Category: The Conversation – UK

Source: The Conversation – UK – By Justin Stebbing, Professor of Biomedical Sciences, Anglia Ruskin University

A new kind of blood test promises to find cancer early – sometimes even before symptoms appear.

The pitch is compelling: a single sample of blood could scan the body for dozens of different cancers at once, catching disease at a stage when it is easier to treat and more likely to be curable. For people who fear cancer – which is most of us – this sounds like a medical revolution.

These tests look for tiny pieces of DNA from cancer cells that are circulating in the blood – something my research teams have spent years working on. In the lab, powerful machines analyse these DNA fragments, searching for patterns that suggest a hidden cancer somewhere in the body.

Instead of waiting for a lump, unexplained weight loss or other symptoms, you could have a blood test every six or 12 months to check if cancer is starting to grow. NHS England described the test – which they were trialling in 142,000 patients – as “the beginning of a revolution”.

The revolution postponed

But when researchers have put these tests through their paces, the reality has fallen well short of the headlines. In one large recent UK study, the blood test missed most cancers that participants went on to develop.

A negative test may feel like a clean bill of health, but at the moment, it is nothing of the sort. This matters because people naturally change their behaviour when they are reassured. If you believe a high-tech blood test has “ruled out” cancer, you may delay seeing a doctor when symptoms appear, or dismiss nagging changes in your body as nothing to worry about.

Traditional screening tests have their own problems, but they are built on decades of evidence. Mammograms for breast cancer, colonoscopy or stool tests for bowel cancer, and cervical screening all went through long, careful trials to show they save lives overall, not just that they find more abnormalities.

Even then, they can miss cancers, and they can also pick up growths that would never have caused harm. With multi-cancer blood tests, the evidence is much thinner, and we still do not know whether using them in healthy people actually reduces deaths from cancer.

The tests also generate false alarms. Sometimes the test can flag people as having cancer when they don’t, causing huge amounts of stress. Health systems that are already stretched risk being overwhelmed by follow-up investigations, triggered by blood test results, that may ultimately lead nowhere.

Cost is another consideration. These tests are not cheap to develop or buy. If these tests are used widely before we know whether they work, health services could waste money and staff time on unproven technology instead of on proven measures like prompt diagnosis, smoking cessation, weight management and ensuring that existing screening programmes reach the people who need them most.

Yet it would be wrong to dismiss these tests entirely. The underlying science is sophisticated, and it is advancing quickly. In high-risk groups – for example, people with strong family histories of certain cancers, or those with inherited genetic mutations – carefully used blood tests might genuinely help to detect tumours earlier than we can today.

They are also helpful in checking if cancer is returning after treatment, or in choosing treatments that match the specific biology of a person’s cancer.

The deeper issue is how we introduce such technology into everyday life. There is a long history of medicine being captivated by new treatments and procedures, only to discover later that the harms and compromises were greater than expected.

Early cancer blood tests are arriving at a time when trust in institutions is fragile, misinformation spreads fast, and many people understandably feel that getting to see a doctor at all is increasingly difficult. Adding another layer of complexity and uncertainty could easily widen inequality between those who can pay privately for extra tests and those who cannot.

Sensible steps you can take

While we wait for better evidence, there are still sensible steps people can take. First, if you are invited to take part in a trial of a new cancer blood test, ask what the study is trying to show and what is already known. Genuine clinical trials, run through the NHS or academic centres, are how we answer important questions about benefits and harms.

Second, if you are offered one of these tests privately, ask who will interpret the result, what support you will get afterwards, and whether it is likely to change your care in a meaningful way.

Most importantly, do not let the idea of a “simple blood test” overshadow the basics. If you notice a new lump, unexplained bleeding, persistent cough, weight loss or a change in bowel habit that goes on for more than a few weeks, you should still contact your GP, even if a previous test was normal.

Trust your instincts about your own body and keep pushing if you feel something is wrong. Stories of delayed diagnoses repeatedly show that persistence from patients, families and doctors can make a crucial difference.

Cancer outcomes have been improving slowly over time, thanks to a combination of better treatments, earlier diagnosis and public health measures. New technology, including blood tests that scan for traces of cancer, will probably play a part in the next chapter of that story. But on their own, they are not a magic bullet against disease.

Justin Stebbing 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. Blood tests for cancer? We’re still a way off – https://theconversation.com/blood-tests-for-cancer-were-still-a-way-off-277798

Source: The Conversation – UK – By Simon Mabon, Professor of International Relations, Lancaster University

A report in the Washington Post the day after the Iran war began suggested that Saudi Arabia and Israel had both lobbied Donald Trump to attack Iran. The Saudis swiftly denied that they had pushed for war.

In the days since, as Iran lashed out in retaliation, Saudi Arabia came under attack. An Iranian drone hit the US embassy in the Saudi capital, Riyadh, and an oil processing plant at Ras Tanura was targeted. Two people were killed on March 8 after a projectile fell on a residential area in Al-Kharj city, near an airbase used by the US military.

My academic and civil society contacts in Saudi Arabia expressed deep scepticism of the idea that Saudi Arabia had pushed the US to bomb Iran. The attacks go against everything that the Saudis have been doing for the past few years, when long-simmering tensions between Iran and Saudi Arabia had begun to thaw.

Heated history

Iran and Saudi Arabia have a long and complex history. Saudi Arabia is an overwhelmingly Arab, Sunni state, while Iran is a mainly Persian, Shia state.

Tensions between the two rivals came to a head in 1979 with the Iranian revolution. Iran’s new leader, Ayatolloh Ruhollah Khomeini, began to criticise the Saudis, saying they were unfit to be the custodians of the two holy places of Islam, Mecca and Medina. That antagonised the Saudis, who tried to diminish the credibility of the new Islamic Republic

Iran then began to provide support to groups across the region who wished to change the status quo, such as Hezbollah in Lebanon. For the Saudis, this attempt to undermine regional order fuelled the antagonism.

In the early 1990s, after the death of Khomeini, more political space opened up and tensions between Saudi Arabia and Iran eased. But after 9/11 and the US-led invasion of Iraq in 2003, relations deteriorated. Iraq descended into a civil war, with Iran and Saudi Arabia supporting different groups in the conflict.

By 2010, diplomatic cables leaked to WikiLeaks revealed Saudi King Abdullah had repeatedly pushed the US to strike Iran’s nuclear capabilities, urging the Americans to “cut off the head of the snake”. In 2016, the two countries cut off diplomatic relations after an attack on the Saudi embassy in Iran following the execution of a Saudi Shia cleric.

An era of rapprochement

Ever since a deal struck in 1945 between US President Franklin D Roosevelt and the Saudi King Abdul Aziz Al Saud on an aircraft carrier, Saudi Arabia has relied on the US for its security.

But after an attack using Iranian-made drones and cruise missiles in September 2019 against oil processing facilities at Abqaiq and Khurais in eastern Saudi Arabia, the Saudis became worried that they couldn’t rely purely on the Americans. The Houthi rebel group claimed responsibility for the attacks, but subsequent investigations by the UN said they were not involved.

Iran denied allegations it was behind the attacks. The US did deploy air and missile defence forces to Saudi Arabia in the wake of the attacks, but the muted response still led to a dramatic change in Saudi Arabia’s approach to regional politics.

At the same time, Saudi Crown Prince Mohammed bin Salman (MBS) realised that if Saudi Arabia wanted to enact its domestic reforms, in particular the ambitious Vision 2030 transformation, the country needed investor confidence and – crucially – regional stability. That meant a move away from comments, such as those by MBS in 2018, likening Iran’s supreme leader to Hitler.

A softening of Saudi rhetoric on Iran began, and back channel dialogue opened up. Then, in April 2021, the foreign ministers of Saudi Arabia and Iran sat down in the Iraqi capital Baghdad for talks, followed two years later by a Chinese-brokered normalisation deal signed in Beijing.

The two countries reopened embassies and started diplomatic initiatives, expressing joint statements in support for each other and carrying out joint military drills. All of this pointed to a thawing in relations – until the new Iran conflict began.

Iran conflict

With the arrival of a US armada in the Gulf in recent months, the Saudis and their Gulf neighbours would have expected another attack on Iran was imminent. But they don’t want a destabilised Iran.

Iraq in 2003 after the fall of Saddam Hossein experienced a terrible, violent period of instability that did not improve the region’s political, social or economic conditions, or encourage investment – all things the Gulf’s leaders hanker after. The US killing of Iran’s supreme leader Ali Khameini in the hope that it would facilitate some type of peaceful transformation will seem like a huge gamble to Gulf leaders at a delicate time in their political trajectories.

If the perception in Iran is that Saudi Arabia has been pushing for war, it could start to pull the US and Saudi Arabia closer together. There is some anger from the Saudis too, however, that the Americans have not done more to protect them. A Saudi analyst told Al Jazeera that America had abandoned it. While Gulf states have very advanced hardware, they have small militaries, and will be now worried about their own security, and about being drawn into a long regional war.

With the future of Iran still deeply uncertain, and very real potential for prolonged instability on their doorstep, Gulf states will be carefully weighing their next move. Whatever happens, Iran’s decision to bomb its neighbours will make it very difficult to rebuild the sort of the trust that had been cultivated over recent years.

This article is based on an interview Simon Mabon gave to The Conversation Weekly podcast, published on March 5.

Simon Mabon receives funding from Carnegie Corporation of New York and the Henry Luce Foundation. He is a Senior Research Fellow with The Foreign Policy Centre

– ref. Why it’s unlikely that Saudi Arabia wanted the US to bomb Iran – https://theconversation.com/why-its-unlikely-that-saudi-arabia-wanted-the-us-to-bomb-iran-277687

Source: The Conversation – UK – By Sally King, Visiting Fellow in Menstrual Physiology, King’s College London

Social media has a habit of turning health topics into viral trends. The latest example is “period scooping”, a term circulating widely on TikTok that promises a way to manage or even shorten menstruation.

The idea sounds intriguing, even empowering. In reality, it reveals how much confusion still surrounds periods.

The term “period scooping” is being used to describe several different practices. One involves consciously contracting pelvic floor muscles while on the toilet or in the shower to push out menstrual fluid that has collected in the vaginal canal. This is not new and it is not dangerous. Many people have discovered it themselves over time. But it does not shorten a period, it merely reduces its flow for a short while. Menstruation is the shedding of the womb lining, a process driven by hormonal changes. What happens in the vaginal canal cannot stop or speed that up.

More concerning are posts that frame “scooping” as washing out the vagina with water, a shower head or soap. This is essentially douching, a practice that research has repeatedly linked to infections such as bacterial vaginosis and thrush, and to more serious complications like pelvic inflammatory disease and premature births. The vagina maintains its own protective environment, including an acidic pH and a balance of beneficial bacteria. Introducing water or soap disrupts this system and increases the risk of infection.

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Read more:
Just don’t douche – what your vaginal biome can tell you about your health and pregnancy

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There are also videos encouraging people to insert fingers or pipettes to remove menstrual fluid. Again, this is not a new behaviour but it is unnecessary and carries risks if fingers or pipettes are not clean, or products such as hand moisturiser or soap are introduced internally.

What is striking is that these trends are emerging at a time when there are more effective menstrual products than ever. Menstrual cups, period underwear and reusable pads allow people to manage heavy bleeding, exercise and even swim without leaking. The persistence of “hacks” suggests a gap in education rather than a lack of options.

The same goes for other viral claims. Some influencers promote drinks made with lime juice, salt or spices as a way to shorten periods. This is physiologically impossible and so, unsurprisingly, there is no scientific evidence supporting such claims.

The menstrual cycle is governed by hormonal signals between the brain and ovaries over an average of four week cycles. Food and drink cannot abruptly interrupt this process. A healthy diet can reduce inflammation over time and may help with symptoms such as pain and heavy bleeding, but no food, drink or even medication can stop a period immediately.

Similarly, some social media influencers may claim that you must have a monthly period to stay healthy. This is misleading. Hormonal contraception can safely reduce blood loss and pain, with some methods eventually stopping periods for several months or years. For some people, particularly those with anaemia or endometriosis, this can be extremely beneficial. Periods can be a sign of overall health in certain contexts (elite sports training, or in recovery from anorexia or other health conditions), but they are not biologically required every month.

Another trend seems to take a more positive approach, celebrating menstrual blood as something powerful and even applying it to the skin as a face mask. Menstrual fluid does contain stem cells, and scientists are studying them for potential use in regenerative medicine. The womb sheds and rebuilds tissue every cycle without scarring, a process that fascinates researchers. But rubbing menstrual fluid directly onto the skin cannot deliver anti-ageing effects. The skin acts as a barrier, so these cells cannot penetrate to where they would have any biological impact.

Where this research does hold real promise is in healthcare. Menstrual fluid may eventually help diagnose conditions such as endometriosis or cervical cancer through simple testing. Biobanks are already collecting samples to support this work. Scientists are also exploring how these unique stem cells might aid wound healing or tissue repair. These developments are still in early stages, but they highlight how valuable menstrual fluid could be if not subject to societal taboos and stigma.

Menstruation itself is rare among mammals. Only about 1.6% of species experience it, among them some primates, a few bats, the spiny mouse and the elephant shrew. In humans, menstruation is thought to be linked to a protective reproductive strategy. The uterine lining prepares itself in advance for pregnancy and may help filter out embryos that implant abnormally or invade too aggressively. If fertilisation does not occur, that lining is shed as menstruation. Yet despite its biological significance, it remains surrounded by myths and misinformation.

Menstrual ignorance and stigma shapes behaviour. Feelings of shame about smell, discharge or infection can push people toward harmful practices like douching. Lack of education means many learn about their bodies through social media rather than reliable sources. Even medical training has historically paid limited attention to menstrual health.

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Read more:
Menstrual health literacy is alarmingly low – what you don’t know can harm you

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Better education from an early age would change this. Teaching children that menstruation is normal, not something secret or shameful, would help dismantle myths before they take hold. It would also make it easier for people to seek medical advice when they need it.

Social media can play a positive role by opening conversations and challenging taboos. But it should not be the primary source of health information. Many viral trends are designed to capture attention or sell products, rather than provide evidence based guidance.

Menstruation is not dirty, and it is not a problem to be hacked. It is a protective biological process that still holds great scientific potential. Treating it as normal rather than something weird or shocking would be a better starting point than most viral trends.

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Strange Health is hosted by Katie Edwards and Dan Baumgardt. The executive producer is Gemma Ware, with video and sound editing for this episode by Anouk Millet. Artwork by Alice Mason.

If you’ve got a question about a viral trend or video you’ve seen and you’d like us to delve into the science behind it in a future episode, please email us at strangehealth@theconversation.com.

Listen to Strange Health via any of the apps listed above, download it directly via our RSS feed or find out how else to listen here. A transcript is available via the Apple Podcasts or Spotify apps.

Sally King is the founder of Menstrual Matters, a non-profit online platform about menstrual health and associated rights issues. She previously received funding from the ESRC for her doctoral research into PMS. She is a visiting fellow in menstrual physiology at King’s College London and an unpaid elected board member of the Society for Menstrual Cycle Research (SMCR).

– ref. TikTok’s period scooping trend shows how little we still understand about menstruation – https://theconversation.com/tiktoks-period-scooping-trend-shows-how-little-we-still-understand-about-menstruation-277075

Source: The Conversation – UK – By Ola Demkowicz, Lecturer in Psychology of Education, University of Manchester

Women experience greater low mood and anxiety than men. This longstanding gender mental health gap reflects a complicated mix of biological, psychological, social, and sociocultural factors – though we are still far from fully understanding it.

NHS data shows that young women aged 17-19 are twice as likely to have a mental health disorder as young men. Other national data shows steeper increases in symptoms of low mood and anxiety for girls.

Common explanations put forward include social media, increased sexualisation of girls and growing academic pressure. But girls themselves have rarely been asked what they think. This limits our understanding of their needs and experiences.

In a study on what girls themselves think about worsening trends in girls’ low mood and anxiety, I worked closely with two young women, Pratyasha and Jo, from start to finish. This was important to make sure we not only listened to girls, but that we also asked them the right questions in a constructive way and could better understand what they told us. We worked together throughout, to design how the research would run, to hold conversations with girls taking part and to interpret what we heard.

Our wider research team included people from many different academic and clinical backgrounds, but Pratyasha and Jo’s lived experience and hands-on input were central to every stage of the project. We spoke with 32 girls aged 16 to 18 across England, from varied ethnic and religious backgrounds, about their views on the worsening adolescent gender mental health gap.

Gender expectations

Girls described how sexist stereotypes shaped their lives from an early age. They described how they saw – and felt expected to conform to – narrow views of how girls “should” behave and present themselves. Many said they had been judged when they were seen as not conforming: they were told to smile, or mocked for liking football. They explained that these experiences shaped their lives in many ways, including normalising school-based sexual harassment and affecting their self-worth.

“People think that an insecure girl is just someone who thinks, ‘oh, my hair isn’t good enough’”, said Sunita, “but it’s so much deeper than that and I think a lot of the insecurities within girls that they just don’t feel like … a person because of how they’ve been treated.”

This echoes research showing that gender norms can be worrying and stressful for girls. This could partly explain higher rates of low mood among girls.

Girls also described considerable academic pressure: intense exams, a fear of mistakes and pressure to excel. They felt these issues could be compounded for girls, who are expected to both succeed and prove themselves. They said this can prompt feeling sad and worried, particularly as they worked towards high-stakes exams.

“In year nine I was perfectly fine,” Hannah recalled, “and then in year ten I was really sad and really depressed and I had so much anxiety because I really wanted to do well in my GCSEs”.

Evidence does suggest that academic pressure affects mental health, with some evidence of greater effects for girls. In the UK, there has been considerable concern about how education reforms in the 2010s might increase the pressure placed on young people.

Although the limited available evidence does not suggest young people are feeling more pressured than they used to, it seems that school satisfaction has dropped sharply in recent years. It’s important that we try to understand what that might mean for girls and their mental health.

Comparison, insecurities and social media

The girls reflected on social media engagement as a mixed experience with some positives. They highlighted that comparison and insecurity are normalised in social media spaces. They said that visual platforms, such as Instagram and TikTok, particularly reiterate gendered expectations for girls on how they should present themselves. They explained that while the standards set on social media about life and how one should look are unrealistic, it’s difficult to understand what is “real”.

“In your mind you’re comparing yourself without even thinking about it and that affects your mood,” reflected Kira. These insights from girls line up with growing evidence that social media’s mental health effects depend on specific experiences, not simply time spent online. Evidence also suggests that the elements of comparison involved in social media may be especially problematic for girls.

Given that girls’ mental health has been declining for several years, it is vital that we engage with and listen to their perspectives. In this project, that meant involving them directly in examining and discussing evidence, so that we can better make sense of trends in their mental health. Girls need meaningful opportunities to share their challenges and priorities on issues affecting their mental health.

For parents, teachers and others who support adolescent girls, it can mean making space for open conversation about the issues affecting them in life. The girls we spoke with repeatedly emphasised how important it is to have supportive environments where they can process and make sense of their worlds – and to be heard and advocated for.

The study was funded by the National Institute for Health and Care Research (NIHR) Public Health Research Programme (project reference NIHR135295). The views expressed in this article are those of the author(s) and not necessarily those of the NIHR.

– ref. Making sense of the widening gender mental health gap: what teenage girls told us – https://theconversation.com/making-sense-of-the-widening-gender-mental-health-gap-what-teenage-girls-told-us-254867

Source: The Conversation – UK – By Richard Sambrook, Emeritus Professor of Journalism, Cardiff University

The news agenda of the last few years has been relentless, from war in Ukraine, Gaza and Iran to political polarisation and violence. The constant flow of distressing images and developments can lead to anxiety and dread for readers and viewers. Many even avoid the news altogether.

For those whose job is to review and edit such stories in newsrooms, the impact can be even more distressing. Often it is younger journalists, working long shifts monitoring online images, who are the most affected by what has been called the “digital frontline”.

Newsrooms have long recognised the dangers of sending staff into war zones and to report on hazardous events. They provide journalists with safety training and equipment, and have well established protocols. Now, they are having to consider how to protect the mental health of staff based in the newsroom, as they see increasing numbers of journalists suffer from post-traumatic stress disorder (PTSD) or related conditions.

The International News Safety Institute and Cardiff University recently conducted a confidential survey of some two dozen newsrooms in the UK and Europe, along with 30 interviews with newsroom leaders and trauma experts. In the survey, more than three-quarters of them were aware of staff suffering PTSD, with an average of four out of ten staff seeking help within their news organisations.

All of those surveyed or spoken to agreed there was increasing potential for trauma to affect newsroom staff, given the issues and images they are expected to deal with on a daily basis. As one newsroom leader commented: “I often think our teams are the ‘invisible’ first responders and we tend to overlook the psychological challenges that come with the job.”

Another said they had not seen a time with so many heavy and traumatic stories coming at once and having an impact on all staff in their newsroom. The traumatic impact of frontline reporting has been recognised for some time. But research is now identifying the risk of trauma to newsroom-based teams and to content moderators, which itself is now a more central news function.

Management response has been patchy. Larger organisations such as Reuters, The New York Times and the BBC have developed sophisticated and proactive approaches to managing the mental health of staff.

Others rely on a basic employee assistance programme provided by a third party – often not tailored to the specific experiences in newsrooms. And some have yet to consider even that. Others have developed peer-to-peer networks within newsrooms, with more experienced editors trained to look for signs of trauma. Some have psychologists in the newsroom or visiting regularly for staff to talk to confidentially.

Only 10% of newsroom leaders surveyed said they had proactive measures in place, preparing staff before they took up roles exposing them to frequent distressing images. Barriers to change include a legacy of “macho” culture, restricted funding or simply a lack of focus on the issue.

The new frontline

Discussion in the media industry still focuses mainly on physical safety for staff in hostile environments, and has not caught up with the rapidly evolving digital landscape. In many ways the situation mirrors the development of safety protocols for war zones developed by the media 30 years ago.

The BBC, with others, developed the first hostile environment training in the early 1990s, providing helmets and flak jackets and armoured vehicles for those reporting the Bosnian war. Other newsrooms took longer to catch up. Today, there are still some reporting teams in war zones without training or equipment – but very few. Adapting to the new digital risks seems to be following a similar trajectory.

It isn’t simply looking at distressing images of suffering which is a problem. It’s increasingly recognised that what’s known as “moral injury”, which comes from witnessing, or failing to prevent events that violate one’s own moral values, can be distressing. Examples include the guilt of being unable to help those in danger or being expected to frame stories in ways the journalist may personally disagree with, violating their personal ethics.

Helplessness can also be a factor. Some reporters covering climate change, for example, refer to it as “the apocalypse beat”. Moral injury is distinct from PTSD, but can be equally debilitating.

The digital environment of most news coverage today also means journalists are more directly exposed to abuse and harassment from readers, or from those who disagree with their coverage. This may be exacerbated when covering controversial or polarising conflicts.

Online harassment of journalists is rising steeply as a consequence of social polarisation and the legitimising of attacks on the media by populist politicians.

Women in journalism are already deeply affected by this. Almost 90% of respondents to a 2025 survey for the European Federation of Journalists, said their female journalists had experienced online harassment and abuse. Such levels of abuse directly affect physical, emotional and mental wellbeing, and have also been found to spill into real-world violence.

The increase in vicarious trauma is a business risk. “As news cycles accelerate and conflicts proliferate, unaddressed trauma will worsen, threatening staff wellbeing, retention and the integrity of journalism itself”, observed one newsroom editor.

The news industry is starting to respond to these challenges. Newsroom leaders and trauma experts recommend using tools like audio muting, screen minimisation and grayscale filters, which can minimise the visceral impact of graphic content. And there is greater support for staff suffering regular harassment as employers increasingly recognise their duty of care with a legal responsibility to manage psychosocial risks. But there is still a sense that news management culture must adapt more rapidly to the changing risks experienced by desk-based staff processing a violent and stressful news agenda.

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

– ref. The relentless cycle of violent news is leading to trauma for journalists, even those not in war zones – https://theconversation.com/the-relentless-cycle-of-violent-news-is-leading-to-trauma-for-journalists-even-those-not-in-war-zones-276806

Source: The Conversation – UK – By Rebecca Payne, Clinical Senior Lecturer, Bangor University

When six-year-old Seren was prescribed antibiotics, taking them four times a day quickly became a battle. The orange liquid tasted revolting, and much of it ended up on kitchen surfaces rather than in her mouth. Her mother was never sure how much she had actually swallowed, but was afraid to give her more in case the dosage was exceeded.

The final straw came on day five, when the bottle was knocked over and the remaining dose spilled across the floor. The family gave up. Seren never finished the course.

This is a situation I come across as a GP, which happens all too often in my clinical practice. But a new paper from my colleagues and I suggests that a solution may be to encourage more children to take tablets.

Liquid medicines are commonly prescribed for children. They are widely assumed to be the safest and most practical option. In reality, they can be difficult to give and easy to get wrong.

Children may spit liquid medicine out, swallow only part of it, or refuse it altogether. Measuring doses accurately can be difficult with a distressed or wriggling child, and many formulations are unpalatable. Liquids spoil quickly, with refrigeration often required. Together, these factors increase the likelihood that courses are not completed as prescribed.

The consequences are significant. Incomplete or inconsistent dosing can make treatment less effective and can contribute to the development of antibiotic resistance. Children may remain unwell for longer or return to the GP for further consultations or alternative antibiotics, adding pressure on families and the health system.

Oral liquid medicines that are prescribed, or purchased from pharmacies, can be very expensive. Research shows more than two thirds of prescriptions for liquid medicines could be safely changed to tablets or capsules, saving three quarters of treatment costs.

Costs don’t just affect parents and health care systems, but the environment too. Liquid medicines typically have a much larger carbon footprint than tablets. They require more packaging, are heavier to transport and, in some cases, need refrigeration.

Despite all this, the assumption that children cannot swallow tablets persists. This belief is widespread among parents and healthcare professionals and strongly influences prescribing habits. Yet a growing body of research challenges this long-held view.

Evidence from the UK and other countries shows that most children can learn to swallow tablets. Research has shown that with brief, structured coaching, most children from around the age of four can learn to swallow tablets safely and confidently.

International experience supports these findings, with European guidance making similar recommendations.

So, if tablets are often cheaper, easier to store and more reliable, why do liquid medicines remain the default?

Longstanding practice plays a major role. Outside specialist paediatric settings, prescribers, pharmacists and parents often assume young children can only manage liquids. Tablets can look intimidating, and both parents and professionals can worry about the risk of choking. Parents may struggle to introduce a new skill when a child is unwell and upset.

How do we teach children to swallow tablets?

Tablet swallowing is best introduced when a child is well. Teaching can be done by parents, with online resources available to help. Training programmes such as KidzMed recommend starting with very small sweets and gradually increasing the size as confidence grows. The child chooses a favourite drink, places the sweet on their tongue, takes a few gulps and swallows. For most children, progress is rapid.

Liquids will always be necessary for babies, infants and children with complex needs or swallowing difficulties. But they do not need to be the default for every child.

GPs and other prescribers could routinely ask whether a child can swallow tablets and record this information in medical notes, making it easily available for future consultations. Prescribing systems could be adjusted so liquids aren’t the default option presented for children.

Education and culture change will be needed. Training on tablet swallowing could be included in GP, pharmacist and prescriber curricula, supported by updates for current practitioners. Community pharmacists are well placed to coach families and advise on suitable formulations. Schools and children’s television shows can support culture change by normalising tablet taking.

Liquid medicines are often messy, expensive and difficult to give. Their widespread use contributes to incomplete treatment, avoidable healthcare use and unnecessary environmental costs.

With simple coaching and system change, many children can take tablets from an early age. Doing so could reduce stress for families, improve treatment effectiveness, cut costs and reduce the environmental footprint of medicines.

Rebecca Payne is partially funded by a University of Oxford Clarendon-Reuben Scholarship. She works on the REMEDY project funded by Health and Care Research Wales.

– ref. Kids can take tablets, so why are we still giving liquid medicines? – https://theconversation.com/kids-can-take-tablets-so-why-are-we-still-giving-liquid-medicines-272368

Source: The Conversation – UK – By Till Koglin, Senior Lecturer and Reader in Transport and Mobility Planning, Lund University

Across Scandinavia many people commute to work or school on their bikes during winter, despite snow and freezing temperatures.

For example, in the Stockholm region of Sweden around 34% of people cycle at some point during the winter months. Oslo in Norway has seen an increase of winter cycling recently. With 15 % of all journeys being made using this form of transport in winter in 2022, up from 7% in 2015.

I live in the small town of Lund in southern Sweden and I am a winter cyclist. Even in temperatures as low as -5°C to -10°C, with snow on the ground, I cycle from home to take one child to school, and another to preschool and then to work on my bike. It’s around 5km every weekday. For me that is the best and cheapest option. Most of my route is on bike paths through the city. In winter I usually wear a warm jacket, but nothing particularly special for cycling. Most other parents bring their kids to school by bike, even in winter.

And cycling in winter is not just a trend in Sweden. Research shows that the Danish capital, Copenhagen, also has high cycling levels in the colder months. Around 66% of Copenhagen’s cyclists say they use their bikes in the winter. Cyclists there report feeling often prioritised and safe, and many see cycling as an efficient mode of transport. Even in winter, cycling often remains the fastest and most convenient option for many urban journeys.

In Sweden, especially in the northern part of the country, studded winter tyres for bikes are fairly common, although where I live in Lund they tend not to be used.

Studies show that studded bicycle tyres significantly improve bicycle grip and braking on ice.

Cycle tracks that are covered with snow can thaw and then freeze creating slushy icy paths that are particularly difficult to manage. Many Scandinavian cities, such as Copenhagen, address this challenge by making sure winter maintenance for cycling routes is given a high priority. Timely snow clearance and anti‑slip treatments, such as combining gravel with salt for better grip, improve safety and encourage people to continue cycling even in cold weather.

Studies show that surface conditions strongly affect cycling decisions.

Snow clearance remains the most important factor in people’s decisions about whether to get on their bikes, while anti‑slip measures help reduce crashes. Good city maintenance of cycle tracks and appropriate equipment encourages people to continue to use this form of transport throughout the winter.

Advice from local authorities often emphasises safe winter cycling practices, such as adjusting speed to cope with winter conditions. It’s these factors, along with knowledge of how to cycle in bad weather and good path clearance that help cyclists get to work even in demanding weather.

Also significant is that cities in Sweden and Denmark usually offer tracks separated from the roads, and give cyclists clear priority at junctions with cars. Features such as cycling bridges and specific traffic signals for cyclists make the journey easier and minimise conflict with motor vehicles, which becomes especially important when visibility is low or surfaces are wet.

In places where infrastructure is not as well suited for cycling or mixed with fast-moving traffic, winter conditions exacerbate stress and discourage cycling.

Better for the environment

Winter cycling has significant implications for sustainable transport policies and reaching climate goals. Each cyclist represents one fewer trip with a car having to start in cold weather, a type of journey associated with disproportionately high emissions and local air pollution. Studies suggest that improving winter maintenance levels of cycle paths could reduce accidents and winter cycling more generally reduces car use.

Sustained winter cycling also helps reduce congestion and eases pressure on public transport during peak periods.

Strong links between public transport and cycling also help people tackle longer journeys. Good cycle parking facilities at stations or being able to take the bike on a train also encourages cycling for parts of a journey.

Winter cycling in Scandinavia is not because people are unusually hardy but because of consistent planning choices, reliable maintenance and a cultural commitment to cycling as an everyday activity. When cities treat cycling as essential transport rather than a seasonal option, people continue to cycle, even in the snow.

Till Koglin receives funding from The Swedish Energy Agency, The Swedish Transport Administration, Sweden’s innovation agency.

– ref. Scandinavians cycle to work even on snowy days, here’s why that makes sense – https://theconversation.com/scandinavians-cycle-to-work-even-on-snowy-days-heres-why-that-makes-sense-276567

Source: The Conversation – UK – By Jennifer Coates, Professor of Japanese Studies, University of Sheffield

How much do any of us really know about who we are? This question haunts director Kei Ishikawa’s adaptation of Kazuo Ishiguro’s first novel, A Pale View of Hills (1982).

The complex story follows “unreliable narrator” Etsuko from Japan to England. A Pale View of Hills starts in 1982, as Etsuko (Yoh Yoshida) packs up her English country house, preparing to move. Her daughter Niki (Camilla Aiko) arrives, taking advantage of the domestic upheaval to ask about their family history.

Both are struggling with the suicide of older daughter Keiko. Niki cannot enter Keiko’s old room, while Etsuko tells neighbours that Keiko is living in Manchester, England. Niki expresses surprise at how easily her mother tells this lie, but as the film progresses we learn that mother and daughter are keeping a number of secrets from one another.

The family secrets are hidden in omissions and untruths. Sometimes the secrets are obscured by mixing up truths to create confusion. When Niki asks Etsuko for the story of how she came to England, she blends truths supported by the evidence of photo albums and family belongings. Stories and pictures wend together into a confusing narrative that doesn’t add up, and is missing important details.

Etsuko’s memories take the film back to Nagasaki in 1952, seven years after the “Fat Man” atomic bomb was dropped on the port city on August 9 1945, killing as many as 70,000 people.

Ongoing hardship in Nagasaki can be inferred from neighbourhood gossip about a local woman rumoured to be entertaining American servicemen for money, and a spate of violent crimes against children. Nostalgic, warm images jar with dialogue about wartime suffering, violence and discrimination against the hibakusha (被爆者, “bomb-affected people”).

Ishikawa evokes postwar Japanese history in subtle references to the cinema of the era. The cinematography bathes Nagasaki in golden light, evoking the colours of Japanese films of the 1950s and 1960s. A poster for Yasujirō Ozu’s The Flavor of Green Tea Over Rice (1952), a drama about a postwar couple considering divorce, signposts the issues in Etsuko’s marriage.

Her relationship to her father-in-law, established during their shared work as schoolteachers, evokes the common trope in postwar atomic bomb film narratives of the young female teacher as heroine. Yet Etsuko emerges as a much more complicated character than the brave heroines of post-war films.

Played by Suzu Hirose, the younger Etsuko befriends her troubled neighbour Sachiko (Fumi Nikaido) and her daughter Mariko. Etsuko is in the early stages of pregnancy and the bullying suffered by Mariko prompts her to help the family. Mariko is ostracised because of the visible scarring on her arms from the atomic bombings, and Sachiko struggles to find work. Sachiko dreams of moving her small family to America, where discrimination against hibakusha will no longer hold them back.

As Etsuko’s story develops, however, the female characters seem to blend.
Sachiko’s hope that Mariko might become an actress in Hollywood echoes Etsuko’s fondness for film magazines, which she reads secretly. While the whole neighbourhood knows of Sachiko and Mariko’s hibakusha status, Etsuko is keeping secret that she was also exposed to radiation during the bombing and worries about its effects on her unborn child.

When Niki finds a family album featuring a photograph of Mariko with the caption “Keiko, 1952”, the audience questions whether Etsuko’s story contains a vital untruth: is Sachiko a version of herself? Ishikawa cites The Hours (Stephen Daldry, 2002) as inspiration for this structure, which shows “the different women at different times in the same story”.

A later photograph shows Niki’s birth in 1958, confirming that she cannot be the baby that the Etsuko in the story is carrying. This suggests that Etsuko will give birth to Keiko who will be a baby disfigured by radiation exposure. Like Sachiko, she will be abandoned by her husband and survive on the outskirts of the community until a move to the west and a new baby changes her fortunes in 1958.

Ishikawa’s desire to “update the story of Nagasaki” and connect contemporary audiences with it is achieved through the echoes that Etsuko’s omissions cast across the film. The subtle performances and beautiful cinematography of Ishikawa’s film creates an inviting and nostalgic atmosphere that allows the disturbing themes of this important book to be gently drawn out.

A rich history of the atomic bombings of Japan and the ongoing impact that continues in the silences, lies and omissions is exposed in A Pale View of Hills. What are people still carrying? For Ishikawa, “the unspoken words, the hidden gestures, the secrets passed on, the narratives that stem from objects” are all “traces of memories” that allow a generational transmission of history.

Jennifer Coates receives funding from UKRI and the Leverhulme Trust.

– ref. A Pale View of Hills: the legacy of atomic bombings in Japan is explored in this adaptation of Kazuo Ishiguro’s first novel – https://theconversation.com/a-pale-view-of-hills-the-legacy-of-atomic-bombings-in-japan-is-explored-in-this-adaptation-of-kazuo-ishiguros-first-novel-273842

Source: The Conversation – UK – By Colin Davidson, Professor of Neuropharmacology, University of Lancashire

Kim Kardashian has launched an energy drink. Instead of containing caffeine, Update includes paraxanthine, a compound the body naturally produces when it breaks down caffeine. According to the brand’s promotional material, using paraxanthine directly “eliminates the crash, jitters and overstimulation” often associated with traditional energy drinks.

Energy drinks are already a huge global market, and most rely on caffeine to provide their stimulant effects. This new product takes a different approach by skipping caffeine and using one of its natural breakdown products instead.

It does not rely on paraxanthine alone. The formula also contains other ingredients commonly used in energy drinks and supplements, including alpha-GPC, sometimes marketed for cognitive performance, and sucralose, an artificial sweetener found in many low or zero sugar beverages. Any assessment of its potential health effects therefore needs to consider these ingredients as well.

Paraxanthine is the main metabolite produced when the body processes caffeine. The liver converts caffeine into three compounds: paraxanthine, theobromine and theophylline. Of these, paraxanthine is the most abundant, accounting for more than 70% of caffeine metabolism, while the other two make up the remaining 20 to 30%.

Caffeine works mainly by blocking adenosine receptors in the brain. Adenosine builds up during the day and promotes tiredness. When those receptors are blocked, we feel more alert. Paraxanthine appears to act on many of the same biological pathways, which may explain its similar stimulant effects.

Some research suggests it may be less toxic than caffeine. Scientists often compare toxicity using LD50, or “lethal dose 50”, the amount required to kill 50% of animals in a study.

In rats, paraxanthine has a higher LD50 than caffeine at around 830 milligrams per kilogram of body weight, while caffeine’s is roughly 300mg per kilogram. In other words, much higher doses are required to reach lethal levels in these animals.

What do animal studies show?

In one long-term study, rats were given either paraxanthine or caffeine for 90 days. Those receiving caffeine showed several signs of overstimulation, including excessive grooming, increased activity and more frequent defecation. Animals given paraxanthine behaved much more normally.

It also appeared less likely to trigger anxiety-like behaviour in rats.

The same study examined biochemical changes after long-term treatment. Rats given caffeine showed increased cholesterol levels and reduced thyroid hormone levels, suggesting a less favourable metabolic profile.

Post-mortem examinations revealed further differences. Several organs were smaller in the caffeine-treated rats, including the spleen, heart, kidneys, liver and testes. These changes were not observed in animals given paraxanthine.

What about human studies?

Animal experiments can provide useful clues, but they do not always reflect what happens in people.

The available human evidence suggests a similar pattern. In one comparison, caffeine produced a greater increase in blood pressure than paraxanthine at comparable doses.

In another study, participants taking paraxanthine performed better in several cognitive tests designed to measure attention and memory, without significant side-effects.

In a small placebo-controlled study, around a dozen healthy adults took it daily for one week. Researchers found no clinically significant changes in standard blood chemistry markers or reports of adverse side effects. However, the study was short and involved a small number of participants, so it cannot establish long-term safety.

It has also attracted interest for potential medical uses and has been patented as a possible treatment for certain psychiatric conditions. That does not necessarily mean it will become an approved therapy.

Taken together, these findings suggest it may produce some of the stimulant effects associated with caffeine, such as improved alertness and concentration, while potentially causing fewer side-effects such as jitteriness or rapid heart rate.

However, an important limitation is that most research comes from studies examining caffeine metabolism rather than people consuming paraxanthine directly. Human trials of the compound itself remain relatively small and short.

What about the other ingredients?

Several additional compounds are included, but the only one for which the dose is clearly stated is alpha-GPC, at 315mg per can.

Alpha-GPC, short for alpha-glycerylphosphorylcholine, occurs naturally in foods such as fish, meat, milk, eggs, cereals and peanuts. After consumption, it is converted into phosphorylcholine, which helps support the production of neurotrophic factors. These proteins help nerve cells grow, survive and communicate.

It has been widely studied for safety. Animal studies using very high doses have found only minor adverse effects, suggesting it is generally considered safe when consumed within typical supplement ranges.

The formula also contains L-theanine, an amino acid found naturally in tea, which may promote a calmer form of alertness and reduce overstimulation.

Another ingredient is sucralose, used in many low or zero-sugar drinks. It is widely regarded as safe by food safety regulators. Some studies have raised questions about possible metabolic effects.

For example, one recent study found that long-term consumption was associated with insulin resistance in mice fed a high-fat diet. Animal findings do not always translate directly to humans, and the amount included in the drink has not been publicly disclosed.

Is paraxanthine better than caffeine?

Each 350ml can contains 300mg of paraxanthine and 315mg of alpha-GPC. That amount is broadly comparable to the quantity the body might generate after metabolising a large dose of caffeine, although the exact conversion varies between people.

Based on the available studies, this level would likely produce stimulant effects similar to caffeine, such as increased alertness and improved attention. Some evidence suggests it may cause fewer of the side-effects often linked to caffeine, including jitteriness or increased heart rate.

The alpha-GPC dose falls within a range generally considered safe and may support brain signalling processes.

The main uncertainty relates to sucralose. While widely approved for consumption, some research suggests that long-term intake could affect metabolic health, although the evidence remains mixed and the quantity here is unknown.

Overall, studies in animals and humans suggest paraxanthine may be less toxic than caffeine and capable of producing similar stimulant effects. However, the evidence base remains far smaller than the decades of research available for caffeine.

More research will be needed before we can determine whether paraxanthine-based energy drinks offer a meaningful advantage over traditional caffeinated options.

Colin Davidson has previously received funding from the US National Institute on Drug Abuse (NIDA). He is a consultant with the Defence Science and Technology Laboratory (UK) and a member of the Advisory Council on the Misuse of Drugs. His views in this article are his own.

– ref. Kim Kardashian’s new caffeine-free energy drink relies on paraxanthine – here’s what the science says – https://theconversation.com/kim-kardashians-new-caffeine-free-energy-drink-relies-on-paraxanthine-heres-what-the-science-says-276921

Source: The Conversation – UK – By Katie Edwards, Commissioning Editor, Health + Medicine and Host of Strange Health podcast, The Conversation

Period scooping sounds like something you would only hear in a biology lab, not while doom-scrolling TikTok. Yet earlier this year, videos claiming you can “scoop out” your period to avoid the mess and shorten the whole thing racked up millions of views. Some people were pushing in the shower using pelvic floor muscles. Others described using water, fingers, or even objects to “clean out” menstrual fluid.

In the final episode of the first season of The Conversation’s Strange Health podcast, co-host Dan Baumgardt and I watched the clips, winced a bit, laughed a bit, then did what we always do: we asked an expert what is actually going on inside the body.

I spoke to Sally King, a visiting fellow at King’s College London and founder of the evidence-based menstrual health project Menstrual Matters. Her first point was almost disappointingly simple: you cannot shorten a period by “scooping”. Menstruation is the shedding of the uterine lining, triggered by hormonal changes and helped along by uterine contractions. Once the process is underway, removing fluid from the vaginal canal does not stop the uterus shedding tissue. It might make you feel less “full” for a moment, but it does not end your period early.

Where King’s tone sharpened was on the version of “scooping” that involves washing inside the vagina with water or soap, essentially douching. This is not harmless hygiene. The vagina is self-cleaning and has an acidic environment that supports protective bacteria. Flooding it with neutral water or alkaline products disrupts that balance and is linked to infections such as bacterial vaginosis, and in some cases more serious reproductive health problems.

If the motivation is smell, discomfort or discharge, the answer is not Dettol or “feminine washes”. It is proper treatment and, crucially, a culture where people feel able to ask for help without shame.

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Read more:
‘Dirty red’: how periods have been stigmatised through history to the modern day

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Then there videos raving about “emergency period stop” drinks. Lime juice. Tajín. Shots of whatever is trending this week. King was blunt: there is no scientific basis for any food or drink instantly halting a period mid-cycle. Menstrual symptoms can change from month to month anyway, which makes it easy to mistake coincidence for cause, especially online where confirmation bias thrives.

And yet not all viral period content is rooted in disgust. Some of it is a backlash against stigma. The most eyebrow-raising example is “period masking”, where influencers smear menstrual blood on their faces and claim the stem cells will transform their skin.

King’s verdict was half delighted, half exasperated. Menstrual fluid does contain unusually interesting stem cells, and scientists are investigating them for regenerative medicine. During the COVID-19 pandemic, for example, researchers reported promising results using menstrual blood-derived mesenchymal stem cells as a treatment in severely ill patients, but these were processed cells delivered in a clinical setting, not a DIY face mask.

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Read more:
Menstrual health literacy is alarmingly low – what you don’t know can harm you

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These trends flourish in the gaps left by poor menstrual health education, including in medicine. King argues that we still teach about menstruation primarily as a prelude to pregnancy, rather than a complex biological process with its own functions and health signals.

If a hack relies on shame, secrecy, or the idea that your body is dirty and must be “fixed” fast, it is probably selling you something, even if what it wants is only your attention.

Strange Health is hosted by Katie Edwards and Dan Baumgardt. The executive producer is Gemma Ware, with video and sound editing for this episode by Anouk Millet. Artwork by Alice Mason.

If you’ve got a question about a viral trend or video you’ve seen and you’d like us to delve into the science behind it in a future episode, please email us at strangehealth@theconversation.com.

Listen to Strange Health via any of the apps listed above, download it directly via our RSS feed or find out how else to listen here. A transcript is available via the Apple Podcasts or Spotify apps.

Katie Edwards is Commissioning Editor, Health and Medicine at The Conversation in the UK. Sally King is the founder of Menstrual Matters- the world’s first evidence-based info hub on menstrual health and rights.

Dan Baumgardt 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. From period scooping to menstrual masking: the strange science of viral period hacks – https://theconversation.com/from-period-scooping-to-menstrual-masking-the-strange-science-of-viral-period-hacks-276733