Category: The Conversation – USA

Source: The Conversation – USA (3) – By Anna Chorniy, Assistant Professor of Pediatrics, Icahn School of Medicine at Mount Sinai; Institute for Humane Studies

It’s a familiar experience for many Americans: You’re watching your favorite show and suddenly you’re ambushed by an ad for a drug whose name sounds like a Wi-Fi password, before a relentlessly cheerful voice tells you to “Ask your doctor” and then blasts through a side-effect list that’s laughably long.

But that might soon change. After nearly 30 years of giving pharmaceutical companies free rein to advertise prescription drugs directly to consumers, U.S. officials are now seeking to curb this practice.

Soon after his appointment in 2025, Health and Human Services Secretary Robert F. Kennedy Jr. stated that he believes direct-to-consumer advertising of prescription drugs has contributed to overmedication and inflated health care costs, and that stronger oversight is long overdue. Meanwhile, politicians on both sides of the aisle have called for banning direct-to-consumer drug ads outright – though the Food and Drug Administration has so far focused on restricting “digital” loopholes and enforcing the laws about advertisement.

As a health economist who studies how health care policies shape decisions made by doctors and patients, I agree that the practice can steer patients toward heavily marketed brands instead of the most appropriate treatment.

But the research on how such advertising affects patients is more nuanced. Many rigorous studies show that these ads can benefit patients’ health by encouraging them to seek lifesaving treatment for conditions such as depression and heart disease and sparking conversations with their doctors. In my view, within the realities of the U.S. health care system, getting rid of direct-to-consumer drug advertising may do more harm than good.

The origins of US prescription drug advertising

Only two countries – the U.S. and New Zealand – allow drug companies to advertise prescription medications directly to the public. Elsewhere, this practice is banned out of concern that short ads cannot adequately explain medical risks and that prescribing decisions should remain under physicians’ control.

And for good reason: Research on risk statements in drug ads on television shows they are often dense, fast-paced and paired with distracting visuals, making them difficult for consumers to understand.

In the European Union, Canada and Japan, for example, manufacturers may run disease awareness campaigns but cannot name specific products.

The U.S. approach to regulating drug advertising evolved gradually over more than a century. Congress’ 1906 Pure Food and Drugs Act was the first major federal step in drug oversight. It required manufacturers to label their products accurately and to disclose the presence of key ingredients.

For decades, pharmaceutical marketing focused on physicians by advertising in medical journals, visits by sales representatives and providing free samples. Drug companies still market heavily to physicians, but FDA policies and television changed the calculus.

By the 1960s and ’70s, the reach of mass media prompted companies to communicate complex medical information in brief commercial formats. The 1962 Kefauver–Harris Amendments, which required drugmakers to prove their products were both safe and effective to receive FDA approval, also gave the FDA explicit authority over prescription drug advertising. This allowed the agency to police exaggerated claims and require that promotional materials present a fair balance of benefits and risks, including clear disclosure of known side effects.

In the 1980s, several pharmaceutical companies experimented with marketing drugs directly to consumers in magazines and newspapers. The FDA paused these efforts in 1985 to study their effects but later allowed them to resume.

An opening for television ads

The pivotal change came in 1997, when the agency issued draft guidance that television ads needed to present only major risk information and could direct viewers elsewhere – via phone lines, print materials or websites – for the full details.

Reliable, up-to-date figures are hard to come by, but according to a widely cited estimate, the U.S. pharmaceutical industry now spends more than US$6 billion on direct-to-consumer advertising, roughly twice the amount spent in 2012.

In September 2025, the FDA announced it would revoke this change, restoring pre-1997 standards for fuller disclosure, and would more aggressively enforce currently existing rules for direct-to-consumer drug advertising. Despite growing interest from policymakers and Congress to ban them outright, a total ban likely would not survive a Supreme Court challenge.

How direct-to-consumer ads affect patients

Studies show direct-to-consumer drug advertising increases demand for medications and prompts more doctor visits and diagnoses. Policymakers and the FDA specifically have raised concerns that these ads mislead patients, encouraging them to overuse or inappropriately use drugs and choose more expensive treatments over less costly alternatives. This, in addition, could raise drug prices and result in wasteful spending. But research convincingly demonstrating this has been difficult to come by.

For example, a 2023 analysis showed that drug companies spend more on advertising drugs that have been rated as having relatively lower clinical benefit than on drugs that offer higher clinical benefit. This may imply, according to the authors, that drug companies are trying to steer patients to drugs that physicians would be less likely to prescribe.

Interestingly, though, rigorous research showed that direct-to-consumer advertising increases prescribing of both advertised and nonadvertised drugs – suggesting that overall this increase is serving patients.

Demonstrated benefits

For all the criticism that these ads are deceptive, the evidence indicates they can generate substantial clinical benefits for patients.

Research finds that ads bring patients into care, while leaving prescribing decisions largely in physicians’ hands, resulting in more patients being diagnosed and treated. For example, according to a 2022 study on antidepressants, advertising encouraged more people to start treatment and expanded overall use, especially for underdiagnosed conditions.

During the 2008 election season, political ads displaced drug commercials, providing a natural experiment on the effects of direct-to-consumer drug advertising. One study probed that period to examine ads for cholesterol-lowering medications known as statins, which are some of the most widely prescribed medications in the U.S. It found that removing drug ads reduced sales.

That study also ran a simulation banning drug ads entirely to show that doing so would have reduced new statin users by about 600,000 in 2008. Combining their estimates with clinical evidence on the drug’s benefits, the researchers found that health gains from additional treatment outweighed the costs of advertising.

Another study took advantage of the rollout of Medicare Part D, which helps cover the cost of prescription drugs, as a natural experiment. After Part D expanded drug coverage, pharmaceutical advertising increased more in areas with larger Medicare populations. In those areas, researchers found that more patients began treatment and stuck with it.

Importantly, the number of prescriptions also rose for nonadvertised drugs, including lower-cost generics, suggesting that advertising expanded overall treatment rather than simply shifting patients to heavily promoted brands.

It’s easy to single out pharmaceutical ads aimed at patients, but they are only one piece of a complex health care system – one in which drug manufacturers, providers, insurers and pharmacies all have financial incentives that shape which medications patients can access.

For example, drug company marketing directly to physicians does skew prescribing, increasing drug costs, with little evidence that patients receive better or more appropriate treatment as a result. Yet in the absence of direct-to-consumer advertising, patients’ choices of medications would be more heavily controlled by that dynamic.

The challenge for policymakers will be to curb misleading promotion without cutting off patients’ access to reliable information or undermining their role in directing their own care – and that will likely require addressing broader issues in the health care system.

Anna Chorniy 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. Drug company ads are easy to blame for misleading patients and raising costs, but research shows they do help patients get needed treatment – https://theconversation.com/drug-company-ads-are-easy-to-blame-for-misleading-patients-and-raising-costs-but-research-shows-they-do-help-patients-get-needed-treatment-265724

Source: The Conversation – USA (3) – By Jerry Gurwitz, Professor of Geriatrics, UMass Chan Medical School

More than 70 million baby boomers – those born between 1946 and 1964 – are alive today. In 2026, the oldest of them are turning 80.

With longer lives often comes more complicated health needs: multiple chronic conditions, long lists of medications, balance problems that can increase the risk of falls, and changes in memory. Many older adults also begin relying more on spouses, children or other family members to help manage medical decisions.

Ideally, health care in later life should go beyond just treating individual diseases and medical conditions. It should aim to help older people maintain health, independence and optimal quality of life for as long as possible.

Doctors and nurse practitioners trained in geriatrics specialize in doing exactly that. As a geriatrician for nearly four decades, I’ve seen how the right care for older people can prevent falls, reduce risk of medication side effects and help patients make medical decisions that reflect their goals and wishes.

The problem? There just aren’t enough of us. Finding a health care provider with expertise in geriatrics can be extraordinarily difficult. But there’s good news: You can use a few simple strategies that geriatricians rely on to have more productive conversations with your or your family member’s doctor.

A whole-person approach to aging

Geriatricians are trained to see the bigger picture of aging. They don’t just treat individual diseases – they also focus on preserving independence, function and safety. That includes addressing memory changes, balance problems, complex medication regimens and the difficult trade-offs that often come with complicated medical decisions.

A geriatrician can help patients and their families weigh whether a test or procedure will truly improve their patient’s life. Specialists in geriatrics know that most falls have multiple causes – and that practical steps like reviewing medications or improving home safety can prevent the next one.

They also recognize that in older adults, new symptoms should not be blamed simply on aging. Sometimes they can be due to drug side effects. For example, stopping certain sleep medications can reduce confusion and daytime drowsiness, and limiting or avoiding use of opioids for pain relief can prevent debilitating constipation.

Unfortunately, geriatrics is a specialty with a dearth of providers. Nationally, there are fewer than 12 geriatric physicians and 10 geriatric nurse practitioners per 100,000 older Americans. In many rural areas, there are none. And the shortage is unlikely to improve anytime soon. That’s because medical students and advanced practice nurses rarely choose to specialize in geriatrics, and many medical schools provide no formal training in the care of older adults.

This means most older adults will be cared for by clinicians without specialized geriatric training. But older patients and families can still steer care in the right direction by using a straightforward framework geriatricians follow called the “5Ms.”

A geriatrician’s framework

This mnemonic captures the core principles of optimal geriatric care. The letters stand for mind, mobility, medications, multicomplexity and matters most. The importance of each of these essentials of care for older adults may seem obvious, but it’s amazing how often they are overlooked when doctors without training in geriatrics take care of their older patients. Here’s how you can think about them in speaking with your doctor:

Mind: About 10% of adults age 65 and older have dementia, and another 22% have mild cognitive impairment. If you’ve noticed changes in your memory – forgetting appointments or conversations, forgetting to take medications, struggling with bills or relying more on family for help with tasks you once handled easily – bring it to your doctor’s attention. These concerns don’t always surface unless you mention them. When doctors know about memory problems, they can check for treatable causes, adjust medications or recommend further evaluation and lifestyle changes that may be of benefit.

Mobility: Each year, about a third of older adults report at least one fall, and 1 in 10 suffer a fall-related injury. Make sure to tell your health care provider if you have fallen, feel unsteady when standing or walking, or if you worry about falling. Request advice about how you can improve strength, flexibility and balance to reduce the risk of falls and serious injury.

Medications: Four out of every 10 Americans age 65 and older take five or more different medications every day, and 1 in 10 take 10 or more. Any new symptom in an older person could be due to a drug side effect of their medication. So don’t be afraid to ask whether every medication you are taking is absolutely necessary, or whether a new symptom you are experiencing might be a side effect. If you see multiple health care providers who each prescribe medications to you, ask for a comprehensive review of your medications to make certain that nothing is being missed and all your drugs and dosages are appropriate.

Multicomplexity: About 75% of older adults live with two or more chronic medical conditions. When you are followed by several specialists – who limit their focus to a single disease – your care can become fragmented. That often means long medication lists, frequent tests and recommendations that don’t always fit together. A whole-person approach looks at how everything connects. You and your family can help by asking your primary health care provider to step back and review the full picture – all medications, all specialists and any upcoming tests – and help coordinate a clear, organized plan that is best for you.

Matters most: Asking yourself to pin down what matters most to you is a simple but powerful way to help your doctors understand what to prioritize in thinking through your care. With that information, your doctor can look beyond focusing on any one disease or condition and instead work with you to support your personal goals for a good old age. Maybe it’s being able to walk to the mailbox without falling. Or staying in your own home for as long as possible. Or avoiding medications that make you sleepy or confused. Or staying out of hospitals and emergency rooms. Whatever it is, it’s important to have your health care provider focus on your own priorities.

Aging well is not about having more doctor’s appointments or medical tests, nor is it about taking more medications. It’s about getting the kind of health care that will maintain function, independence and quality of life into old age. You may not be able to find a geriatrician, but you can definitely help your doctor better understand the care that’s right for you or your loved one.

Jerry Gurwitz receives funding from the National Institute on Aging. He serves as a paid consultant to United Healthcare.

– ref. There aren’t enough geriatricians – here’s how older adults can still get the right care – https://theconversation.com/there-arent-enough-geriatricians-heres-how-older-adults-can-still-get-the-right-care-269789

Source: The Conversation – USA – By R. Alexander Bentley, Professor of Anthropology, University of Tennessee

In graduate school, my experimental archaeology professor told a student to create a door socket – the hole in a door frame that a bolt slides into – in a slab of sandstone by pecking at it with a rounded stone. After a couple of weeks, the student presented his results to the class. “I pecked the sandstone about 10,000 times,” he said, “and then it broke.”

This kind of experience is known as individual learning. It works through trial and error, with lots of each. Also known as reinforcement learning, it is how children, chimpanzees, crows and AI often learn to do something on their own, such as making a simple tool or solving a puzzle.

But individual learning has limits. No matter how much someone experiments through trial and error, improvement eventually hits a ceiling. Humans have been throwing javelins for a few hundred thousand years, yet performance has largely plateaued. At the 2024 Olympics in Paris, the gold medal javelin throw was about 5% shy of Jan Železný’s 1996 record. The level of expert play in the strategy game Go was essentially flat from 1950 to 2016, when artificial intelligence changed the equation.

Throughout humanity’s existence, these limits on individual learning have not applied to technology. Since IBM’s Deep Blue defeated world chess champion Garry Kasparov in 1997, supercomputers have become a million times faster – and now routinely outperform humans in chess and many other domains.

Why is technological improvement so different? My work as an anthropologist on cultural evolution and innovation shows that, unlike individual performance, technology advances through combination and collaboration. As more people and ideas connect, the number of possible combinations grows superlinearly. Technological innovation scales with the number of collaborators.

My new book with anthropologist Michael J. O’Brien, “Collaborators Through Time,” reveals these patterns across human existence. It traces how 2 million years of technological traditions progressed through collaboration among specialists, across generations and with other species.

Expertise has been the key. Because traditional communities know who their experts are, specialization and collaboration have consistently underpinned human success as a species.

I’d summarize our insight into how technology keeps advancing as TECH: tradition, expertise, collaboration and humanity.

Traditions and expertise – the critical foundation

The longest technological tradition documented by paleoanthropologists was the Acheulean hand axe. The multipurpose stone tool was made by our hominin ancestors for almost a million years, including some 700,000 years at a single site in eastern Africa. People produced Acheulean tools through techniques they learned, practiced and refined across generations.

Later, small prehistoric societies of modern humans thrived on millennia of specialized knowledge, such as music, thatched roofs, seed cultivation, burying dead bodies in bogs, and making millet noodles and even cheese suitable for interring with mummies.

As early as 22,000 years ago, communities near the Sea of Galilee stored and used more than a hundred plant species, including medicinal plants. Shamans – ritual experts in medicinal knowledge and caregiving – helped their groups survive. Archaeological evidence from burial sites suggests these specialists were widely revered across thousands of years: One shaman woman was interred with tortoise shells, the wing of a golden eagle and a severed human foot in a cave in Israel.

Collaboration – knowledge spanning time and place

Traditional expertise alone does not advance technology. Technological progress occurs when different forms of expertise are combined.

The wheel may have emerged from copper-mining communities. One expert sourced copper from the Balkans, another transported it, another smelted it. By about 4000 B.C., additional specialists cast copper into an early wheel-shaped amulet: shaping a wax model, encasing it in clay, firing it in a kiln, pouring molten metal into the mold, then breaking the mold away.

Transport technologies reshaped ancient product networks. As communities across Eurasia and Africa built wheeled vehicles and ships, and raised domesticated horses and other pack animals, collaboration expanded across continents. Maritime and overland trade linked blacksmiths, scribes, religious scholars, bead makers, silk weavers and tattoo artists.

Expertise was often distributed between cities and their hinterlands, with cities functioning as hubs in cross-continental product networks. In ancient Egypt, no single community could produce a mummy. Mummification experts at Saqqara drew on a continental network that supplied oils, tars and resins, combining these materials with specialized techniques of antisepsis, embalming, wrapping and coffin sealing.

Around the world, states and empires – from the Indus Valley Civilization to the Vikings, Mongols, Mississippians and Incas – expanded these networks, serving as hubs that coordinated the exchange of raw materials, specialized knowledge and finished products. These exchanges could be highly specific: Chinese porcelain was shipped exclusively to 12th-century palaces in Islamic Spain via Middle Eastern traders who added Arabic inscriptions in gold leaf.

The scale has changed, but the structure has not. Today, within a global product space, an iPhone is assembled from a distributed network of specialized expertise and facilities.

Humanity – social learning

Today, AI may disrupt the millennia-long pattern of technological advancement through TECH. Most large language models generate statistically common responses, which can flatten culture and dilute expertise and originality. The risk grows as untapped high-quality training data – our reservoir of expertise – becomes scarcer.

This creates a feedback loop: Models trained heavily on low-quality content may degrade over time, with measurable declines in reasoning and comprehension. Some scientists now warn that humans and large language models could become locked in a mutually reinforcing cycle of recycled, generic content, with brain rot for everyone involved. The dystopian extreme is AI model collapse, in which systems trained heavily on their own output begin to produce nonsense.

Brain rot is one reason some AI pioneers now question whether large language models will achieve human-level intelligence. But that, I think, is the wrong focus. The key to continually improving AI models is the same one that has sustained human expertise for millennia: keeping human experts in the loop – the E in TECH. Thanks to a kind of “pied piper” effect, an informed minority can guide an uninformed majority who copy their neighbors.

In a classic experiment, guppies, following their neighbors, ended up schooling behind a robotic fish that guided them toward food. A recent study showed that traffic congestion eases when autonomous vehicles make up as little as 5% of cars on the road. In both cases, a small, informed minority reshaped the behavior of the whole system.

Like humans, large language models are social learners, and the learning can go in either direction. Designers can increase the likelihood that models continue to improve by ensuring they incorporate the accumulated lessons of human expertise across history. In turn, this creates the conditions for people and models to learn from one another.

In the 2010s, DeepMind’s AlphaGo rediscovered centuries of accumulated human Go knowledge through individual learning, then went beyond it by crafting strategies no human had ever played. Human Go masters subsequently adopted these AI-generated strategies into their own play.

Well-trained large language models can likewise summarize vast bodies of scientific information, help talk people out of conspiracy thinking and even support collaboration itself by helping diverse groups find consensus. In these cases, the learning flows both ways.

From Acheulean hand axes to supercomputers, human innovation has always depended on tradition, expertise, collaboration and humanity. If AI is tuned to find and trust expertise rather than dilute it, it can become humanity’s next great technology – on par with ancient writing, markets and early governments – in our long story as collaborators through time.

R. Alexander Bentley 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. Will AI accelerate or undermine the way humans have always innovated? – https://theconversation.com/will-ai-accelerate-or-undermine-the-way-humans-have-always-innovated-272246

Source: The Conversation – USA (2) – By Karen Stollznow, Research Fellow of linguistics, Griffith Centre for Social and Cultural Research, Griffith University; University of Colorado Boulder

There’s a common assumption that if someone starts learning a language when they are very young, they will quickly become fluent.

Many people also assume that it will become much harder to learn a language if they start later in life.

Research into language learning shows that how old someone is when they learn a language does matter, but there is no point at which the ability to learn a language switches off.

While a young language learner can more easily acquire a native accent, adults retain the ability to learn new languages well into later life. Anyone can continue to learn and refine their vocabulary and grammar. Other factors, like motivation, can also play a role for learners of all ages.

I am a linguist and the author of a forthcoming book, “Beyond Words: How We Learn, Use, and Lose Language,” which looks at how language is learned, used and lost across a lifespan — and why age alone does not set hard limits on our linguistic abilities.

Instead, the strategies learners use, the outcomes they achieve most easily, and how others judge their progress can all change over time.

How age shapes language learning

Someone’s age can influence their language learning ability in a variety of ways.

Scientists sometimes talk about sensitive periods, or an early development window in which the brain is especially receptive to certain kinds of input.

When it comes to language, babies and children are particularly sensitive to the sound patterns of speech. They can also pick up on subtle phonetic distinctions that adults struggle to perceive or reproduce.

This helps explain why children who grow up bilingual often sound native in both languages. Accents, more than vocabulary or grammar, are where age-related differences are most pronounced.

Sensitive periods are found in other animals, too, especially birds, which have an early sensitive period for learning their species-specific song from an adult tutor.

After this window closes, learning a new language is still very much possible. But it usually takes more conscious effort and practice.

Studies also show that children exposed to a second language early, roughly before puberty, are more likely to develop nativelike pronunciation and intonation.

Brain imaging research shows that people who learn two languages early in life tend to process both languages in the same parts of the brain. Those who learn a second language later often use slightly different brain areas for each language.

In practical terms, early bilinguals are more likely to switch between languages effortlessly. Later learners may have to more consciously work through their second language, especially at first.

Benefits to learning a language as an adult

Pronunciation is only one part of language proficiency. Adults bring their own strengths to the task.

Unlike young children, adult learners already have a fully developed first language. They also have skills in reasoning and pattern recognition, as well as an awareness of how language works.

This allows adults to learn in a more deliberate way, as they study grammar rules and consciously compare languages. Adults are also more likely to rely on deliberate strategies, such as memorization, to learn a language.

In classroom settings, adults often outperform children in early stages of learning, particularly in reading and writing.

Language learning never truly stops. Even in adulthood, people continue to develop and refine their first language, shaped by their education, work and social environment, and how they use it day to day.

While it may be harder for adults to acquire a nativelike accent later in life, the good news is that grammar, vocabulary and fluency remain well within reach for most adult learners.

Benefits of learning a language as a kid

Children, meanwhile, tend to learn languages implicitly, through immersion and interaction, often without conscious attention to rules.

Social and emotional factors also play a major role in successfully learning a language.

Children are generally less self-conscious than adults and more willing to take risks when speaking.

Adults, by contrast, are often acutely aware of mistakes and may hesitate to speak for fear of sounding foolish or being judged.

Research consistently shows that being willing to communicate is a strong predictor of success in learning a new language. Anxiety, inhibition and negative feedback from others can significantly slow progress, regardless of age.

Accent, bias and social pressure

Other factors, like social pressure and discrimination, matter as someone tries to learn a new language.

Research into language and identity shows that listeners frequently associate accented speech with lower intelligence or competence, despite there being no connection between accent and cognitive ability.

Non-native speakers often experience stigmatization, discrimination and prejudice from native speakers.

This bias can discourage adult learners and reinforce the false belief that successful language learning means sounding native.

Motivation and aptitude matter, too

Motivation is another key factor that affects learners of all ages.

People learn new languages for many reasons: a new country, work, school, relationships or interest in another culture.

Research distinguishes between the different reasons people learn a language. Some are practical, like advancing a career or passing a test. Others are personal, such as wanting to connect with a community, culture or family.

Learners who feel a strong personal or emotional connection to the language are more likely to keep going even when it gets difficult, and they often reach higher levels of fluency than those without this connection.

Other people have a natural aptitude for learning a language and can pick it up easily. Perhaps they quickly notice sound patterns, or they can remember new vocabulary after hearing it once or twice.

Language aptitude is different from intelligence and varies from person to person. Aptitude makes success in learning a language more likely, but it doesn’t guarantee it.

Learners with average aptitude can still become very proficient in new languages as adults if they have consistent exposure, practice and motivation.

Different ages, different strengths

So is it better to learn a second language as a child or as an adult? Research suggests the more useful question is which aspects of language learning, such as pronunciation, fluency or long-term mastery, matter most.

Learning a new language early makes it easier to sound like a native speaker and to use the language smoothly, without having to think about the rules.

Learning that language later in life draws on adult strengths, such as planning, problem-solving and focused practice.

Ultimately, some people pick up languages quickly while others struggle, regardless of how old they are.

Beliefs about language learning shape education policy, parenting choices and how multilingual speakers are treated in everyday life.

When adults are told they’ve missed their chance to learn a language, many never bother to try. When foreign accents are treated as flaws, capable speakers can be unfairly discriminated against.

In fact, research shows that learning a language is possible at any age – it’s a lifelong, achievable journey, rather than a race against the clock.

Karen Stollznow 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. It’s never too late to learn a language – adults and kids bring different strengths to the task – https://theconversation.com/its-never-too-late-to-learn-a-language-adults-and-kids-bring-different-strengths-to-the-task-276583

Source: The Conversation – USA (3) – By Kaylin Klie, Associate Professor of Family Medicine, University of Colorado Anschutz Medical Campus

In Colorado, from 2016 to 2020, 33 women who were pregnant or had recently given birth died from accidental overdoses. That’s more than died from traditional obstetric complications like infection, high blood pressure or bleeding combined.

More recent data shows an encouraging turnaround. The number of maternal overdose deaths dropped 60%, from 20 in 2022 to eight in 2023. I think one contributing factor might be increased access to naloxone for moms and families across the state.

As a perinatal addiction medicine physician, I specialize in taking care of pregnant people and families impacted by substance use disorder. Part of the care I provide is prescribing or distributing naloxone directly to patients and their family members. Naloxone is an over-the-counter medication that reverses the effects of opioid overdose.

I served as a member and then co-chair of the Colorado Maternal Mortality Review Committee from 2017 to 2023. The committee reviews every death of a person in Colorado that occurs during a pregnancy or within 12 months of the end of a pregnancy. I personally reviewed the records of Colorado mothers who died from overdoses.

In Colorado, unintentional overdose and suicide have been the top two causes of maternal mortality each year since 2016. Nationally, the leading cause of maternal mortality is overdose, followed by homicide and then suicide.

Almost all overdose deaths occur in the community, outside of a medical center: in homes, cars and public places. In almost all circumstances, the review committee determined that if naloxone had been present, there was a good chance the mother would have survived.

Giving naloxone directly to patients and families

In 2023, The Naloxone Project, a nonprofit, started distributing naloxone directly to pregnant and postpartum moms and their families before leaving one of the 48 birthing hospitals in Colorado. The distribution is through a program called the Maternal Overdose Matters Initiative, also known as MOMs. The initiative was in direct response to the number of women dying from overdose during pregnancy or within a year after pregnancy.

The Naloxone Project was started in Colorado in 2021 by an emergency and addiction medicine physician. The project distributes naloxone directly to patients in Colorado hospital emergency rooms at risk for opioid overdose.

To date, The Naloxone Project has distributed more than 2,500 naloxone kits to 107 hospitals to give to patients across the state. The project also works to normalize the conversation about opioid overdose and prevention in health care settings. It’s grown, and now it has chapters in 16 states.

Naloxone can make recovery possible

The American Society of Addiction Medicine defines substance use disorder as “a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment and an individual’s life experiences.” People with the disease of addiction can, and do, recover – but only if they can stay alive to receive the support and treatment they need.

Research shows direct distribution of naloxone to people, families and communities saves lives. Access to naloxone gives people, including Colorado moms, a literal second chance at life.

Naloxone for more than substance use disorder

While people with substance use disorder are at the highest risk for overdose, they’re not the only ones. In 2024 alone, 1,603 people died of accidental opioid overdoses in Colorado.

Prescription opioids, such as oxycodone, hydrocodone and morphine, are commonly prescribed after a surgery, including C-sections. Opioids like these taken at home, even with a prescription, can be a source of accidental overdose. For example, a person prescribed these medicines may take too much at once or have an unexpected interaction with other medications or alcohol.

Accidental overdose also occurs in people the prescription was not intended for. That includes children who find medications in their homes. In Colorado, 17 children died from opioid overdoses in 2024.

Today, parents leaving the hospital with their new baby are given naloxone and education. They learn about safe storage and disposal of medications, how to recognize an opioid overdose, and how to give naloxone in case of emergency. Nasal-spray naloxone, the most common form provided by The Naloxone Project, is safe for all ages, including infants and toddlers.

Naloxone as a standard of care

Caring for people impacted by substance use disorder has convinced me that naloxone has a place in every home, school and workplace in our community.

Recognizing and responding to opioid overdose, including giving naloxone, is now a standard part of Basic Life Support training. Opioid overdose reversal is now seen as a critical, lifesaving skill comparable to CPR. Including this skill in training empowers bystanders to intervene.

For some of my patients, receiving naloxone during an overdose event gave them a chance to seek treatment and enter long-term recovery from substance use. Opioid use disorder treatment includes evidence-based medication for opioid use disorder, such as methadone, buprenorphine or naltrexone, residential or intensive outpatient treatment, individual therapy and peer support services, especially programs designed for pregnant and parenting moms.

How these facets of treatment come together in an individual person’s journey is unique. As much as I seek to individualize treatment plans, naloxone is for everyone. It can build a bridge between despair and hope — life and death — and as the data shows, it might be a part of saving Colorado moms’ lives.

Kaylin Klie receives funding from Colorado State Opioid Response funding. She is affiliated with The Naloxone Project as the Physician Lead for MOMS Plus.

– ref. Fewer new moms are dying in Colorado – naloxone might be one reason why – https://theconversation.com/fewer-new-moms-are-dying-in-colorado-naloxone-might-be-one-reason-why-273761

Source: The Conversation – USA (3) – By Daniel Cueto-Villalobos, PhD Candidate, Sociology, University of Minnesota

I’ve been living in Minneapolis and working on my doctoral dissertation about local religious communities since 2019.

It’s given me a chance to personally witness how the COVID-19 pandemic, the aftermath of the killing of George Floyd by police officers, and the surge in federal law enforcement presence have fostered grassroots networks of what’s known broadly as “mutual aid.”

Simply put, mutual aid is when communities work together to distribute resources people need to survive, whether it’s food, shelter, clothing or help paying bills. Unlike charity or government assistance, mutual aid is decentralized, grassroots-led and not channeled through nonprofits or government agencies.

One reason why mutual aid flourishes in Minnesota is that it has deep roots in the state.

Enduring ‘Operation Metro Surge’

Citing an already prosecuted case of fraud in which some of the perpetrators were Somali American citizens residing in Minnesota, the Trump administration dispatched Immigration and Customs Enforcement and Customs and Border Protection agents to the Twin Cities in late 2025.

Within weeks, the number of federal agents in what the Department of Homeland Security dubbed “Operation Metro Surge” had topped 3,000, outnumbering those in local police forces and ushering in widespread fear and uncertainty.

Local mutual aid networks quickly mobilized in response to these federal operations. Immigrant advocacy organizations have organized constitutional observer trainings and distributed “know your rights” information on flyers.

As in other cities, including Los Angeles and Chicago, “ICE Watch” volunteers in Minneapolis sound 3D-printed whistles and car horns to alert neighbors during ongoing raids. Constitutional observers document key details and provide support to neighbors.

The participants come from every walk of life.

Churches and sex shops alike have pivoted away from their routines to distribute food, diapers, cash and other household items that immigrant households need. Residents with disposable income have organized targeted “cash mobs” to support struggling local businesses.

Crowd-sourced campaigns have directed rent money to families whose breadwinners are afraid to go to work.

Federal agents have targeted schools and bus stops, apprehending adults and children. Parents and neighbors across the region have begun patrolling school drop-off zones to shield students from federal immigration actions.

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Read more:
How anti-ICE organising in Minnesota reactivated mutual aid networks started after George Floyd’s murder

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The North Star State’s heritage

The local grassroots resistance to Operation Metro Surge came as no surprise to me. Mutual aid has deep roots in Minnesota, and this history is closely connected to the violence of European settlement and American expansion.

Minnesota’s harsh winters have always demanded cooperation and neighborliness, not merely as an expression of “Minnesota Nice” – the state’s reputation for a warm, if guarded, way of interacting – but as a survival strategy that predated the first European arrivals in the 17th century.

Generosity, respect and compassion are central values among Dakota and Ojibwe people, Minnesota’s original inhabitants.

From when French fur trappers and Catholic missionaries first made their way to the Great Lakes in the 17th century until the onset of a population boom in the mid-19th century, Indigenous inhabitants sustained relatively stable and mutually beneficial relations with colonial powers.

The North Star State’s Minnesota Nice reputation has long encompassed progressive politics; a polite, if guarded, interpersonal demeanor; and a hearty neighborliness formed out of necessity during frigid winters.

Undergoing demographic changes

After Minnesota gained statehood in 1858, a series of broken treaties, armed conflicts and several laws forced Indigenous people onto reservations, opening up large swathes of land for white settlement. Immigrants from countries like Sweden, Norway and Germany settled in Minnesota in hopes of better opportunities than they had back home. Catholic and Lutheran churches and mutual benefit societies preserved cultural heritage, combated isolation and shaped the new state’s religious culture for generations.

In 1850, 6,100 people lived in the Minnesota Territory. By 1900, the state’s population had reached more than 1.75 million residents, 37% of whom were foreign-born.

Beginning in the 1970s, Minnesota welcomed Somali and Hmong refugees, as well as immigrants from Latin America. Robust social services and Catholic and Lutheran refugee settlement agencies have helped to integrate new arrivals, many of whom fled their countries of origin in response to economic crises and geopolitical instability.

While more than 4 in 5 Minnesotans today are white, the Minneapolis-St. Paul region remains far more diverse in terms of race, religion and national origin.

The seven-county region is 72% white, 10% Black or African American, 8% Asian or Pacific Islander, 7% Latino and just under 1% Native American, according to the 2022 American Community Survey. White people make up just over 50% of the population in both Minneapolis and St. Paul. At just under 20%, Black people constitute a higher share of population in Minneapolis. In St. Paul, about 1 in 5 people are Asian, mainly Hmong and other people of Southeast Asian descent.

Minnesota’s religious landscape is changing too. Since 2000, for example, the share of Muslim Minnesotans has grown from 1% to 3%.

Hmong and Somali Minnesotans play an increasingly prominent role in Twin Cities politics. The Trump administration has harangued the region’s Somali American elected officials, including Rep. Ilhan Omar of Minneapolis, especially during its immigration crackdown.

Welcoming donations

The fatal shooting of Minneapolis resident Renee Good on Jan. 7, 2026, by ICE agent Jonathan Ross further galvanized the local resistance. While it is unclear if Good was acting as part of a local ICE Watch group, attendance at observer trainings increased in the following weeks.

A few weeks after Good died, on Jan. 23, more than 50,000 people marched in frigid weather through downtown Minneapolis to demand “ICE out!”

In what organizers billed “A Day of Truth and Freedom,” over 700 local businesses closed in solidarity. An estimated 100 clergy were arrested outside the city’s airport, where they decried daily deportation flights to detention facilities.

The outrage increased when, the next morning, border patrol officers shot and killed Alex Pretti, a South Minneapolis Veterans Administration nurse who was documenting ICE actions at the intersection of 26th Street and Nicollet Avenue.

In response, local businesses sheltered people from the chemical that agents deployed. Residents of the neighborhood opened warming stations and distributed granola bars, hot water and hand warmers to mourners.

One organizer insisted they were not accepting payments for these goods and services, although donations were welcome.

Lasting harm

The federal government said it had detained over 4,000 people as of Feb. 4. With public pressure welling up, Tom Homan, Trump’s border czar, announced on Feb. 12 that Operation Metro Surge would come to an end.

As of Feb. 25, ICE is less visible in South Minneapolis. But locals across the region are well aware of the ongoing presence in suburban areas, where agents are reportedly using new tactics.

Even if the immigration agents do completely clear out, the damage caused will surely be long-lasting.

Children like 5-year-old Liam Conejo Ramos, who was taken from his suburban Twin Cities home and flown to a detention facility in Dilley, Texas, have received inadequate food and limited access to recreation while held there, according to ProPublica’s investigative reporters. The American Academy of Pediatrics has called attention to the lasting harms of juvenile detention.

South Minneapolis’ Lake Street corridor, home to over 1,000 immigrant-owned small businesses, has lost over US$46 million in revenue since December. Local leaders estimate that the citywide economic damage exceeds $200 million.

But Minneapolis residents are carrying on the state’s long-standing tradition of solidarity through mutual aid.

Daniel Cueto-Villalobos receives funding from the Lilly Endowment.

– ref. Minneapolis united when federal immigration operations surged – reflecting a long tradition of mutual aid – https://theconversation.com/minneapolis-united-when-federal-immigration-operations-surged-reflecting-a-long-tradition-of-mutual-aid-275987

Source: The Conversation – USA (3) – By Christy Cobb, Associate Professor of Christianity, University of Denver

Of Jesus’ 12 disciples, Saint Peter is one of the most important. In the Book of Matthew, Jesus declares that Peter is the “rock” on which “I will build my church,” and Catholic tradition considers him the first pope. Martyred in Rome in the first century, Peter asked to be crucified upside down so that he would not die in the same way as Christ.

However, that famous story is not in the Bible. It appears in a text called “Acts of Peter,” an “apocryphal” writing.

In ancient Greek, “apocrypha” means “hidden.” The word is used for texts that are not part of an approved set of religious books, especially Christian texts outside the official biblical canon.

Yet these books are not so hidden. Some of them, like Acts of Peter, have shaped Christian tradition for centuries and are read by many people today. These stories are not only fun to read, but also provide valuable information about ideas that interested early Christians.

In my research as a scholar of early Christianity, I read and interpret apocryphal texts to explore the ways that early Jews and Christians understood and practiced their religion.

Capital-A ‘Apocrypha’

When the word is capitalized, “Apocrypha” refers to a set of Jewish texts that are found in Roman Catholic Bibles, but they are not included in most Protestant Bibles.

These texts were valued within ancient Judaism, yet are not included in the Jewish sacred text the Tanakh. The Tanakh is similar to what Christians call the “Old Testament” or the “Hebrew Bible,” but there are many important differences, including the order of texts and the books that are emphasized.

Examples of these Apocryphal books include Judith, Sirach and the First and Second Books of Maccabees. The story of Hanukkah comes from the Books of Maccabees when Jewish rebels overcame an oppressive ruler and rededicated the temple in Jerusalem – a reminder of the Apocryphal books’ significance.

Most Christians viewed the Apocrypha as scripture until the Protestant Reformation of the 16th century. During this period, Protestant reformers such as Martin Luther argued that these texts were valuable to Christians but should not be viewed as scripture.

Today, Roman Catholicism and Orthodox Christianity affirm these texts as a part of their canon. Thus, not all Christian Bibles include the same number of books.

Lower-case ‘apocrypha’

The word apocrypha is also used to reference a second set of texts: Christian books that are not included in the New Testament, the faith’s officially recognized set of texts.

The New Testament canon usually includes 27 books, including the four gospels that describe Jesus’ life – Matthew, Mark, Luke and John – and Acts, which describes the works of the apostles who continued Jesus’ ministry after his death. The New Testament also contains many books of letters, or Epistles, written by early Christian leaders, and Revelation, a vision of the end of the world.

Yet early Christians wrote more than just these books. These additional texts are often grouped together and referred to as “Christian apocrypha.” They include a number of different genres.

For example, apocryphal gospels tell of the life, ministry and death of Jesus. One of the earliest is the Gospel of Thomas, probably written in the mid-second century. Unlike the New Testament gospels, Thomas does not include the death of Jesus. Instead, it is a collection of sayings, many of which are also found in the New Testament gospels.

There are other apocryphal gospels named after important people in Jesus’ life and ministry, such as the Gospel of Mary. Named after one of Jesus’ female followers, Mary Magdalene, it notes that Jesus loved her more than any other woman.

Another genre is “apocryphal acts” – books that expand upon stories of the apostles who followed Jesus. One example is the Acts of Thecla, a story about a female follower of Jesus who was called to preach and teach the gospel. There are also apocryphal letters, apocalyptic texts and passion narratives that add details to the death and resurrection of Jesus.

One way to think about Christian apocryphal texts is as fan fiction written about the stories found in the New Testament. The New Testament gospels do not provide information about Jesus’ experience as a child. Yet there are apocryphal texts called “infancy gospels” that fill in the gaps, saying more about Jesus’ birth and how he navigated his perceived divine powers. In the “Infancy Gospel of Thomas,” the young Jesus brings a set of clay birds to life, rebukes his teacher and even kills his playmates.

Creating the canon

So why were these interesting texts not included in the New Testament?

The process of canonization was a slow one. Contrary to popular belief, there was not one early meeting of Christians to vote on which books should be in the New Testament. Instead, much of the canon developed slowly, as widely read texts circulated among the people and were read aloud.

Theology seems to have been a primary factor behind how the canon took shape. Early Christians fiercely debated things like Jesus’ nature: whether he was divine, human or both. Bishops and priests often challenged texts that did not conform with what became orthodox doctrine. Early Christians tended to read, copy, share and preserve the texts whose contents they already agreed with.

Even still, some Christians continued to read and value apocryphal texts. One of the oldest complete versions of the New Testament, the Codex Sinaiticus, dates to the fourth century and includes two apocryphal texts: the Shepherd of Hermas and the Epistle of Barnabas.

Christians throughout the years have continued to read and value the texts of the apocrypha. Medieval artwork illustrates this, as many stories only found within apocryphal texts are depicted on the ceilings of basilicas, on altarpieces and in paintings. Today, many Christians remain enthralled by these stories, which fill in gaps from the New Testament and provide intriguing details of the lives and ministries of biblical figures.

Christy Cobb 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. The apocrypha, Christianity’s ‘hidden’ texts, may not be in the Bible – but they have shaped tradition for centuries – https://theconversation.com/the-apocrypha-christianitys-hidden-texts-may-not-be-in-the-bible-but-they-have-shaped-tradition-for-centuries-274103

Source: The Conversation – USA (2) – By Promise Longe, Ph.D. Candidate in Chemical and Petroleum Engineering, University of Kansas

In the search for more, new and cleaner sources of energy, a largely untapped resource is emerging: natural hydrogen.

Unlike hydrogen produced from industrial processes, natural hydrogen forms through geological reactions that occur normally within the Earth’s crust, meaning it costs nothing to make – though it costs some amount to extract – and does not emit any carbon dioxide or other human‑caused pollutants.

Today, hydrogen is used mainly in oil refining, production of ammonia for fertilizer and to make methanol, which can be a fuel and an ingredient in plastics. Emerging technologies are making hydrogen a viable fuel for cars, planes, ships and factories. Hydrogen demand around the world is projected to grow from around 90 million metric tons in 2022 to more than 500 million metric tons by 2050. Some of that supply could come from nature itself, as well.

To describe each source of hydrogen, energy researchers like me, and the energy industry as a whole, use a range of colors. In general, “gray” and “blue” hydrogen are made by burning fossil fuels, with blue hydrogen incorporating technology that captures the carbon dioxide produced in the process to reduce emissions. “Green” hydrogen comes from renewable‑energy‑powered electrolysis, using electricity to split water into hydrogen and oxygen. “White” or “gold” hydrogen occurs naturally underground and can be extracted directly with minimal processing.

How natural hydrogen forms

Natural hydrogen originates from several geological processes. The most well‑studied mechanism is serpentinization, a reaction where water interacts with iron‑rich rocks known as ultramafics, releasing hydrogen gas.

Serpentinization occurs in diverse settings around the world, including ocean ridges and continental formations such as the Midcontinent Rift in North America, a band of mostly igneous rocks with some sedimentary rocks mixed in, which extends from Minnesota through the Lake Superior region and southward toward Kansas.

Another process, thermogenic hydrogen formation, occurs in deep sedimentary basins when organic material decomposes under high temperatures, roughly 480 to 930 degrees Fahrenheit (250 to 500 degrees Celsius). These reactions can also produce hydrogen alongside other gases, such as methane or nitrogen.

Because these processes happen over millions of years, using natural hydrogen generally requires far less energy than human‑made methods such as electrolysis, which consumes roughly 50 kilowatt-hours of electricity per kilogram of hydrogen produced – enough to power an average home for a day or two, and more than the energy that kilogram of hydrogen can provide. Natural hydrogen is already made – it just has to be collected.

The science and the search

Researchers and exploration companies are developing methods similar to those used in oil and gas exploration to locate potential hydrogen accumulations. They are looking at three types of geological formations:

1. Focused seepage, where hydrogen seeps naturally through cracks and faults. It tends to reach the surface and disperse quickly, making large-scale capture difficult.

2. Coal beds, where hydrogen binds to coal layers, offer higher potential density but pose difficulties for extraction. The hydrogen must first be separated from the coal and then flow through tight rock layers to the extraction point.

3. Reservoir‑trap‑seal systems, comparable to the rock formations that trap natural gas underground, are considered the most promising for commercial production because they can concentrate large volumes of hydrogen in well‑defined, drillable structures. However, they remain largely unproven in practice: The basic idea is well established, and geologists have a good sense of where those formations might occur, but they still lack detailed data on how much hydrogen these formations actually contain and how easy it would be to extract.

Massive reserves – somewhere

The U.S. Geological Survey estimates there could be more than 5 trillion metric tons of geological hydrogen underground around the world. But only a small fraction of that is estimated to be recoverable, both technically and in terms of reasonable costs.

However, even 2% of that total would be more than all proven natural gas reserves on the planetand enough to meet projected demand for the next 200 years, even accounting for increased consumption.

All of that reserve has built up over billions of years. The Earth naturally produces between 15 million and 31 million metric tons of natural hydrogen each year – less than 1% of the amount expected to be needed each year by 2050. But only a fraction of that is likely to be efficiently captured.

So geologic hydrogen is likely best viewed as a very large but ultimately finite source of low‑carbon energy that can substantially complement, but not replace, other energy sources, including various methods of producing hydrogen.

Global hot spots

Currently, only one hydrogen field, at Mali’s Bourakébougou village, produces natural hydrogen commercially, supplying tens of tons of hydrogen per year to power the village.

However, the number of companies exploring for natural hydrogen has increased rapidly, from roughly 10 in 2020 to about 40 by the end of 2023, according to Rystad Energy and related government and research‑lab reports.

Apart from that one field in Mali, exploration is concentrated in the United States, Australia, Canada and several European countries.

In the U.S., HyTerra’s Nemaha Project in Kansas has confirmed subsurface hydrogen concentrations reaching more than 90% hydrogen and 3% helium. The higher the concentration of hydrogen, the more efficient and cost‑effective it is to recover. HyTerra is also exploring elsewhere in the Midwest and Rocky Mountain regions.

Technical barriers

Transforming geological hydrogen into a commercial energy source presents tough scientific and technical challenges. Detecting and measuring hydrogen underground is difficult because of its small molecular size and reactivity with other elements in the rocks.

And if what’s found is low concentrations of hydrogen mixed with large amounts of other gases, it can be costly, even prohibitively so, to separate and purify the hydrogen before it can be used.

Economics and efficiency

The economic promise of natural hydrogen lies in its simplicity.

Because geological processes already performed the production work, early estimates suggest that extraction costs could be one‑tenth the production costs for other traditional hydrogen generation techniques – or possibly even less than that.

But those figures are based on the small amounts of hydrogen found so far and may not represent future large‑scale performance. Producing enough to serve commercial demand will require discovering large, high-quality accumulations.

As one leading research group noted, “This is not a gold rush.” It’s a careful exploration for scientific evidence that could lead, in time, to an abundant, carbon‑free and continuous energy source that complements other renewable energy sources.

Promise Longe 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 natural hydrogen, hiding deep in the Earth, could serve as a new energy source – https://theconversation.com/how-natural-hydrogen-hiding-deep-in-the-earth-could-serve-as-a-new-energy-source-273174

Source: The Conversation – USA – By Shelley Inglis, Senior Visiting Scholar with the Center for the Study of Genocide and Human Rights, Rutgers University

President Donald Trump in his State of the Union address on Feb. 24, 2026, doubled down on his false claims that the U.S. elections system is compromised. He asserted that “the cheating is rampant in our elections. It’s rampant.”

These pronouncements follow the January 2026 FBI seizure of 2020 ballots from Fulton County, Georgia, and the president’s recent call for the Republican Party to nationalize elections. The Trump administration is also suing 24 states and Washington, D.C., for voter lists to monitor voter registrations.

In his speech, Trump asked Republicans to pass the SAVE America Act. Approved by the House on Feb. 11, 2026, the measure would require that voters provide documentary proof of U.S. citizenship, effectively ending all online voter registration. “They want to cheat. They have cheated,” he said of Democrats.

These calls spread distrust in the U.S. electoral process, despite extensive evidence showing that voter fraud is rare, especially by noncitizens.

All this has led to speculation about how much further the Trump administration and Republican Party might go to tilt the 2026 midterm and 2028 presidential elections in their favor.

After decades of working internationally on democracy and peace-building, I know that efforts to undermine elections are not uncommon. Citizens of many affected countries have learned various techniques to help protect the integrity of their elections and democracy that may be helpful to Americans today.

International electoral assistance

Leaders, even in established democracies such as India, have used increasingly sophisticated and wide-ranging means to manipulate elections in their favor. Those means vary from legal changes that suppress votes to harassment and prosecution of the opposition, to promoting widespread disinformation campaigns.

These methods have evolved despite international efforts to counter rigged elections and improve election integrity. These countering efforts are called electoral assistance, and they support societies to develop electoral systems that reflect the will of the people and adhere to democratic principles.

Electoral assistance has been shown to strengthen transparency and election administration in countries such as Armenia and Mexico. It has also improved voter registration and education in countries such as Ghana and Colombia.

It’s mostly provided by international nonprofits, such as the National Democratic Institute and The Carter Center in the U.S. Multilateral organizations such as the United Nations also provide electoral assistance.

Five international responses to electoral manipulation

Here are five areas of electoral assistance that have shown some success internationally.

Early warning and community resilience: Early warning efforts track threats of violence and intimidation against election officials, candidates and voters. They seek to mitigate risks and prepare for crises. This happens from the early stages of an election through election day in countries such as Sri Lanka and Liberia.

Law enforcement, civic groups and election officials usually undertake these efforts together. But where such direct cooperation with government authorities is not feasible, civic groups can help by undertaking risk assessments and tracking coercion and threats. They can also raise alarms with officials and the media.

Indicators, or established metrics, can track sophisticated coercion tactics such as the misuse of government funds for campaign purposes. They also can track vote buying, like civic groups in North Macedonia did during 2024 parliamentary and 2025 local elections.

For these efforts to be successful, it’s critical that networks of trusted leaders urge early action to put in place greater safeguards long before election day. Raising alarms and urging action was done successfully by religious leaders in Kenya during general elections in 2022.

Real-time disinformation and local media reaction: Real-time fact-checking and debunking of false or manipulative information has proven critical to election integrity in countries such as Mexico and South Africa.

A highly organized and fast-moving approach involving media, technology companies and authorities successfully countered disinformation to ensure a competitive democratic election in Brazil in 2022. A coalition of Brazilian media outlets, for example, fact-checked political claims and viral rumors during the election period, using innovative tools such as online apps.

Robust local media play a particularly important role. In the 2024 presidential election of Maia Sandu in Moldova, a new investigative newspaper uncovered a Russia-backed network that paid people to attend anti-Sandu rallies and to vote against the president. That outlet had received training by an expert nonprofit group. It also received free legal advice and human resource management that were critical to its effectiveness.

Neutrality, transparency and systems reform: Amid efforts to sow doubt in elections, increasing transparency and ethical standards can help build awareness and deepen trust.

Various tools, such as codes of conduct that detail ethical standards, can be formulated for candidates, media and businesses. This has been done in Nigeria and the Philippines.

International groups, including the the International Foundation for Electoral Systems, published model commitments for advancing genuine and credible elections in 2024, which have been used for preelection assessments in Bangladesh.

Additionally, major technology companies such as Google and Meta in 2024 helped draft the international Voluntary Election Guidelines for Technology Companies. Meta also helped target false content and deepfakes during Australia’s 2025 election.

The neutrality of election officials is critical to tackle distrust. In New Zealand, high levels of public trust in elections align with robust neutrality rules for public officials. The key is to develop public awareness of such commitments and how they can be useful to hold election officials, media and businesses accountable.

More profoundly, the design of the electoral system can also be linked to levels of public trust and polarization. New Zealand, South Africa and Northern Ireland, for example, reformed from winner-take-all elections to proportional representation elections to address deep internal divisions and dissatisfaction with unrepresentative results.

Broad-based mobilization and civic campaigns: Significant voter turnout that delivers large winning margins make efforts to manipulate results more difficult.

In Zambia, for example, a landslide victory for the opposition candidate in the 2021 presidential elections was driven by high youth turnout and people switching parties in urban areas.

Mobilization efforts can span from public campaigns to digital tools and voter registration and education. These efforts can motivate key groups, such as youth, minority or overseas voters. Participation of diaspora groups in Poland’s 2023 parliamentary elections was a key factor in the opposition’s win.

Proactively building public awareness of election security measures, called prebunking campaigns, has demonstrated results in increasing trust in elections in Brazil and the U.S. Additionally, civic education has shown to have positive impact on voter choice of pro-democracy candidates over their preferred party.

Strategic coalitions and nonpartisan monitoring: Nonpartisan monitoring and observation of an electoral process is a key tool in the electoral assistance tool kit. Effective monitoring often involves coalitions of nonpartisan civic groups, which Senegal has used, and faith-based organizations, as in the Philippines, to ensure adequate coverage of polling stations and consistent application of standards.

Key tools, such as parallel vote tabulation, or “quick counts,” which provide independent and statistically accurate reports on the quality of voting and counting process, have helped verify official election results in Ukraine, Ghana and Paraguay.

International observation by entities such as the Organization for Security and Cooperation in Europe assesses whether elections meet global standards. Where it identifies serious flaws or fraud, such scrutiny can help justify mass protests or mobilization, such as in Serbia’s parliamentary and local elections in 2023, trigger new elections, such as in Bolivia’s general elections in 2019, or support international condemnation, such as in Georgia’s 2024 parliamentary elections. They also make recommendations on reforms, such as changes to elections laws and systems, to strengthen integrity and align with democratic principles.

From May 2023 until July 1, 2025, the author served in the Bureau for Democracy, Human Rights, and Governance at the United States Agency for International Development (U.S.A.I.D.).

– ref. How to prevent elections from being stolen − lessons from around the world for the US – https://theconversation.com/how-to-prevent-elections-from-being-stolen-lessons-from-around-the-world-for-the-us-275390

Source: The Conversation – USA – By Marlo Rossi, PhD Candidate in Public Affairs & Community Development, Rutgers University–Camden, Rutgers University

Representational government rests on a simple idea: that the laws the nation lives under generally reflect what the public wants. In the United States, few issues test that idea more than abortion.

In 2022, the U.S. Supreme Court ruled in Dobbs v. Jackson Women’s Health Organization that the Constitution does not guarantee a right to an abortion. The decision effectively overturned nearly 50 years of federally protected access to the procedure and returned primary authority over abortion policy to states.

Individual states now have the authority to enact permissive or restrictive abortion laws. These vary substantially, from near-total bans on the procedure – such as in Florida or Texas, where abortion is banned except in very limited circumstances – to guarantees of abortion access that are enshrined in state constitutions, including in California and Vermont.

Abortion serves as a clear example of how difficult it can be to translate public opinion into law. It is an issue where public views have remained relatively consistent over time, with the majority of the public supporting abortion rights according to polls. Still, laws have shifted dramatically from state to state and year to year.

As a researcher who studies the relationship between public opinion and state-level policy, I examine whether laws reflect the preferences of the American public. The dichotomy between abortion protections and restrictions suggests that this dynamic is often more complicated than many people might assume.

State legislatures, courts and election methods – and the interplay between them – all influence how public preferences are translated into law. Additionally, lobbying by well-connected interest groups that may represent a minority viewpoint can exert significant pressure on lawmakers, sometimes outweighing the desires of the broader public.

As a result, there is not always a direct line between what a majority of voters might want and the policies that are enacted.

Where public opinion stands

Despite these broad policy differences, public opinion has remained relatively stable around the abortion issue since the 1970s. Sixty-three percent of Americans say abortion should be legal in all or most cases, compared with 36% who say it should be illegal in all or most cases, according to the Pew Research Center. In 34 states and the District of Columbia, more people say abortion should be legal than say it should be illegal.

Even in states with restrictive policies, opinion is often closely divided. In Utah, where abortion is banned after 18 weeks of pregnancy, public opinion is split nearly down the middle.

Support for abortion does vary by religion, age, education level, political views and gender. Eighty-six percent of religiously unaffiliated Americans say abortion should be legal in all or most cases, compared with 25% of white evangelical Protestants, for example.

Similar divides appear across other partisan or demographic groups. About 85% of those who lean Democratic say abortion should be legal in most cases, according to Pew, compared with about 41% of those who lean Republican. Differences also emerge by education, with college graduates more likely to support legal abortion than those without a college degree. More women than men support abortion access, although the difference is relatively minor – 64% of women, 61% of men.

Abortion on the ballot

In response to the 2022 Dobbs decision, voters in multiple states turned to ballot initiatives, mostly to restore or affirm abortion rights. In 2024, voters in 10 states decided on abortion-related measures. Seven states passed measures to protect abortion rights: Arizona, Colorado, Maryland, Missouri,
Montana, Nevada and New York. Measures to enact protections failed in Florida, Nebraska and South Dakota.

Ballot initiatives are one of the few ways Americans can directly shape policy, though the rules for their passage vary by state. Citizen-generated initiatives are only available in about half the states.

In states such as Arizona and California, simple majorities were able to approve their 2024 measures affirming abortion protections. That same year, 57% of Florida voters supported a similar measure to protect abortion access up to 24 weeks of pregnancy, but that did not meet the state’s 60% threshold for passage of initiatives.

Even in states where ballot initiatives have passed, translating voter preferences into policy is not always a straight line. In Missouri, for example, the state Supreme Court in May 2025 allowed preexisting restrictions to remain in effect while legal challenges to a 2024 abortion rights amendment continued. Because that amendment remains part of the state constitution, legislators have placed a new measure on the November 2026 ballot specifically to repeal those protections and reinstate a nearly total ban.

Seen in this context, the abortion issue represents not only a debate about access. It also offers a clear example of how representation works in practice.

The relationship between public opinion and policy is not always direct or immediate, but is shaped by the institutions and processes that define American democracy.

Marlo Rossi 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. Abortion laws show that public policy doesn’t always line up with public opinion – https://theconversation.com/abortion-laws-show-that-public-policy-doesnt-always-line-up-with-public-opinion-274699