Category: The Conversation – USA

Source: The Conversation – USA (2) – By Shiri Melumad, Assistant Professor of Marketing, University of Pennsylvania

Since the release of ChatGPT in late 2022, millions of people have started using large language models to access knowledge. And it’s easy to understand their appeal: Ask a question, get a polished synthesis and move on – it feels like effortless learning.

However, a new paper I co-authored offers experimental evidence that this ease may come at a cost: When people rely on large language models to summarize information on a topic for them, they tend to develop shallower knowledge about it compared to learning through a standard Google search.

Co-author Jin Ho Yun and I, both professors of marketing, reported this finding in a paper based on seven studies with more than 10,000 participants. Most of the studies used the same basic paradigm: Participants were asked to learn about a topic – such as how to grow a vegetable garden – and were randomly assigned to do so by using either an LLM like ChatGPT or the “old-fashioned way,” by navigating links using a standard Google search.

No restrictions were put on how they used the tools; they could search on Google as long as they wanted and could continue to prompt ChatGPT if they felt they wanted more information. Once they completed their research, they were then asked to write advice to a friend on the topic based on what they learned.

The data revealed a consistent pattern: People who learned about a topic through an LLM versus web search felt that they learned less, invested less effort in subsequently writing their advice, and ultimately wrote advice that was shorter, less factual and more generic. In turn, when this advice was presented to an independent sample of readers, who were unaware of which tool had been used to learn about the topic, they found the advice to be less informative, less helpful, and they were less likely to adopt it.

We found these differences to be robust across a variety of contexts. For example, one possible reason LLM users wrote briefer and more generic advice is simply that the LLM results exposed users to less eclectic information than the Google results. To control for this possibility, we conducted an experiment where participants were exposed to an identical set of facts in the results of their Google and ChatGPT searches. Likewise, in another experiment we held constant the search platform – Google – and varied whether participants learned from standard Google results or Google’s AI Overview feature.

The findings confirmed that, even when holding the facts and platform constant, learning from synthesized LLM responses led to shallower knowledge compared to gathering, interpreting and synthesizing information for oneself via standard web links.

Why it matters

Why did the use of LLMs appear to diminish learning? One of the most fundamental principles of skill development is that people learn best when they are actively engaged with the material they are trying to learn.

When we learn about a topic through Google search, we face much more “friction”: We must navigate different web links, read informational sources, and interpret and synthesize them ourselves.

While more challenging, this friction leads to the development of a deeper, more original mental representation of the topic at hand. But with LLMs, this entire process is done on the user’s behalf, transforming learning from a more active to passive process.

What’s next?

To be clear, we do not believe the solution to these issues is to avoid using LLMs, especially given the undeniable benefits they offer in many contexts. Rather, our message is that people simply need to become smarter or more strategic users of LLMs – which starts by understanding the domains wherein LLMs are beneficial versus harmful to their goals.

Need a quick, factual answer to a question? Feel free to use your favorite AI co-pilot. But if your aim is to develop deep and generalizable knowledge in an area, relying on LLM syntheses alone will be less helpful.

As part of my research on the psychology of new technology and new media, I am also interested in whether it’s possible to make LLM learning a more active process. In another experiment we tested this by having participants engage with a specialized GPT model that offered real-time web links alongside its synthesized responses. There, however, we found that once participants received an LLM summary, they weren’t motivated to dig deeper into the original sources. The result was that the participants still developed shallower knowledge compared to those who used standard Google.

Building on this, in my future research I plan to study generative AI tools that impose healthy frictions for learning tasks – specifically, examining which types of guardrails or speed bumps most successfully motivate users to actively learn more beyond easy, synthesized answers. Such tools would seem particularly critical in secondary education, where a major challenge for educators is how best to equip students to develop foundational reading, writing and math skills while also preparing for a real world where LLMs are likely to be an integral part of their daily lives.

The Research Brief is a short take on interesting academic work.

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

– ref. Learning with AI falls short compared to old-fashioned web search – https://theconversation.com/learning-with-ai-falls-short-compared-to-old-fashioned-web-search-269760

Source: The Conversation – USA (3) – By Stephen Neely, Associate Professor of Public Affairs, University of South Florida

Over 40 million American adults – approximately 19% – live with an anxiety disorder, according to the National Institutes of Health.

Studies show this anxiety is most prevalent in young people. In recent years, social psychologists such as Jonathan Haidt have started to draw connections between tech use and anxiety. They argue that the ubiquity of smartphones and social media may affect not only the habits and emotions of young people but also key aspects of their brain development during adolescence.

Maintaining a constant online presence can result in excessive social comparison, disrupted sleep, fragmented attention and increased exposure to cyberbullying – all of which can increase the prevalence of anxiety.

We’re public health and policy researchers with an interest in mental health. We understand that this problem goes well beyond youthful angst. Evidence increasingly links this type of prolonged anxiety to a number of detrimental health issues, including weakened immune function, increased cardiovascular risk and impaired cognitive performance. Over time, these effects can increase the risk of chronic illness and other negative health outcomes.

So, in May 2025 we conducted our own survey to measure the prevalence of anxiety in the state where we live, Florida, and explore whether it is, in fact, related to age and social media use.

What our survey asked

We surveyed 500 adults, and we designed our research to ensure that our survey group matched the state’s population in terms of age, race, gender, political affiliation and geographic distribution.

We used a questionnaire called the GAD-7, which was developed by mental health professionals to assess symptoms of generalized anxiety disorder. The GAD-7 asks participants to identify how bothered they were about seven items during the past two weeks. They answered on a four-point scale, from “not at all” to “nearly everyday.” These seven items included questions on worrying, irritability, restlessness and feeling afraid or on edge.

A score under 10 indicates minimal (0-4) or mild (5-9) anxiety. Those who score between 10 and 14 exhibit moderate anxiety, while a score of 15 or higher is indicative of a severe anxiety disorder.

The difference between moderate and severe generalized anxiety corresponds to how often the participant experiences any of the seven items. For example, someone with severe generalized anxiety might experience all seven items nearly every day, while someone with moderate generalized anxiety might have experienced some of the items several days in the past two weeks.

We also asked participants about how much time they spend on social media platforms, such as Facebook, Instagram and TikTok, and how they feel while using these platforms.

What we found

Our survey found that roughly 1 in 5 Floridians are struggling with moderate to severe anxiety, which is consistent with national statistics.

While the average GAD-7 score was 4.74 – this would indicate that the “average” Floridian doesn’t have an anxiety disorder – 18.6% of participants reported symptoms of at least moderate anxiety, with nearly half of them rising to the level of severe.

This result tells us that nearly 3.5 million Floridians may suffer from clinically significant anxiety.

Members of Generation Z, ages 18 to 27 in our sample, reported the highest rates of anxiety by a significant margin. In fact, the average GAD-7 score for this group was 8.17 – just below the threshold for moderate anxiety – compared with an average of 6.50 for millennials, 5.32 for Gen Xers and 3.04 for baby boomers.

These averages track with previous nationwide studies, which have found that the portion of the U.S. adult population that suffers the most anxiety are members of Gen Z. According to a study conducted in 2020, 30.9% of adults ages 18 to 23 reported generalized anxiety disorder symptoms, compared to only 27.9% of millennials, 17.2% of Gen Xers and 8.1% of baby boomers.

Social media and anxiety in Gen Z

In order to understand whether social media use might help explain the higher rates of anxiety we observed among younger Floridians, we examined the relationship between time spent on social media and anxiety.

In general, those who didn’t use social media at all reported lower levels of anxiety, with an average GAD-7 score of 3.56. In comparison, the average GAD-7 score for those who use social media less than one hour per week was 3.74, and it rose consistently as social media use increased, climbing to an average of 6.10 among those who spent seven to nine hours a week on social media, and 7.08 for those who were logged on for 10 hours or more.

While time spent was important, the reasons why Floridians use social media also made a big difference in whether they experienced anxiety. Anxiety was lowest among those who use social media primarily to stay connected with family and friends. But it rose significantly among those who use social media to stay up to date with current trends and pop culture or to learn about health, fitness and beauty trends.

We also asked respondents whether they “sometimes feel like they’re missing out when they see what others post on social media.” Among those who agreed that they sometimes get social media FOMO, average anxiety scores ranged between 7.26 and 9.00. But among those who disagreed, average scores were significantly lower – 4.16 or less.

Time spent on social media matters for young people

In this data, we see a clear correlation between social media use and heightened anxiety, and we also see a greater tendency for Gen Zers and millennials to report higher levels of anxiety. This makes sense, given that younger people generally spend more time on social media.

But one important question remained to be answered: Can reducing social media use lead to lower rates of anxiety for the youngest adults?

In order to answer this question, we reexamined the relationship between average weekly social media use and anxiety. But this time, we restricted the analysis to only those respondents who were members of the Gen Z and millennial groups.

Even when the study was restricted to just these two groups, we found a clear and decisive link between social media use and anxiety. Those who reported spending less than one hour on social media each week had average GAD-7 scores of 2.89. Those scores rose consistently as time on social media increased, reaching a high of 8.73 among those who use social media 10 hours or more per week.

Moderating intake to bring down anxiety

The results of our survey appear to confirm the suspicions of social psychologists and techno-critics – namely, that the high rates of anxiety observed among younger Americans appear to be connected to their time online. This is particularly true for those spending time in digital spaces that facilitate social comparison and information overload.

We cannot be sure from just this survey that social media alone is to blame for increased generalized anxiety. Other factors may be involved, such as digital information overload and a decline in person-to-person contact. But the amount of time spent on social media does appear to be affecting the mental health of young people in Florida.

One potential solution may be to moderate intake. Some emerging research has suggested setting up automated daily reminders to limit social media use to 30 minutes a day. Another suggestion includes occasionally taking a monthlong break from social media.

Those who feel they need more support taking time off social media may benefit from seeking professional help, such as talking with a licensed therapist.

Read more stories from The Conversation about Florida.

Stephen Neely receives funding from the Florida Center for Cybersecurity for this study

Kaila Witkowski receives funding from the Florida Center for Cybersecurity for this study.

– ref. Florida residents’ anxiety is linked to social media use and varies with age, new study shows – https://theconversation.com/florida-residents-anxiety-is-linked-to-social-media-use-and-varies-with-age-new-study-shows-263010

Source: The Conversation – USA (3) – By William Cornwell, Associate Professor of Cardiology, University of Colorado Anschutz Medical Campus

The life and political legacy of former Vice President Dick Cheney, who died on Nov. 4, 2025, at the age of 84, has been well documented. But his decades-long battle with heart disease may be less appreciated.

Cheney benefited from almost every major advance made in cardiovascular medicine. These breakthroughs enabled him to sustain an active political career and gave him additional years of an enjoyable life after he moved away from the political spotlight.

As a cardiologist who specializes in both sports medicine and heart disease, as well as advanced heart failure and transplant cardiology, I frequently provide care for patients who, like Cheney, are supported by powerful medicines and procedures to help support heart function.

Cheney’s passing provides an opportunity to reflect on the rapid evolution in medical technology, especially in the past half-century, that improved the lifespan and overall quality of life for Cheney, as well as millions of heart patients around the world.

The formative days of cardiac medicine

Cheney suffered his first of five heart attacks at age 37, in 1978, when the standard of care mainly involved pain relief and bed rest, and when medical professionals did not yet have a clear understanding of what causes heart attacks in the first place.

Today, doctors understand that a heart attack occurs when blood flow through an artery is blocked by a blood clot called a thrombus and oxygen cannot get to the heart muscle. Imagine a kink in a hose that prevents water passing through it. When the heart muscle does not receive oxygen for a long enough period of time, the heart muscle will die and a scar will form.

In the 1960s and ’70s, however, doctors thought a thrombus was the result of – not the cause of – a heart attack.

It is now clear that the formation of a thrombus leads to a heart attack rather than the other way around. That important lesson revolutionized the way doctors like me treat patients with heart attacks.

Big and small breakthroughs

Today, we reopen arteries with stents. When stents are not available, we use powerful medications called thrombolytics, or clot-busters, to break down the thrombus. These kinds of treatments seem commonplace today, but it wasn’t until 1988 that a pivotal study showed combining aspirin and streptokinase, a clot-buster drug, improved survival after a heart attack by almost 50%.

Cheney had additional heart attacks in 1984, 1988, 2000 and 2010. Notably, all but the last were during election years, underscoring the detrimental effects of stress on heart health. His heart attack in 2000 occurred as the courts worked to determine whether Al Gore or George W. Bush – with whom Cheney would become vice president – had won the presidential election.

As technology advanced over the years, Cheney had multiple angioplasties – a procedure to open up narrowed or blocked arteries. During an angioplasty, a procedure developed in the 1980s, heart doctors would place a balloon made of flexible polymers inside an artery to open up and clear the thrombus.

While angioplasties were helpful, one of the main limitations was that the walls of the artery would quickly shrink back – known as recoiling – after the balloon was deflated.

How stents became mainstream

That limitation led to the concept of stents – devices that are now frequently used to treat heart attack patients.

Cheney’s first heart attack in 1978 occurred well before the first stents became available.

Stents started out as metal, tubelike structures that cardiologists used to open up narrowed or blocked blood vessels. The original stents, made of stainless steel, fixed the problem of blood vessels recoiling.

But over time, cardiologists found that stents become stenotic, meaning they themselves would become narrow, making it difficult for blood to flow through them. This problem was solved with the introduction of drug-eluting stents, which have a polymer that coats the metal struts of a stent and prevents stenosis from occurring.

Drug-eluting stents were a game-changer and reduced the need for repeated procedures by about 50% to 70%. Like millions of Americans, Cheney received several stents during his long battle with heart disease.

While stents are helpful, sometimes patients require a surgery called coronary artery bypass graft. Heart surgeons perform this procedure when there are blockages that angioplasty or a stent cannot fix, or when there are too many blockages in the heart arteries.

In 1988, at age 47, Cheney underwent a quadruple bypass operation to help restore blood flow to his heart following his third heart attack.

Battling heart disease

Despite the best efforts of cardiologists, many patients with heart disease, like Cheney, go on to develop heart failure.

There are two main types of heart failure. One – called heart failure with preserved ejection fraction – occurs when the left ventricle, the largest and strongest chamber of the heart, becomes stiff and unable to relax.

The other type – heart failure with reduced ejection fraction – occurs when the left ventricle becomes enlarged and weakened, and fails to pump blood efficiently.

Both types of heart failure make it difficult for the heart to adequately pump blood throughout the body. Cheney, like millions of people throughout the world, suffered from a dilated and weakened heart.

Fortunately, now there are several classes of medications used to treat the kind of heart failure that Cheney suffered from.

There are four main types of drugs that heart failure cardiologists use to manage patients with this condition, which are referred to as the “four pillars” of heart failure management. These medications work together to reduce the amount of stress placed on the heart and to create an environment that helps a weakened heart pump blood more efficiently throughout the body.

Thanks to these four medication types, millions of patients with dilated, weak hearts are living much longer with a higher quality of life and staying out of the hospital. Some of these medications are also used for patients with stiffened hearts, but there is a lot of ongoing research to better understand how to take care of patients with that kind of heart failure.

Despite the use of medications to treat dilated, weak hearts, some patients suffer from continued weakening of the heart muscle and progress to end-stage, or advanced, heart failure. When this happens, there are only two treatment options available. These options are a mechanical pump or a heart transplant.

Heart transplantation is the gold-standard, preferred treatment option for advanced heart failure that results from a dilated, weakened heart.

In 2023, there were about 4,500 heart transplants in the U.S. and about 2,200 in Europe. On average, patients live well over a decade with a heart transplant, and many will go on to live for 20 to 30 more years.

An ounce of prevention is worth a pound of cure

Benjamin Franklin famously quipped, “An ounce of prevention is worth a pound of cure.”

In an interview with “60 Minutes” in 2013, Cheney said his heart disease was the result of genetics and an unhealthy lifestyle. He admitted that he drank beer, ate fatty foods and also smoked three packs of cigarettes per day.

Millions of people across the U.S. and Europe have a lifestyle that is similar to that of Cheney’s prior to his heart transplant. While heart patients benefit from medications, stents and surgeries, preventive strategies cannot be underestimated.

Almost all major health organizations, including the American Heart Association, American Cancer Society and the Department of Health and Human Services, recommend 150 minutes per week of moderate-intensity exercise.

This recommendation translates to a brisk walk about 30 minutes per day, five days per week. This level of exercise leads to large increases in survival and preservation of overall health throughout a lifetime.

While Cheney lived through five heart attacks, the goal for patients and their doctors is to avoid the first. Scientific advances in cardiology have led to a dramatic improvement in survival and quality of life for millions of people, but preventive measures are still by far the most effective lifesaving measure.

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

– ref. Vice President Dick Cheney’s life followed the arc of the biggest breakthroughs in cardiovascular medicine – https://theconversation.com/vice-president-dick-cheneys-life-followed-the-arc-of-the-biggest-breakthroughs-in-cardiovascular-medicine-269081

Source: The Conversation – USA (3) – By Michal Raucher, Assistant Professor of Jewish Studies, Rutgers University

When people picture a rabbi, they may imagine a man standing in front of a congregation in a synagogue. But “rabbi” means much more than that. For example, a rabbi could be a teacher, a nonprofit executive for a Jewish organization or a scholar of Jewish law – and, increasingly, some of those roles are held by Orthodox women.

For decades, liberal denominations have permitted women to be ordained. Orthodox Judaism, however, has largely prohibited it. Yet attitudes toward women’s study of rabbinic texts is changing, leading some Orthodox leaders to conclude that women are qualified for rabbinic jobs.

Israel’s chief rabbis – known as the Rabbinate, and historically seen as the top authority for the country’s Orthodox institutions – do not recognize women as rabbis or permit their ordination. But a significant change came in July 2025, when Israel’s High Court of Justice determined that women must be allowed to take the Rabbinate’s exams about Jewish law. The chief rabbis appealed the decision, but the court rejected their request for a retrial in November.

These tests are required to apply for public sector jobs as any kind of Jewish religious authority in Israel: ensuring that restaurants adhere to Jewish dietary laws, for example. Passing does not make someone an ordained rabbi; ordination is conferred through private rabbis and schools, and most Orthodox communities do not recognize female rabbis. But it does allow women to apply for jobs previously available only to men and receive higher salaries for the educational jobs they have already. Most importantly, the High Court’s decision recognizes that women have achieved high levels of education in rabbinic law.

I am a scholar of Jewish women and gender who researches religious authority among Orthodox women. While there have always been highly educated women, the court’s ruling reflects a growing trend among Orthodox women, while also opening up professional opportunities.

From Torah to Talmud

Formed in the 19th century, Orthodox Judaism is oriented around a strict observance of Jewish law and commitment to traditional gender roles. The denomination contains many divisions, each one adjusting their observance of Jewish law differently in response to modernity. While boys and men have been traditionally educated in Torah and rabbinic texts, historically girls and women did not have access to any formal Jewish education.

In the early 20th century, Jewish Polish teacher Sarah Schenirer revolutionized Orthodox girls’ education by founding the Bais Yaakov school system, now found in many countries. The Bais Yaakov education focused on teaching women Torah, while maintaining women’s place within the Jewish home.

But soon another debate arose: whether women could study Talmud. This text, composed between the second and seventh centuries C.E., contains the building blocks of rabbinic law. Studying the Talmud means learning the language, references and argument style of the Jewish legal system, called “halakha.”

Supporters and opponents of Talmud study for women both argued that it would forever alter orthodoxy. Opponents feared that if women understood Talmudic discussions, they would be interested in participating more in public religious life, upsetting the gender norms at the heart of orthodoxy.

Yet, in the 1970s, some well-known rabbis in Israel and America invited women into Talmud study. Since then, the number of Orthodox institutions that offer advanced Talmud study for women has grown significantly. Fifty years ago, there were only two options: Stern College of Yeshiva University in New York, or Michlelet Bruriah in Israel, now called Midreshet Lindenbaum. Today, dozens of institutions offer programs for Orthodox women who want to study rabbinic law.

The institutions where women can learn Talmud and rabbinic law span the Orthodox landscape. Many are affiliated with open or modern orthodoxy, which have embraced changes related to gender roles. Some cater to the Haredi or “ultra-Orthodox” population, and others to communities in between.

Most students who complete these programs are not seeking traditional ordination as rabbis. But the women graduate prepared for several other types of religious leadership, such as Jewish education, or as halakha guides for other women. Some programs prepare students to answer Jewish legal questions in particular areas, such as practices during menstruation or childbirth.

Feminist network

This growth in opportunities for Orthodox women is the result of a network of Orthodox feminists working across borders since the 1970s.

Michlelet Bruriah, for example, was founded by two American Jews who immigrated to Israel in the 1960s. Several other educational institutions developed through this network, including Matan, Nishmat and Drisha – all currently located in Israel.

Yeshivat Maharat, the first Orthodox seminary to ordain women as rabbis, is in New York. Several of its teachers and students came from these Israeli institutions, and some of their donors have also supported the schools in Israel.

The lawsuit challenging the Israeli chief rabbis’ restriction on women taking the Jewish law exam was filed by several people involved in this network.

Rabbi Seth Farber, for example, is an American immigrant to Israel and the founder of ITIM, a nonprofit that advocates for Jewish religious pluralism within Israeli society. He filed the lawsuit along with his wife, Michelle Cohen Farber, another American immigrant to Israel. She uses the title “rabbanit,” which traditionally refers to someone married to a rabbi. In her case, it also refers to her own expertise in Jewish legal texts: She co-founded Hadran, an organization that promotes Talmud study among women.

Other petitioners include Rabbanit Avital Engelberg, an Israeli-born graduate of Yeshivat Maharat who directs the seminary’s Israeli branch.

Impact

Women’s training allows them to enter a variety of fields. Opportunities for Orthodox women’s religious leadership is growing, and it’s not all about ordination. “Yoatzot halacha,” for example, counsel other women about issues related to marriage, sex and reproduction.

More broadly, these programs – and the Israeli court’s decision – validate women’s religious leadership. For decades, many Orthodox Jews have looked to Israel’s Orthodox rabbinate as the arbiter of religious authenticity. The ruling forces Orthodox Judaism worldwide to recognize that women can achieve high levels of Talmudic education.

Finally, the proliferation of educational programs reflects – and creates – a need within orthodoxy. It is not just a small cadre of women seeking these opportunities. Programs continue to open because there is a demand among Orthodox women for the chance to study rabbinic texts. As more institutions create programs for women, they are creating a new reality: one where Orthodox women are religious leaders.

Michal Raucher received funding from the Israel Institute, the University of Cincinnati, and the Hadassah Brandeis Institute to conduct research related to this article.

– ref. Orthodox Judaism is making space for women’s religious leadership – even without traditional ordination – https://theconversation.com/orthodox-judaism-is-making-space-for-womens-religious-leadership-even-without-traditional-ordination-261933

Source: The Conversation – USA – By Alex Hinton, Distinguished Professor of Anthropology; Director, Center for the Study of Genocide and Human Rights, Rutgers University – Newark

With the latest shift by President Donald Trump on releasing the Epstein files held by the U.S. Department of Justice – he’s now for it after being against it after being for it – the MAGA base may finally get to view the documents it’s long wanted to see. On the afternoon of Nov. 18, 2025, the House voted overwhelmingly to seek release of the files, with only one Republican voting against the measure. The Conversation’s politics editor, Naomi Schalit, talked with scholar Alex Hinton, who has studied MAGA for years, about Make America Great Again Republicans’ sustained interest in the case of accused child sex trafficker Jeffrey Epstein. Hinton explains how MAGA’s interest in the case fits into what he knows about the group of die-hard Trump supporters.

Naomi Schalit: You are an expert on MAGA. How do you learn what you know about MAGA?

Alex Hinton: I’m a cultural anthropologist, and what we do is field work. We go where the people we’re studying live, act, talk. We observe and sort of hang out and see what happens. We listen and then we unpack themes. We try and understand the meaning systems that undergird whatever group we’re studying. And then, of course, there’s interviewing.

It appears that MAGA, Trump’s core supporters, are very concerned about various aspects of the Epstein story, including the release of documents that are in the possession of the U.S. government. Are they, in fact, concerned about this?

The answer is yes, but there’s also a sort of “no” implicit, too. We need to back up and think, first of all, what is MAGA.

I think of it as what we call in anthropology a nativist movement, a foregrounding of the people in the land. And this is where you get America First discourse. It’s also xenophobic, meaning that there’s a fear of outsiders, invaders coming in. It’s populist, so it’s something that’s sort of for the people.

Tucker Carlson interviewed Marjorie Taylor Greene, and he said, “I’m going to go over the five pillars of MAGA.” Those were America First, this is absolutely central. Borders was the second. You’ve got to secure the borders. The third was globalist antipathy, or a recognition that globalization has failed. Another one was free speech, and another one he mentioned was no more foreign wars. And I would add into that an emphasis on “we the people” versus elites.

Each of those is interwoven with a key dynamic to MAGA, which is conspiracy theory. And those conspiracy theories are usually anti-elite, going back to we the people.

If you look at Epstein, he’s where many of the conspiracy theories converge: Stop the Steal, The Big Lie, lawfare, deep state, replacement theory. Epstein kind of hits all of these, that there’s this elite cabal that’s orchestrating things that ultimately are against the interests of we the people, with a sort of antisemitic strain to this. And in particular, if we go back to Pizzagate in 2016, this conspiracy theory that there were these Democratic elitists who were, you know, demonic forces who were sex trafficking, and lo and behold, here’s Epstein doing precisely that.

There’s kind of a bucket of these things, and Epstein is more in it than not in it?

He’s all over it. He’s been there, you know, from the beginning, because he’s elite and they believe he’s doing sex trafficking. And then there’s a suspicion of the deep state, of the government, and this means cover-ups. What was MAGA promised? Trump said, we’re going to give you the goods, right? Kash Patel, Pam Bondi, everyone said we’re going to tell you this stuff. And it sure smacks of a cover-up, if you just look at it.

But the bottom line is there’s a realization among many people in MAGA that you’ve got to stay with Trump. It’s too much to say there is no MAGA without Trump. There’s certainly no Trumpism without Trump, but MAGA without Trump would be like the tea party. It’ll just sort of fade away without Trump.

People in MAGA are supporting Trump more than more mainstream Republicans on this. So I don’t think there’s going to be a break over this, but it certainly adds strain. And you can see in the current moment that Trump is under some strain.

The break that we are seeing is Trump breaking with one of his leading MAGA supporters, Marjorie Taylor Greene, not the MAGA supporter breaking with Trump.

With Greene, sometimes it’s like a yo-yo in a relationship with Trump. You fall apart, you have tension, and then you sort of get back. Elon Musk was a little bit like that. You have this breakup, and now she’s sort of backtracking like Elon Musk did. I don’t think what is happening is indicative of a larger fracturing that’s going to take place with MAGA.

It seems that Trump did his about-face on releasing the documents so that MAGA doesn’t have to break with him.

It’s absolutely true. He’s incredible at taking any story and turning it in his direction. He’s sort of like a chess player, unless he blurts something out. He’s a couple of moves ahead of wherever, whatever’s running, and so in a way we’re always behind, and he knows where we are. It’s incredible that he’s able to do this.

There’s one other thing about MAGA. I think of it as “don’t cross the boss.” It’s this sort of overzealous love of Trump that has to be expressed, and literally no one ever crosses the boss in these contexts. You toe the line, and if you go against the line, you know what happened to Marjorie Taylor Greene, there’s the threat Trump is going to disown you. You’re going to get primaried.

Trump has probably made a brilliant strategic move, which is suddenly to say, “I’m all for releasing it. It’s actually the Democrats who are these evil elites, and now we’re going to investigate Bill Clinton and all these other Democrats.” He takes over the narrative, he knows how to do it, and it’s intentional. Whoever says Trump is not charismatic, he doesn’t make sense – Trump is highly charismatic. He can move a crowd. He knows what he’s doing. Never underestimate him.

Does MAGA care about girls who were sexually abused?

There is concern, you know, especially among the devout Christians in MAGA, for whom sex trafficking is a huge issue.

I think if you look at sort of notions of Christian morality, it also goes to notions of sort of innocence, being afflicted by demonic forces. And it’s an attack on we the people by those elites; it’s a violation of rights. I mean, who isn’t horrified by the idea of sex trafficking? But again, especially in the Christian circles, this is a huge issue.

Alex Hinton receives funding from the Rutgers-Newark Sheila Y. Oliver Center for Politics and Race in America, Rutgers Research Council, and Henry Frank Guggenheim Foundation.

– ref. Why MAGA is obsessed with Epstein − and why the files are unlikely to dent loyalty to Trump – https://theconversation.com/why-maga-is-obsessed-with-epstein-and-why-the-files-are-unlikely-to-dent-loyalty-to-trump-270109

Source: The Conversation – USA (2) – By Shelley Mitchell, Senior Extension Specialist in Horticulture and Landscape Architecture, Oklahoma State University

Pecans, America’s only native major nut, have a storied history in the United States. Today, American trees produce hundreds of million of pounds of pecans – 80% of the world’s pecan crop. Most of that crop stays here. Pecans are used to produce pecan milk, butter and oil, but many of the nuts end up in pecan pies.

Throughout history, pecans have been overlooked, poached, cultivated and improved. As they have spread throughout the United States, they have been eaten raw and in recipes. Pecans have grown more popular over the decades, and you will probably encounter them in some form this holiday season.

I’m an extension specialist in Oklahoma, a state consistently ranked fifth in pecan production, behind Georgia, New Mexico, Arizona and Texas. I’ll admit that I am not a fan of the taste of pecans, which leaves more for the squirrels, crows and enthusiastic pecan lovers.

The spread of pecans

The pecan is a nut related to the hickory. Actually, though we call them nuts, pecans are actually a type of fruit called a drupe. Drupes have pits, like the peach and cherry.

The pecan nuts that look like little brown footballs are actually the seed that starts inside the pecan fruit – until the fruit ripens and splits open to release the pecan. They are usually the size of your thumb, and you may need a nutcracker to open them. You can eat them raw or as part of a cooked dish.

The pecan derives its name from the Algonquin “pakani,” which means “a nut too hard to crack by hand.” Rich in fat and easy to transport, pecans traveled with Native Americans throughout what is now the southern United States. They were used for food, medicine and trade as early as 8,000 years ago.

Pecans are native to the southern United States, and while they had previously spread along travel and trade routes, the first documented purposeful planting of a pecan tree was in New York in 1722. Three years later, George Washington’s estate, Mount Vernon, had some planted pecans. Washington loved pecans, and Revolutionary War soldiers said he was constantly eating them.

Meanwhile, no one needed to plant pecans in the South, since they naturally grew along riverbanks and in groves. Pecan trees are alternate bearing: They will have a very large crop one year, followed by one or two very small crops. But because they naturally produced a harvest with no input from farmers, people did not need to actively cultivate them. Locals would harvest nuts for themselves but otherwise ignored the self-sufficient trees.

It wasn’t until the late 1800s that people in the pecan’s native range realized the pecan’s potential worth for income and trade. Harvesting pecans became competitive, and young boys would climb onto precarious tree branches. One girl was lifted by a hot air balloon so she could beat on the upper branches of trees and let them fall to collectors below. Pecan poaching was a problem in natural groves on private property.

Pecan cultivation begins

Even with so obvious a demand, cultivated orchards in the South were still rare into the 1900s. Pecan trees don’t produce nuts for several years after planting, so their future quality is unknown.

To guarantee quality nuts, farmers began using a technique called grafting; they’d join branches from quality trees to another pecan tree’s trunk. The first attempt at grafting pecans was in 1822, but the attempts weren’t very successful.

Grafting pecans became popular after an enslaved man named Antoine who lived on a Louisiana plantation successfully produced large pecans with tender shells by grafting, around 1846. His pecans became the first widely available improved pecan variety.

The variety was named Centennial because it was introduced to the public 30 years later at the Philadelphia Centennial Expedition in 1876, alongside the telephone, Heinz ketchup and the right arm of the Statue of Liberty.

This technique also sped up the production process. To keep pecan quality up and produce consistent annual harvests, today’s pecan growers shake the trees while the nuts are still growing, until about half of the pecans fall off. This reduces the number of nuts so that the tree can put more energy into fewer pecans, which leads to better quality. Shaking also evens out the yield, so that the alternate-bearing characteristic doesn’t create a boom-bust cycle.

US pecan consumption

The French brought praline dessert with them when they immigrated to Louisiana in the early 1700s. A praline is a flat, creamy candy made with nuts, sugar, butter and cream. Their original recipe used almonds, but at the time, the only nut available in America was the pecan, so pecan pralines were born.

During the Civil War and world wars, Americans consumed pecans in large quantities because they were a protein-packed alternative when meat was expensive and scarce. One ounce of pecans has the same amount of protein as 2 ounces of meat.

After the wars, pecan demand declined, resulting in millions of excess pounds at harvest. One effort to increase demand was a national pecan recipe contest in 1924. Over 21,000 submissions came from over 5,000 cooks, with 800 of them published in a book.

Pecan consumption went up with the inclusion of pecans in commercially prepared foods and the start of the mail-order industry in the 1870s, as pecans can be shipped and stored at room temperature. That characteristic also put them on some Apollo missions. Small amounts of pecans contain many vitamins and minerals. They became commonplace in cereals, which touted their health benefits.

In 1938, the federal government published the pamphlet Nuts and How to Use Them, which touted pecans’ nutritional value and came with recipes. Food writers suggested using pecans as shortening because they are composed mostly of fat.

The government even put a price ceiling on pecans to encourage consumption, but consumers weren’t buying them. The government ended up buying the surplus pecans and integrating them into the National School Lunch Program.

While you are sitting around the Thanksgiving table this year, you can discuss one of the biggest controversies in the pecan industry: Are they PEE-cans or puh-KAHNS?

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

– ref. How pecans went from ignored trees to a holiday staple – the 8,000-year history of America’s only native major nut – https://theconversation.com/how-pecans-went-from-ignored-trees-to-a-holiday-staple-the-8-000-year-history-of-americas-only-native-major-nut-268976

Source: The Conversation – USA (2) – By George C. Homsy, Director of Environmental Studies, Associate Professor of Public Administration and Policy, Binghamton University, State University of New York

Rising energy costs consume a bigger and bigger chunk of family budgets in the United States. Our research has found that for many African American families, those costs take an extra big bite out of their incomes. This bite, the percentage of a household’s income used to pay energy bills, is called a household’s “energy burden.”

Households with high energy burdens struggle to adapt to rising prices. The U.S. Energy Information Administration reports that more than 12 million households keep their homes either colder or hotter than is actually comfortable, specifically in an effort to keep control of energy costs. And 24 million households report having had to forgo food or medicine at least once in the past year to pay utility bills.

Also, studies indicate that people facing high energy burdens often turn to unsafe heating sources, such as space heaters, stoves or fireplaces, and are at higher risk of asthma, depression, premature mortality and poor self-reported health. Our recent study of 2019 data found that those burdens are not spread evenly across the country or across society.

Specifically, families living in majority-Black census tracts spent 5.1% of their income on energy – significantly higher than the 3.2% share spent by average American households. Census tracts dominated by other racial groups in our study – whites, Latinos and Asian Americans – were much closer to the overall average.

Energy injustice

Often, disparities like this are attributed to income, which is indeed a factor given that Black households have a median income of $53,444, while the overall median in the U.S. is $78,538. However, our study found that even when a majority-white and a majority-Black census tract had the same median household income, the average share of household income spent on energy was higher in the majority-Black census tract.

We found two possible reasons for this difference, both rooted in race and housing situations.

First, our analysis of U.S. Census Bureau data finds that African American-majority census tracts have older homes on average than other census tracts. Older homes often have lower energy efficiency due to less insulation, single-pane windows, and gaps and cracks in the building’s structure, especially around windows, doors and chimneys. So even if a Black family earns the same income as another family, the Black family might live in an older house, requiring them to use more energy to warm or cool their homes, cook food, heat water and so on.

Also, we found that Black families are more likely to live in rental properties, where they cannot easily make energy-efficiency upgrades – such as installing new windows, insulation or appliances. At the same time, most landlords do not have an incentive to spend money to improve building efficiency because tenants usually pay utility bills. In the United States, 9 in 10 rental households pay for all or some of their energy bills and therefore face this split-incentive problem.

Many of these challenges can be attributed to the structural racism inherent in redlining. This early 20th century practice made it harder for prospective homeowners to get mortgages to buy homes in neighborhoods with high concentrations of Black people, immigrants or other minorities. That left more of the homes in those communities owned by landlords and occupied by tenants.

Even though redlining was banned in 1968, it left a legacy of underinvestment in properties, decreased property values and worse health outcomes.

Intersecting inequities

Other factors also likely intersect to impose a higher energy burden on Black families. Many of these were beyond the scope of our study but are well documented. For example, energy support programs are notoriously underfunded and often hard to access, especially for families without the time or connections to know about them or understand application requirements.

These are just some possible factors that increase the energy burden for Black families. The main lesson for policymakers is that communities are complicated. Energy efficiency upgrade programs that also seek to alleviate high energy burdens cannot be one-size-fits-all. A program for middle-class families in one neighborhood may not work in another community with older housing stock or large numbers of rental units.

To be successful, local officials designing programs that are aimed at families’ energy burdens will have to learn about the different challenges facing each distinct community – whether it’s leaky older homes, outdated water heaters, low incomes or rental split incentives. Reducing energy burdens for Black families will take more than technical fixes; it will take policies based in community engagement to build a deeper understanding of place.

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

– ref. Black families pay more to keep their houses warm than average American families – https://theconversation.com/black-families-pay-more-to-keep-their-houses-warm-than-average-american-families-269047

Source: The Conversation – USA (3) – By Genevieve Hofmann, Assistant Professor of Nursing and Women’s Health, University of Colorado Anschutz Medical Campus

For more than 20 years, hormone therapy for menopause has carried a warning label from the Food and Drug Administration describing the medication’s risk of serious harms – namely, cancer, cardiovascular disease and possibly dementia.

On Nov. 10, 2025, the FDA announced that drugmakers should remove these “black box” safety warnings.

The Conversation U.S. asked Genevieve Hofmann, a women’s health nurse practitioner at the University of Colorado Anschutz Medical Campus, to explain how the decision will affect health care for people going through menopause or postmenopause.

How did the FDA’s decision come about?

When people think of hormone therapy for menopause, they generally think of systemic estrogen and progestogens – for example, pills or patches that deliver hormones throughout the body.

Health care providers prescribed hormone therapy to manage symptoms of menopause such as hot flashes, night sweats and brain fog much more widely in the 1980s and 1990s than they do today. That’s because in the early 2000s, researchers analyzed data from a study called the Women’s Health Initiative and reported that hormone therapy increased the risk of breast cancer, heart disease, blood clots and stroke, as well as cognitive decline after menopause.

After this research was first published in 2002, the use of hormone therapy fell by 46% within six months – both because clinicians were reluctant to prescribe it and patients were fearful of taking it. In 2003, the FDA added black box warnings – the most serious warnings, indicating a risk of serious harm or death – to all estrogen-containing hormone products for menopause.

But researchers soon pointed out methodological flaws in the analysis. And over the past two decades, careful reanalyses of data from that study, as well as newer studies, have shown that systemic hormone therapy is very safe for most women, though there are nuances surrounding its use.

Meanwhile, women’s health experts have been increasingly vocal in the past five years in calling to remove the black box warnings from a form of hormone menopause therapy that’s applied locally, not systemically. Topical localized estrogen is applied directly to the vagina and surrounding areas, usually in the form of a cream or vaginal insert. It’s used to treat the genitourinary syndrome of menopause, which manifests as genital and urinary symptoms.

Even though topical estrogen products are extremely safe and were not evaluated in the Women’s Health Initiative study, the FDA warnings were added to them, too.

In July 2025, the FDA held an expert panel to discuss what’s currently known about the risks and benefits of hormone therapy for menopause. At the meeting, most experts urged the agency to remove the warning labels on topical vaginal estrogen products.

The Nov. 10 announcement was the outcome of that discussion, and it included both systemic and topical hormone therapy.

Why is systemic estrogen no longer considered unsafe?

Researchers are now finding that the balance of risks and benefits of systemic hormone therapy for menopause seems to depend strongly on when someone starts hormones, as well as the type, dose and length of use.

For women under 60 or within 10 years of their final period, the therapy is much safer than it is for older women. A 2017 follow-up of Women’s Health Initiative participants showed that overall deaths from any causes actually decreased in this younger cohort of menopausal women taking hormones.

For women who are more than 10 years from their final menstrual period, starting hormone therapy may increase their risk of cardiovascular disease. Researchers now refer to this as the timing hypothesis. Newer studies also support this idea.

Also, some ways of delivering hormones to the body turned out to be safer than others. Taking estrogen orally, as pills or tablets, carries a higher risk of blood clots. Those risks go away when it’s delivered through the skin using a patch, gel or spray. Many more options for hormone therapy exist today than in the early 2000s.

Additionally, it’s well established that hormone therapy improves bone health by preventing bone loss. Some studies suggest that in younger menopausal women, it may actually protect against cardiovascular disease, though this link is not yet proven and needs more study.

Unfortunately, many people missed out on the timing window. In my practice, I see patients who went through menopause 10 or 15 years ago and either didn’t get hormone therapy at the time or stopped taking it when the initial Women’s Health Initiative results came out. Now, they are hearing about the benefits, and many want to try it. But their higher cardiovascular risk may overshadow the benefit.

What about topical estrogen?

Genitourinary syndrome of menopause is ubiquitous – it affects every person with ovaries who goes through menopause, and the symptoms tend to worsen with age.

They include vaginal dryness, painful sex and urinary issues such as an increase in urgency or frequency, along with incontinence. Urinary tract infections often tend to get more frequent with menopause, particularly in older women. Treating them can require multiple courses of antibiotics.

Tissues in the genitourinary area are loaded with estrogen receptors – proteins in cells that bind the hormone. So adding some estrogen back to these areas can help restore the quality and thickness of these tissues, and possibly even promote the growth of healthy bacteria around the vagina and the urinary tract. The treatment can greatly improve quality of life and promote better health and longevity.

Despite topical estrogen’s safety and effectiveness, the FDA did not distinguish between it and systemic estrogen when adding the black box warnings in 2003. For this reason, many providers whose patients have symptoms relating to the genitourinary syndrome of menopause have been reluctant to prescribe it. Often, providers simply don’t know that it has a different safety profile than systemic estrogen.

How will removing the black box warnings affect patients?

Overall, I see this as a big win for women and their ability to manage the symptoms of menopause. I think this will make clinicians and patients far less anxious about prescribing and taking this medication.

Clinicians like me who specialize in women’s health and menopause – and who have been following the research – have been safely prescribing hormone therapy all along. But many general practitioners who often lacked either menopause-specific training or the time and resources to stay on top of the latest findings have been more reluctant to do so.

Safety concerns that led to the black box warnings, especially in regard to local vaginal estrogen, have turned out to be overblown. While clinicians still need to consider who is a good candidate for systemic hormone use, the evidence shows that for most people, it is a safe option.

Even more important, patients who were previously convinced that hormone therapy was unsafe may feel more comfortable discussing it with their provider and considering it. And if they do receive a prescription for hormone therapy, I hope that the likelihood of them starting this effective treatment is no longer hindered by reading a scary package insert that was based on outdated evidence.

While this medication is not a silver bullet that reverses aging, starting hormones at the right time can safely improve symptoms that diminish people’s quality of life. So if you’re having symptoms that are bothersome, consider asking your provider about menopause hormone therapy to help manage them.

Genevieve Hofmann has participated in advisory boards with Astellis Pharma and Mayne Pharma. She is President-elect of the Board of Directors of National Association of Nurse Practitioner’s in Women Health Board.

– ref. I treat menopause and its symptoms, and hormone replacement therapy can help – here’s the science behind the FDA’s decision to remove warnings – https://theconversation.com/i-treat-menopause-and-its-symptoms-and-hormone-replacement-therapy-can-help-heres-the-science-behind-the-fdas-decision-to-remove-warnings-269773

Source: The Conversation – USA (3) – By Kahli Zietlow, Physician and Clinical Associate Professor of Geriatrics & Internal Medicine, University of Michigan

Hollywood legend Gene Hackman and his wife, Betsy Arakawa, were found dead in their home in February 2025. Hackman had been living with Alzheimer’s and depended on Arakawa as his full-time caregiver.

Disturbingly, postmortem data suggests that Arakawa died of complications from pulmonary Hantavirus several days before her husband passed. The discordant times of death point to a grim scenario: Hackman was left alone and helpless, trapped in his home after his wife’s death.

The couple’s story, while shocking, is not unique. It serves as a warning for our rapidly aging society. The U.S. population is aging, but most Americans are not adequately planning to meet the needs of older adulthood.

As a geriatric physician and medical educator, I care for older adults in both inpatient and outpatient settings. My research and clinical work focus on dementia and surrogate decision-making.

In my experience, regardless of race, education or socioeconomic status, there are some universal challenges that all people face with aging and there are steps everyone can take to prepare.

Aging is inevitable but unpredictable

Aging is an unpredictable, highly individualized process that varies depending on a person’s genetics, medical history, cognitive status and socioeconomic factors.

The majority of older Americans report a strong sense of purpose and self-worth. Many maintain a positive view of their overall health well into their 70s and 80s.

But at some point, the body starts to slow down. Older adults experience gradual sensory impairment, loss of muscle mass and changes in their memory. Chronic diseases are more likely with advancing age.

According to the U.S. Census Bureau, 46% of adults over age 75 live with at least one physical disability, and this proportion grows with age. Even those without major health issues may find that routine tasks like yard work, housekeeping and home repairs become insurmountable as they enter their 80s and 90s.

Some may find that subtle changes in memory make it difficult to manage household finances or keep track of their medications. Others may find that vision loss and slowed reaction time make it harder to safely drive. Still others may struggle with basic activities needed to live independently, such as bathing or using a toilet. All of these changes threaten older adults’ ability to remain independent.

The costs of aging

Nearly 70% of older Americans will require long-term care in their lifetime, whether through paid, in-home help or residence in an assisted living facility or nursing home.

But long-term care is expensive. In 2021, the Federal Long Term Care Insurance Program reported that the average hourly rate for in-home care was US$27. An assisted living apartment averaged $4,800 per month, and a nursing home bed cost nearly double that, at a rate of $276 per day.

Many Americans may be shocked to discover that these costs are not covered by Medicare or other traditional medical insurance. Long-term care insurance covers the cost of long-term care, such as in-home care or nursing home placement. However, what is covered varies from plan to plan. Currently, only a small minority of Americans have long-term care insurance due to high premiums and complex activation rules.

I am not aware of any high-quality, peer-reviewed studies that have demonstrated the cost effectiveness of long-term care insurance. Yet, for many Americans, paying for care out of pocket is simply not an option.

Medicaid can provide financial support for long-term care but only for older adults with very low income and minimal assets – criteria most Americans don’t meet until they have nearly exhausted their savings.

Those receiving Medicaid to cover the costs of long-term care have essentially no funds for anything other than medical care, room and board. And proposed federal financial cuts may further erode the limited support services available. In Michigan, for example, Medicaid-covered nursing home residents keep only $60 per month for personal needs. If individuals receive monthly income greater than $60 – for instance, from Social Security or a pension – the extra money would go toward the cost of nursing home care.

Those who don’t qualify for Medicaid or cannot afford private care often rely on family and friends for unpaid assistance, but not everyone has such support systems.

Planning for the care you want

Beyond financial planning, older adults can make an advance directive. This is a set of legal documents that outlines preferences for medical care and asset management if a person becomes incapacitated. However, only about 25% of Americans over 50 have completed such documentation.

Without medical and financial powers of attorney in place, state laws determine who makes critical decisions, which may or may not align with a person’s wishes. For instance, an estranged child may have more legal authority over an incapacitated parent than their long-term but unmarried partner. Seniors without clear advocates risk being placed under court-appointed guardianship – a restrictive and often irreversible process.

In addition to completing advance directives, it is important that older adults talk about their wishes with their loved ones. Conversations about disability, serious illness and loss of independence can be difficult, but these discussions allow your loved ones to advocate for you in the event of a health crisis.

Who’s going to care for you?

Finding a caregiver is an important step in making arrangements for aging. If you are planning to rely on family or friends for some care, it helps to discuss this with them ahead of time and to have contingency plans in place. As the Hackman case demonstrates, if a caregiver is suddenly incapacitated, the older adult may be left in immediate danger.

Caregivers experience higher rates of stress, depression and physical illness compared with their peers. This is often exacerbated by financial strain and a lack of support. It helps if the people you will be relying on have expectations in place about their role.

For instance, some people may prefer placement in a facility rather than relying on a loved one if they can no longer use the bathroom independently. Others may wish to remain in their homes as long as this is a feasible option.

Connecting with available resources

There are local and federal initiatives designed to help aging adults find and get the help they need. The Centers for Medicare & Medicaid Services recently launched the GUIDE Model to improve care and quality of life for both those suffering from dementia and their caregivers.

This program connects caregivers with local resources and provides a 24-hour support line for crises. While GUIDE, which stands for Guiding an Improved Dementia Experience, is currently in the pilot stage, it is slowly expanding, and I am hopeful that it will eventually expand to provide enhanced coverage for those suffering from dementia nationwide.

The Program for All-Inclusive Care of the Elderly helps dual-eligible Medicare and Medicaid recipients remain at home as they age. This program provides comprehensive services including medical care, a day center and home health services.

Area agencies on aging are regionally located and can connect older adults with local resources, based on availability and income, such as meals, transportation and home modifications that help maintain independence.

Unfortunately, all of these programs and others that support older adults are threatened by recent federal budget cuts. The tax breaks and spending cuts bill, which was signed into law in July 2025, will result in progressive reductions to Medicaid funding over the next 10 years. These cuts will decrease the number of individuals eligible for Medicaid and negatively affect how nursing homes are reimbursed.

The government funding bill passed on Nov. 13 extends current Medicare funding through Jan. 30, 2026, at which point Medicare funding may be reduced.

Even as the future of these programs remains uncertain, it’s important for older adults and their caregivers to be intentional in making plans and to familiarize themselves with the resources available to them.

Kahli Zietlow receives funding from Health Resources and Services Administration via grant 1 K01HP49055‐01‐00

– ref. Americans are unprepared for the expensive and complex process of aging – a geriatrician explains how they can start planning – https://theconversation.com/americans-are-unprepared-for-the-expensive-and-complex-process-of-aging-a-geriatrician-explains-how-they-can-start-planning-259237

Source: The Conversation – USA – By Volha Chykina, Assistant Professor of Leadership Studies, University of Richmond

Since President Donald Trump took office for the second time, many researchers across academic disciplines have had their funding cut because of their purported ideological bias. These funding cuts were further exacerbated by the extensive 2025 government shutdown.

As a team of sociologists studying universities, higher education policy and administration, academic freedom and science production, we recognized these cuts as part of a recent global trend of weakened academic freedom. Since the mid-2000s, political attacks on higher education have increased in many countries. Consequently, academic freedom has declined in countries as different as India, Israel, Nicaragua and the United Kingdom, among others.

For example, for years Hungarian Prime Minister Viktor Orbán accused the internationally respected Central European University of “liberal bias.” By 2019, he had effectively forced the university and its faculty into exile in Vienna, Austria. Since Argentinian President Javier Milei came to power in 2023, he has made repeated claims that academics are corrupt elites. He used this narrative to restrict universities’ autonomy and funding of their research programs.

Today, most research is done collaboratively. But research finds that when individual scholars have less academic freedom and universities’ autonomy declines, global research collaborations are also threatened.

The prevalence and complexity of those collaborations that optimize human and material resources has grown, with substantial impact on scientific productivity — what we call the global “collaboration dividend.” Collaborations foster solutions to complex problems, from vaccine development to renewable energy. Diminishing academic freedom erodes these collaboration dividends, which then reduces the quantity and quality of scientific discovery worldwide.

The United Nations Educational, Scientific and Cultural Organization recommendation concerning the status of higher education teaching personnel builds on Article 26 of the Universal Declaration of Human Rights and urges governments to protect academics from political surveillance and interference on two levels.

First, UNESCO affirms the right of individual faculty to teach, research, share findings and express their expert opinions independently. Second, UNESCO recognizes the right of universities to autonomously make decisions about facilitating research, hiring and promoting faculty, and developing curricula without state interference.

Academic freedom and global collaborations

Data from the Varieties of Democracy, or V-DEM, project demonstrate international trends in academic freedom. V-DEM is a large, widely used international dataset based on experts evaluating political developments. It tracks infringements and protections of these rights in every country over the past hundred years. The index we used measures dimensions of academic freedom.

Suppressed in the 1930s by global economic depression, rising fascism and military conflict, academic freedom reached a low point during World War II. It then rebounded and grew strongly.

More countries began recognizing the benefits of free inquiry and guaranteed independent science, especially from 1980 to the mid-2000s. Nations everywhere expanded the capacity of their universities to undertake scientific research and collaborate across boundaries. A new global model of the research university fostered the exponential growth of scientific knowledge.

Also, in part as a defense against totalitarianism, many countries signed on to international agreements upholding academic freedom, such as the International Covenant on Economic, Social and Cultural Rights. This agreement declares that the basic human right to an education “can only be enjoyed if accompanied by the academic freedom of staff and students.”

The strengthening of academic freedom paralleled the largest historical expansion of the world’s capacity to undertake research on science, technology, engineering, mathematics and medicine, or STEMM. But over the past decade, freedoms of faculty members and universities began to weaken in many countries, including in the United States.

Today, university-based scientists co-author 85% to 90% of the several million STEMM research papers produced annually. Large, complex collaborations are increasingly a driving force in discovery. The global expansion of academic freedom enables universities and their scientists to participate in this intensifying collaboration dividend through joint research with colleagues elsewhere.

In studies published between 2024 and 2025, we presented troubling trends about declining academic freedom, collaborations and scientific research at universities in countries across the world.

First, we analyzed individual academic freedom and STEMM production in 17 research productive countries from 1981 to 2007. We found that academic freedom protections raise the quantity and quality of research, while infringements on these safeguards lower them.

Second, we found that safeguarding universities’ organizational autonomy also increases the volume and excellence of a country’s STEMM research output. Both associations are independent of other influential factors behind countries’ scientific productivity, such as governmental research spending, a country’s wealth or university enrollments.

Third, a related study by others finds that restricting academic freedom reduces scientists’ and universities’ ability to effectively participate in international research collaborations.

Diminishing the collaboration dividend

Together, these findings underscore that academic freedom allows researchers to participate in complex collaborations, which in turn increases research production. Most of these collaborations aren’t just facilitated by individual scientists, however. Global collaborations are made up of networks of universities, and declining academic freedom can threaten the ties between these institutions and their scientists’ projects.

The popular image of the solitary genius making isolated breakthroughs is largely a myth. Research teams have steadily increased in size, and “super-collaborative” groups of hundreds or even thousands of scientists now work together on complex projects. Together, they produce ever greater amounts of knowledge. Because individual researchers’ output is fairly steady over their careers, real productivity gains in science now depend on global collaboration and shared resources. This is true even as the number of scientists grows.

In the early 1980s, three geographical superhubs of robust, primarily university-based collaborative research emerged. One is Europe, another is North America. The third, East Asia, is growing rapidly.

By 1980, universities in the European and North American hubs collaborated on publications with scientists in 100 other countries. This number grew to 193 countries by 2010. Currently, over a fourth of the millions of annual STEMM papers are the result of international collaborations. This process is heavily dependent on universities and their freedom to pursue science.

Moreover, superhubs can accelerate international collaboration for scientists in other countries not originally in these hubs. Such collaborations enable their universities to leapfrog into new superhub status. South Korean universities have been an example of this process over the past several decades.

This collaborative capacity has enabled the production of millions of co-authored papers and scientific advances. For instance, these collaborations allowed for the rapid development of COVID-19 vaccines.

Collaborative networks depend on university support, not just individual scientists. This is why our research suggests declining academic freedom at the university level makes them vulnerable. A troubling three-quarters of U.S.-based scientists have considered leaving the country in response to threats against academic freedom in the U.S. since early 2025.

This research suggests that at stake here is not only the freedom of scholars and academic institutions, but also the future of discovery itself. Academic freedom is essential for scientists around the world to collaborate, enabling the scientific discoveries necessary for technological innovation, medical breakthroughs, and social and environmental problem-solving.

Volha Chykina has received funding from Mellon Foundation / Scholars at Risk to support her research on academic freedom.

David P. Baker has received funding for research on higher education and science from Luxembourg’s FNR, and Qatar’s QNRF

Frank Fernandez has received funding from Mellon Foundation/Scholars at Risk to support his research on academic freedom.

Justin Powell has received funding for research on higher education and science from Germany’s BMBF, DFG, and VolkswagenStiftung; Qatar’s QNRF; and Luxembourg’s FNR.

– ref. Research breakthroughs often come through collaborations − attacks on academic freedom threaten this vital work – https://theconversation.com/research-breakthroughs-often-come-through-collaborations-attacks-on-academic-freedom-threaten-this-vital-work-266644