Category: The Conversation – USA

Source: The Conversation – USA (3) – By Ana Santos Rutschman, Professor of Law, Villanova University

The Food and Drug Administration has refused to review an application from the biotech company Moderna to approve its mRNA-based flu vaccine.

The agency’s decision, which Moderna announced in a press release on Feb. 10, 2026, is the latest step in efforts by federal health officials under Health and Human Services Secretary Robert F. Kennedy Jr. to disrupt longstanding public health practices relating to vaccine access and approval, as well as to reshape the public’s perception of vaccine safety.

Vaccines based on mRNA came to the forefront in the early days of the COVID-19 pandemic, but researchers are now using the technology to create other vaccines, as well as treatments for diseases such as cancer and autoimmune disorders. The Nobel Prize-winning technology may be especially promising for flu because vaccines can be developed rapidly each season to match mutating influenza strains.

However, Kennedy and other federal health officials, including at the FDA, have expressed particular skepticism toward mRNA-based vaccines, raising safety concerns while providing no credible data on their health risks, and defunding research on their development.

The Conversation asked Ana Santos Rutschman, a Villanova University law professor and vaccine policy expert, to explain the significance of the FDA’s decision and how it fits into the rapidly changing landscape of public health policy.

What exactly did the FDA do, and why is it unusual?

In December 2025, Moderna submitted an application to the FDA to approve an mRNA flu vaccine for adults age 50 and older. The vaccine had been tested in clinical trials including more than 40,000 people. In response to the application, the agency sent Moderna a “refusal-to-file” letter, dated Feb. 3, 2026. This is a type of notice the regulator sends to companies when it deems a new drug or vaccine’s application to be incomplete.

Because companies developing new products meet with the FDA early in the process to agree on requirements for approval, it’s rare for the agency to take this action. What’s more, there have been very few occasions in which the FDA has diverged significantly from other major drug regulators around the world. But in this case, drug regulators in Canada, Europe and Australia accepted Moderna’s application for review.

Especially concerning is that several FDA scientists and other staff have confirmed that they expected to review Moderna’s application. The director of the FDA’s Office of Vaccines Research and Review, David Kaslow, wrote a memo recommending it be reviewed. But Vinay Prasad, who directs the center that oversees the vaccine research office, overruled the decision.

Directors rarely overrule agency scientists, especially regarding vaccines. But this is at least the fourth time Prasad has done so since being appointed to the FDA in 2025.

What reasons did the FDA give for its decision?

Moderna took the unusual step of announcing the FDA’s refusal and releasing the agency’s letter. The letter states that Moderna did not conduct an “adequate and well-controlled” study because it had not compared patients receiving its vaccine to patients receiving what the agency claimed to be “the best-available standard of care.”

In the U.S., standard-dose flu vaccines are approved for everyone over 6 months of age, but health authorities recommend that adults over 65 receive a more potent dose. Moderna’s announcement quoted the language the FDA used when approving the company’s clinical trial protocol in 2024. The agency had originally suggested that for people age 65 and older, the company compare the efficacy of its vaccine to the more potent dose. But after reviewing Moderna’s protocol, the FDA deemed the standard vaccine “acceptable.”

Besides the fact that the FDA agreed to the trials Moderna conducted, I believe the agency’s claim that the company didn’t use “the best-available standard of care” is problematic because it does not reflect the legal requirements for vaccine approval. Although this phrase sounds official, it is nowhere to be found in FDA law or guidance for companies developing vaccines.

Instead, FDA law requires a company to provide data from “adequate and well controlled studies” and using standard dose flu vaccines aligns with the requirement because they are widely used across age groups.

Shortly after Moderna announced the refusal, the health news outlet STAT quoted an unnamed FDA official stating that if Moderna were to “show some humility,” the agency might still review the application, but only for people under 65. Imposing this restriction after refusing to review the application has no basis in the law because FDA approves clinical trial parameters early on, in consultation with companies.

From a legal perspective, the FDA’s decision could potentially meet what’s called the “arbitrary and capricious” standard, because the agency seems to have altered its position without a valid reason for that change. If a court makes such a determination, it could invalidate the FDA’s decision. That process, however, would take time.

Does the FDA’s decision reflect a change in vaccine policy?

This is the first time that the FDA has tried to preclude the review of a vaccine for reasons that do not have to do with safety or efficacy. The move, which ties into a broader strategy by federal health officials under Kennedy, signals an escalation in the agency’s efforts to intervene in established procedures for testing vaccines.

In April 2025, Kennedy announced that new vaccines would require additional clinical trials. In November 2025, Prasad released an internal FDA memo claiming that mRNA-based COVID-19 vaccines had killed children. Although he provided no evidence, he said that in response to the alleged deaths, large-scale changes to requirements for vaccine approval were coming.

The FDA’s refusal of Moderna’s application appears to be Prasad’s policy in action.

What might this mean for vaccines going forward?

On a practical level, the fact that the FDA is now articulating requirements that are nowhere to be found in the law creates major uncertainty for companies with pending or upcoming vaccine applications. That’s because manufacturers now have reason to worry that they might invest resources in the lengthy process of developing a vaccine, only to receive similarly unpredictable refusals.

More broadly, with so many areas in vaccine law and policy in turmoil, incentives for vaccine manufacturers to bring vaccines to market are shrinking. In January 2026, even before the flu vaccine refusal, Moderna’s chief executive officer said the company was scaling back on vaccine development .

Finally, the FDA’s move risks fueling further mistrust in vaccines, aligning with a wider push from federal health officials to question long-settled science.

Ana Santos Rutschman 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. FDA rejects Moderna’s mRNA flu vaccine application – for reasons with no basis in the law – https://theconversation.com/fda-rejects-modernas-mrna-flu-vaccine-application-for-reasons-with-no-basis-in-the-law-275771

Source: The Conversation – USA – By Eric Yttri, Associate Professor of Biological Sciences, Carnegie Mellon University

At the Winter Olympics, skiers, bobsledders, speedskaters and many other athletes all have to master one critical moment: when to start. That split second is paramount during competition because when everyone is strong and skilled, a moment of hesitation can separate gold from silver. A competitor who hesitates too much will be left behind – but moving too early will get them disqualified.

Though the circumstances are less intense, this paradox of hesitation applies to daily life. Waiting for the right moment to cross the street, or pausing before deciding whether to answer a call from a number you don’t recognize, are daily examples of hesitation. Importantly, some psychiatric conditions such as obsessive-compulsive disorder are characterized by impulsivity, or a lack of hesitation, while excessive hesitation is a crippling consequence of several anxiety disorders.

As a neuroscientist, I have been working to uncover how the brain decides when to act and when to wait. Recent research from my team and me helps explain why this split-second pause happens, offering insight not only into elite athletic performance, but also how people make everyday decisions when the potential outcome isn’t clear.

We found that the key to hesitation is a response to uncertainty. This could be where a dropped hockey puck will land, when a race starts, or placing your order at a new restaurant.

Hesitation and the brain

To understand how the brain controls hesitation, my colleagues and I designed a simple decision-making task in mice.

The task required the mouse’s brain to interpret signals that were predictably good, predictably bad or – most importantly – uncertain, meaning somewhere in between. Different auditory tones indicated whether a drop of sugar water would soon be delivered, not delivered, or had a 50/50 chance of delivery.

How the mice behaved would not affect the outcome. Nevertheless, mice would still wait longer before licking to see whether a reward had been given in the uncertain scenario. Just like in people, unpredictable situations led to delays in response. This hesitation was not the result of vacillating between options in indecision, but an active and regulated brain process to pause before acting due to environmental uncertainty.

When we examined neural activity associated with the onset of licking, we identified a specific group of neurons that became active only when outcomes were unclear. Those neurons effectively controlled whether the brain should commit to an action or pause to gather more information. The degree to which these neurons were active could predict whether mice would hesitate before making a decision.

To confirm that these neurons played a role in controlling hesitation, we used a technique called optogenetics to briefly turn these brain cells on or off. When we activated the neurons, mice hesitated more. When we silenced them, that hesitation faded and their responses were quicker by several hundred milliseconds, in line with their reactions to predictable situations.

Daily life, disease and downhill racing

Our findings suggest that, rather than a weakness to overcome, hesitation appears to be a fundamental brain feature that helps people and animals navigate an uncertain world and avoid costly mistakes.

Our study also provides insights into the balance of action and inaction in health and disease. The hesitation neurons are located in the basal ganglia, the same part of the brain affected in Parkinson’s disease, OCD and addiction. While researchers must still determine how much overlap or interaction there is between the cells involved in hesitation and those affected in psychiatric disorders, their overlap in circuitry points to possible targets for treatment.

Our next step is to understand how cells controlling hesitation interact with drugs treating ADHD and OCD, conditions where patients can respond impulsively during volatile or uncertain situations.

We also aim to identify which brain areas provide these cells with information about uncertainty – the environmental signal so critical to hesitation. While researchers have found that several parts of an area of the brain called the prefrontal cortex encode uncertainty, it’s unclear how the brain actually makes use of this information, where the rubber meets the road.

Hesitation is not a flaw – it’s a critical feature for navigating an unpredictable world. Whether you’re a figure skater waiting for the perfect moment to launch your jump or just going about your day, the circuitry behind hesitation plays an important role in figuring out the timing to get the action right.

Eric Yttri receives funding from the National Institute of Health and the Binational Science Foundation.

– ref. Hesitation is costly in sports but essential to life – neuroscientists identified its brain circuitry – https://theconversation.com/hesitation-is-costly-in-sports-but-essential-to-life-neuroscientists-identified-its-brain-circuitry-274680

Source: The Conversation – USA (2) – By Eric Hengyu Hu, Research Scientist of Educational Policy, University at Albany, State University of New York

Families with children who have dyslexia have long pushed lawmakers to respond to a pressing concern: Too many young students struggle for years to learn to read, before schools recognize the problem.

In response, nearly every state in the U.S. passed some sort of dyslexia laws over the past decade. Most of these laws encourage or require schools to screen young children for reading difficulties, train teachers in evidence-based reading instruction and provide targeted support to students who show early signs of dyslexia.

Families of children with dyslexia, educators and dyslexia advocacy groups widely praised these laws. If schools could identify dyslexia early and respond with evidence-based instruction, reading outcomes would likely improve and fewer children would fall behind.

But what actually happened after these laws passed?

My colleagues and I examined nearly two decades of national student data to answer this question. The results tell a complicated story.

An undetected problem

Dyslexia is a brain-based learning difference that makes reading words slow and effortful, even when children have typical intelligence and education.

About 5% to 15% of U.S. children experience persistent reading difficulties consistent with dyslexia. Without early support, these difficulties can have long-term academic and emotional consequences.

Before the 2000s, dyslexia was rarely mentioned explicitly in education policy. Students with dyslexia were typically grouped under a broad learning disability category, often without focused instruction or support.

Parent advocacy groups and dyslexia advocacy organizations began pushing lawmakers in the early 2010s to recognize dyslexia in state education policy. They also lobbied for states to require early screening for reading difficulties and to teach reading with rigorous methods backed by scientific research.

Their advocacy coincided with a growing scientific consensus: Early, explicit instruction in phonics and language structure helps struggling readers, including students with dyslexia.

Research and advocacy also highlighted that many children with reading difficulties were not identified until later in elementary school, after years of academic struggle, when gaps in reading skills are harder to correct.

States respond with dyslexia laws

A few states, like Texas and Arkansas, first passed dyslexia laws in the early 2010s. One central goal was to help schools identify dyslexia in students earlier, rather than waiting until these students experience repeated academic failure.

By the late 2010s, most states had adopted some form of dyslexia legislation.

As of 2025, all states except Hawaii have enacted dyslexia legislation.

While the laws shared similar goals of promoting early screening for reading difficulties, improving reading instruction and expanding support for struggling readers, they varied widely in strength, funding and expectations for schools.

My colleagues and I wanted to examine whether the wave of state dyslexia laws that began in the early 2010s was associated with changes in students’ reading outcomes.

Mixed results

We analyzed fourth grade reading assessments from the National Assessment of Educational Progress, often called the nation’s report card, from 2003 to 2022.

We focused on how often students were identified with reading-related learning disabilities and how well those students performed in reading. We compared trends before and after dyslexia laws were enacted across 47 states.

Two findings stood out:

• First, more than half of the states with these new laws showed no significant shift in identifying learning disabilities related to reading. Some states identified more students, some fewer, but there was no consistent national pattern.

• Second, reading achievement among students identified with learning disabilities often declined, rather than improved, after these laws passed in many states, including Alaska, Maine, Massachusetts, New York, Ohio and West Virginia.

Only four states – Arizona, Mississippi, Nevada and Oklahoma – showed significant gains in reading scores on state assessments, with average increases ranging from 3 points in Oklahoma’s case to 10 points in Arizona’s example. Many other states experienced flat trends or declines over the same period.

Passing a law doesn’t equal classroom change

Our findings suggest that dyslexia laws often raised awareness about dyslexia and early reading difficulties without fully changing classroom practices.

Many states, such as Connecticut, Maine, Massachusetts and North Carolina, required early screening for dyslexia – but did not ensure schools had trained staff, for example, on how to conduct this screening.

Even with enough teachers to screen for dyslexia, screening alone does not help students unless it is followed by high-quality instruction and sustained support.

Funding has been another major challenge. Most dyslexia laws were passed without dedicated funding for teacher training or instructional materials, leaving districts to absorb the costs. As a result, implementation has been uneven, with well-funded districts moving faster than others.

Teacher preparation also matters. Teaching reading effectively, especially for students with dyslexia, requires specialized knowledge that many teachers were never taught in their training programs. Without strong professional development and ongoing coaching, new mandates can be difficult to carry out.

Taken together, these factors help explain why dyslexia laws alone have not produced widespread gains.

What distinguishes states that improved

Despite the mixed national picture, students in some states, including Arizona and Mississippi, did better on reading outcomes after their schools adopted dyslexia-related policies. These states shared several features.

First, when young children in these states were flagged as at risk for reading difficulties, schools were expected to provide additional reading instruction – rather than treating screening as an end in itself.

Second, schools in these states invested in practical teacher training, focused on how to teach foundational reading skills – such as phonics and word decoding – that are especially important for students with dyslexia.

Third, these states aligned their dyslexia laws with broader literacy reforms – like using evidence-based reading curricula and providing coaching to teachers – rather than treating dyslexia policy as a stand-alone mandate.

Mississippi is often cited as an example of a state that successfully paired dyslexia policy with a broader overhaul of reading instruction, resulting in a boost in reading achievement scores from 2013 to 2019. This overhaul included more structured reading instruction, teacher training and literacy coaches in schools.

Other states, including Louisiana and Alabama, adopted similar approaches and also saw reading gains for kids with learning disabilities – including dyslexia – after they enacted their dyslexia laws.

The takeaway

Dyslexia laws recognize that struggling young readers deserve early, evidence-based support rather than years of delay. That alone is meaningful progress.

But two decades of national data suggests that legislation by itself is not enough.

If states want dyslexia laws to fulfill their promise, the next step is clear: Move beyond mandates and focus on how schools are supported to carry them out. For children struggling to learn to read, the difference between policy and practice can shape their entire educational future.

Eric Hengyu Hu 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. Nearly every state in the US has dyslexia laws – but our research shows limited change for struggling readers – https://theconversation.com/nearly-every-state-in-the-us-has-dyslexia-laws-but-our-research-shows-limited-change-for-struggling-readers-275202

Source: The Conversation – USA (2) – By Alcina Johnson Sudagar, Research Scientist in Chemistry, Washington University in St. Louis

Concrete is all around you – in the foundation of your home, the bridges you drive over, the sidewalks and buildings of cities. It is often described as the second-most used material by volume on Earth after water.

But the way concrete is made today also makes it a major contributor to climate change.

Portland cement, the key component of concrete, is responsible for about 8% of global greenhouse gas emissions. That’s because it’s made by heating limestone to high temperatures, a process that burns a large amount of fossil fuels for energy and releases carbon dioxide from the limestone in the process.

The good news is that there are alternatives, and they are gaining attention.

Portland cement: A greenhouse gas problem

Cementlike substances have been used in construction for thousands of years. Architects have found evidence of their use in the pyramids of Egypt and the buildings and aqueducts of the Roman Empire.

The Portland cement commonly used in construction today was patented in 1824 by Joseph Aspdin, a British bricklayer.

Modern cement preparation starts with crushing the excavated raw materials limestone and clay and then heating them in a kiln at around 2,650 degrees Fahrenheit (about 1,450 degrees Celsius) to form clinker, a hard, rocklike residue. The clinker is then cooled and ground with gypsum into a fine powder, which is called cement.

About 40% of the carbon dioxide emissions from cement production come from burning fossil fuels to generate the high heat needed to run the kiln. The rest come as the heat converts limestone (calcium carbonate) to lime (calcium oxide), releasing carbon dioxide.

In all, between half a ton and 1 ton of greenhouse gas is released per ton of Portland cement. Cement is a binding agent that, mixed with water, holds aggregate together to create concrete. It makes up about 10% to 15% of the concrete mix by weight.

Alternative technologies can lower emissions

As populations, cities and the need for new infrastructure expand, the use of cement is growing, making it important to find alternatives with lower environmental costs.

Some techniques for reducing carbon dioxide emissions include substituting some of the clinker – the hard residue typically made from limestone – with supplementary materials such as clay, or fly ash and slag from industries. Other methods reduce the amount of cement by mixing in waste sawdust or recycled materials like plastics.

The long-term solution for reducing cement’s emissions, however, is to replace traditional cement completely with alternatives. One option is geopolymers made from earthen clay and industrial wastes.

Geopolymers: A more climate-friendly solution

Geopolymers can be made by mixing claylike materials that are rich in aluminum and silicon minerals with a chemical activator through a process called geopolymerization. The activator transforms the silicon and aluminum into a structure that will look like cement. All of this can happen at room temperature.

The major difference between cement and geopolymer is that cement is mainly made of calcium, whereas geopolymers are made of silicon and aluminum with some possible calcium in their structure.

These geopolymers have been found to possess high strength and durability, including resilience in freeze-thaw cycles and resistance to heat and fire, which are important requirements in construction. Studies have found that some geopolymers can provide comparable if not better strength than traditional cement and, because they don’t require heat the way clinker does, they can be produced with significantly lower greenhouse gas emissions.

Geopolymers can also be produced from a variety of raw materials rich in aluminum and silicon, including earthen clays, fly ash, blast furnace slag, rice husk ash, iron ore wastes and recycled construction brick waste. Geopolymer technology can be adapted depending on the clay or industrial waste locally available in a region.

An added advantage of geopolymers is that changes to the mixture can produce a range of features.

For example, I and my co-researchers at the University of Aveiro in Portugal added a small amount of cork industry waste – the leftovers from creating bottle corks – to clay-based geopolymer and found it could improve the strength of the material by up to twofold. The cork particles filled the spaces in the geopolymer structure, making it denser, which increased the strength.

Similarly, additives such as sisal fibers from the agave plant, recycled plastic and steel fibers can change geopolymer properties. The additives do not participate in the geopolymerization process but act as fillers in the structure.

The structure of geopolymers can also be designed to act as adsorbents, attracting toxic metals in wastewater and capturing and storing radioactive wastes. Specifically, incorporating materials like zeolite that are natural adsorbents in the geopolymer structure can make them useful for such applications as well.

Where geopolymers are used now

Geopolymers have been used in many types of construction, including roads, coatings, 3D printing, coastal environmental protection, the steel and chemical industries, sewer rehabilitation and building radiation shielding and rocket launchpad and bunker infrastructure.

One of the earliest examples of a modern geopolymer concrete project was the Brisbane West Wellcamp airport in Australia.

It was built in 2014 with 70,000 metric tons of geopolymer concrete, which was estimated to have reduced the project’s carbon dioxide emissions by as much as 80%.

The geopolymer market is currently estimated to be between US$7 billion and $10 billion, with the largest growth in the Asia-Pacific region.

Analysts have estimated that the market could grow at a rate of 10% to 20% per year and reach about $62 billion by 2033.

In several countries, greenhouse gas regulations and green-building certifications are expected to support the continued growth of geopolymers in the construction industry.

Expanding the use of cement alternatives

The advantage of using industrial wastes in geopolymers is a double-edged sword, however. The composition of industrial wastes varies, so it can be difficult to standardize the processing methods. The geopolymer components need to be mixed in particular ratios to achieve desired properties.

Producing the activator for the geopolymer, typically done in chemical facilities, can raise the cost and contribute to the carbon footprint. And the long-term data about these materials’ stability is only now being developed given their newness. Also, these geopolymers can take longer to set than cement, though the setting time can be sped up by using raw materials that react quickly.

Developing cheaper, naturally available activators like agricultural waste rice husk with sustainable supply chains could help lower the costs and environmental impact. Also, printing the recipe on the raw material packaging could help simplify the job of determining the mixing ratio so geopolymers can be more widely used with confidence.

Even though geopolymer technology has some drawbacks, these low-carbon alternatives have great potential for reducing emissions from the construction sector.

Alcina Johnson Sudagar has received funding from GeoBioTec.

– ref. Polymers from earth can make cement more climate-friendly – https://theconversation.com/polymers-from-earth-can-make-cement-more-climate-friendly-270354

Source: The Conversation – USA (3) – By Emma Fenske, DO, Addiction Medicine Fellow and Internal Medicine Physician, Oregon Health & Science University

Addiction is one of the most common and consequential chronic medical conditions in the United States. Nationwide, more than 46 million people met the criteria for a substance abuse disorder as of 2021, the most recent data available.

Decades of evidence show that addiction is a chronic, relapsing disease of the brain. Nonetheless, there’s still widespread public misunderstanding of what constitutes “treatment” for addiction, not to mention heavy stigma associated with it.

Many patients, families and even health care systems view entering a detoxification or medically managed withdrawal unit as the primary step in recovery. Sometimes, this first step is considered all that is needed. As a physician and fellow in addiction medicine, I know firsthand that this common perception is wrong, and that it perpetuates misinformation about evidence-based treatment.

Centers that provide medically managed withdrawal are designed to stabilize patients in crisis, safely manage acute withdrawal and interrupt dangerous use patterns. However, the idea that “getting through detox” equates to recovery has taken hold over the past several years. This belief appears to be rooted in outdated models of addiction, public misunderstanding and media portrayals that frame addiction as solely a problem of physical dependence.

Detox is a starting point, not a treatment plan

It is not uncommon for patients to show up for medically managed withdrawal, more commonly known as “detox,” without a post-discharge plan. “I haven’t thought that far,” “I just want to get through this,” or “I am getting treatment now, aren’t I?” are some of the responses I frequently hear.

However, this first step is only the start of recovery. Detoxification from alcohol or benzodiazapines – drugs commonly known as “benzos,” such as Xanax, Ativan or Valium – can be dangerous or even deadly if it’s not managed in a medical setting. While detox is often necessary to safely get someone through withdrawal, it only addresses short-term physical symptoms, not the underlying addiction – nor does it address the factors that drive people to use alcohol and drugs problematically.

Addiction has causes that are neurobiological, psychological and structural. Treating these drivers is as important as managing the initial withdrawal. Medically managed withdrawal does not restore neurochemical imbalances, provide long-term relapse prevention strategies or help patients manage ongoing life stressors or triggers as they arise.

In a 2023 study of adults with opioid use disorder, relapse rates six months after treatment were highest among individuals who received only short-term inpatient treatment, with 77% of these patients returning to use. Relapse rates were significantly lower among those who remained in inpatient care for a longer duration or who transitioned to outpatient treatment following short-term inpatient treatment.

When people were also treated with a long-acting form of an opioid-blocking medication called naltrexone, relapse rates dropped across all settings — to 59% after short-term inpatient care, 46% after long-term inpatient care and 38% for those treated as outpatients. These results highlight that brief detoxification without ongoing care is often not enough to support lasting recovery.

However, many centers that provide medically managed withdrawal face clinical, regulatory and financial constraints. As a result, they often have limited resources and can only admit patients for as few as three to five days. In these circumstances, the centers work mainly to stabilize acute withdrawal symptoms rather than to home in on underlying factors that may drive substance use and possible return to use.

Why addiction doesn’t end after withdrawal

Addiction is a chronic, occasionally relapsing condition. It disrupts three interconnected systems in the brain:

– the reward pathway, in which dopamine, a neurotransmitter, works on pleasure centers of the brain;

– stress centers in the amygdala, the part of the brain that processes emotions such as fear, aggression and anxiety; and

– motivation and control systems in the prefrontal cortex, which manage higher-level executive functions like planning and problem-solving.

When individuals repeatedly use substances like alcohol or drugs, they may discover that things they once found rewarding or joyful no longer can compete on the same scale. This often leads to increased stress and impaired self-control. Their body reduces the number of dopamine receptors – sites in the brain that bind dopamine – as a result, causing previously motivating and joyous activities to seem bleak.

This was what had happened to a patient who told me: “After meth, everything was messed up and nothing brought me joy.” At first, using methamphetamine creates a “high,” or euphoria; over time, though, individuals use it simply to avoid being sick. The substance that once was euphoric becomes a proverbial ball and chain.

These neurobiological changes do not happen overnight, and neither does recovery. It is unrealistic to expect that a typical admission for medically managed withdrawal, which may only span three to five days, will heal patients’ damaged circuits.

Furthermore, some symptoms, such as anxiety, mood changes, trouble sleeping and overall discontentment with life, can persist for three to six months or more following the initial withdrawal period. Cravings, which are intense psychological urges, often arise without warning. When this happens, having recovery support systems in place, such as a sponsor, mental health professional or relapse prevention plan, can be crucial.

Addiction often is rooted in exacerbating factors like anxiety, depression, trauma, chronic stress and pain. For example, chronic pain from a past injury can often lead to misuse of prescription opioids, which later may evolve into using other substances like heroin or fentanyl.

Patients with substance use disorders have often relied on substances as their escape lever from these deeper problems, rather than developing healthier coping mechanisms. All they have known in times of suffering is their drug of choice.

It often requires months or years to develop new ways of thinking, emotional regulation, habits and trauma responses after leaving a history of substance use behind. Learning to live substance-free and unaltered can be a new and terrifying concept.

Treatment after detox

If medically managed withdrawal is just the first step, what should come next? Patients may confer with their doctors and choose to start medication-assisted therapy, which helps prevent cravings and withdrawal as they address deeper issues through mental health treatments such as cognitive behavioral therapy. Opioid use disorder is treated with medications like buprenorphine or methadone, while alcohol use disorder medications include naltrexone, acamprosate or disulfiram.

These medications are at least as effective as many standard treatments in medicine, and I believe they should be considered when appropriate. Medications for alcohol use disorder have proved to be effective at reducing risk of death and hospitalizations, but these medications are often underutilized.

Treating substance use disorders is like managing diabetes, high blood pressure or other chronic health conditions. Even after patients are out of imminent crisis, the work is ongoing.

Emma Fenske, DO 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. Addiction affects your brain as well as your body – that’s why detoxing is just the first stage of recovery – https://theconversation.com/addiction-affects-your-brain-as-well-as-your-body-thats-why-detoxing-is-just-the-first-stage-of-recovery-270784

Source: The Conversation – USA – By John J. Martin, Assistant Professor of Law, Quinnipiac University

The Republican-led House of Representatives voted Feb. 11, 2026 to approve the Safeguard American Voter Eligibility Act – or SAVE America Act. The bill would require individuals to provide proof of citizenship when they register to vote and present photo identification when they do vote in federal elections.

This marks the third year in a row that the House has passed similar legislation. Passage in the Senate, which would require Democratic votes, continues to appear unlikely. But Republicans from President Donald Trump on down are clearly interested in finding ways to enhance election security – although critics contend the SAVE America Act would unfairly disenfranchise millions of citizens.

The SAVE America Act would require anyone registering to vote in federal elections to first “provide documentary proof of U.S. citizenship” in person, such as a passport or birth certificate. The new version goes further than its predecessor by requiring many individuals voting in federal elections to present photo identification at the polls indicating proof of U.S. citizenship.

Voting rights experts and advocacy organizations have detailed how the legislation could suppress voting. In part, they say it would particularly create barriers in low-income and minority communities. People in such communities often lack the forms of ID acceptable under the SAVE America Act for a variety of reasons, including socioeconomic factors.

As of now, at least 9% of voting-age American citizens – approximately 21 million people – do not even have driver’s licenses, let alone proof of citizenship. In spite of this, many legislators support the bill as a means of eliminating noncitizen voting in elections.

As a legal scholar who studies, among other things, foreign interference in elections, I find considerations about the potential effects of the SAVE America Act important, especially given how rare it is that a noncitizen actually votes in federal elections.

Yet, it is equally crucial to consider a more fundamental question: Is the SAVE America Act even constitutional?

How the SAVE America Act could change voting requirements

The SAVE America Act would forbid state election officials from registering an individual to vote in federal elections unless this person “provides documentary proof of United States citizenship.” Furthermore, it would forbid individuals from voting unless they bring such proof to the polls each time they vote, unless their state agrees to submit voter registration lists to the U.S. Department of Homeland Security on a quarterly basis.

Acceptable forms of proof for voter registration would include a REAL ID that demonstrates U.S. citizenship – most of which do not – as well as a U.S. passport or a U.S. military identification card.

So – should the SAVE America Act become law – if a person turns 18 or moves between states and wishes to register to vote in federal elections in their new home, they would likely be turned away if they do not have any such documents readily available. At best, they could still fill out a registration form, but they would need to mail in acceptable proof of citizenship.

For married people with changed last names, among others, questions remain about whether birth certificates could even count as acceptable proof of citizenship for them.

The Constitution says little about voting rights

Despite the national conversation the SAVE America Act has sparked, it is unclear whether Congress even has the power to enact it. This is the key constitutional question.

The U.S. Constitution imposes no citizenship requirement when it comes to voting. The original text of the Constitution, in fact, said very little about the right to vote. It was not until legislators passed subsequent amendments, starting after the Civil War up through the 1970s, that the Constitution even explicitly prohibited voting laws that discriminate on account of race, sex or age.

Aside from these amendments, the Constitution is largely silent about who gets to vote.

Who, then, gets to decide whether someone is qualified to vote? No matter the election, the answer is always the same – the states.

Indeed, by constitutional design, the states are tasked with setting voter-eligibility requirements – a product of our federalist system. For state and local elections, the 10th Amendment grants states the power to regulate their internal elections as they see fit.

States also get to decide who may vote in federal elections, which include presidential and congressional elections.

When it comes to presidential elections, for instance, states have – as I have previously written – exclusive power under the Constitution’s electors clause to decide how to conduct presidential elections within their borders, including who gets to vote in them.

The states wield similar authority for congressional elections. Namely, according to Article 1 of the Constitution and the Constitution’s 17th Amendment, if someone can vote in their state’s legislative elections, they are entitled to vote in its congressional elections, too.

Conversely, the Constitution provides Congress zero authority to govern voter-eligibility requirements in federal elections. Indeed, in the U.S. Supreme Court’s 2013 ruling on the Arizona v. Inter Tribal Council case, the court asserted that nothing in the Constitution “lends itself to the view that voting qualifications in federal elections are to be set by Congress.”

Is the SAVE America Act constitutional?

The SAVE America Act presents a constitutional dilemma. By requiring individuals to show documentary proof of U.S. citizenship to vote, the SAVE America Act is implicitly saying that someone must be a U.S. citizen to vote in federal elections.

In other words, Congress would be instituting a qualification to vote, a power that the Constitution leaves exclusively to the states.

Indeed, while all states currently limit voting rights to citizens, legal noncitizen voting is not without precedent. As multiple scholars have noted, at least 19 states extended voting rights to free male “inhabitants,” including noncitizens, starting from our country’s founding up to and throughout the 19th century.

Today, over 20 municipalities across the country, as well as the District of Columbia, allow permanent noncitizen residents to vote in local elections.

Any state these days could similarly extend the right to vote in state and federal elections to permanent noncitizen residents. This is within their constitutional prerogative. And if this were to happen, there could be a conflict between that state’s voter-eligibility laws and the SAVE America Act.

Normally, when state and federal laws conflict, the Constitution’s supremacy clause mandates that federal law prevails.

Yet, in this instance, where Congress has no actual authority to implement voter qualifications, the SAVE America Act would seem to have no constitutional leg on which to stand.

Reconciling the SAVE America Act with the Constitution

So, why have 108 U.S. representatives sponsored a bill that likely exceeds Congress’ powers?

Politics, of course, plays some role here. Namely, noncitizen voting is a major concern among Republican politicians and voters. Every SAVE America Act co-sponsor is Republican, as were all but four of the 220 U.S. representatives who voted to pass the SAVE Act in April 2025.

When it comes to the constitutionality of the SAVE America Act, though, proponents simply assert that Congress is acting within its purview.

Specifically, many proponents have cited the Constitution’s elections clause, which gives Congress the power to regulate the “Times, Places and Manner” of congressional elections, as support for that assertion. Utah Sen. Mike Lee, for example, explicitly referenced the elections clause when defending the SAVE Act earlier in 2025.

But the elections clause only grants Congress authority to regulate election procedures, not voter qualifications. The Supreme Court explicitly stated this in the Inter Tribal Council ruling.

Congress can, for instance, require states to adopt a uniform federal voter registration form and even include a citizenship question on said form. What it cannot do, however, is implement a nonnegotiable mandate that effectively tells the states they can never allow any noncitizen to vote in a federal election.

For now, the SAVE America Act is simply legislation. Should the Senate pass it, Trump will almost assuredly sign it into law, given, among other factors, his recent call for Republicans to nationalize elections. If and when that happens, the courts would have to reckon with the SAVE America Act’s legitimacy within the country’s constitutional design.

This is an update of an article originally published on April 22, 2025.

John J. Martin 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. Citizenship voting requirement in SAVE America Act has no basis in the Constitution – and ignores precedent that only states decide who gets to vote – https://theconversation.com/citizenship-voting-requirement-in-save-america-act-has-no-basis-in-the-constitution-and-ignores-precedent-that-only-states-decide-who-gets-to-vote-275658

Source: The Conversation – USA – By Pawan Dhingra, Professor of U.S. Immigration Studies, Amherst College

Stephen Miller’s January 2026 announcement to Immigration and Customs Enforcement officers – telling them that they have “immunity to perform your duties” and that no “illegal alien, no leftist agitator or domestic insurrectionist” can stop them – may seem like an extreme statement outside the political mainstream.

And when ICE agents use facial recognition software to monitor immigrants and protesters, that might seem like an unacceptable invasion of people’s privacy.

While extreme, these cases are not too unexpected. Both Miller’s statements and ICE’s monitoring extend from the framework of immigration enforcement that grew from the Sept. 11, 2001, terrorist attacks.

Immigration enforcement was reorganized and reframed after 9/11, particularly through the creation of ICE and the Department of Homeland Security.

As a scholar of immigration in the U.S., I find that the growth of extreme immigration enforcement, both at the border and across the country, results from this change 25 years ago.

From criminality to terrorism

In November 2002, the Homeland Security Act created DHS. The founding of ICE followed a few months later. As the agency notes, it was part of “the single-largest government reorganization since the creation of the Department of Defense.” Immigration enforcement was folded into a national security priority whose primary purpose was to defend “homeland security.”

The notion of immigrants as potential criminals was widespread well before the creation DHS.

In 1996, for example, President Bill Clinton signed the Illegal Immigration Reform and Immigration Responsibility Act. That law expanded the number of offenses that could result in automatic deportation, including of legal residents. The act also limited judicial review of deportation cases, while the very title of the law framed people in the U.S. without legal status as lawbreaking criminals.

But after 9/11, the connection between immigration and law enforcement intensified and took on a new dimension: counterterrorism. Immigration was no longer treated as a civil issue in which immigrants were deported if found through a civil court to have violated the law.

Instead, immigrants were evaluated as possible threats to the country.

Immigration trials, such as for overstaying visas, increasingly took place in closed hearings, with the government’s secret evidence not shared with the accused. Those arrested for crossing the border illegally were imprisoned and faced [criminal prosecutions]. Expedited deportations took place at the border and across the country, even for immigrants who had been in the U.S. for years.

Further federal government practices connected immigrants to terrorism. The National Security Entry-Exit Registration System or NSEERS, introduced in 2002, required immigrant men from 25 countries – almost entirely in the Middle East, South Asia and North Africa – to register with the federal government after already residing in the country. It was framed as an effort to defend homeland security, and hundreds of people who had overstayed their visas for less than a month were detained.

United Nations human rights experts later criticized NSEERS for racial and religious profiling. Of the approximately 80,000 people registered, not a single terrorism prosecution resulted. About 14,000 were placed in deportation proceedings for visa irregularities, none for terrorism-related activity.

DHS suspended NSEERS in 2011, and it was terminated in 2016.

Lessons learned from 9/11

If the purpose of NSEERS was to identify terrorists, it failed.

But it succeeded in treating immigrants as potential terrorists. That connection has intensified since.

Federal government investment in facial recognition technology grew substantially after 9/11 with bipartisan support. The goal was to identify possible terrorists in American airports and cities.

Today, facial recognition has become a common tactic used by ICE officers to identify not just immigrants for potential detention but also citizen observers.

Additionally, privately owned detention centers grew in response to the mass arrests of immigrants. Treatment of immigrants at these centers, according to human rights advocates, has included “abuse, solitary confinement, and medical neglect.” For years, ICE detention centers have been criticized for similar conditions.

Programs like NSEERS produced fear and led to what policymakers have called self-deportation, where immigrants voluntarily leave the U.S. Today, self-deportation has become a government-endorsed program.

Research also shows that heightened immigration enforcement after 9/11 led many immigrants, even those with legal status, to withdraw from public life, avoiding schools, hospitals and work. ICE today produces the same kinds of fear.

Going beyond technical reforms

The immigration enforcement response to 9/11 set the stage on which Miller’s language and the collection of everyday Americans’ data become viable.

Under this way of thinking, if the homeland is under threat, then those who challenge immigration enforcement are “domestic terrorists.” Investigations into ICE officers are muted, for the officers are protecting the homeland against existential danger. Severe tactics to detain immigrants and condemn protesters become not only permissible but also advisable, according to advocates.

Perhaps technical reforms, such as requiring ICE agents to use body cameras or requiring ICE agents to have judicial warrants before entering homes, may limit some abuses.

But these measures do not address the underlying premise since 9/11 that immigration has become primarily viewed as a national security threat.

Pawan Dhingra 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 the 9/11 terrorist attacks shaped ICE’s immigration strategy – https://theconversation.com/how-the-9-11-terrorist-attacks-shaped-ices-immigration-strategy-275313

Source: The Conversation – USA – By Filippo Menczer, Professor of Informatics and Computer Science, Indiana University

In mid-2023, around the time Elon Musk rebranded Twitter as X but before he discontinued free academic access to the platform’s data, my colleagues and I looked for signs of social bot accounts posting content generated by artificial intelligence. Social bots are AI software that produce content and interact with people on social media. We uncovered a network of over a thousand bots involved in crypto scams. We dubbed this the “fox8” botnet after one of the fake news websites it was designed to amplify.

We were able to identify these accounts because the coders were a bit sloppy: They did not catch occasional posts with self-revealing text generated by ChatGPT, such as when the AI model refused to comply with prompts that violated its terms. The most common self-revealing response was “I’m sorry, but I cannot comply with this request as it violates OpenAI’s Content Policy on generating harmful or inappropriate content. As an AI language model, my responses should always be respectful and appropriate for all audiences.”

We believe fox8 was only the tip of the iceberg because better coders can filter out self-revealing posts or use open-source AI models fine-tuned to remove ethical guardrails.

The fox8 bots created fake engagement with each other and with human accounts through realistic back-and-forth discussions and retweets. In this way, they tricked X’s recommendation algorithm into amplifying exposure to their posts and accumulated significant numbers of followers and influence.

Such a level of coordination among inauthentic online agents was unprecedented – AI models had been weaponized to give rise to a new generation of social agents, much more sophisticated than earlier social bots. Machine-learning tools to detect social bots, like our own Botometer, were unable to discriminate between these AI agents and human accounts in the wild. Even AI models trained to detect AI-generated content failed.

Bots in the era of generative AI

Fast-forward a few years: Today, people and organizations with malicious intent have access to more powerful AI language models – including open-source ones – while social media platforms have relaxed or eliminated moderation efforts. They even provide financial incentives for engaging content, irrespective of whether it’s real or AI-generated. This is a perfect storm for foreign and domestic influence operations targeting democratic elections. For example, an AI-controlled bot swarm could create the false impression of widespread, bipartisan opposition to a political candidate.

The current U.S. administration has dismantled federal programs that combat such hostile campaigns and defunded research efforts to study them. Researchers no longer have access to the platform data that would make it possible to detect and monitor these kinds of online manipulation.

I am part of an interdisciplinary team of computer science, AI, cybersecurity, psychology, social science, journalism and policy researchers who have sounded the alarm about the threat of malicious AI swarms. We believe that current AI technology allows organizations with malicious intent to deploy large numbers of autonomous, adaptive, coordinated agents to multiple social media platforms. These agents enable influence operations that are far more scalable, sophisticated and adaptive than simple scripted misinformation campaigns.

Rather than generating identical posts or obvious spam, AI agents can generate varied, credible content at a large scale. The swarms can send people messages tailored to their individual preferences and to the context of their online conversations. The swarms can tailor tone, style and content to respond dynamically to human interaction and platform signals such as numbers of likes or views.

Synthetic consensus

In a study my colleagues and I conducted last year, we used a social media model to simulate swarms of inauthentic social media accounts using different tactics to influence a target online community. One tactic was by far the most effective: infiltration. Once an online group is infiltrated, malicious AI swarms can create the illusion of broad public agreement around the narratives they are programmed to promote. This exploits a psychological phenomenon known as social proof: Humans are naturally inclined to believe something if they perceive that “everyone is saying it.”

Such social media astroturf tactics have been around for many years, but malicious AI swarms can effectively create believable interactions with targeted human users at a large scale, and get those users to follow the inauthentic accounts. For example, agents can talk about the latest game to a sports fan and about current events to a news junkie. They can generate language that resonates with the interests and opinions of their targets.

Even if individual claims are debunked, the persistent chorus of independent-sounding voices can make radical ideas seem mainstream and amplify negative feelings toward “others.” Manufactured synthetic consensus is a very real threat to the public sphere, the mechanisms democratic societies use to form shared beliefs, make decisions and trust public discourse. If citizens cannot reliably distinguish between genuine public opinion and algorithmically generated simulation of unanimity, democratic decision-making could be severely compromised.

Mitigating the risks

Unfortunately, there is not a single fix. Regulation granting researchers access to platform data would be a first step. Understanding how swarms behave collectively would be essential to anticipate risks. Detecting coordinated behavior is a key challenge. Unlike simple copy-and-paste bots, malicious swarms produce varied output that resembles normal human interaction, making detection much more difficult.

In our lab, we design methods to detect patterns of coordinated behavior that deviate from normal human interaction. Even if agents look different from each other, their underlying objectives often reveal patterns in timing, network movement and narrative trajectory that are unlikely to occur naturally.

Social media platforms could use such methods. I believe that AI and social media platforms should also more aggressively adopt standards to apply watermarks to AI-generated content and recognize and label such content. Finally, restricting the monetization of inauthentic engagement would reduce the financial incentives for influence operations and other malicious groups to use synthetic consensus.

The threat is real

While these measures might mitigate the systemic risks of malicious AI swarms before they become entrenched in political and social systems worldwide, the current political landscape in the U.S. seems to be moving in the opposite direction. The Trump administration has aimed to reduce AI and social media regulation and is instead favoring rapid deployment of AI models over safety.

The threat of malicious AI swarms is no longer theoretical: Our evidence suggests these tactics are already being deployed. I believe that policymakers and technologists should increase the cost, risk and visibility of such manipulation.

Filippo Menczer receives funding from Knight Foundation, National Science Foundation, Swiss National Science Foundation, and Air Force Office of Scientific Research.

– ref. Swarms of AI bots can sway people’s beliefs – threatening democracy – https://theconversation.com/swarms-of-ai-bots-can-sway-peoples-beliefs-threatening-democracy-274778

Source: The Conversation – USA (3) – By Tucker J. Gregor, Doctoral Candidate in Religious Studies, University of Iowa

Love and hate seem like obvious opposites. Love, whether romantic or otherwise, involves a sense of warmth and affection for others. Hate involves feelings of disdain. Love builds up, whereas hate destroys.

However, this description of love and hate treats them as merely emotions. As a religious ethicist, I am interested in the role love plays in our moral lives: how and why it can help us live well together. How does our understanding of the love-hate relationship change if we imagine love not as an emotion but as a virtue?

The 13th-century theologian Thomas Aquinas is a foundational thinker in the history of Christian ethics. For Aquinas, hate is not the antithesis of love, or even opposed to it. In his most important work, the “Summa Theologiae,” he writes that hate responds to love. In other words, hate is a reaction to threats against what we love, or what we deeply value. We can better understand the experience of hate by getting clear on what it means to love.

Greek roots

Today, scientists know that feelings of love are related to biochemical processes that release chemicals in the brain, increasing pleasure and excitement. Beyond mere biology or even emotions, some philosophers and psychologists contend that love is also a practice.

Love can also refer to a virtue: a habit or settled disposition that increases the likelihood of people thinking, feeling and acting in ways that promote happiness and well-being. For example, the virtue of courage can help people endure and thrive in the midst of fear and uncertainty.

The concept of virtue is as old as philosophy itself. In the “Republic,” written in the fourth century B.C.E., Plato distinguishes between virtue in general and the individual virtues that he believes characterize well-being, such as wisdom, courage, moderation and justice.

Love is not among them. Instead, he associates love – for which he used the Greek word “eros” – with feelings of physical desire.

It was Aristotle, one of Plato’s students, who inched love closer toward virtue. In Aristotle’s “Nicomachaen Ethics,” he writes that virtue involves learning how to act and feel “at the right times, about the right things, toward the right people, for the right end, and in the right way.” The individual virtues are cultivated over time through repetition.

For an act to be virtuous, one must consciously and deliberately act for the sake of some moral value. For example, Aristotle states that a generous person does good by giving wealth to the right people. Someone who spends with the aim of receiving some benefit in return merely appears generous. The person’s character and the spirit in which they give matters.

The virtuous life isn’t easy – but true friends can help. Aristotle believed that relationships of mutual respect and concern can empower us to develop virtues. Unlike friendships that are situational or superficial, these deeper connections are characterized by “philia,” a kind of love. Friendships based in philia are virtuous: They involve mutual accountability and concern for each other, as if each person were an extension of oneself.

Aquinas’ take

The Christian moral tradition builds and elaborates on these Greek foundations. For Christian theologians and moral philosophers, love can refer to an emotion, an affection, a duty and, yes, a virtue.

Aquinas considers virtue to be a stable disposition of the will – our capacity to choose – that contributes to a well-lived life. Individual virtues are good habits that influence how we relate to ourselves and other people in our daily lives, including love.

He also considers love to be a theological virtue – a gift of God’s grace that people can choose to embrace or reject. “Caritas,” or “charity” in Latin, is defined as friendship with God. Aquinas writes that it has a social benefit, too: Caritas inclines people toward treating their fellow humans with kindness, acting to advance others’ well-being.

The other types of love, eros and philia, are subjective. They respond to our perception of value in other people and things. Caritas creates value in other people, whether or not we are able to see it.

Love and hate

How can approaching love as a virtue – rather than an emotion, affection or biochemical reaction – help us understand feelings of hatred?

From Aquinas’ perspective, the feeling of hate is dependent on and conditioned by the people and things that we love, or that we consider good for ourselves and other people, whether that’s a sports team, a movie or an ideology.

Yet if we take love to be a virtue – a daily habit that we choose to guide our practices – then we can exercise a degree of control over how we respond to feelings of hatred.

Consider how much hate there is in politics, such as hatred of a particular policy, politician or belief – or hatred of injustice itself. But at root, perhaps that hate is a response to love; for example, love for one’s neighbors, one’s country or one’s ideals. Recognizing that possibility can help us respond with a loving choice, like peaceful protest, as a way to advocate for rights. By cultivating the virtue of love, people are more likely to engage in practices of care and empathy necessary for communities to thrive.

Distinguishing between feelings of love, practices of love and the virtue of love can empower us to respond to feelings of hatred. Becoming better lovers requires engaging with destructive emotions, rather than running from them.

Tucker J. Gregor 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. More than a feeling – thinking about love as a virtue can change how we respond to hate – https://theconversation.com/more-than-a-feeling-thinking-about-love-as-a-virtue-can-change-how-we-respond-to-hate-272330

Source: The Conversation – USA (3) – By Tim Swift, Professor of Management, St. Joseph’s University

For the past decade I have volunteered at St. Francis Inn, a soup kitchen in the Kensington neighborhood of Philadelphia.

Kensington, for those not from Philly, has long had a reputation for potent but affordable street drugs. Interstate 95 and the Market-Frankford elevated commuter train line provide easy access to the neighborhood for buyers and sellers, and abandoned buildings offer havens for drug use and other illicit activity.

St. Francis Inn Ministries, which was founded by two Franciscan friars in 1979, serves sit-down breakfast and dinner for thousands of people each year, many of whom suffer from poverty, homelessness and substance use disorder. It also runs Marie’s Closet, a charity that provides free used clothing and housewares.

These ministries are operated by a core team of nine full-time members, hundreds of volunteers from local high schools and colleges, and an ad hoc team of folks from many walks of life.

In the years I’ve been volunteering at St. Francis, significant changes have occurred in Kensington, including gentrification, soaring housing prices and increased police activity. Such changes can make it harder for people who suffer from poverty and homelessness to remain in the neighborhood.

Around 2018, the number of guests visiting St. Francis Inn was already dwindling noticeably. I heard volunteers speculate on whether St. Francis Inn should relocate further north in Philadelphia where there are more people in need. Others wondered whether St. Francis Inn should create a mobile unit that traveled to people in need wherever they may be.

As I listened, I realized that this was a business decision. As a professor of management at St. Joseph’s University in Philadelphia, I decided to present this decision to the students in my Management Honors Capstone Seminar. In January 2026 I published a business case study titled “Dealing with Change in Kensington, Philadelphia: The Case of Saint Francis Inn.”

An interesting business case

The capstone seminar I teach is the second of two strategic management courses that honors business students take in their senior year. Using the Harvard case study method, students identify the critical issues embedded in a variety of cases and find the information needed to evaluate those issues using seminal theories in strategic management.

Students then propose a solution – a hypothesis they believe best addresses the situation. They test whether that solution works by building a plan of action – called a “proof” – that provides logic and evidence that their solution would work.

Part of what I believe makes this case study interesting is that it involves some of the most vulnerable people in Philadelphia. I felt it was important to give students the opportunity to consider important issues of social justice when applying their business decision-making skills.

Morally sound recommendations

Among other material, the course covers two different perspectives that students can use to make informed decisions and propose solutions for St. Francis Inn.

The first is the resource-based view. Using this framework, students identify the unique resources and capabilities that a firm – in this case, St. Francis Inn – has built over the years. Then they determine how to use those resources and capabilities best to carry out the firm’s mission.

St. Francis Inn’s mission is to live among and serve the poor, following the example of St. Francis of Assisi. The organization has built decades-long relationships with food companies – which share leftover meat, vegetables and other products with the inn – as well as with members of the community in Kensington. In addition, they have developed a network of hundreds of well-trained and motivated volunteer workers throughout Philadelphia and, indeed, the entire country.

The second framework that students are expected to use is “formal moral theory,” which provides a set of different theories for determining moral rules. It enables us to make ethical decisions that are structured, rational and logical.

For example, using “utilitarianism,” students quantify all of the costs and benefits of a decision and choose the option that provides the largest net benefit – or utility – to society. “Rights theory” requires students to make decisions that respect the intrinsic dignity of all persons. Students can use these theories to make morally sound recommendations on how St. Francis Inn can best serve the stakeholders in its community.

Perhaps the most obvious people affected by St. Francis Inn are the people living in the neighborhood who struggle with homelessness and substance use disorder and receive food and other assistance there. Other groups of concern include longtime neighbors who have homes nearby but still live in poverty, new residents moving into the neighborhood, local property developers who generally want to see fewer homeless people in the neighborhood, and city officials who are responsible for various government functions. These include police and emergency medical services, city council members and social services organizations.

Students must answer a two-dimensional question: Given what St. Francis Inn does best, how can it best address the needs of its most important stakeholders?

Since they are business majors, many quickly gravitate to logical business decisions that St. Francis Inn can make, such as continuing its operation where it is, relocating, or creating a mobile service. Without fail, there are students each semester who argue that regardless of what’s “best” for St. Francis Inn, the interests of the various people of concern in the neighborhood must be respected. To be honest, I enjoy watching them grapple with this problem with sincerity and care.

Here, students must balance an organization’s core competencies with the moral impact of its decisions, while prioritizing the rights and needs of diverse, nontraditional groups who have a stake in this decision. That’s a valuable skill for any future – or, for that matter, current – business executive.

Read more of our stories about Philadelphia and Pennsylvania, or sign up for our Philadelphia newsletter on Substack.

Tim Swift received funding from the Villanova University Center for Church Management to write this case study in 2022.

– ref. How business students learn to make ethical decisions by studying a soup kitchen in one of America’s toughest neighborhoods – https://theconversation.com/how-business-students-learn-to-make-ethical-decisions-by-studying-a-soup-kitchen-in-one-of-americas-toughest-neighborhoods-274508