a total of 26 vessel transits through the strait have followed a route pre-approved under an IRGC [Islamic Republican Guard Corps] ‘toll booth’ system that requires the ship operators to submit to a vetting scheme”.

This was reportedly a sticking point in negotiations between the US and Iran in Pakistan on April 11. Tehran wants to retain control of the Strait and the ability to levy tolls from transiting ships. The US is demanding that the maritime right of free passage must be enforced. It was when the first round of talks ended in deadlock that the US president decided to impose the naval blockade.

Former US diplomat to the Middle East, David Satterfield, told the BBC on April 13 that it was now about which country could absorb more pain, adding: “The Iranians believe … that they can absorb more pain for a longer period than their opponents can.”

Expensive – and risky – gambit

The cost calculus is asymmetric. It will be more expensive for the US to maintain its blockade than it was for Iran to close the Strait. The question will be whether Washington can sustain interdiction long enough to effectively undermine the regime – always remembering that the Islamic Republic has potentially had decades to prepare for this sort of scenario.

If the blockade can be implemented effectively, it could – in time – have an effect on an economy wrecked by years of sanctions and further weakened by the recent war and nationwide protests in January. The question is how long that might take.

To be effective, the blockade will require considerable naval resources. The US is reported to have as many as 21 warships in the Middle East, including the aircraft carrier USS Abraham Lincoln and the USS Tripoli, an amphibious assault ship with a complement of marines who are trained to board ships using helicopters and small boarding craft.

This introduces another layer of risk as assets operating near to the Iranian coasts will need to be protected against Iranian missiles, drones and fast attack craft. So, this would be resource‑intensive, operationally demanding and thus politically exposed for the US.

How the US will go about enforcement remains to be seen. In December and January, US naval and coastguard ships boarded and seized several vessels linked to Venezuela’s shadow fleet that had broken America’s blockade. Whether it would pursue the same action with a vessel linked to China is another matter though. And while another option would be to fire warning shots, these can be dangerous around tankers because of the risk of oil spillage, as well as the obvious political risk attached to Chinese-linked vessels.

It’s not clear at present that imposing a blockade on the Strait of Hormuz will restore free navigation of the waterway any time soon. But it now appears that, in the absence of free navigation, some countries have decided to call America’s bluff and attempt to transit the waterway in defiance of the US blockade. And the big concern must be the serious risk of escalation if the US attempts to enforce the blockade on a Chinese-owned vessel.

None of this will be welcomed by the US president and his national security team.

Basil Germond 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. US naval blockade of Strait of Hormuz: what it involves and the risks attached – https://theconversation.com/us-naval-blockade-of-strait-of-hormuz-what-it-involves-and-the-risks-attached-280482