Category: The Conversation – UK

Source: The Conversation – UK – By Nicky Hudson, Professor of Medical Sociology, De Montfort University

Around 200 children in several countries were conceived with sperm from a single donor who unknowingly carried a rare genetic mutation linked to early onset cancers, it has been revealed. The consequences have been devastating. Several children have already died and many families across Europe are now facing a risk they never expected.

The case has prompted urgent questions. How was one donor used so widely? Why did standard safeguards fail to identify a mutation that can have such severe consequences? And how did a system created to create families allow a tragedy of this scale?

When someone donates sperm or eggs they are screened for a set of common inherited conditions before being accepted by a clinic. The exact process varies by country and it has limitations. Screening depends heavily on accurate family history, yet many people have incomplete information about their relatives.

Some conditions emerge later in adulthood, which means a young donor may appear healthy. Clinics also focus primarily on established, higher frequency conditions rather than the vast number of rare variants that exist.

Ordinarily, donors complete a detailed questionnaire covering their medical background and their family’s health history. If the information suggests a possible inherited risk, the donor may be offered further testing or, more commonly, they may be declined.

More recently, clinics have begun to use expanded genetic screening. These tests can examine hundreds of genes linked to childhood or early adulthood conditions.

However, the technology is still developing and cannot detect every possible disease-causing variant. Many rare mutations are not part of routine panels, either because they have only recently been identified or because the evidence base is still small.

That context matters in this case. The donor had no family history of the condition and showed no symptoms. A person can carry a harmful mutation without being affected themselves, so nothing in his medical history raised concerns. The newer, broader screening was not used, but even if it had been, the variant is so rare that it may not have been included or detectable.

The donor provided sperm to the European Sperm Bank in Denmark for around 17 years. His donations were used to create roughly 200 children across multiple European countries, although experts say the true number could be higher.

This scale was possible because there is no international law limiting how widely donor sperm can be distributed. Many countries have rules on how many families can be created from a single donor.

The United Kingdom, for instance, permits no more than ten families. These limits, however, apply only within national borders. A donor can be used in several countries without any system to flag that the overall number has far exceeded what any one country would allow.

A recent unrelated case showed how extreme this can become. A different donor was found to have fathered around 1,000 children in several countries. There were no known health issues in that situation, but it revealed how donor use can expand rapidly without oversight.

The challenges in the current case are profound. Families are dealing with grief and uncertainty. Some have lost children. Others face a very high likelihood that their child will develop cancer before the age of 60, often in infancy or childhood.

There has been little public discussion about the sperm donor himself, although the emotional impact of learning these outcomes is likely to be significant.

Because the mutation was so rare, additional routine testing would probably not have prevented what happened. In truth, every person carries some genetic variants that remain undetected and harmless in everyday life.

There have been earlier examples of donors unknowingly passing on inherited conditions, such as cystic fibrosis or fragile X syndrome, but those cases typically involved far fewer families. What makes this case stand out is the sheer number of children affected.

For this reason, simply calling for more screening is unlikely to be the full answer. The more pressing issue is the lack of limits and monitoring on how many families can be created from one donor across borders.

In this case, families were created in several countries and in some places even the national limits were breached. Belgium, for example, permits only six families per donor, yet reports indicate that about 38 families were created.

What is needed is a robust system for tracking and tracing donor use both within and between countries. Without coordinated oversight, national limits are easily bypassed. Establishing international upper limits will be difficult and politically complex, but the conversation has to begin if further tragedies are to be prevented.

As more people use commercial DNA testing to find donor relatives, large networks of siblings connected across countries are becoming increasingly visible. The implications for those families are significant. A coordinated global approach is overdue and would help prevent another case like this one, where families are left facing consequences they could never have foreseen.

Nicky Hudson receives funding from the Economic and Social Research Council on expanded carrier screening and gamete donation (reference: ES/W012456/1, ES/N010604/1, ES/V002430/1. She is a member of the NICE Guideline Committee on Fertility and a member of the British Fertility Society’s Law Policy and Ethics Special Interest Group.

– ref. One sperm donor fathered 200 children and passed on a deadly mutation – and it could easily happen again – https://theconversation.com/one-sperm-donor-fathered-200-children-and-passed-on-a-deadly-mutation-and-it-could-easily-happen-again-271856

Source: The Conversation – UK – By Matt Jacobsen, Senior Lecturer in Film History in the School of Society and Environment, Queen Mary University of London

Despite a wonderful central performance from June Squibb, Scarlett Johansson’s directorial debut is a sentimental, tonally uncertain drama about grief and holocaust survival

Eleanor Morgenstein, a 94-year-old Midwesterner living in Florida, moves to New York after the death of her close friend and roommate Bessie, a Holocaust survivor. She joins a Jewish seniors group and accidentally finds herself part of a meeting of Holocaust survivors.

Eleanor, at first buoyed by the prospect of new friends, fabricates past experiences based on the Bessie’s stories, claiming harrowing recollections as her own.

Nina (Erin Kellyman), a journalism student writing a piece on Holocaust survivors, attends the meetings and is moved by Eleanor’s stories. Having recently lost her mother she connects with Eleanor through shared grief.

Eleanor starts out with ambiguously good intentions of preserving the memory of a dear friend. However, she is soon out of her depth when Nina’s article is taken up by Nina’s news anchor father (Chiwetel Ejiofor) as a human interest story for his show.

Early in the film, a comic exchange in a supermarket aisle telegraphs the film’s central theme. An acquaintance in his 90s tells Eleanor crossly: “You were born in New York. You can’t feel bad about the Holocaust. You weren’t there.”

The film wants to probe the ways in which grief is processed individually and collectively, asking us to consider what drives Eleanor to appropriate her friend’s traumatic life history.

At the centre of the film is the wonderful performance by Squibb, then 94 but now 96, who had a sturdy but unspectacular stage and screen career for more than 60 years before her breakthrough performance in Alexander Payne’s superb Nebraska in 2013.

Eleanor the Great is not a film specifically concerned with ageing and we are not so conscious of the vivacious Squibb’s age until a care home subplot is shoehorned in.

Scarlett Johansson was motivated to direct this film after her own investigations into her family’s history of Holocaust survival. She may have the highest grossing body of work in Hollywood for action films like The Avengers series, but she has a considerable track record of excellent low key independent films – from her breakthrough in Ghost World to Noam Baumbach’s powerful Marriage Story. Eleanor the Great most clearly takes its inspiration from that kind of American character drama.

There is little technical flair or stylistic character to distinguish Johansson as a director in this first feature. The gently sentimental scenes of New York City, its diners, crosswalks and ranks of yellow taxis are clearly inspired by the work of Baumbach as well as Woody Allen, Johansson’s director in two films (Vicky Cristina Barcelona, Match Point).

The film is at its strongest in the Allen-esque day-to-day moments in the city that let Squibb embody her character with gentle acidity and likeable crankiness. Johansson, like many actors-turned-directors, has a strength when it comes to allowing performers space to breathe and inhabit their characters. Scenes unfold quietly and unhurriedly.

The script, by Tory Kamen, could be wittier, sharper and more engaging, as there is a promise in character interactions that never quite take flight. When the film reaches what should be its narrative peak with the unravelling of Eleanor’s fabrications it is neither emotional nor funny.

Instead the climax’s tone is uncertain, sentimental and lands flat. What follows is a series of fraught conversations where the actors gamely try to mine emotional heft from a dreary screenplay.

The cultural memory of the Holocaust and the enormity of its legacy on Jewish descendants has been probed with considerably more success elsewhere. Jesse Eisenberg’s impressive, Bafta-winning and Oscar-nominated A Real Pain featured a pair of cousins on a tour of Jewish Poland, confronting its young characters with the memory of the Holocaust.

That film takes a well-executed midway tonal turn from broad character comedy to unexpected powerful poignancy. This happens in a scene where the usually motor-mouthed, bickering men are silenced in the face of a visit to the Majdanek concentration camp. Eleanor the Great doesn’t possess a moment like this that would drive its well-intentioned message home.

The film attempts to sidestep the callousness of Eleanor’s appropriation of Bessie’s stories by switching to flashbacks. In these memories we see Eleanor hear these stories for the first time in the middle of a sleepless night. These scenes, where the words come directly from Bessie, are well acted and moving, especially in a longer, emotional monologue towards the film’s climax.

When the film’s attention turns in the final third to the issue of whether Eleanor should be placed in a retirement home, the tone similarly skirts between humour and pathos – neither of which connect.

The film has admirable intentions but its script and plotting are not worthy of the excellent performance at the film’s heart. It also can’t quite bear the seriousness or the potential power of its central themes, leading to a disappointingly hollow experience.

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Matt Jacobsen 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. Eleanor the Great: a tonally uncertain Holocaust drama with a wonderful central performance – https://theconversation.com/eleanor-the-great-a-tonally-uncertain-holocaust-drama-with-a-wonderful-central-performance-271895

Source: The Conversation – UK – By Dominic Wyse, Professor of Early Childhood and Primary Education, UCL

Since 2012, England has taken an increasingly narrow approach to how primary school teachers should teach reading.

The policies on teaching reading have insisted that an approach called “systematic synthetic phonics” is the only way to teach reading. Synthetic phonics involves teaching children the 44 sounds, or “phonemes”, of language and how they are represented by letters in words.

England’s approach to teaching reading was alleged to have created “the best readers in the Western world” by the previous government, when England rose up the rankings of an international reading assessment.

Other countries and regions are now following England’s lead. For example, Australia is following many aspects of England’s approach to phonics. The US has moved towards a much greater emphasis on synthetic phonics. And New Zealand has abandoned the programme called Reading Recovery in favour of more emphasis on phonics.

These regions claim to be basing their new teaching approaches on “the science of reading”. But an accurate reading of the science shows that there are a range of different evidence-based approaches that can be taken to teaching children about phonemes and letters. If countries are following England’s lead, then we need to be sure that England’s approach is based on the most up to date research evidence.

Unfortunately the outcomes for children with reading difficulties in England, over more than a decade, tell a different story from those who claim that narrow synthetic phonics is the only approach. The proportion of children struggling to read has remained at a similar level for many years. The percentage of children not at the expected standards in reading at the age of ten or 11 has remained at about 25% since 2017.

As part of new research my colleagues and I conducted, we surveyed a group of 133 experienced teachers and special educational needs specialists in England. We also carried out a new analysis of already published research. We examined the findings of studies that tested which approaches work best for children with reading difficulties, including those with particular problems such as dyslexia.

There are hundreds of well-conducted studies that have examined how children with reading difficulties can best be taught to read. We found more than 40 systematic reviews of all of these studies. There is clear evidence that flexible teaching approaches are more effective than a narrow emphasis on synthetic phonics.

This means that teachers emphasise a range of components – such as the meanings of words and sentences to contextualise learning about phonemes and letters in real purposes for reading, and teaching writing to help reading.

Another of the components that is vital to attend to is children’s motivation for reading. The kinds of books that are used as part of the teaching is connected to this.

Systematic synthetic phonics is taught using “decodable” books that often have very limited content. But using real books is a way to motivate children through the imaginative ways that stories, poems and information are portrayed in these books. And my own research with Charlotte Hacking shows that phonics can be taught using real books.

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Read more:
Phonics isn’t working – for children’s reading to improve, they need to learn to love stories

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I argue that teaching reading should explicitly focus on motivating children to read. This involves understanding more about children’s interests and providing reading materials that are likely to motivate them. It also requires teachers to actively assess children’s levels of motivation, and take steps to address this as needed.

Deviating from the script

Some of the teachers that we surveyed said that if synthetic phonics was not working to teach a child to read they would try a different approach, including multi-component approaches. But more than 20% of our respondents said they would continue with synthetic phonics even if it wasn’t working, because that was the government’s policy.

Some teachers are more confident than others to innovate with their teaching, and they will have the support of head teachers to innovate. But in education systems with great pressures to conform to one particular approach all teachers find it harder to innovate.

The previous Conservative government used a variety of ways to require teachers to use only synthetic phonics for all children, including those with reading difficulties.

The phonics screening check, taken by all children in year one, and associated targets for schools, encourage a narrow focus on teaching phonics. Ofsted inspections reinforce government messages about synthetic phonics. Teachers in training and new teachers also have new tight requirements on synthetic phonics.

The Labour government has not said it will change any of this. England has just reviewed its national curriculum. No changes were proposed for the teaching of reading in primary schools.

Unless action is taken this will be a missed opportunity that will probably mean that some of our children most in need will not get the teaching based on robust research evidence that they need. However, children and schools cannot wait. The evidence shows that when synthetic phonics is not working, multi-component approaches should be tried.

Dominic Wyse currently receives funding from the Helen Hamlyn Trust and The Welsh Government.

– ref. England’s synthetic phonics approach is not working for children who struggle to read – https://theconversation.com/englands-synthetic-phonics-approach-is-not-working-for-children-who-struggle-to-read-271344

Source: The Conversation – UK – By Jonathan Este, Senior International Affairs Editor, Associate Editor, The Conversation

This newsletter was first published in The Conversation UK’s World Affairs Briefing email. Sign up to receive weekly analysis of the latest developments in international relations, direct to your inbox.

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Venezuelan Nobel peace laureate, María Corina Machado, plans to return home with her accolade “at the correct moment”. You have to presume the correct moment will be at such a time as her bitter political foe Nicolás Maduro is on holiday or otherwise unavoidably detained, or she certainly risks arrest as soon as she sets foot in her home country.

She told the Times of reports from a local NGO that young people were being detained for simply having the news of the Nobel prize in their phone. So she’d be well aware that the crime of being one of the most prominent opposition figureheads might place her in considerable legal jeopardy.

Perhaps that’s the point. It’s not up to us to speculate, but it’s not hard to imagine news of her arrest going down extremely badly in Washington right now. Having conducted 22 strikes on boats in the Caribbean alleged to be carrying what the US president has designed as “narcoterrorists” with the deaths of at least 87 people, closed the airspace above the country and, on December 10, intercepted and boarded an oil tanker off the coast (more of which anon), one wonders what the Trump administration’s next step might be.

Will there be a “Gulf of Tonkin incident?” The equivalent of the now-infamous confrontation between North Vietnamese and US naval forces which precipitated the Vietnam War – an episode which turned out to be wholly cooked-up by the Americans. Announcing the seizure of the oil tanker, Donald Trump told reporters, cryptically: “Other things are happening.” He did not go into details, but we’ll be watching closely as this develops.

Understandably the Venezuelans are not amused by the incident, which a government spokesman said was “barefaced robbery and an act of international piracy”. We asked Mark Chadwick, an expert in international law at Nottingham Trent University, who has written a book on piracy, for his opinion on the matter.

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Read more:
What does international law tell us about the US seizure of an oil tanker off the coast of Venezuela?

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Let’s avoid, for now at least, the irony of Trump’s decision to pardon a man convicted in a US court for “flooding the US with cocaine”, while instructing his military to target boats piloted by people he has designated as “narcoterrorists”.

It has been interesting to follow the coverage of these attacks and their legality, or lack of it. For the record, and in case you have missed our expert analysis, these attacks appear very risky, legally.

But it’s not as if the US – and her allies, including the UK – have’t sailed pretty close to the legal wind with “targeted killings” across the Middle East and elsewhere over past decades. Elisabeth Schweiger is an expert on international law and the use of force at the University of Stirling. She writes that the fact that there has not been more of an international outcry at these killings has created a situation where these extrajudicial killings have been almost normalised. Indeed the discussion is “beginning to shift from whether such strikes should occur to how they should be conducted, focusing on issues like target identification”.

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Read more:
Donald Trump’s strikes against narcoterrorists are new but the logic behind them isn’t

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One country where they will be watching what’s going on in Venezuela with close interest is China, writes Tom Harper. Harper, an expert in Chinese foreign policy at the University of East London, says that Beijing reacted to news of the closure by the US of Venezuelan airspace with an admonitory message that China “opposes external interference in Venezuela’s domestic affairs under any pretext”.

As Harper notes, Beijing has worked hard over decades to develop relations and influence with a range of Latin American countries, partly for trade reasons, partly as a counterweight to US influence. China is also one of the largest buyers of its oil. In turn, Venezuela buys Chinese arms.

But now, in its new national security strategy, the Trump administration has invoked the Monroe doctrine. This policy originating from the 19th century essentially claimed that Latin America was America’s backyard to mess around in and that any outside interference in the region would be seen as a hostile act towards US interests. It was discontinued in 2013 by the Obama administration, as the then secretary of state John Kerry declared that “the era of the Monroe doctrine is over”.

Now it’s back, in what the White House is calling the “Trump corollary”, which states that “the American people – not foreign nations nor globalist institutions – will always control their own destiny in our hemisphere”. How Beijing reacts to this remains to be seen.

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Read more:
Why China is watching Trump’s Venezuela campaign closely

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National security strategy

The Chinese aren’t the only people who will have read Trump’s 2025 national security statement with interest, although in the case of most of us in Europe, it’s more a case of bemusement and horror. While barely mentioning Russia and not mentioning North Korea at all, the 33-page document describes Europe’s shortcomings in lavish detail.

Europe, we read, has become weakened by allowing immigration to get out of control to the extent that it now risks “civilizational erasure”. Meanwhile Europe’s politicians have undermined free speech and suppressed democratic opposition. Ominously, the national security strategy talks of “cultivating resistance to Europe’s current trajectory within European nations”. He doubled down on that theme in an interview with the US, hinting that he might consider endorsing candidates who align better with his geopolitical vision.

Reading between the lines of the document, David Dunn and Stefan Wolff, experts in international security at the University of Birmingham, conclude that “the transatlantic alliance that was the cornerstone of European security and underpinned the liberal international order has ceased to exist”.

It’s a worrying time for Nato’s European members, they believe. Trump and some of his most senior officials have signalled that the US is no longer prepared to act as the security backstop – the principle around which the alliance was originally built. If any silver lining to this is to be found it’s that the US president’s insistence that all Nato members must increase their defence spending has already got them scrambling to adjust their budgets. And Trump’s perceived unreliability around the Ukraine war has led them to form a Europe-oriented “coalition of the willing”.

As our authors conclude: “If Nato founders, which is not now inconceivable, [this coalition] may be Europe’s best hope of surviving in a world where it is no longer one of, or aligned with, the dominant great powers of the day. But for that to become a reality, the coalition of the willing needs to become a coalition of the able. And this is a test it has yet to pass.”

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Read more:
Donald Trump’s national security strategy puts America first and leaves its allies to fend for themselves

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That Washington has often viewed the unwillingness of some European powers to join in with America’s foreign policy adventures as a sign of weakness is well known. When France and Germany declined to join George W. Bush’s invasion of Iraq, there were quips about “Euroweenies” and “EU-nuchs”. So it’s not surprising that the new US national security strategy focuses on this perceived shortcoming.

But, the document’s focus on the risk of “civilizational erasure” in Europe came as a surprise to many. It feels for all the world like a reheated version of the “great replacement theory” – namely the idea that indigenous Europeans are being outbred by immigrants, to the extent that “will be unrecognizable in 20 years or
less”.

The fact is, writes Roman Birke, an expert in modern European history at Dublin City University, that this has become something of an obsession for some thinkers in the US and parts of Europe. Leaders that Trump admires, such as Hungary’s Viktor Orbán, have promoted policies to get women having more children. “We Hungarians have a different way of thinking,” Orban is quoted as saying. “Instead of just numbers, we want Hungarian children. Migration for us is surrender.”

Birke believes that Trump and his Maga movement’s suspicion of Europe focuses on these issues which to them mean the Europe has become weak and decadent.

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Read more:
America’s anti-European attitudes are centred on perceptions of military weakness and the decline of native populations

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But you’d be mistaken if you believe Trump’s national security strategy to reveal him as an isolationist, writes Andrew Gawthorpe. Far from it. Gawthorpe, whose research has focused on the changing views of civilisation inherent in Trump’s foreign policy when contrasted with that of the great liberal US president Woodrow Wilson, thinks that Trump sees himself as “the protector of a racially and culturally defined civilisation that covers both the US and Europe”.

Gawthorpe picks out three broad themes from the national security strategy which illustrate how the US president and his top aides see the world and America’s place astride it.

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Read more:
What the US national security strategy tells us about how Trump views the world

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– ref. Did Donald Trump order piracy on the high seas? – https://theconversation.com/did-donald-trump-order-piracy-on-the-high-seas-271881

Source: The Conversation – UK – By Alice Godden, Senior Research Associate, School of Biological Sciences, University of East Anglia

The Arctic Ocean current is at its warmest in the last 125,000 years, and temperatures continue to rise. Due to these warming temperatures more than two-thirds of polar bears are expected to be extinct by 2050 with total extinction predicted by the end of this century.

But in our new study my colleagues and I found that the changing climate was driving changes in the polar bear genome, potentially allowing them to more readily adapt to warmer habitats. Provided these polar bears can source enough food and breeding partners, this suggests they may potentially survive these new challenging climates.

We discovered a strong link between rising temperatures in south-east Greenland and changes in polar bear DNA. DNA is the instruction book inside every cell, guiding how an organism grows and develops. In processes called transcription and translation, DNA is copied to generate RNA (molecules that reflect gene activity) and can lead to the production of proteins, and copies of transposons (TEs), also known as “jumping genes”, which are mobile pieces of the genome that can move around and influence how other genes work.

In carrying out our recent research we found that there were big differences in the temperatures observed in the north-east, compared with the south-east regions of Greenland. Our team used publicly available polar bear genetic data from a research group at the University of Washington, US, to support our study. This dataset was generated from blood samples collected from polar bears in both northern and south-eastern Greenland.

Our work built on the Washington University study which discovered that this south-eastern population of Greenland polar bears was genetically different to the north-eastern population. South-east bears had migrated from the north and became isolated and separate approximately 200 years ago, it found.

Researchers from Washington had extracted RNA from polar bear blood samples and sequenced it. We used this RNA sequencing to look at RNA expression — the molecules that act like messengers, showing which genes are active, in relation to the climate. This gave us a detailed picture of gene activity, including the behaviour of TEs. Temperatures in Greenland have been closely monitored and recorded by the Danish Meteorological Institute. So we linked this climate data with the RNA data to explore how environmental changes may be influencing polar bear biology.

Does temperature change anything?

From our analysis we found that temperatures in the north-east of Greenland were colder and less variable, while south-east temperatures fluctuated and were significantly warmer. The figure below shows our data as well as how temperature varies across Greenland, with warmer and more volatile conditions in the south-east. This creates many challenges and changes to the habitats for the polar bears living in these regions.

In the south-east of Greenland, the ice-sheet margin, which is the edge of the ice sheet and spans 80% of Greenland, is rapidly receding, causing vast ice and habitat loss.

The loss of ice is a substantial problem for the polar bears, as this reduces the availability of hunting platforms to catch seals, leading to isolation and food scarcity. The north-east of Greenland is a vast, flat Arctic tundra, while south-east Greenland is covered by forest tundra (the transitional zone between coniferous forest and Arctic tundra). The south-east climate has high levels of rain, wind, and steep coastal mountains.

Temperature across Greenland and bear locations

How climate is changing polar bear DNA

Over time the DNA sequence can slowly change and evolve, but environmental stress, such as warmer climate, can accelerate this process.

TEs are like puzzle pieces that can rearrange themselves, sometimes helping animals adapt to new environments. In the polar bear genome approximately 38.1% of the genome is made up of TEs. TEs come in many different families and have slightly different behaviours, but in essence they all are mobile fragments that can reinsert randomly anywhere in the genome.

In the human genome, 45% is comprised of TEs and in plants it can be over 70%. There are small protective molecules called piwi-interacting RNAs (piRNAs) that can silence the activity of TEs.

Despite this, when an environmental stress is too strong, these protective piRNAs cannot keep up with the invasive actions of TEs. In our work we found that the warmer south-east climate led to a mass mobilisation from these TEs across the polar bear genome, changing its sequence. We also found that these TE sequences appeared younger and more abundant in the south-east bears, with over 1,500 of them “upregulated”, which suggests recent genetic changes that may help bears adapt to rising temperatures.

Some of these elements overlap with genes linked to stress responses and metabolism, hinting at a possible role in coping with climate change. By studying these jumping genes, we uncovered how the polar bear genome adapts and responds, in the shorter term, to environmental stress and warmer climates.

Our research found that some genes linked to heat-stress, ageing and metabolism are behaving differently in the south-east population of polar bears. This suggests they might be adjusting to their warmer conditions. Additionally, we found active jumping genes in parts of the genome that are involved in areas tied to fat processing – important when food is scarce. This could mean that polar bears in the south-east are slowly adapting to eating the rougher plant-based diets that can be found in the warmer regions. Northern populations of bears eat mainly fatty seals.

Overall, climate change is reshaping polar bear habitats, leading to genetic changes, with south-eastern bears evolving to survive these new terrains and diets. Future research could include other polar bear populations living in challenging climates. Understanding these genetic changes help researchers see how polar bears might survive in a warming world – and which populations are most at risk.

Don’t have time to read about climate change as much as you’d like?

Get a weekly roundup in your inbox instead. Every Wednesday, The Conversation’s environment editor writes Imagine, a short email that goes a little deeper into just one climate issue. Join the 47,000+ readers who’ve subscribed so far.

This study was funded by grants from the Natural Environment Research Council (NE/S011188/1) and the European Research Council (SELECTHAPLOID – 101001341)

– ref. Polar bears are adapting to climate change at a genetic level – and it could help them avoid extinction – https://theconversation.com/polar-bears-are-adapting-to-climate-change-at-a-genetic-level-and-it-could-help-them-avoid-extinction-269852

Source: The Conversation – UK – By Jake Phillips, Associate professor, University of Cambridge

In England and Wales, whole-life imprisonment is the harshest sanction available to the courts, emerging in the decades after the abolition of the death penalty. The whole-life order requires people to spend their whole lives in prison with no prospect of release, except on exceptional compassionate grounds.

From 1988, whole-life sentences (called “whole-life tariffs”) could be imposed by the home secretary and were used for handful of criminals. However, a number of legal challenges in the 1990s chipped away at the home secretary’s power to do so. In 2003, the Criminal Justice Act formally introduced whole-life orders, giving judges the power to impose them.

The European Court of Human Rights initially ruled in 2013 in response to a challenge from three people serving whole-life tariffs that these sentences breached human rights law, as they constituted inhuman and degrading treatment. A later ruling in 2017 found that the compassionate release clause (part of the 1997 Crime Act) keeps the order lawful. However, notably, no one has ever been released under it.

This punishment represents the state’s most severe power to harm its citizens. Understanding how and why it is used tells us about our appetite for punishment and the state’s power to inflict it. And evidence suggests that its use is rising.

Historically, data on whole-life orders has been difficult to come by. The Ministry of Justice has not reliably published figures on how many people are given these sentences, nor how many are serving them at a given time. Online lists of names, we have found, are inaccurate.

This is where our recent paper, published in The Howard Journal of Crime and Justice in October 2025, comes in.

We sought to understand how whole-life orders have been used since their introduction in 2003. We started by generating what we believe to be the most accurate dataset on the use of whole-life sentencing through a combination of Freedom of Information requests to the Ministry of Justice, as well as in-depth archival research drawing on court transcripts, media reports and parliamentary debates.

In analysing this dataset, we found that there are currently 74 people serving whole-life sentences. The year with the highest number of whole-life orders given was 2023, when Lucy Letby received 15 for her crimes.

Notably, 74% of all whole-life sentences imposed since 1965 were imposed after the Criminal Justice Act in 2003. This suggests that transferring the power of this sentence from the home secretary to the courts created the conditions for it to be used more widely.

Since 2003, the population serving whole-life sentences has risen significantly faster than the prison population as a whole, which has more than doubled since 1990 but remained relatively stable since 2000.

We also found that whole-life orders are being used for a wider range of offences, including those which are not on the specific list of offences for which these sentences can be imposed.

Examples include Wayne Couzens, who was given this sentence for the murder of a single person, and Letby, who received eight whole-life orders for the attempted murder of seven babies (alongside seven others for actual murder). Prior to Couzens, those who received whole-life orders for a single murder had previous convictions for serious offences.

Finally, courts are increasingly imposing more than one whole-life order on individual people. Before 2022, the maximum number of orders imposed on one person was two. Since then, Damien Bendall was given five whole-life orders for four counts of murder and rape, and Letby received 15.

In 2025, Kyle Clifford received three whole-life orders for the murders of Louise, Hannah and Carol Hunt. In most cases, this reflects the seriousness of the offending and the number of victims. It also makes appeals increasingly difficult.

Penal populism

This is not to suggest that we should not be using whole-life orders – clearly these people have caused significant harm to victims, the public and, in some cases, trust in public institutions such as the police and the NHS. But these trends raise an important question: why is this severe punishment becoming more common?

The answer doesn’t lie in a rise in the most serious offences such as homicide, which have remained stable or even declined over the last few decades. Rather, we would point to what criminologists call penal populism: the tendency of politicians to respond to perceived public opinion by introducing tougher sentences.

Over the last half a century, a series of legislative changes have led to sentence lengths significantly increasing, particularly for serious offences. This is especially relevant given recent proposals to make whole-life orders mandatory for certain crimes.

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Read more:
How a doubling of sentence lengths helped pack England’s prisons to the rafters

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We are also concerned about the lack of data publicly available on this topic, which makes it difficult for the government to be held to account, and raises further questions: if the whole-life order is only compliant with human rights legislation because of the possibility of release on compassionate grounds, should we not expect someone to have been released via this mechanism? And if no one has, what does that say about how human rights protections work in practice?

Human rights aside, the cost of imprisoning people on whole-life orders far exceeds that of people who are released, especially as they age and need increasing levels of care and medical treatment. And when we consider the constant problems of overcrowding in the prison system, these pressures become even more paramount.

If we are willing to accept ever-harsher punishment via sentences which do not allow for redemption or rehabilitation, then the rise of the whole-life order may seem justified. People who cause high levels of harm do – perhaps rightly – elicit anger and revulsion.

At the same time, evidence suggests that people believe in rehabilitation as an important purpose of punishment. We argue, therefore, that we need to look more closely at how and why the state is choosing to exercise its most extreme power to punish in increasing numbers of cases.

Nothing to disclose

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

– ref. Why whole-life imprisonment is rising in England and Wales – https://theconversation.com/why-whole-life-imprisonment-is-rising-in-england-and-wales-269226

Source: The Conversation – UK – By Anthony Smith, Lecturer in Television Theory, University of Salford

The recent news that Netflix has agreed to buy part of Warner Bros Discovery (WBD) for US$83 billion (£61.8 billion), followed by Paramount Global’s hostile counterbid to acquire WBD in its entirety for US US$108.4 billion, has triggered shockwaves through Hollywood and the wider entertainment industry.

Initial responses – and passionate outcries – have largely centred on fears over job cuts, subscription fee rises, anti-trust concerns regarding the increased market share either bid would create, and the potential negative impact that Netflix’s acquisition might have on the future of the film industry.

While these issues are no doubt important, one aspect of the Netflix deal has been relatively overlooked: the streamer’s decision to cut out Discovery’s portfolio of cable channels from its agreed acquisition of WBD. But this element of the deal is significant for what it reveals about the current state, and future, of the television industry.

Netflix’s decision to excise Discovery’s cable channels from the agreement indicates its desire to avoid ownership of the legacy TV infrastructure of broadcast, cable and satellite television. It also reflects the broader trend of linear TV businesses becoming less attractive to media corporations as audiences continue to migrate online. At first glance, Netflix’s exclusion of Discovery seems to confirm what we’ve been told for over a decade: streaming is killing traditional TV.

Since launching House of Cards in 2013, Netflix has cultivated an image as television’s great disruptor, a tech company that rendered the old broadcast model obsolete. What’s more, this is a reputation that journalistic and scholarly debate has often burnished.

But as we argue in our new book, Television Goes Back to the Future: Rethinking TV’s Streaming Revolution, this narrative of revolution is overstated and oversold. Beneath the rhetoric, streamers have persistently adopted, adapted, and often directly copied the conventions of legacy television.

The Netflix-WBD deal is no exception to this trend. Netflix’s own announcement celebrates combining its “innovation” with Warner Bros’ “century-long legacy of world-class storytelling”. Yet in potentially acquiring HBO, Netflix is set to buy the very cable TV innovator it originally modelled its prestige drama strategy on. This deal, then, represents less of a break from television history than prevailing narratives suggest.

Back to the evergreen future

This is evident in the rationale underpinning Netflix’s aims to acquire WBD’s vast back catalogue of film and television. For decades, channels like TBS, TNT, and in the UK, Gold and Dave, have built their business models on syndicated repeats of evergreen programming, such as studio sitcoms and police procedurals.

Streaming platforms have adopted the same approach. For example, both Suits and Lost recently became streaming hits years after their original linear TV runs ended.

When Netflix UK recently announced Friends would be leaving the platform at the end of the year, subscribers responded with uproar, revealing just how much “reruns” matter to streaming audiences. The Warner catalogue – which includes Friends – offers Netflix a ready-made library to meet this demand.

Amazon’s US$8.5 billion purchase of MGM in 2022 reflected a similar calculation, with the studio’s library alone valued at US$3.4 billion. What this tells us is that the film and TV back catalogue, long the foundation of cable television, has become equally foundational to streaming.

Should the Netflix-WBD deal succeed, it would represent another step in what industry observers call “the great rebundling”. Under the American cable model that solidified in the 1980s, viewers pay a monthly fee for a large package of channels rather than selecting them individually.

Streaming initially fragmented this model, leaving viewers to juggle competing subscriptions (and frequently cancel them). In response, platforms have begun consolidating content and brands in ways that echo the cable bundle model.

This pattern is already evident in Disney’s ongoing integration of Hulu within the Disney+ app, offering US consumers both services as part of a bundle deal. Industry commentators predict Netflix will take a similar approach with HBO.

Media analyst Rua Aguete foresees that Netflix will eventually operate as “a global gateway” for viewers, with HBO sitting as a “premium content brand within that ecosystem”, allowing Netflix to offer both services under a single subscription.

But Netflix’s embrace of traditional television practices is not new, nor limited to bundling and the reliance on much-loved TV classics. The platform spent years positioning itself against appointment viewing: watch what you want, when you want.

Yet as we show in Television Goes Back to the Future, the platform has increasingly embraced live events that create shared, simultaneous experiences in the long tradition of broadcast TV: WWE wrestling, NFL matches and comedy specials like The Roast of Tom Brady.

Netflix’s introduction of an ad-supported tier in 2022 marked a further retreat from its original promise of uninterrupted viewing – a direct adoption of commercial television’s long-established funding model.

Similar continuities are evident in how Netflix operates across borders. Streaming was supposed to make borders irrelevant: one global library, available everywhere. Instead, as media scholar Ramon Lobato argues, Netflix can be seen as “a series of national services linked through a common platform architecture”.

The company establishes local production offices, hires regional executives, and commissions programming calibrated to national audiences, resulting in culturally specific originals such as the UK’s Adolescence, Spain’s Money Heist, and South Korea’s Squid Game. Through such practices, Netflix, in some ways, mimics the practices and infrastructures of national broadcasting systems.

Should Netflix’s deal with WBD go through, it would represent not a departure from Netflix’s recent trajectory, but its logical culmination. For all its disruptive rhetoric, the platform has spent the past decade embracing the very conventions it once positioned itself against.

Purchasing WBD would simply accelerate this process, enabling Netflix to further adapt the models and logics of longstanding network and cable TV practices to online contexts.

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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. Why does Netflix want to buy Warner Bros? To copy, not kill, traditional TV – https://theconversation.com/why-does-netflix-want-to-buy-warner-bros-to-copy-not-kill-traditional-tv-271770

Source: The Conversation – UK – By Julia Toppin, Senior Lecturer, Music Enterprise and Entrepreneurship, University of Westminster

Documenting the life of an extraordinarily talented musician and writer, Bread of Angels – Patti Smith’s latest memoir, published at the age of 78 – further charts a life filled with genius, creativity, adversity and tragedy.

“It took a decade to write this book, grappling with the beauty and sorrow of a lifetime,” she wrote. “I’m hoping that people will find something they need.”

Bread of Angels follows on from Just Kids (which details her relationship with the artist Robert Mapplethorpe), M Train (which focuses on her life with her husband Fred “Sonic” Smith), and Year of the Monkey (written after a year of travelling in 2016, examining loss and ageing).

Released on the date of her late husband’s death, and close to the 50th anniversary of her seminal debut album, Horses, Bread of Angels is a deeply personal and authentic story that will provide inspiration for women trying to forge a career in the music industry.

The memoir takes the reader on a journey through the myriad roles Smith has inhabited: daughter, sister, invalid; friend, collaborator, activist; lover, poet, musician; wife, mother, widow. This moving account of a life well lived details the highs and lows of walking the earth as a woman.

Bread of Angels begins in infancy, building up a portrait of a young artistic and creative performer who gives it all up for love at the height of her fame. It ends with a rediscovery of music, writing and being on the road as a touring performer.

The six-decade rollercoaster ride that Smith describes so eloquently serves as a reminder that there is no joy without pain. And sadly, that perhaps the most creative of us are those to whom fate has been most unkind. Yet, to read how Patti Smith has lived, created, loved and lost while staying true to herself is an uplifting experience.

The blossoming of an artist

Smith endured a childhood of hardship, frailty and illness boosted by a mother who used art – from Puccini’s Madame Butterfly to Lewis Carroll’s Alice in Wonderland – to inspire her daughter to stay alive. Bread of Angels starkly illustrates the plight of a post-war working-class American family moving from place to place to stay above the poverty line.

Moving into young adulthood, Smith quickly rejects a conventional life and blossoms into an artist and key collaborator in the New York punk scene. Here she lives in the notorious Chelsea Hotel alongside contemporaries Robert Mapplethorpe, Bob Dylan, Allen Ginsberg, Janis Joplin, Jimi Hendrix and Andy Warhol. But the focus of Bread of Angels is Smith’s career as a recording artist and falling in love, marrying and forging a family.

Smith’s career as a recording artist parallels many of the challenges facing women in the music industry. It satisfyingly describes Smith’s insistence on asserting her creative independence in a male-dominated environment that seems to want to control every aspect. Smith’s refusal to submit to the patriarchal control that is still so pervasive in the industry will resonate with many women.

But more importantly, Bread Of Angels will probably embolden young female artists to reject this pressure. Smith made a brave decision to go for less money and sign with legendary A&R Clive Davis of Arista Records. Davis honoured his promise that Smith would have full creative control, which led to eight albums.

These include her groundbreaking debut Horses (produced by JJ Cale), the politically charged Radio Ethiopia (produced by Jack Douglas) and Easter (produced by Jimmy Iovine), which included Smith’s biggest hit Because The Night. It is fascinating to read the author’s recollections on how various albums were produced, including her initial ambivalence about the track written with Bruce Springsteen that would become her most well-known song.

Then there’s the startling tale of Smith’s infamous stage accident on tour in Tampa, Florida, where she tripped and fell 15ft into a concrete orchestra pit breaking several vertebrae in her neck. Once again she returns to the convalescent bed of her youth. Her recovery was a great period of reflection that allowed Smith to re-evaluate her life. To get back to music, she joined a strenuous sports rehabilitation programme while writing her first published collection of poetry entitled Babel.

At the height of her fame after the release of Easter, Smith gives it all up to go and live with the love of her life, Fred Smith. She states simply: “I did it for art. I did it for love. But most of all I did it for myself.”

She describes their instant attraction and marriage as inevitable. They make a life in Michigan, have two children and immerse themselves in reading, writing and being by the sea. Smith creates Virginia Woolf’s notion of a room of one’s own in the kitchen and allows the writer within her to fully evolve.

The penultimate section of the book is permeated with grief, loss and pain as Smiths loses several people dear to her. These include the man she describes as the “artist of her life”, Robert Mapplethorpe; the “love of her life” Fred Smith; her brother Todd; and several friends during the Aids epidemic.

A yearning for purpose following an extended period of grieving leads Smith back on the road, where this memoir ends, leaving the reader with a sense of Smith’s relentless vitality and positivity.

Bread of Angels is a beautifully life-affirming memoir. Smith’s eloquent rendering of an extraordinary life makes the ending inspiring when it could have easily been profoundly sad. Patti Smith remains, as she enters her 80th year, a touchstone for women in music everywhere.

Looking for something good? Cut through the noise with a carefully curated selection of the latest releases, live events and exhibitions, straight to your inbox every fortnight, on Fridays. Sign up here.

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Julia Toppin 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. Bread of Angels: Patti Smith’s eloquent memoir wrestles with ‘the beauty and sorrow of a lifetime’ – https://theconversation.com/bread-of-angels-patti-smiths-eloquent-memoir-wrestles-with-the-beauty-and-sorrow-of-a-lifetime-271067

Source: The Conversation – UK – By Samantha Ward, Professor of Zoo Animal Welfare & Legislation, Nottingham Trent University

Imagine sipping a latte while stroking an owl or watching an otter play at your feet. This is the promise of exotic animal cafes, a trend that blends coffee culture with wildlife encounters. But behind the Instagram-worthy photos lies a troubling reality – the welfare of the animals themselves.

Since the mid-2000s, animal cafes have increased in popularity with customers paying low-cost entrance fees, ranging from £8 to around £15, depending on the location and animals housed there. The concept seemed to have started with cat cafes but now include owls, meerkats, capybara, snakes and even penguins.

Taiwan, China and Japan seem to be leading the trend. But they are starting to pop up in the UK too, with plans for a capybara cafe in Norfolk announced in 2025. And there are already capybara cafes in Florida, US, that offer a “curated, slow-living experience that lets you connect with animals in a meaningful and memorable way”.

The appeal is obvious: exotic animals are fascinating. However animal rights activists have concerns about the cost to the animals. My colleagues and I recently published research on animal cafes in Japan which reveals they are failing animals on almost every welfare measure.

We visited 79 exotic animal cafes across Tokyo, Osaka, Kyoto and other regions, observing 231 mammal, bird and reptile species. We scored conditions in five areas: environment, nutrition, behaviour, restraint and visitor interactions.

Our findings showed welfare standards were consistently poor across all species.

Birds suffered most. Owls, by far the most common species, were often tethered to
perches, unable to fly. Owls are nocturnal species and therefore their natural behaviour is to hide away during daylight hours. Many were exposed to loud music and constant human contact, conditions known to cause stress to birds.

Otters didn’t have water for swimming during opening hours. Meerkats, highly social animals, were kept alone in tiny cages. Even domestic species such as rabbits scored poorly for the number of human-animal interactions and the environment that was provided for them.

Reptiles fared slightly better, probably because their spatial needs are smaller.
But many were housed in enclosures with no place for them to escape the public gaze or people tapping on their glass enclosures and had minimal enrichment.

Rabbits however did score higher on the nutrition scores. We linked this to the fact that they are domesticated, which means appropriate food is easy to purchase.

Poor welfare isn’t just an ethical issue, it’s a public health concern. Close contact with stressed wild animals increases the risk of bites, scratches and disease transmission, from salmonella to cryptosporidiosis, a parasitic infection that causes profuse watery diarrhoea, stomach pains, nausea or vomiting and low-grade fever for up to two weeks.

In cramped cafes, these risks multiply. A recent study and report compiled by WWF Japan found dangerous bacteria such as enterohemorrhagic Escherichia coli, salmonella, and drug-resistant bacteria in some facilities.

Another issue is where these animals are coming from. Many of the species housed in exotic cafes are of conservation importance. It might be that they are being bought and sold in violation of international animal trade laws that prohibit the movement or sale of certain animals from their original native homeland.

The bigger picture

As mentioned above, Japan isn’t an outlier, with similar opportunities in China and Taiwan. The UK has more than 40 cat cafes plus the proposed capybara cafe in Norfolk. The number of cat cafes in the UK is increasing, with a 44% surge in licences granted over the past financial year.

A report from the RSPCA and Cats Protection, two of the largest animal welfare charities in the UK, is calling for a phase-out of cat cafes. They believe that cats, “having descended from solitary, territorial, roaming wildcats” are “likely to find the enforced proximity to other felines as well as unfamiliar visitors wishing to stroke them extremely stressful.”

It’s unclear whether these types of cafe can ever meet the complex physical and psychological needs of any species that they house any species that they house, whether they are wild or domesticated animals. Our research suggests the answer is no. These environments cannot provide space, stimulation or choice – the foundations of good animal welfare.

Animal welfare legislation around the world is complex. In a lot of countries, exotic cafes would fall under the same license as zoos. This is the case in Japan. Japan’s animal welfare law offers little specific protection for exotic species. It acknowledges animal sentience but provides little consideration to the care of captive wild animals.

In England, Scotland and Wales there are two forms of legislation that might be relevant to animal cafes. For a domestic cat cafe, The Animal Welfare (Licensing of Activities Involving Animals) (England) Regulations 2018 applies.

This includes the need for the cafe staff and owners to provide a suitable environment and diet and protect the animals from pain, suffering, injury and disease. It would also require cat cafes to monitor the animals’ behaviour, handling of the cats and interactions with customers. Inspections of these facilities do occur but are dependant on the local authorities who may or may not have animal welfare knowledge.

If cafes are to house non-domestic species, such as capybara, they would also need to have a dispensation zoo license under the Zoo Licensing Act 1981. This will mean that in the case of the proposed capybara cafe, they will need to be inspected in a similar way to a standard GB zoo but without having to contribute to conservation or education.

No matter where you are in the world or which animals they showcase, society must ask whether such cafes align with modern ethical values.

The simplest and most effective action you can take to oppose them is not to support these businesses. Every visit fuels demand for keeping wild animals in unsuitable environments.

When away from the UK, visit accredited zoos, wildlife sanctuaries, or conservation centres where animal welfare, conservation and education are prioritised. If you encounter cafés with poor conditions you should report them to local authorities or animal welfare charities such as Wild Welfare.

As these cafes gain popularity on social media, the conversation must shift from cuteness to responsibility.

Samantha Ward is the Research Advisor for Wild Welfare, an international animal welfare charity.

– ref. Exotic animal cafes: cute trend or welfare crisis? – https://theconversation.com/exotic-animal-cafes-cute-trend-or-welfare-crisis-271147

Source: The Conversation – UK – By Robin Bailey, Assistant professor, University of Cambridge

Picture a busy A&E department on a winter evening. Among the emergencies – heart attacks, broken bones, severe injuries – sits someone with a sore throat. Another with an ingrown toenail. Last winter in England, over 200,000 people turned up to emergency departments with complaints like these, leading many to ask: are people misusing A&E – or is something else going on?

A perspective not always considered in this discussion is that the sore throat (or other seemingly minor ailment) isn’t really the problem. The problem is the terror that it might be something worse. Unfortunately, the healthcare system has no idea how to address that fear.

The term for this fear is health anxiety. A person with health anxiety constantly worries that they might be sick or have a serious disease. It’s accompanied by repeatedly checking the body for symptoms, obsessively searching online for explanations and constantly seeking reassurance – often from medical professionals.

Studies suggest that 3% of people in the general population and 20% of hospital out-patients struggle with health anxiety. And the trend appears to be moving in the wrong direction. A large international review found that health anxiety has increased over the past 30 years.

One catalyst for this trend could be the internet. Researchers call this aspect of health anxiety “cyberchondria”.

Studies find that people who worry a lot about their health tend to feel worse, not better, after searching for their symptoms, and that they are more likely to seek further reassurance from doctors and emergency departments.

A dry throat becomes a sign of a serious infection. A headache becomes a brain tumour. A rash becomes sepsis.

The more a person searches, the more alarming possibilities they find. The more alarming possibilities they find, the more urgently they seek reassurance.

Emergency departments are a natural destination for this problematic cycle. They offer rapid testing, expert authority and the promise of immediate safety.

For someone whose worry feels uncontrollable, waiting days for a routine appointment can feel like gambling with survival.

A 2025 study in Australia looked at 400 people who came to emergency care with non-urgent problems. Researchers found that people who worried most about their health were more likely to see symptoms as needing emergency attention, even when they did not.

This group also reported more emergency visits and more use of other health services over the previous six months. This suggests that worry itself, rather than the severity of the symptom, may be driving repeat visits.

Similar findings are emerging in the UK. A recent emergency department study found that severe health anxiety was common in patients well enough to walk into a hospital and was closely tied to how they interpreted and escalated symptoms.

The cost of fear

The cost of this cycle is not just emotional. A 2023 review pulled together studies from Europe and the US and estimated that untreated health anxiety costs healthcare systems between about US$857 (£644) and US$21,138 per person per year.

Although common and costly – and placing high demands on health services – health anxiety remains neglected in policy.

Although health anxiety is recognised by professionals as a real condition, the UK’s National Institute for Health and Care Excellence and the American Psychiatric Association have not published specific guidelines on how doctors should treat it.

In a recent Lancet article, I argued for health anxiety to be treated with the same seriousness as other mental disorders, and for clear routes between physical and mental health services so that health anxiety does not simply keep cycling through clinics and emergency departments.

The absence of guidance leaves doctors in an awkward position. In emergency departments, staff are trained to rule out serious physical illness quickly. But when tests suggest low risk and a patient remains intensely frightened, there is no agreed-upon clinical approach for addressing the fear that brought them in.

A review of health anxiety in hospitals suggests that, without a consistent way to recognise and explain this problem, the encounter often ends with further investigation, brief reassurance or discharge.

These responses are understandable when staff are busy and under pressure, but they don’t address the underlying anxiety and can lead to people coming back again and again.

A consistent approach would help doctors acknowledge someone’s distress without making them more worried, explain what’s happening in a clear way, and connect them to psychological support before a pattern of seeking emergency reassurance becomes established.

Researchers have begun to explore practical ways to do this.

The debate about minor ailments in emergency care is perhaps missing an important point. The issue is not always the symptom, but the meaning the symptom has become.

Until health anxiety is given the same clinical seriousness as other common disorders, emergency departments may continue to absorb a problem they were never designed to treat.

Robin Bailey 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. Patients blocking A&E with minor ailments? Here’s what’s probably going on – https://theconversation.com/patients-blocking-aande-with-minor-ailments-heres-whats-probably-going-on-271346