Category: The Conversation – Global Perspectives

Source: The Conversation – Global Perspectives – By Adam Guastella, Professor and Clinical Psychologist, Michael Crouch Chair in Child and Youth Mental Health, University of Sydney

Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental condition that affects around 7% of children and 2.5% of adults.

ADHD causes difficulties holding and sustaining attention over periods of time. People with ADHD also experience hyperactivity and high levels of impulsiveness and arousal. This can make it difficult to plan, coordinate and remain engaged in tasks.

ADHD is linked to problems at work, school and home, and to higher rates of mental illnesses such as anxiety. It’s also associated with higher rates of long-term harms.

Stimulant medication, such as methylphenidate and dexamphetamine, is the most common treatment for managing ADHD symptoms. Most people with ADHD will respond to at least one ADHD medication.

But, rising rates of prescriptions in recent years has prompted concern for their effectiveness and safety.

New research published today in the journal BMJ points to additional longer-term benefits. It found people with ADHD who took medication were less likely to have suicidal behaviours, transport accidents, issues with substance misuse, or be convicted of a crime.

What did the study do?

The study tracked 148,581 people who received a new diagnosis of ADHD between 2007 and 2018.

The authors used population-based data from Swedish national registers, including everyone aged six to 64 who was newly diagnosed with ADHD. The average age was 17.4 years and 41% were female.

Participants either started or did not start medication within three months of their ADHD diagnosis.

The authors examined the effects of drug treatment for ADHD on five critical outcomes: suicidal behaviours, substance misuse, accidental injuries, transport accidents and committing crime. They looked at both first-time and recurrent events.

This study used a method that uses data from health records or registries to mimic the design of a randomised controlled trial, in an attempt to reduce bias.

The researchers accounted for age, education, other mental and physical illnesses, prior history and use of other drugs, to account for factors that may influence results.

What did they find?

Within three months of receiving an ADHD diagnosis, 84,282 (56.7%) of people had started drug treatment for ADHD. Methylphenidate was the most commonly prescribed drug, accounting for 88.4% of prescriptions.

Drug treatment for ADHD was associated with reduced rates of a first occurrence for four out of the five outcomes: a 17% reduction for suicidal behaviours, 15% for substance misuse, 12% for transport accidents and 13% for committing crime.

When the researchers looked at people with recurrent events, the rate reductions associated with ADHD medication were seen for all five outcomes (including accidental injury).

The effect of medication was particularly strong when someone had a history of these events happening frequently. This means those with the most severe symptoms may benefit most.

Stimulant drugs were associated with lower rates of all five outcomes compared with non-stimulant drugs.

It’s likely these benefits are associated with improvements in attention, impulsivity and hyperactivity. People may be less likely to be distracted while driving, to self-medicate and show impacts from other mental health challenges.

What didn’t the study do?

The large sample size, use of national linked registers and sophisticated design give greater confidence that these findings are due to medication use and not due to other factors.

But the study was not able to examine medication dosages or track whether people reliably took their medication as prescribed. It also had no way to track the severity of ADHD symptoms. This means it can’t tell us if this helped most people or just some people with severe symptoms.

We know that ADHD medication helps most people, but it is not effective for everyone. So, we still need to understand why some people don’t benefit from ADHD medication, and what other treatments might also be helpful.

Finally, even though the study was rigorous in its design and adjusted for many factors, we can’t rule out that other unaccounted factors could be associated with these effects.

As prescribing increases, the size of the benefit decreases

A second study, published in June, used the same Swedish national registers and self-controlled case series design.

This study also concluded ADHD medication was associated with reduced risks for self-harm, accidental injuries, transport accidents and committing crime.

However, this study also showed that as prescribing rates increased nearly five-fold between years 2006 to 2020, the size of the observed benefits of ADHD medications reduced.

While remaining significant, the size of the associations between ADHD medication use and lower risks of unintentional injury, traffic crashes, and crime weakened over this time.

This could mean people who are less likely to need ADHD medications are now receiving them.

What are the impacts for patients and policymakers?

People need to know that if ADHD medications are helpful for them or their children, it might also improve many other areas of life.

These findings can also give governments confidence that their recent initiatives and efforts to increase access to ADHD support and treatment may have positive downstream impacts on broader social outcomes.

But medications aren’t the only ADHD treatment. Medication should only represent one part of a solution, with other psychological supports for managing emotional regulation, executive and organisational skills and problem-solving also beneficial.

Psychological therapies are effective and can be used in combination with, or separately to, medication.

Yet research shows drug treatments are relied on more frequently in more disadvantaged communities where it’s harder to access psychological supports.

Policymakers need to ensure medication does not become the only treatment people have access to. People with suspected ADHD need a high-quality diagnostic assessment to ensure they get the right diagnosis and the treatment most suitable for them.

Adam Guastella receives independent research funding from research organisations (e.g., MRFF, NHMRC, ARC) to investigate the effecicy of supports for children and adults with neurodevelopmental conditions. He is employed as the Michael Crouch Chair in Child and Youth Mental Health at the University of Sydney.

Kelsie Boulton receives funding from research organisations (MRFF) to evaluate the efficacy of interventions for neurodevelopmental conditions.

– ref. For people with ADHD, medication can reduce the risk of accidents, crime and suicide – https://theconversation.com/for-people-with-adhd-medication-can-reduce-the-risk-of-accidents-crime-and-suicide-263044

Source: The Conversation – Global Perspectives – By Craig Martin, Lecturer in Screen Studies, Swinburne University of Technology

For half a century, The Rocky Horror Picture Show has lured costumed fans to cinemas for late-night screenings. Its raunchy mix of Broadway musical, science fiction and schlock horror was originally a box-office flop. However, after its first midnight screening on April Fool’s Day 1976 at the Waverly theatre in New York, it never left the late-night circuit and became the ultimate cult film.

Tim Curry’s powerhouse performance as Frank-N-Furter is central to the film’s success. Yet, his truly astounding work often overshadows the film’s many other dynamic performances.

Rocky Horror’s supporting characters and chorus feature alluring oddballs who irreverently challenge norms of physical desirability. Their “imperfect” bodies are not only a tribute to diversity: they radically upturn genre expectations of stage and screen musicals, and discredit broader cultural ideals of beauty.

It’s so dreamy, oh fantasy free me!

Brad Majors (Barry Bostwick) and Janet Weiss (Susan Sarandon) are an attractive young couple seeking help at an isolated castle when their car blows a tyre. During their night, they find the castle’s inhabitants are of a variety of sizes, physiques and galaxies.

Adapted from Richard O’Brien’s 1973 stage musical, Rocky Horror’s anti-Broadway aesthetic is apparent as soon as the “butler” Riff Raff (O’Brien) opens the castle door. This wiry framed hunchback with tangled hair is a far cry from the athletic ideal of the Broadway body.

Inside the creepy mansion, we are dazzled by a festive troupe of alien “Transylvanians” wearing off-beat tuxedos and textured waistcoats. It’s a broad assortment of unconventional body types squeezed into colourful costumes.

Lanky actor Stephen Calcutt stands at 198 centimetres tall, and Sadie Corré at just over 120cm. Hugh Cecil, then 62, has alopecia, which exaggerates his stark monocled whiteness. Fran Fullenwider, with her wild, teased-out coiffure and curvy frame, is clad in skin-tight pants.

Cecil and Fullenwider were among a handful of Transylvanians director Jim Sharman recruited from London-based Ugly Models. While this agency’s name and viability is, to say the least, unfortunate, Rocky Horror’s rejection of cookie-cutter casting was celebratory, not diminishing.

The Transylvanians’ subversion of “sameness” is especially powerful because of the history of its film genre. Busby Berkeley, one of film musicals’ founding innovators in the 1930s and 1940s, is famously quoted as approving the “girls” in his ensembles as being “matched, just like pearls”.

Inverting such sexist tropes, the crass collective of Transylvanians is widely adored as the chorus of the film’s legendary song, Time Warp. They are also welcomingly representative of the throngs of fans who the film has continued to assemble these past five decades.

I can make you a man

Once Frank-N-Furter has invited everyone “up to the lab”, we encounter two more vital characters: the dichotomous Eddie and Rocky.

Gregarious rocker Meat Loaf’s Eddie refuses the lean hypersexual image typical of frontmen in 1970s rock acts. Eddie motorbikes around Frank’s lab and delights his sweetheart Columbia (Nell Campbell). He is loud, sexy and very nearly loved.

Overtly parodying Frankenstein’s creation of a grotesque monster, Frank-N-Furter scientifically “births” the perfectly chiselled Rocky (Peter Hinwood).

With Rocky, Frank-N-Furter has made a “perfect specimen of manhood”: muscular, a sharp jawline, blonde hair and a tan. But Rocky does not have Eddie’s charismatic body positivity, which Frank-N-Furter resents.

Rocky’s blonde hair and sculpted physique bears more than a passing resemblance to Jack Wrangler or Casey Donovan, superstars in the “Golden Age of Porn” of 1969 to 1984.

Wrangler was a pioneering porn star who adopted a rugged Marlborough Man aesthetic. Not unlike Frank-N-Furter, Wrangler was sexually fluid, working in gay porn for ten years from 1970 before crossing over to straight porn.

Donovan found fame in Wakefield Poole’s successful X-rated film Boys in the Sand (1971). Both Donovan and Poole were newcomers to filmmaking and porn. Poole (himself a Broadway dancer) applied a dreamlike narrative and an artistically verité shooting style to his hardcore yet poetic pornography.

On its release, Boys in the Sand was reviewed in Variety, and ads for the film appeared in the New York Times. Poole’s film achieved an enviable level of critical legitimacy and public appeal, which evaded Rocky Horror until it gained legitimacy via its enduring cult status.

Rocky Horror’s presentation of the creature as a queer ideal of masculine physical perfection spicily mirrors the coveted masculine form on display in much gay pornography.

Yet, among Rocky Horror’s eclectic cast, Rocky’s musclebound physique is positioned as very much the exception.

Don’t dream it, be it

Unlike gay icon Wrangler, the blonde Adonis Rocky figure is not a rugged hero, but the monster: an aberration whose existence is the result of “mad science”.

In this reading, the alluring but destructive Frank-N-Furter represents western society’s beauty machine, intent on artificially creating bodies designed to be looked at as objects of sexual desire, queer or straight.

This insight is far from outdated. Indeed, since 1975, Rocky’s queer-inflected bodily “perfection” has today become a problematic norm in the mainstreaming of men’s body sculpting and the proliferation of homoerotic imagery marketed to men.

However, Rocky Horror remains a place where people of all shapes, sizes, ages, abilities, and colours can dance and sing and celebrate without such constraints. In fact, Riff Raff, the “imperfect” figure who first welcomes us to the castle, ultimately kills Frank-N-Furter and halts his exploitation.

Rocky Horror offers many and varied midnight-movie audiences freedom from society’s troubling and relentless obsession with body image, even 50 years on.

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. At 50, The Rocky Horror Picture Show is ‘imperfectly’ good (and queer) as ever – https://theconversation.com/at-50-the-rocky-horror-picture-show-is-imperfectly-good-and-queer-as-ever-261852

Source: The Conversation – Global Perspectives – By Michelle Grattan, Professorial Fellow, University of Canberra

Prime Minister Anthony Albanese has announced Australia will recognise Palestine as a state at the United Nations leaders’ week in late September.

Unlike some other countries, the government has put no conditions on the recognition, relying on assurances received from the Palestinian Authority, the current Palestinian governing body in the West Bank.

Announcing the decision on Monday, Albanese said he had spoken to Israeli Prime Minister Benjamin Netanyahu last Thursday. In what Albanese said was a long call, Netanyahu argued the case against the proposed Australian action.

“I put the argument to him that we need a political solution, not a military one, because a military response alone has seen the devastation in Gaza, and that has contributed to the massive concern that we see from the international community,” Albanese said.

Albanese told a joint news conference with Foreign Minister Penny Wong “a two-state solution is humanity’s best hope to break the cycle of violence in the Middle East and to bring an end to the conflict, suffering and starvation in Gaza”.

Asked whether this was a symbolic gesture, Albanese said, “This is a practical contribution towards building momentum. This is not Australia acting alone. What we are seeing is a range of countries engaging in detailed dialogue.”

Albanese said that over the past fortnight, he had discussed the issue with UK Prime Minister Keir Starmer, French President Emmanuel Macron, New Zealand Prime Minister Chris Luxon and Japanese Prime Minister Shigeru Ishiba.

He also had a call last week with the Palestinian Authority President Mahmoud Abbas.

Albanese said the Palestinian Authority had committed to there being no role for Hamas in a Palestinian state and reaffirmed it recognised Israel’s right to exist, as well as making other pledges.

Shadow Defence Minister Angus Taylor said there is a risk the decision would be rewarding Hamas for its attacks on Israel on October 7 2023.

When asked earlier about such criticism, Albanese said “Hamas don’t support two states”.

“This is an opportunity to isolate Hamas, that has been forged by the very clear statements of the Palestinian Authority on June 10, and the very clear statements of the Arab League,” he said.

Before the announcement, Netanyahu strongly condemned the move.

He said it was “shameful” and “disappointing” that European countries and Australia would “march into that rabbit hole” and buy “this canard”. He made it clear Israel would not be deterred.

Asked about Australia and other countries moving to recognition, he said, “Well, first of all, those who say that Israel has a right to defend itself are also saying, ‘but don’t exercise that right’.”

He said Israel was applying force judiciously and “they know it”.

“They know what they would do if right next to Melbourne or right next to Sydney you had this horrific attack. I think you would do, at least what we’re doing – probably maybe not as efficiently and as precisely as we’re doing it.”

The Albanese government’s decision, which was reported to a cabinet meeting early Monday, followed years of pressure within the Labor party which has ramped up dramatically in recent months.

Wong spoke at the weekend to US Secretary of State Marco Rubio about Australia’s proposed course.

The Executive Council of Australian Jewry said in a statement about the announcement: “Israel will feel wronged and abandoned by a longstanding ally. The Palestinian Authority will feel that a huge diplomatic prize has been dropped in its lap, despite its consistent failures to reform, democratise and agree to peaceful coexistence alongside a Jewish state. Hamas and other Islamist groups will see that barbarity on a grand scale can lead to desired political transformation”.

Michelle Grattan 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. Australia to recognise Palestine state next month at the United Nations – https://theconversation.com/australia-to-recognise-palestine-state-next-month-at-the-united-nations-262602

Source: The Conversation – Global Perspectives – By Therese O’Sullivan, Associate Professor in Nutrition and Dietetics, Edith Cowan University

Many people are familiar with the saying that a woman is “eating for two” during pregnancy. Although this is an exaggeration, nutritional needs do certainly increase during pregnancy to support the growing baby.

But what’s perhaps less known is that energy needs are actually even slightly higher during breastfeeding than during pregnancy.

Human breastmilk is a dynamic liquid and its composition (including carbohydrates, fats, proteins, vitamins and minerals) varies over the entire breastfeeding period, and even between feeds.

It can change depending on what mum is eating, environmental factors, and what the baby needs, through a biofeedback system (sometimes called “baby backwash”). For example, if a baby is starting to get sick, breastmilk will adjust to include more leukocytes, immune cells that fight infection.

So what should breastfeeding women be eating? And how does a mother’s diet influence the nutritional makeup of her milk?

Nutritional needs increase during breastfeeding

Fully breastfeeding mums can produce around 800 millilitres of milk a day in the first six months after birth, which has an energy content of roughly 3 kilojoules per gram.

Even factoring in using up excess fat stored during pregnancy, mums still need on average an extra 2,000 kilojoules to support milk production. This is roughly equivalent to adding a cheese sandwich, a handful of nuts and a banana on top of normal dietary intake.

Interestingly, requirements don’t drop off after the baby starts solids. In the second six months, milk production is thought to drop to an average of 600ml per day, as babies start to eat solid foods. But because maternal fat stores deplete by this stage, additional energy requirements remain similar.

Some nutrients are particularly important during breastfeeding, including protein, calcium, iron, iodine and vitamins.

For example, compared with a non-pregnant, non-breastfeeding woman, protein requirements increase by almost half when breastfeeding (from 0.75 grams to 1.1 grams per kg of body weight per day).

Meanwhile, iodine requirements almost double (from 150 micrograms per day to 270 micrograms per day). Iodine is important for thyroid function, and can impact baby’s growth and brain development.

It’s important women who are breastfeeding eat a variety of foods, including:

• high-protein foods (meat, fish, eggs, nuts, seeds, soy-based protein such as tofu and tempeh, legumes such as chickpeas, baked beans and lentils)
• dairy foods or alternatives (for dairy alternatives, check calcium is included)
• whole grains
• fruits and vegetables.

While making all that milk, drinking more water also becomes extremely important. Thirst is a good guide, but around 2.5 litres per day is generally recommended, or more if it’s hot or with exercise.

Is there anything I shouldn’t be eating?

What a mum consumes can pass into her breastmilk. For example, in one study, babies whose mothers drank small amounts of carrot juice while breastfeeding were more accepting of cereal flavoured with carrot juice compared with a control group of babies whose mothers drank water.

It’s therefore important to limit alcohol and caffeine, which can also pass though to the baby. No alcohol is the safest choice, but if you’re planning to have a drink, tools such as the Feed Safe app can be used to estimate when your breastmilk should be free of alcohol.

Up to 200mg of caffeine per day (equivalent to roughly a cup of brewed coffee, an energy or cola drink, or four cups of tea) is considered safe for breastfeeding.

Breastfeeding mums don’t need to take any particular foods out of their diet to prevent allergies in their baby. In fact, experts believe babies exposed to common allergens via breast milk could be less likely to develop allergies to these foods, however we need more research into this question.

Although relatively uncommon, babies can be allergic or intolerant to certain aspects of their mothers’ diet when breastfeeding. They may react in the form of colic or wind, reflux, mucus or blood in their poo, eczema or rash, or appear to be in pain.

In these cases, mum’s diet may need adjustment. The most common culprits include cows’ milk (the protein, not the lactose component), soy and egg.

It’s recommended to remove suspected foods from the diet for a minimum of three weeks. This should ideally be done with supervision from an Accredited Practising Dietitian who specialises in allergy, to ensure the mother’s nutritional needs continue to be met.

4 tips for breastfeeding mums

1. it’s a good idea to get a blood test to check your vitamin D and iron levels – these can be depleted over pregnancy and are important for breastfeeding. If your levels are low, you can discuss options with your doctor

2. iodine requirements are so much higher in breastfeeding that an iodine supplement of 150 micrograms a day is recommended to support infant growth and neurodevelopment

3. have a variety of nutritious snacks that can be eaten with one hand for those late-night feeds, such as peeled boiled eggs, a peanut butter sandwich on wholegrain bread, or avocado and cheese on a rice cake. My personal favourite is homemade rocky road with dark chocolate, nuts, seeds and dried fruit

4. keep a drink bottle with water nearby when breastfeeding.

If you’re considering a gift for a family with a new baby, remember new parents’ personal needs often take a back seat when bub arrives, including eating well. Consider a hearty frozen meal, muffins with oats and nuts, a nice stainless steel water bottle, gourmet trail mix or even some homemade rocky road.

Therese O’Sullivan has previously received funding from the Stan Perron Charitable Foundation and the Department of Health Western Australia for a project on antenatal colostrum expressing.

– ref. What should I eat (and avoid) while breastfeeding? How does my diet affect baby’s milk? – https://theconversation.com/what-should-i-eat-and-avoid-while-breastfeeding-how-does-my-diet-affect-babys-milk-260423

Source: The Conversation – Global Perspectives – By Flora Hui, Research Fellow, Centre for Eye Research Australia and Honorary Fellow, Department of Surgery (Ophthalmology), The University of Melbourne

Drugs such as Ozempic, Wegovy and Mounjaro (known as semaglutide and tirzepatide) have changed the way clinicians manage diabetes and obesity around the world.

Collectively known as GLP-1 agonists, these drugs mimic the hormone GLP-1. This limits both hunger and interest in food, helping users lose weight, and helps control blood sugar levels.

But two new studies published today show that people taking these drugs may have a small increased risk of serious eye conditions and vision loss.

Here’s what you need to know if you’re taking or considering these medications.

What damage can occur?

Non-arteritic anterior ischaemic optic neuropathy, or NAION, is a rare but devastating eye condition that occurs when blood flow to the optic nerve is suddenly reduced or blocked. It’s also called an “eye stroke”.

The exact cause of NAION remains unclear and there are no current treatments available. People with diabetes are at increased risk of developing NAION.

Unlike other eye conditions that develop gradually, NAION causes a sudden, painless loss of vision. Patients typically notice the condition when they wake up and discover they’ve lost vision in one eye.

Vision tends to worsen over a couple of weeks and slowly stabilises. Recovery of vision is variable, but around 70% of people do not experience improvement in their vision.

What has previous research shown?

A previous study from 2024 found participants prescribed semaglutide for diabetes were four times more likely to develop NAION. For those taking it for weight loss, the risk was almost eight times higher.

In June, the European Medicines Agency concluded NAION represented a “very rare” side effect of semaglutide medications: a one in 10,000 chance. In a first for medicines regulators, the agency now requires product labels to include NAION as a documented risk.

However the recent studies suggest the risks may be lower than we first thought.

In addition to NAION, there is also evidence to suggest GLP-1 drugs can worsen diabetic eye disease, also known as diabetic retinopathy. This occurs when high blood sugar levels damage the small blood vessels in the retina, which can lead to vision loss.

It may sound counter-intuitive, but rapid blood sugar reductions can also destabilise the fragile blood vessels in the retina and lead to bleeding.

What do the new studies say?

Two newly published studies investigated people with type 2 diabetes living in the United States over two years. The studies looked at the medical records of 159,000 to 185,000 people.

One study found semaglutide or tirzepatide was associated with a more modest risk of developing NAION than previously thought. Of 159,000 people with type 2 diabetes who were taking these drugs, 35 people (0.04%) developed NAION, compared with 19 patients (0.02%) in the comparison group.

The researchers also found an increased risk of developing “other optic nerve disorders”. However, it’s unclear what kind of optic nerve disorders this includes, as the medical record codes used didn’t specify.

Counter to this, the second study did not find an increased risk of NAION among those taking GLP-1 drugs.

However, the researchers found a small increase in the number of people developing diabetic retinopathy in those prescribed GLP-1 drugs.

But overall, participants on GLP-1 drugs experienced fewer sight-threatening complications related to their diabetic retinopathy and required less invasive eye treatments compared to the group taking other diabetes medications.

Further studies are still needed to understand how GLP-1 drugs can lead to eye complications. A current, five-year clinical trial is studying the long-term effects of semaglutides and diabetic eye disease in 1,500 people, which should tell us more about the ocular risks in the future.

What does this mean for people taking GLP-1 drugs?

NAION is a serious condition. But we need to strike a balance between these (and other) risks and the benefits of GLP-1 medications in diabetes care, obesity treatment, reducing heart attack risks and extending lives.

The key lies in informed decision-making and identifying different levels of risk.

People with multiple NAION risk factors – such as sleep apnoea, high blood pressure and diabetes – should undergo careful consideration with their treating doctor before starting these medications.

“Crowded” optic nerve heads are also a risk factor for NAION. This is an anatomical feature where blood vessels at the optic nerve head are tightly packed together. People with crowded optic nerve heads should also undergo careful consideration before starting GLP-1 medications.

Although NAION can strike without warning, regular comprehensive eye examinations with your optometrist or ophthalmologist still serve important purposes. They can detect other drug-related eye problems, including worsening diabetic retinopathy, and can identify patients with crowded optic nerve heads. It’s also important to tell them if you are taking GLP-1 medications so they can keep a close watch on your eye health.

Emerging research also suggests that improving your heart health might help reduce risks of developing NAION. This includes proper management of high blood pressure, diabetes and cholesterol – all conditions that compromise the small blood vessels feeding the optic nerve.

Studies also show patients with heart conditions who better adhere to their medication prescriptions have lower risks of NAION than those who don’t.

Doctors should discuss NAION risks during prescribing decisions and work with eye care providers to monitor regularly for diabetic eye disease. Patients need clear instructions to seek immediate medical attention for sudden vision loss and the need for regular eye examinations.

Aggressive treatment of sleep apnoea and other heart conditions may also help reduce NAION risks. But for now, there remains an ongoing need for more research to understand how GLP-1 medications can affect the eye.

Pete A Williams has received past funding from Novo Nordisk Fonden (Foundation) for glaucoma neuroprotection research and is involved in, but does not directly receive funds from, a Novo Nordisk Fonden-funded clinical trial for glaucoma neuroprotection. Novo Nordisk Fonden has no role in the planning, execution, or data analysis of these studies. Novo Nordisk Fonden owns Novo Holdings A/S, which owns and controls Novo Nordisk A/S, the pharmaceutical company that makes Ozempic and Wegovy.

Flora Hui 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. Ozempic and other weight-loss drugs linked to rare but serious eye conditions – https://theconversation.com/ozempic-and-other-weight-loss-drugs-linked-to-rare-but-serious-eye-conditions-262874

Source: The Conversation – Global Perspectives – By Aayushi Badhwar, Lecturer in Enterprise and Technology, RMIT University

Today’s consumers are swimming in a sea of information. Products are marketed with big, bold words such as “sustainable”, “ethical” and “organic”. They sound good, they catch our attention, and they make us feel better about what we buy.

The reality is, in today’s market, figuring out which claims are true is no easy task.

One big reason is greenwashing, when brands use these buzzwords to sell products without living up to what the words actually mean. In fashion especially, these terms are thrown around so often that their meaning has been watered down. Instead of being about genuine change, they are often just a sales tool.

So, how can you know what to look out for?

Who should take responsibility for green claims?

Greenwashing takes many forms. Sometimes brands know they are misleading; this is direct greenwashing. Other times, it’s indirect, when brands simply do not know the full story of their own supply chains. A T-shirt, for example, might start as raw cotton in one country, get processed into fabric in another, sewn into a garment, and then shipped overseas for sale.

At each stage, there are different suppliers, factories and workers. The brand has limited visibility over what happens in these tiers. When a brand claims it produces ethically, but does not, that is greenwashing. If it involves exploitation or forced labour, it then becomes modern slavery, turning greenwashing into something more dangerous.

This raises a big question: who is responsible? The obvious answer is the brands. They design, order, and sell the products, and they profit from them. Consumers are paying for these goods, so they should have access to credible information, not just vague claims or nice-sounding labels.

The fashion industry is constantly in the spotlight for problems in its supply chains. Stories about poor working conditions, environmental damage, and lack of transparency pop up all the time. But just like a viral trend on social media, the attention often fades quickly, and people move on to the next story.

Certifications aren’t perfect

There are many certifications in the fashion industry trying to help, but they are not foolproof. A label might promise ethical sourcing, but that does not guarantee transparency or prove that every step was ethical.

A large portion of China’s cotton comes from the Xinjiang region, which has long been linked to forced labour; concerns were highlighted in a United Nations report in 2022. Another example is deforestation in Brazil, where cotton from affected areas was certified under the “Better Cotton” scheme. Many major brands – like ASICS producing the Australian Olympic uniforms – have faced scrutiny for sourcing cotton from controversial regions.

Tracing global supply chains is hard. But the responsibility does not disappear just because it’s complicated.

In Australia, the Modern Slavery Act took effect in January 2019 to tackle issues such as forced labour and exploitation. Penalties include heavy fines or jail time.

However, there is a major loophole, as only companies with an annual revenue over A$100 million are required to report under the act. For big corporations, even if they are caught, the penalty can be tiny compared to the profits they have made.

This is not just an Australian problem, it’s global. For example, luxury brand Dior was placed under judicial administration after being found negligent for failing to act against worker exploitation in its subcontracted supply chain in Italy. The pattern is often the same; a company gets accused, sometimes even fined, but the cost is minimal compared to their annual revenue, so it’s barely a setback.

Is there a role for government?

So, should the responsibility rest only with brands? Not entirely. Governments also benefit from these companies through taxes and trade. They profit indirectly when the companies profit, and they benefit from the jobs these companies provide.

A stronger approach would involve government bodies and brands working with supply chain mapping companies, such as Textile Genesis, TrusTrace or FibreTrace. These platforms, often powered by blockchain and artificial intelligence, track a product through every stage of production.

Blockchain – which uses a decentralised database – can be a game changer.

Unlike websites or paper trails, blockchain data cannot be altered without leaving trace. Once recorded, the information is permanent, and it can be shared across manufacturers, brands and government bodies to maintain real-time disclosure.

When products enter a country, the ethical claims behind them could be verified in real time, instead of relying on brands to respond after an allegation is made.

The upfront cost is high and adoption might be slow. But in the long run it could save money on compliance, audits and damage control, while also building consumer trust.

Brands would still make profits, but consumers would have the confidence the products they are buying live up to the claims. Instead of government agencies being passive players, they would actively enforce that products meet the standards consumers expect.

In short, brands need to be held accountable, but so do governments. Greenwashing, modern slavery, and unethical sourcing will keep slipping through the cracks, unless they both work together.

The tools to make the fashion industry more transparent and honest already exist; it’s just a matter of using them.

Aayushi Badhwar 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. How can you be sure your clothing has been produced ethically? – https://theconversation.com/how-can-you-be-sure-your-clothing-has-been-produced-ethically-262800

Source: The Conversation – Global Perspectives – By James Watson, Professor in Conservation Science, School of the Environment, The University of Queensland

Human-driven climate change threatens many species, including birds. Most studies on this topic focus on long-term climate trends, such as gradual rises in average temperatures or shifts in rainfall patterns. But extreme weather events are becoming more common and intense, so they warrant further attention.

Our new research shows extreme heat is having a particularly severe effect on tropical birds. We found increased exposure to extreme heat has reduced bird populations in tropical regions by 25–38% since 1950.

This is not just a temporary dip – it’s a long-term, cumulative effect that continues to build as the planet warms.

Our research helps explain why bird numbers are falling even in wild places relatively untouched by humans, such as some very remote protected tropical forests. It underscores the urgent need to reduce greenhouse gas emissions, to conserve the remaining biodiversity.

Digging into huge global datasets

We analysed data from long-term monitoring of more than 3,000 bird populations worldwide between 1950 and 2020. This dataset captures more than 90,000 scientific observations.

Although there are some gaps, the dataset offers an unmatched view of how bird populations have changed over time. Some parts of the world such as western Europe and North America were better represented than others, but all continents were covered.

We matched this bird data with detailed daily weather records from a global climate database that stretches back to 1940. This allowed us to track how bird populations responded to specific changes in daily temperatures and rainfall, including extreme heat.

We also looked at average yearly temperatures, total annual rainfall, and episodes of unusually heavy rainfall.

Using another dataset that reflects human industrial activity over time, we accounted for human pressures such as land development and human population density.

By combining all these sources of data, we created computer models to evaluate how climate factors and human impacts influence bird population growth.

Our research confirmed the work of other climate scientists showing extreme heat events have increased dramatically over the past 70 years, especially near the equator.

Birds in tropical regions are now experiencing dangerously hot days about ten times more often than they did in the past.

What we found: extreme heat is the biggest climate threat to birds

While changes in average temperature and rainfall do affect birds, we found the increasing number of dangerously hot days had the greatest effect – especially in tropical regions.

This is a major concern because tropical birds often have small home ranges and are highly specialised in terms of the habitats and climates they persist in. In many cases tropical birds exist within a small range of heat tolerance.

At temperatures beyond a bird’s limit of endurance, they go into hyperthermia, where their body temperature rises uncontrollably. In this state, birds may adopt a drooped-wing posture to expose more skin for heat loss, hold their beaks open and pant rapidly, spread their feathers, and become lethargic or disoriented. In severe cases, they lose coordination, fall from perches, or even collapse unconscious.

If they survive the experience, they can suffer long-term damage such as heat-induced organ failure and reduced reproductive capacity. Heat exposure reduces breeding success by lowering adult body condition and reducing time spent foraging – because the birds must rest or seek shade during the hottest hours.

It also causes heat stress in eggs and nestlings. In extreme events, nestlings may die from hyperthermia, or parents may abandon nests to save themselves.

Heat also increases a bird’s demand for water — not because they sweat (birds lack sweat glands) but because they lose water rapidly through evaporative cooling. This happens mainly via panting (respiratory evaporation) and, in some species, gular fluttering (rapid vibration of throat skin to increase airflow), as well as evaporation through the skin. As temperatures climb, these processes accelerate, causing significant dehydration unless birds can drink more frequently or access moister food.

Our study found that across tropical areas, the impact of climate change on birds is perhaps even greater now than the impact of direct human activities such as logging, mining or farming. This is not to say habitat destruction due to these activities is not a serious issue – it clearly is a major concern to tropical biodiversity. But our study highlights the challenges climate change is already bringing to birds in tropical regions.

A clear warning

Our research highlights the importance of focusing not just on average climate trends, but also on extreme events. Heatwaves are no longer rare, isolated incidents – they are becoming a regular part of life in many parts of the world.

If climate change continues unchecked, tropical birds – and likely many other animals and plants – will face increasing threats to their survival. Change may be too fast and too extreme for many species to adapt.

And as tropical regions host a huge share of the world’s biodiversity, including nearly half of all bird species, the ripple effects could be far-reaching.

Conservation strategies must take this into account. Protecting habitats from human industrial development remains important, but it’s no longer enough on its own. Proactive action to help species adapt to climate change needs to be part of wildlife protection plans – especially in the tropics.

Ultimately if we are to preserve global biodiversity, slowing down and eventually reversing climate change is essential. That means cutting greenhouse gas emissions, investing in ways to draw down existing carbon dioxide levels, and supporting policies that reduce our impact on the planet. The fate of tropical birds – and countless other species – depends on it.

James Watson has received funding from the Australian Research Council, National Environmental Science Program, South Australia’s Department of Environment and Water, Queensland’s Department of Environment, Science and Innovation as well as from Bush Heritage Australia, Queensland Conservation Council, Australian Conservation Foundation, The Wilderness Society and Birdlife Australia. He serves on the scientific committee of BirdLife Australia and has a long-term scientific relationship with Bush Heritage Australia and Wildlife Conservation Society. He serves on the Queensland government’s Land Restoration Fund’s Investment Panel as the Deputy Chair.

Maximilian Kotz receives funding from European Union’s Horizon 2020 research and innovation programme under a Marie Sklodowska-Curie grant.

Tatsuya Amano receives funding from the Australian Research Council Future Fellowship and Discovery Project.

– ref. 70 years of data show extreme heat is already wiping out tropical bird populations – https://theconversation.com/70-years-of-data-show-extreme-heat-is-already-wiping-out-tropical-bird-populations-259892

Source: The Conversation – Global Perspectives – By Olaf Meynecke, Research Fellow in Marine Science and Manager Whales & Climate Program, Griffith University

As the annual humpback whale migration is underway with thousands of whales passing by the Australian coast, there are reports of dolphins joining the mass movement.

But this isn’t a one off. In fact, our new study, published today in Discover Animals, shows interspecies interactions between dolphins and whales are widespread and frequent around the world.

An astonishing interaction

There have been several reports of whale and dolphin interaction in the past.

One that astonished the public back in 2004 featured a humpback whale in Hawaii repeatedly lifting a bottlenose dolphin on its head.

Researchers suggested such close contact between whales and dolphins is likely very rare – and maybe related to care giving.

But other forms of interactions resembling joint feeding, play and harassment are now being frequently documented thanks to drone technology. Many are also featured on social media.

A ‘whale’s-eye view’ of the world

For our new study, we undertook an analysis of 199 independent whale-dolphin interaction events involving 19 different species. These interactions spanned two decades and occurred across 17 countries.

We drew from social media platforms – such as Facebook, YouTube and Instagram – and footage contributed by citizens to get a variety of observations.

Each entry was carefully reviewed to identify the species involved, validate the interaction and categorise behaviours. Two additional cases came from camera tags attached to humpback whales. These offered an underwater “whale’s-eye view” of their encounters with dolphins.

We categorised behaviours such as rolling, tail slaps, bow riding, and rubbing, and classified dolphin positions relative to whale body parts such as head, flank and tail fluke.

Having fun or fighting?

The study contradicted earlier assumptions that interspecies interactions between dolphins and whales are very rare.

The most common interaction was dolphins swimming near the whale’s head (akin to bow riding). This accounted for 80% of observed dolphin positions. Humpback whales were the most involved whale species, while bottlenose dolphins led the dolphin side.

Based on videos we analysed, dolphins initiated most interactions through bow riding, swimming in formation, or even touching whales.

In more than one-quarter of the events, the whales responded in seemingly similar ways. For example, humpback whales often rolled, exposed their bellies, or gently turned toward dolphins.

Tail slaps and other signs of distress or aggression were rare (roughly 5% of cases).

As a result of this, we classified more than one-third of all interactions between humpback whales and dolphins as positive or possible social play.

The two camera-tag videos revealed previously undocumented interaction. Dolphins were observed following humpback whales not only at the surface but down to the ocean floor. They maintained eye contact or even touched the whales’ head – suggesting intentional, possibly social, engagement.

Reflecting advanced emotional capabilities

The findings reshape our understanding of how social marine mammals interact across species. They suggest interspecies interaction among marine mammals may be far more prevalent and complex than previously believed.

Dolphins may seek out whales as companions for stimulation, play or even courtship-like behaviour. Meanwhile, certain whale species, particularly humpback whales, may not only tolerate but also engage with dolphins in a social capacity.

This interspecies dynamic adds a new dimension to marine mammal social ecology and could point to cultural elements in whale and dolphin societies. The playfulness, cooperation and apparent enjoyment observed in many interactions reflect advanced cognitive and emotional capabilities.

The study also demonstrates the power of new technologies and community science. Social media and drones proved invaluable for collecting a range of diverse behavioural data that traditional surveys might miss.

Social media data has limitations, such as geographic and observer bias caused by different angles, heights, equipment and frequency of use of social media. But it does complement other data and helps uncover previously unknown behaviours.

Whales and dolphins don’t just coexist but also seek each other out. Future studies incorporating acoustic recordings and longer observation periods could further unravel the motivations and meanings behind these fascinating encounters.

Olaf Meynecke receives funding from the Whales and Climate Research Program through a private, charitable trust and is a board member of the not for profit organisation Humpbacks and Highrises Inc.

– ref. Whales and dolphins regularly hang out with each other – new study – https://theconversation.com/whales-and-dolphins-regularly-hang-out-with-each-other-new-study-260196

Source: The Conversation – Global Perspectives – By Martin Kear, Sessional Lecturer, Department of Government and International Relations, University of Sydney

Australia will recognise a Palestinian state at the UN General Assembly meeting in September, joining the United Kingdom, Canada and France in taking the historic step.

Recognising a Palestinian state is at one level symbolic – it signals a growing global consensus behind the rights of Palestinians to have their own state. In the short term, it won’t impact the situation on the ground in Gaza.

Practically speaking, the formation of a future Palestinian state consisting of the West Bank, Gaza Strip and East Jerusalem is far more difficult to achieve.

The Israeli government has ruled out a two-state solution and reacted with fury to the moves by the four G20 members to recognise Palestine. Israeli Prime Minister Benjamin Netanyahu called the decision “shameful”.

So, what are the political issues that need to be resolved before a Palestinian state becomes a reality? And what is the point of recognition if it doesn’t overcome these seemingly intractable obstacles?

Settlements have exploded

The first problem is what to do about Israeli settlements in the West Bank and East Jerusalem, which the International Court of Justice has declared are illegal.

Since 1967, Israel has constructed these settlements with two goals in mind: prevent any future division of Jerusalem, and expropriate sufficient territory to make a Palestinian state impossible. There are now more than 500,000 settlers in the West Bank and 233,000 in East Jerusalem.

Palestinians see East Jerusalem as an indispensable part of any future state. They will never countenance a state without it as their capital.

In May, the Israeli government announced it would also build 22 new settlements in the West Bank and East Jerusalem – the largest settler expansion in decades. Defence Minister Israel Katz described this as a “strategic move that prevents the establishment of a Palestinian state that would endanger Israel”.

The Israeli government has also moved closer to fully annexing the West Bank in recent months.

Geographical complexities of a future state

Second is the issue of a future border between a Palestinian state and Israel.

The demarcations of the Gaza Strip, West Bank and East Jerusalem are not internationally recognised borders. Rather, they are the ceasefire lines, known as the “Green Line”, from the 1948 War that saw the creation of Israel.

However, in the Six-Day War of 1967, Israel captured and occupied the West Bank, Gaza, East Jerusalem, Egypt’s Sinai Peninsula (since returned), and Syria’s Golan Heights. And successive Israeli governments have used the construction of settlements in the occupied territories, alongside expansive infrastructure, to create new “facts on the ground”.

Israel solidifies its hold on this territory by designating it as “state land”, meaning it no longer recognises Palestinian ownership, further inhibiting the possibility of a future Palestinian state.

For example, according to research by Israeli professor Neve Gordon, Jerusalem’s municipal boundaries covered approximately seven square kilometres before 1967. Since then, Israeli settlement construction has expanded its eastern boundaries, so it now now covers about 70 square km.

Israel also uses its Separation Wall or Barrier, which runs for around 700km through the West Bank and East Jerusalem, to further expropriate Palestinian territory.

According to a 2013 book by researchers Ariella Azoulay and Adi Ophir, the wall is part of the Israeli government’s policy of cleansing Israeli space of any Palestinian presence. It breaks up contiguous Palestinian urban and rural spaces, cutting off some 150 Palestinian communities from their farmland and pastureland.

The barrier is reinforced by other methods of separation, such as checkpoints, earth mounds, roadblocks, trenches, road gates and barriers, and earth walls.

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Read more:
Explainer: what is the two-state solution to the Israeli-Palestinian conflict?

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Then there is the complex geography of Israel’s occupation in the West Bank.

Under the Oslo Accords of the 1990s, the West Bank was divided into three areas, labelled Area A, Area B and Area C.

In Area A, which consists of 18% of the West Bank, the Palestinian Authority exercises majority control. Area B is under joint Israeli-Palestinian authority. Area C, which comprises 60% of the West Bank, is under full Israeli control.

Administrative control was meant to be gradually transferred to Palestinian control under the Oslo Accords, but this never happened.

Areas A and B are today separated into many small divisions that remain isolated from one another due to Israeli control over Area C. This deliberate ghettoisation creates separate rules, laws and norms in the West Bank that are intended to prevent freedom of movement between the Palestinian zones and inhibit the realisation of a Palestinian state.

Who will govern a future state?

Finally, there are the conditions that Western governments have placed on recognition of a Palestinian state, which rob Palestinians of their agency.

Chief among these is the stipulation that Hamas will not play a role in the governance of a future Palestinian state. This has been backed by the Arab League, which has also called for Hamas to disarm and relinquish power in Gaza.

Fatah and Hamas are currently the only two movements in Palestinian politics capable of forming a government. In a May poll, 32% of respondents in both Gaza and the West Bank said they preferred Hamas, compared with 21% support for Fatah. One-third did not support either or had no opinion.

Mahmoud Abbas, leader of the Palestinian Authority, is deeply unpopular, with 80% of Palestinians wanting him to resign.

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Read more:
The politics of recognition: Australia and the question of Palestinian statehood

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A “reformed” Palestinian Authority is the West’s preferred option to govern a future Palestinian state. But if Western powers deny Palestinians the opportunity to elect a government of their choosing by dictating who can participate, the new government would likely be seen as illegitimate.

This risks repeating the mistakes of Western attempts to install governments of their choosing in Iraq and Afghanistan. It also plays into the hands of Hamas hardliners, who mistrust democracy and see it as a tool to impose puppet governments in Palestine, as well as Israel’s narrative that Palestinians are incapable of governing themselves.

Redressing these issues and the myriad others will take time, money and considerable effort. The question is, how much political capital are the leaders of France, the UK, Canada and Australia (and others) willing to expend to ensure their recognition of Palestine results in an actual state?

What if Israel refuses to dismantle its settlements and Separation Wall, and moves ahead with annexing the West Bank? What are these Western leaders willing or able to do? In the past, they have been unwilling to do more than issue strongly worded statements in the face of Israeli refusals to advance the two-state solution.

Given these doubts around the political will and actual power of Western states to compel Israel to agree to the two-state solution, it begs the question: what and who is recognition for?

Martin Kear 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. Beyond recognition: the challenges of creating a new Palestinian state are so formidable, is it even possible? – https://theconversation.com/beyond-recognition-the-challenges-of-creating-a-new-palestinian-state-are-so-formidable-is-it-even-possible-262493

Source: The Conversation – Global Perspectives – By Heather Ford, Professor, Communications, University of Technology Sydney

Last month, the American non-profit organisation behind Wikipedia issued draft guidelines for researchers studying how neutral Wikipedia really is. But instead of supporting open inquiry, the guidelines reveal just how unaware the Wikimedia Foundation is of its own influence.

These new rules tell researchers – some based in universities, some at non-profit organisations or elsewhere – not just how to study Wikipedia’s neutrality, but what they should study and how to interpret their results. That’s a worrying move.

As someone who has researched Wikipedia for more than 15 years – and served on the Wikimedia Foundation’s own Advisory Board before that – I’m concerned these guidelines could discourage truly independent research into one of the world’s most powerful repositories of knowledge.

Telling researchers what to do

The new guidelines come at a time when Wikipedia is under pressure.

Tech billionaire Elon Musk, who was until recently also a senior adviser to US President Donald Trump, has repeatedly accused Wikipedia of being biased against American conservatives. On X (formerly Twitter), he told users to “stop donating to Wokepedia”.

In another case, a conservative think tank in the United States was caught planning to “target” Wikipedia volunteers it claimed were pushing antisemitic content.

Until now, the Wikimedia Foundation has mostly avoided interfering in how people research or write about the platform. It has limited its guidance to issues such as privacy and ethics, and has stayed out of the editorial decisions made by Wikipedia’s global community of volunteers.

But that’s changing.

In March this year, the foundation established a working group to standardise Wikipedia’s famous “neutral point of view” policies across all 342 versions in different languages. And now the foundation has chosen to involve itself directly in research.

Its “guidance” directly instructs researchers on both how to carry out neutrality research and how to interpret it. It also defines what it believes are open and closed research questions for people studying Wikipedia.

In universities, researchers are already guided by rules set by their institutions and fields. So why do the new guidelines matter?

Because the Wikimedia Foundation has lots of control over research on Wikipedia. It decides who it will work with, who gets funding, whose work to promote, and who gets access to internal data. That means it can quietly influence which research gets done – and which doesn’t.

Now the foundation is setting the terms for how neutrality should be studied.

What’s not neutral about the new guidelines

The guidelines fall short in at least three ways.

1. They assume Wikipedia’s definition of neutrality is the only valid one. The rules of English Wikipedia say neutrality can be achieved when an article fairly and proportionally represents all significant viewpoints published by reliable sources.

But researchers such as Nathaniel Tkacz have shown this idea isn’t perfect or universal. There are always different ways to represent a topic. What constitutes a “reliable source”, for example, is often up for debate. So too is what constitutes consensus in those sources.

2. They treat ongoing debates about neutrality as settled. The guidelines say some factors – such as which language Wikipedia is written in, or the type of article – are the main things shaping neutrality. They even claim Wikipedia gets more neutral over time.

But this view of steady improvement doesn’t hold up. Articles can become less neutral, especially when they become the focus of political fights or coordinated attacks. For example, the Gamergate controversy and nationalist editing have both created serious problems with neutrality.

The guidelines also leave out important factors such as politics, culture, and state influence.

3. They restrict where researchers should direct their research. The guidelines say researchers must share results with the Wikipedia community and “communicate in ways that strengthen Wikipedia”. Any criticism should come with suggestions for improvement.

That’s a narrow view of what research should be. In our wikihistories project, for example, we focus on educating the public about bias in the Australian context. We support editors who want to improve the site, but we believe researchers should be free to share their findings with the public, even if they are uncomfortable.

Neutrality is in the spotlight

Most of Wikipedia’s critics aren’t pushing for better neutrality. They just don’t like what Wikipedia says.

The reason Wikipedia has become a target is because it is so powerful. Its content shapes search engines, AI chatbot answers, and educational materials.

The Wikimedia Foundation may see independent and critical research as a threat. But in fact, this research is an important part of keeping Wikipedia honest and effective.

Critical research can show where Wikipedians strive to be neutral but don’t quite succeed. It doesn’t require de-funding Wikipedia or hunting down its editors. It doesn’t mean there aren’t better and worse ways of representing reality.

Nor does it mean we should discard objectivity or neutrality as ideals. Instead, it means understanding that neutrality isn’t automatic or perfect.

Neutrality is something to be worked towards. That work should involve more transparency and self-awareness, not less – and it must leave space for independent voices.

Heather Ford receives funding from the Australian Research Council. She was previously a member of the Wikimedia Foundation Advisory Board.

– ref. Wikipedia’s ‘neutrality’ has always been complicated. New rules will make questioning it harder – https://theconversation.com/wikipedias-neutrality-has-always-been-complicated-new-rules-will-make-questioning-it-harder-262706