Category: The Conversation – USA

Source: The Conversation – USA (2) – By Sean Cho Ayres, Assistant Professor of English – AI Writing, Kennesaw State University

It’s week one of the semester, the first day of class: 20 students, mostly freshmen, sit silently waiting for our English 101 Writing Composition class to begin. Most have one AirPod in listening to whatever their Spotify AI DJ thinks they want to listen to; some scroll past AI-selected ads for drop-shipped fast fashion. And then someone who has forgotten to silence their phone opens TikTok and the 6-7 second sound blares. They hurriedly close the app, no apology, not even a half-hearted laugh from their classmates.

Welcome to the contemporary college classroom.

I am a college professor working at the intersection of humanities and artificial intelligence, and yes, I believe the latter not only threatens to devalue college, but it also risks stripping humanity from our lives altogether.

It doesn’t have to be this way. AI automating away parts of work and life challenges the next generation of the workforce to re-instill the importance of interpersonal social skills, and I see the college classroom as the ideal place for this rehumanization to take place.

Here’s my framework for building a classroom centered around student socialization. The goal: Equip students with the vital human skills needed in the AI-augmented workforce.

Target: Bring humanity to work

Young adults sit in college classes fully aware that an AI-infused workplace is just on the other side of graduation. But they – and everyone else – have little idea how best to prepare for it.

How to make this work for today’s college students? Known for the infamous Gen Z stare, having their faces glued to their screens, and their fidgeting, doomscrolling thumbs, Gen Z has been pegged as the generation that lacks the social skills needed to succeed in an AI-augmented workforce.

To me, this represents a clear tension between the young adults they are and the adults they need to be.

It’s easy for my rhetoric to give off “kids these days” vibes. But I’m a young millennial. Which is to say, I too don’t know what to do with my hands at dinner parties and have to make a conscious effort to maintain eye contact.

Simply put: I teach what I wish I would have been taught.

Shifting the mentality of the classroom

In the college classroom, it’s all too easy to talk at the students for 90 minutes – to just be a professor with a slide deck who tosses in a few canned jokes that you know work because you’ve already said them a dozen times. Time passes, and you hear the next class waiting outside the door.

“All right, y’all,” you say. “Let’s get outta here.”

The students dash off to their dorm rooms or dining hall, and wait to do the homework until midnight. You wait a few weeks too long to grade it – also at midnight, right before midterm grades are due – like two digital ships passing each other in the moonlight.

Instead, I offer a different mindset: The classroom is not some intermediary between two computers – the assignment creator and the assignment doer, which only serves to build an “us versus them” mentality between student and professor.

Rather, it’s us together in the battle against the midterm or final exam.

“OK, that sounds great, random guy on the internet,” I hear you say from the other side of the screen. “But how?”

Small social interactions

We academics like to use fancy words phrases like “student-centered classroom” or “student-driven approach.” What this means for me is simple: I constantly interact with the students and make social interactions integral to the classroom experience.

I used to hear professors brag about knowing each of their students’ names, so I made it a priority to do the same. But now I don’t think that’s enough. Instead, I’m asking the frat bros-future-businessmen and the honors-society-students-soon-to-be-doctors to get to know each other as peers and future colleagues.

As I shuffle into class and try to remember if I capitalized my first pet’s name as I log into the computer, I simply ask students to tell each other: What was the most challenging question on the homework? What did you do this weekend? And more importantly, what did you wish you did?

At the end of class, I give five minutes for students to plan out when they’re going to complete the homework, and then I have them talk to the person next to them about it.

These conversations often lead to friendships formed over common struggles: Alex would love to do his English paper tonight but has to study for his bio test, and Professor Smith’s exams are the worst. As luck has it, James is also in the lecture. “Man, you’re in the class too? Where do you sit? Professor Smith talks way too fast!”

Centering the importance of public speaking

Sure, in my writing-intensive classes we turn in term papers, they get grades, and yes, some students use AI. That’s all fine and well, but that’s not the important part. Instead, I’m interested in students knowing the material well enough to articulate it to the group – well enough to tell us why the subject matters to them, to us and to the world at large.

So we spend a week where students give a short 5-10 minute presentation on their work. “Tell us why fast fashion is destroying the planet. Tell me why we need to care more about the future of pork and factory farming practices.”

And for those brief moments of positive peer pressure as the students stand at the front of the class, it doesn’t matter that ChatGPT helped with the commas, did the googling or even wrote the entire conclusion because “I was just getting too tired.” What matters is the students’ ability to look a group of 20 peers in the eye and bring the private work of thinking, writing and sometimes even chatbot-prompting into the public sphere.

The point isn’t whether students used AI to compose the words; it’s whether the ideas feel like they originate from the person behind the words. Whether they’ve wrestled with them long enough to know what they’re trying to say. If ChatGPT helped them get there, fine. What matters is what they did after. Did they question it? Did they revise it? Did they decide it wasn’t quite right and try again?

That’s the work I care about. To me, it’s the difference between turning something in and actually turning something over — in your mind, in your hands, to the people around you. That’s what makes it real. What makes it theirs. What makes it college.

Back in the classroom …

It’s week 12. I just sent my students off into a small-group discussion on “the value of adapting AI-augmented practices into your daily life.” Five minutes go by. “All right, y’all, let’s bring it back in.” But no one stops talking.

And in that small moment as I pull my phone out to play the Snapchat notification sound, Rizzlord soundtrack or whatever the sound meme of the day is to get their attention, I know I’ve done my small part as an educator: teaching students how to be human again.

Sean Cho Ayres 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 I rehumanize the college classroom for the AI-augmented age – https://theconversation.com/how-i-rehumanize-the-college-classroom-for-the-ai-augmented-age-269168

Source: The Conversation – USA (2) – By Brian Mittendorf, Professor of Accounting, The Ohio State University

Charitable giving in the United States has changed significantly in recent years.

Two of the biggest changes are the swift growth of donor-advised funds and the increasingly blurred lines between charity and politics.

Donor-advised funds, or DAFs, are charitable investment accounts. After donors put money or other financial assets into these accounts, the assets are technically no longer theirs. But they do get a say in how those funds are invested, as well as when and which charities should get some of the money.
Americans gave nearly US$90 billion to DAFs in 2024 – up from the $20 billion DAFs took in a decade earlier.

One distinguishing feature about DAF donors is that when they dispatch money from their charitable accounts, they fund politically engaged charities at higher rates than people who give directly to charity.

That’s what we, two scholars who research the flow of money between donors and nonprofits, found when we conducted a study examining the links between donor-advised funds and donations to charities that are politically active. Our results will be published in a forthcoming issue of Nonprofit Policy Forum, a peer-reviewed academic journal.

Resembling family foundations

As charitable investment accounts, donor-advised funds straddle a middle ground between family foundations and organizations doing direct charitable work.

Like foundations, DAFs give donors a sense of long-term control over funds they’ve designated for charitable spending in the future. But because DAFs are accounts held within certified public charities, often those affiliated with financial institutions like Fidelity and Vanguard, they offer added tax benefits and simplicity.

DAFs let donors take charitable tax deductions immediately, and then decide later how much of that money to give to which charity – and when – by telling the account managers what to do.

Timing gifts this way can increase the tax advantages tied to charitable giving through tax deductions. And DAFs help donors do this without the expenses, staffing and complexity of running their own foundations.

These advantages – coupled with persuasive marketing campaigns – have helped spur a DAF boom. Donor-advised funds held $326 billion in 2024.

More politically engaged charitable activity

We consider charities “politically engaged” if they either do lobbying or have related organizations that participate in political campaigning. These groups span the political spectrum: For example, they include both the National Rifle Association and the Environmental Defense Fund.

We gathered data from the nearly 250,000 charities in the U.S. that filed a 990 form with the Internal Revenue Service from 2020 to 2022. The country’s largest charities must file these informational forms annually and make them available to the public.

When we crunched the numbers, we discovered that nearly 6% of payments from DAF accounts go to politically engaged charities. In comparison, other funding sources paid out only 3.6% to politically engaged charities.

This means a funding rate from DAFs is 1.7 times the benchmark level. When it comes to fringe hate and antigovernment charities, overall funding levels are low, but the DAF difference is more pronounced – DAF donors fund these groups at a rate 3.5 times that of other donors.

Giving donors more privacy

One other advantage DAFs offer donors is that they provide more anonymity than if donors give to a cause directly.

Under current disclosure rules, when donors give more than $5,000 to any charitable nonprofit – whether it’s their local food bank or animal shelter or art museum – both the charity and the IRS have to know who they are. When donors give that much to private foundations, it becomes part of the public record as well.

But when donors give any amount, even if it’s much more than $5,000, through their DAFs, even the charity that ultimately gets the money may not know the donor’s identity.

This anonymity may be one reason donors more often use DAFs to give to organizations that engage in politics, either directly or indirectly.

To be sure, charities are permitted to engage in different types of political engagement to varying degrees. In fact, U.S. charities have long been important public policy advocates. And it is also understandable that donors might want to be anonymous. Yet the use of DAFs to provide gifts to fringe groups suggests this lack of transparency is not always a good thing.

The rules around donor disclosure were originally set up to prevent private interests from abusing the system.

This is the reason that foundations – like those set up by tech billionaire Elon Musk or Google co-founder Larry Page – must publicly disclose both their major donors and their grant recipients.

But when these foundations make grants to donor-advised funds, the digital trail becomes a dead end. The public has no way to know which charities the foundations are ultimately funding with their grants after the money enters a DAF’s coffers.

Consistent with this arrangement, we found that the DAFs that get more grants from foundations tend to fund politically active organizations at higher rates.

Changing the charity landscape

As DAFs continue to expand, further research can help cast light on what effect they will ultimately have. Though much research and many proposed new rules have focused on whether Americans need to move the money in their DAFs out to charities more quickly, we’re focused on where that money goes.

In examining tax filings, we have also learned that some charitable sectors get more money from DAFs than others.

For example, social service nonprofits, which include homeless shelters and food banks, get 25% of all giving, but only 20% of DAF giving. This may seem like a small difference, but it can actually represent seismic shifts in where charitable dollars go.

And we’re now examining whether the size of a charity’s DAF program can influence that organization’s behavior. The data collected from 990 forms suggests that even community foundations may become less focused on their local communities when they court DAF donors.

Helen Flannery is employed by the Institute for Policy Studies, a progressive think tank that has done research related to charity reforms.

Brian Mittendorf 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. Donor-advised funds have more money than ever – and direct more of it to politically active charities – https://theconversation.com/donor-advised-funds-have-more-money-than-ever-and-direct-more-of-it-to-politically-active-charities-270758

Source: The Conversation – USA (2) – By Matthew Jordan, Professor of Media Studies, Penn State

News of Netflix’s bid to buy Warner Bros. last week sent shock waves through the media ecosystem.

The pending US$83 billion deal is being described as an upending of the existing entertainment order, a sign that it’s now dominated by the tech platforms rather than the traditional Hollywood power brokers.

As David Zaslav, CEO of Warner Bros. Discovery, put it, “The deal with Netflix acknowledges a generational shift: The rules of Hollywood are no longer the same.”

Maybe so. But what are those rules? And are they being rewritten, or will moviegoers and TV audiences simply find themselves back in the early 20th century, when a few powerful players directed the fate of the entertainment industry?

The rise of the Hollywood oligopolies

As Hollywood rose to prominence in the 1920s, theater chain owner Adolf Zuker spearheaded a new business model.

He used Wall Street financing to acquire and merge his film distribution company, Famous Players-Lasky, the film production company Paramount and the Balaban and Katz chain of theaters under the Paramount name. Together, they created a vertically integrated studio that would emulate the assembly line production of the auto industry: Films would be produced, distributed and shown under the same corporate umbrella.

Meanwhile, Harry, Albert, Sam and Jack Warner – the Warner brothers – had been pioneer theater owners during the nickelodeon era, the period from roughly 1890 to 1915, when movie exhibition shifted from traveling shows to permanent, storefront theaters called nickelodeons.

They used the financial backing of investment bank Goldman Sachs to follow Zucker’s Hollywood model. They merged their theaters with several independent production companies: the Vitagraph film distribution company, the Skouras Brothers theater chain and, eventually, First National.

But the biggest of the Hollywood conglomerates was Metro-Goldwyn-Mayer, created when the Loews theater chain merged Metro Pictures, Goldwyn Pictures and Mayer Pictures.

At its high point, MGM had the biggest stars of the day under noncompete contracts and accounted for roughly three-quarters of the entire industry’s gross revenues.

By the mid-1930s, a handful of vertically integrated studios dominated Hollywood – MGM, Paramount, Warner Brothers, RKO and 20th Century Fox – functioning like a state-sanctioned oligopoly. They controlled who worked, what films were made and what made it into the theaters they owned. And though the studios’ holdings came and went, the rules of the industry remained stable until after World War II.

Old Hollywood loses its cartel power

In 1938, the Department of Justice and the Federal Trade Commission sued the “Big Five” studios, arguing that their vertically integrated model was anti-competitive.

After the Supreme Court decided in favor of the U.S. government in 1948 – in what became known as the Paramount Decision – the studios were forced to sell off their theater chains, which checked their ability to squeeze theaters and squeeze out independent producers.

With the studios’ cartel power weakened, independent filmmakers like Elia Kazan and John Cassavetes flourished in the 1950s, making pictures like “On the Waterfront” that the studios had rejected. Foreign films found their ways to American screens no longer constrained by block booking, a practice that forced exhibitors to pay for a lot of mediocre films if they wanted the good ones, too.

By the 1960s, a new generation of filmmakers like Mike Nichols and Stanley Kubrick scored big with audiences hungry for something different than the escapist spectacles Hollywood was green-lighting. They took risks by hiring respected writers and unknown actors to tell stories that were truer to life. In doing so, they flipped Hollywood’s generic formulas upside down.

A decade ago, I wrote about how Netflix’s streaming model pointed to a renaissance of innovative storytelling, similar to the period after the Paramount Decision.

By streaming their indie film “Beast of No Nation” directly to subscribers at home, Netflix posed a direct threat to Hollywood’s blockbuster model, in which studios invested heavily in a small number of big-budget films designed to earn enormous box office returns. At the time, Netflix’s 65 million global subscribers gave it the capital to produce exclusive content for its expanding markets.

Hollywood quickly closed the streaming gap, developing its own platforms and restricting access of its vast catalogs to subscribers.

Warner Bros. bought and sold

In 2018, AT&T acquired Time Warner, the biggest media conglomerate of the time, and DirectTV. It hoped to merge its 125 million-plus telecommunication customers with Time Warner’s content and create a streaming giant to compete with Netflix.

Then came the COVID-19 pandemic, and the theatrical model for film distribution collapsed.

The pressure on AT&T’s stock led the company to sell off HBO and WarnerMedia to Discovery in 2022 for $43 billion. Armed with the HBO and Warner Bros. libraries – along with the advertising potential of CNN, TNT and Turner Sports – CEO David Zaslav was bullish about the company’s potential for growth.

Warner Bros. Discovery became the third-largest streaming platform in terms of subscribers behind Netflix and Disney+, which had gobbled up 20th Century Fox.

But the results have been bad for audiences.

In 2023, Zaslav rolled out a bundled streaming platform called Max that combined the libraries of HBO Max and Discovery+, which ended up confusing consumers and the market. So it reverted back to HBO Max because consumers recognized the brand.

Zaslav then decided it was more cost effective to cancel innovative projects or write off completed films as losses. Zaslav often claims his deals are “good for consumers,” in that they get more content in one place. But conglomerates who defend their anti-competitive practices as signs of an efficient market that benefit “consumer welfare” frequently say that, even when they are making the product worse and limiting choices.

His deals have been especially bad for the television side, yielding gutted newsrooms and canceled scripted shows.

Effectively, in only three years, the Warner Bros. Discovery merger has validated nearly all the concerns that critics of “market first” policymaking have warned about for years. Once it had a dominant market share, the company started providing less and charging more.

Meet the new boss – same as the old boss

If it does go through, the Netflix-Warner Bros. merger will likely please Wall Street, but it will further decrease the power of creators and consumers.

Like other companies that have moved from being a growth stock to a mature stock, Netflix is under pressure to be profitable. Indeed, it has been squeezing its subscribers with higher fees and more restrictive login protocols. It’s a sign of what tech blogger Cory Doctorow describes as the logic of “enshittification,” whereby platforms that have locked in audiences and producers start to squeeze both. Buying the competition – HBO Max – will mean Netflix can charge even more.

After the Netflix deal was announced, Paramount joined forces with President Donald Trump’s son-in-law Jared Kushner, the Saudi Sovereign Wealth fund and others to announce a hostile counteroffer.

Now, all bets are off. Whichever platform acquires Warner Bros. will have enormous power over the kind of stories that get sold and told.

In either case, Warner Bros. would be bought by a direct competitor. The Department of Justice, under the first Trump administration, already pushed to sunset the Paramount Decision, claiming that the distribution model had changed to such an extent that it was unlikely that Hollywood could ever reinstate its cartel. It’s hard to imagine that Trump 2.0 will forbid more media concentration, especially if the new parent company is friendly to the administration.

No matter which bidder becomes the belle of Trump’s ballroom, this merger illustrates how show business works: When dominant platforms also own the studios and their assets, they control the fate of the movie business – of actors, writers, producers and theaters.

Importantly, the concentration is taking place as artificial intelligence threatens to displace many aspects of film production. These corporate behemoths will determine if the film libraries spanning a century of Hollywood production will be used to train the machines that could replace artists and creatives. And with each prospective buyer taking on over $50 billion in bank debt to pay for the deal, the new parent of Warner Bros. will be looking everywhere for profits and opportunities to cut costs.

If history is any guide, there will be struggles ahead for consumers and competing creatives. In a media system that has veered back to following Hollywood’s yellow brick rules of the road, the new oligopolies are an awful lot like the old ones.

Matthew Jordan 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. Whether Netflix or Paramount buys Warner Bros., entertainment oligopolies are back – bigger and more anticompetitive than ever – https://theconversation.com/whether-netflix-or-paramount-buys-warner-bros-entertainment-oligopolies-are-back-bigger-and-more-anticompetitive-than-ever-271479

Source: The Conversation – USA (3) – By Jenalee Doom, Associate Professor of Psychology, University of Denver

Imagine you got a rough night of sleep. Perhaps you went to bed too late, needed to wake up early or still felt tired when you woke up from what should have been a full night’s sleep.

For the rest of the day, you feel groggy and unfocused. Things that are usually fun or exciting don’t give you the same level of pleasure. You don’t have energy to exercise, so you avoid it. You don’t feel motivated to see friends, so you cancel plans with them. You focus on your rough day as you try to fall asleep that night and start to have anxiety about the next day. Instead of getting the restful night of sleep you need, you have another night of poor sleep. You become caught in a vicious cycle of poor sleep and depressed mood.

Sleep and mental health problems often go hand in hand. Sleep problems are a core symptom of depression. In addition, there is strong evidence that sleep problems contribute to many mental health disorders, including schizophrenia and post-traumatic stress disorder, or PTSD.

Yet our mental health also affects how well we sleep. Issues such as distressing thoughts and trouble relaxing can make it difficult for people to fall asleep or stay asleep, exacerbating sleep problems.

These issues are particularly pronounced during pregnancy, when the circular effects of inadequate sleep and mental health challenges can have harmful effects for mothers and their offspring.

We are a developmental psychologist and a doctoral student in psychology who study sleep and mental health from pregnancy through adulthood. As researchers in this field, we see the impacts of sleep and mental health problems firsthand.

Sleep and mental health problems are so entangled that it is unsurprising that they can each make the other worse. But it does make treating them more challenging.

Biology of sleep and mental health

Researchers and medical professionals know that sleep is essential for the body and brain to function properly.

Sleep is important for establishing circadian rhythms, which optimize alertness during the day and rest at night. When sunlight fades in the evening, the brain produces more of the hormone melatonin, and your core body temperature drops to promote sleep. When the brain detects sunlight, it reduces melatonin production, and body temperature increases to promote wakefulness.

Although light and dark are the most important signals to the brain about when you should be awake and when you should be sleeping, other things such as stress, disruptions in daily routines and social interactions can also throw off your circadian rhythm.

Circadian rhythms affect other important biological processes, including the body’s production of the stress hormone cortisol. Cortisol follows a daily rhythm where it is highest soon after waking in the morning and lowest in the middle of the night. Disruptions in normal sleep can lead to difficulties in daily regulation of cortisol levels, which can have negative effects on mental health and the ability to effectively manage stress.

Sleep is central to the proper functioning of the immune system, which in turn has implications for mental and physical health. Sleep disturbances have been linked to poorer immune responses against viruses and other challenges to the immune system, making it harder to stay healthy and to recover after getting sick.

Sleep disturbances also lead to greater inflammation, which is when the immune system’s natural responses become overactive. Inflammation underlies mental and physical health problems, including depression, heart disease and cancer.

How poor sleep leads to behavior changes

Chronic disruptions to a person’s natural circadian rhythm – such as people who work night shifts or who switch between day and night shifts – lead to greater risk for both depression and anxiety.

Shift work is an extreme example of disrupting the natural pattern of sleeping at night. However, less severe types of sleep problems, such as not getting enough sleep or waking up feeling tired, are also bad for mental health.

Sleep disruptions make it more difficult to regulate emotions. Having too little or poor quality sleep make handling everyday stressors more difficult. This is because sufficient sleep is necessary for effective problem-solving, memory and focusing. The combination of impaired emotion regulation and stress management abilities are a recipe for greater mental health difficulties.

One key reason why poor sleep and mental health struggles can become so problematic and difficult to treat is that without adequate sleep, it’s challenging to muster energy for healthy activities such as exercise and maintaining social relationships.

What’s more, when decision-making is impaired by poor sleep and negative emotions, people are more likely to reach for alcohol, drugs and unhealthy foods to cope with stress. These unhealthy behaviors can, in turn, reinforce the cycle by interfering with sleep.

Sleep and mental health problems in pregnancy

These cycles between poor sleep and mental health challenges can be especially problematic during pregnancy.

Common pregnancy symptoms include nausea, heartburn, back and joint pain, cramps, a frequent urge to pee and contractions, all of which can make it more difficult to get restful sleep.

Sadly, around 76% of pregnant women report having sleep problems at some point in their pregnancy, compared with only 33% in the general population. Relatedly, about 1 in 5 pregnant women in the U.S. struggle with mental health problems such as anxiety and depression.

Our team’s new research, published in December 2025, further establishes these links between sleep and mental health. We found that during pregnancy, mental health problems contribute to sleep problems over time and that sleep problems in turn can exacerbate mental health problems.

This cycle can also have negative effects on the fetus and on the child after birth.

Prenatal sleep problems such as short sleep, sleep apnea and restless sleep can lead to preterm births and low birth weight in newborns.

A large study in Sweden in 2021 found that pregnant women who frequently worked the night shift or quickly shifted between night and day work in early pregnancy showed a three-to-four times greater risk for having a preterm birth. Preterm birth and low birthweight are associated with greater cardiovascular risk in both mothers and their offspring.

Prenatal maternal sleep problems can also lead to problems later in the child’s development. A review we also published in 2025 found that children of mothers who had sleep problems in pregnancy tend to have more sleep problems themselves. Our review also reported that children of mothers with prenatal sleep problems are more likely to develop obesity and have more behavioral problems in childhood.

Talking to your doctor about these concerns

In our opinion, it should be standard to screen for sleep problems at medical visits, given the potential implications of inadequate sleep for both mothers and their babies.

If you’re close to someone who is pregnant, consider asking how their sleep is and how they’re feeling. If they note ongoing sleep issues or emotional or behavior changes, you can ask if they have talked to their doctor.

They may feel overwhelmed and need support in talking to their doctor or help finding resources. The Sleep Foundation’s website has a list of sleeping tips for pregnant women as well as guidelines for when to speak with a doctor.

If you are the person experiencing these issues, you can report sleep problems to your doctor and ask for guidance for improving sleep.

If you’re experiencing difficulties with depression or anxiety, tell your doctor and ask for resources. There are mental health resources specific to pregnancy that can help. You can also find mental health professionals through Psychology Today’s find-a-therapist tool.

Healthy sleep is a necessity for improving your mental health during pregnancy and at all times of life.

Jenalee Doom receives funding from the National Institutes of Health.

Melissa Nevarez-Brewster receives funding from the National Institutes of Health.

– ref. Sleep problems and depression can be a vicious cycle, especially during pregnancy − here’s why it’s important to get help – https://theconversation.com/sleep-problems-and-depression-can-be-a-vicious-cycle-especially-during-pregnancy-heres-why-its-important-to-get-help-264737

Source: The Conversation – USA (3) – By Emma Kennedy, Assistant Professor of Christian Ethics, Villanova University

Along the 2024 presidential campaign trail, Donald Trump pledged to make in vitro fertilization, or IVF, free – part of his party’s wider push for a new American “baby boom.”

But in October 2025, when the administration revealed its IVF proposal, many health care experts pointed out that it falls short of mandating insurance companies to cover the procedure.

Since Trump returned to the White House, it has become clear just how fraught IVF is for his base. Some conservative Christians oppose IVF because it often involves destroying extra embryos not implanted in the woman’s uterus.

According to Politico, anti-abortion groups lobbied against a requirement for employers to cover IVF. Instead, some vouched for “restorative reproductive medicine” – a term that has been around for decades but has received much more attention, especially from conservatives, in the past few months.

Proponents of restorative reproductive medicine tend to present it as an alternative to IVF: a different way of treating infertility, focused on treating underlying causes. But the approach is controversial, and some practitioners closely link their treatments to Catholic teachings.

As a scholar of religion, I study U.S. Catholics’ varied perspectives on infertility, seeking to understand how religious beliefs and practices influence physicians’ and patients’ choices. Their perspectives help provide a more nuanced understanding of Christianity’s role in the U.S. reproductive and political landscape.

Defining restorative reproductive medicine

Clinics that advertise themselves as offering restorative reproductive medicine try to diagnose underlying issues that could make conception difficult, like endometriosis. Typically, a patient and provider will closely monitor the patient’s menstrual cycle to identify potential abnormalities. Interventions include hormone therapies, medications, supplements, surgeries and lifestyle changes.

Much of the approach resembles the initial testing used to evaluate patients in mainstream reproductive endocrinology and infertility clinics. However, restorative reproductive medicine clinics do not typically offer IVF or other assisted reproductive technologies.

Depending on who you ask, proponents are not necessarily opposed to IVF; they see their treatments as another option to explore. Some clinicians, however, closely link their treatment offerings to their religious commitments and opposition to abortion.

Restorative reproductive medicine has prompted criticism from professional medical organizations. The American Society for Reproductive Medicine issued a statement in May 2025 calling it a “rebranding” of standard infertility treatment, with “ideologically driven restrictions that could limit patient care.” The American College of Obstetricians and Gynecologists issued a brief warning that it is a “nonmedical approach” that threatens to impede access to IVF.

These critics are concerned that the focus on lifestyle changes and surgery may not address patients’ difficulties conceiving, while putting them through other unsuccessful treatments.

Church teachings

Today, restorative reproductive medicine is often described as gaining steam with conservative Christians and the “Make America Healthy Again,” or MAHA, movement. Its roots, though, are decades old, and largely Catholic.

Part of the Catholic Church’s objection to IVF stems from a concern that unused embryos are often discarded and destroyed. The church’s position is that all embryos ought to be treated with the same respect afforded a person – one of the key reasons its teachings oppose abortion.

Disapproval of IVF also stems from the church’s official teachings on marriage. According to this teaching, marriage has two chief ends, which it calls “procreation and union”: Typically, procreation is understood to mean having children, while union involves physical, emotional and spiritual intimacy. In this understanding, sexual intercourse should preserve what the church calls an “inseparable connection” between these two meanings.

The Catholic Church opposes artificial contraception because its goal is to block procreation. Instead, Catholics are encouraged to use “Natural Family Planning” – tracking a woman’s cycle so that couples can choose to abstain from sex during fertile periods. Similarly, it opposes artificial insemination and IVF because, by moving fertilization out of the body and into the lab, the process separates procreation from the act of sexual intercourse.

Survey data suggests most U.S. Catholics do not agree with these official stances, nor do they follow them.

Catholic doctors who do agree with official church teachings, however, have played a key role in developing infertility treatments that align with them. One of the most influential is Dr. Thomas W. Hilgers, who co-developed a “Natural Family Planning” method called the Creighton Model. In the early 1990s, he also developed NaProTechnology, an approach that seeks to identify fertility issues using cycle tracking, and then treat them with various medical and surgical interventions.

The NaProTechnology approach could be said to fall under the umbrella of restorative reproductive medicine, but it has mostly been used by Catholic reproductive health clinics and hospitals. Catholic physicians’ networks promote it, as do parishes and dioceses.

Navigating infertility

For Catholics who share the church’s official perspective on IVF, NaProTechnology and the clinics offering it are often a welcome alternative. Several of the Catholic women I interviewed as part of my academic research had also been to mainstream fertility clinics, but they felt that those providers did not offer much apart from IVF.

By contrast, the clinics offering NaProTechnology were often cheaper, in part because they do not offer IVF. They were also easier to navigate, since clinicians shared these patients’ religious views. Many felt that the providers were able to spend more time with them, helped them learn about their bodies, and were committed to understanding underlying issues beyond infertility.

However, others found clinics offering NaProTechnology to be lacking, often because clinicians weren’t up front about its limitations, especially when it comes to male infertility. Some patients felt that clinicians weren’t willing to admit drawbacks, for fear it would encourage couples to try IVF.

Most Catholics dealing with infertility, however, find themselves in mainstream clinical settings that offer IVF. Women I interviewed who opted for IVF were frank in their critiques of church teachings and their skepticism of Catholic clinics. Many took issue with the underlying assumption that the people who ought to be procreating are heterosexual, married couples and that conception is usually possible without the help of IVF.

However, many of these women were also dissatisfied with the approach that mainstream clinics take. Some felt that those clinics were focused on profit – a concern shared by some scholars scrutinizing the fertility industry. Some women also felt pressured to genetically test their embryos for chromosomal abnormalities and to discard unused embryos, even after explaining to staff that destroying them would be out of step with their moral commitments.

Understanding patient experiences in either kind of clinic helps underscore the difficulties many people face navigating infertility – and the stakes of policy reform.

The Trump administration’s plan largely maintains the status quo for IVF access while making more room for alternative treatments. But it intensifies questions about how the government responds to religious beliefs about reproductive health care, especially disagreements about the moral status of embryos. For now, patients and providers will continue to navigate a fractured landscape.

Emma Kennedy is affiliated with the Center for Genetics and Society.

– ref. How a niche Catholic approach to infertility treatment became a new talking point for MAHA conservatives – https://theconversation.com/how-a-niche-catholic-approach-to-infertility-treatment-became-a-new-talking-point-for-maha-conservatives-265461

Source: The Conversation – USA (2) – By Francisco J. Monaldi, Wallace S. Wilson Fellow in Latin American Energy Policy, Rice University

The U.S. seizure of an oil tanker off the Venezuelan coast looks designed to further squeeze the economy of President Nicolás Maduro’s country.

The Dec. 10, 2025, operation – in which American forces descended from helicopters onto the vessel – follows months of U.S. military buildup in the Caribbean and was immediately condemned by the Venezuelan government as “barefaced robbery and an act of international piracy.”

But what exactly is the Trump administraion’s aim in going after the tanker, and how could this impact the already beleaguered economy of Venezuela? The Conversation U.S. turned to Rice University’s Francisco J. Monaldi, an expert on Latin American energy policy, for answers.

What do we know about the tanker that was seized?

The seized tanker, which according to reports is a 20-year-old vessel called the Skipper, is a supertanker that can carry around 2 million barrels of oil.

According to the Trump administration, the vessel was heading to Cuba. But because of the size of the ship, I strongly suspect that the final destination was likely China – tankers the size of the seized one don’t tend to be used to take oil across the Caribbean to Cuba. The ones used for that task are far smaller.

This particular tanker was sanctioned by the U.S. Treasury in 2022 due to it carrying prohibited Iranian oil. At the time, it was claimed that the ship – then called Adisa – was controlled by Russian oil magnate Viktor Artemov and was engaged in an oil smuggling network.

Attorney General Pam Bondi released a video of the seizure on X.

So the latest U.S. seizure was, on the surface, unrelated to the sanctions placed on Venezuela by U.S. authorities in 2019 and expanded in 2020 to include secondary sanctions – that is, on countries that do business on the targeted nation or company.

As such, Venezuelan officials have said this is unprecedented. And they are largely right. While there have been a few occasions in which Iranian tankers have been seized due to sanctions busting, this is the first time that there has been a seizure of a vessel departing Venezuela and with a Venezuelan crew.

The Trump administration has signaled that it is not only seizing the cargo but the ship itself – which would represent a significant loss for the company owning the ship. The loss will be borne by the company, not Venezuela, as it was under a “Free on Board” contract, meaning that as soon as it left Venezuela the buyer takes responsibility for it.

Nonetheless, this is a significant escalation of the pressure campaign on Venezuela, which looks set to continue. Reuters has reported that around 30 other tankers near Venezuela have some kind of sanction against them. They form part of a large shadow fleet that try to skirt sanctions through hiding their identity while transporting oil from Russia, Venezuela and Iran.

The signal from U.S. officials is that they are prepared to go after more vessels and further squeeze Venezuela’s oil revenues through fresh sanctions.

How often they will seize vessels is not known, but the clear threat from the White House is that the U.S. will continue with this seizure campaign.

How important are oil exports to Venezuela?

Venezuela’s economy is tremendously dependent on oil production.

We do not have exact figures, as the Venezuela government has not published them in seven years, but most analysts believe oil constitutes north of 80% of all of the country’s exports – some even put this figure above 90%.

Most of that oil goes to the black market, and a majority ends up with independent refiners in China. State-owned enterprises in China tend not to buy this oil because they do not want to fall foul of the sanctions regime. But Beijing tends to turn a blind eye to tankers heading to non-state entities, especially if those tankers have hidden their true identity so it doesn’t look like they are coming from Venezuela.

Around 80% of Venezuelan oil goes to China in this way; around 17% goes to the U.S. through a license awarded by the U.S. Treasury to oil giant Chevron. And 3% goes to Cuba, which tends to be subsidized by the Venezuelan government.

Venezuela’s economy itself is also very dependent on oil, with the sector making up about 20% of total GDP, more than any other industry. And when it comes to government income, the oil sector makes up north of 50%.

How have US actions affected Venezuelan oil production?

It is important to know that even before U.S. sanctions began in 2019, Venezuela’s oil production was in severe decline.

In 1998, before Hugo Chávez, the leftist military officer who became a populist president, came to power, oil production peaked at around 3.4 million barrels a day. By the time Chávez died and Maduro succeeded him in 2013, it had fallen to 2.7 million barrels a day.

When U.S. sanctions targeting the state-owned oil company, Petróleos de Venezuela, were enacted in 2019, production was down to 1.3 million barrels a day – but that had already been affected by the other financial sanctions that came in two years earlier.

The oil sanctions of 2019 closed the U.S. market, taking away half a million barrels a day that at the time headed from Venezuela to the U.S. As a result, Venezuela had to increase oil sales to India and China.

But then the 2020 secondary sanctions, which apply to countries doing business with Venezuela, came in. As a result, Europe and India stopped buying Venezuelan oil, meaning that its only markets were Cuba and China. Of course, that year also saw the onset of the COVID-19 pandemic, which resulted in a massive cooling of the oil market globally.

Venezuelan oil production collapsed to 400,000 barrels a day that year. Today it has recovered to around 1 million barrels a day. This has been helped by the U.S. allowing Chevron – which, after Petróleos de Venezuela, is the second-largest oil company operating in the country – to continue production.

How does Venezuela get around oil sanctions?

Venezuela relies on a shadow fleet to help it skirt U.S. sanctions. These vessels hide their identity by using false flags and false names.

Companies often take a tanker that is going to be retired and change the identity, put on a new coat of paint and make sure transponders – devices that transmit radio signals to give a map reading – are doctored so that it looks like the ship is in a different place altogether.

These ships arrive in Venezuela, pick up oil and then set sail. Sometimes they then transfer the cargo to another ship – which carries huge environmental risks. And then it arrives typically in Malaysia, where it takes on a Malaysian identity and on it goes to China.

What impact has this latest seizure had on the price of oil?

The seizure had little impact on global oil prices, because of exiting oversupply and due to the fact that Venezuela makes up only around 1% of the overall market. That could change, depending on how aggressive the U.S. gets. But the Trump administration will be mindful that it doesn’t want to see domestic prices rise as a result.

As to the price of Venezuelan oil, that could be more drastic. Venezuelan oil is already sold at a discount on the black market because of the existing risk relating to the sanctions. This latest action is likely to widen these discounts even further.

In addition, Venezuela has until now required companies to pay some of the payment for oil cargo upfront – and a lot will be unwilling to do so now, due to high costs involved in a U.S. seizure. For example, a tanker of 2 million barrels, even with the current discount, will be worth around US$100 millon – no one wants to risk that much money. So very few buyers will be willing to prepay. Instead they will expect Venezuela to share the risk.

The bottom line for Maduro is that the only way to get someone to buy Venezuelan oil amid the heightened risk of this moment is to offer higher discounts with fewer prepayments. Besides discounts, export volumes could also be affected and that in turn would lead to production cuts, which are costly to reverse.

And all this will further choke off the already limited revenue that Maduro is relying on to keep Venezuela’s government functioning.

Francisco J. Monaldi 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. Black-market oil buyers will push Venezuela for bigger discounts following US seizure – starving Maduro of much-needed revenue – https://theconversation.com/black-market-oil-buyers-will-push-venezuela-for-bigger-discounts-following-us-seizure-starving-maduro-of-much-needed-revenue-271896

Source: The Conversation – USA – By John E. Jones III, President, Dickinson College

The public has been hearing from a lot of federal judges over the past year, much more than normal. That’s because many of them are concerned about the Trump administration’s commitment to the rule of law.

Dickinson College President John E. Jones III was appointed as a federal judge by President George W. Bush and spent 20 years on the bench after being confirmed unanimously by the U.S. Senate in 2002. Jones spoke with The Conversation U.S. senior politics editor, Naomi Schalit, about America’s legal landscape after almost a year of Donald Trump’s presidency.

What does the case just argued at the Supreme Court about the president’s ability to fire leaders at independent agencies tell you about Donald Trump’s presidency?

We’ve seen a progression over time, with both Republican and Democratic presidents, where there’s been a stronger and stronger chief executive. But there’s been nothing like this administration, where the president has fired members of heretofore independent agencies. Having listened to oral arguments, which at times can be misleading, there’s very little question that the Supreme Court is going to overturn the “Humphreys Executor” precedent.

---

Read more:
Supreme Court ignores precedent instead of overruling it in allowing president to fire officials whom Congress tried to make independent

---

What it means is that this president will have the opportunity to
utterly remake all of these independent agencies now. He’s going to take people out, root and branch, and put folks in who are either with the program or they’re not going to get appointed.

So this case is emblematic of Trump’s approach to presidential power?

He does not recognize and does not want among his appointees – certainly we see this in the Cabinet – any modicum of independence. You’re either with him 100% or you’re against him. Now that will extend to these independent agencies, and that means that the measured sort of regulations that have existed for a long time are going to be disrupted and maybe even eliminated.

This year has seen unusual amounts of activity in the Supreme Court’s shadow docket. What is the significance of that?

This is the court’s emergency docket. If the court takes these cases, they order a very abbreviated briefing and they decide the matter very quickly. Typically, this is a problem for lower court judges, as the cases are decided with very little explanation.

Sometimes months and months intervene before the court gets back to that case and renders a full and complete determination. One example would be the birthright citizenship case that came up to the court on the shadow docket. The court rendered an interim decision about whether U.S. District Court judges could issue orders stopping nationwide enforcement of Trump policies. They didn’t rule on the merits of the birthright citizenship case.

Since then, there have been conflicting decisions across the country. You have circuits that have ruled on the question and other circuits that haven’t ruled on it at all. So depending on where you live in the United States, you may or may not be subject to what heretofore has been the accepted interpretation of the 14th Amendment.

This administration’s clear strategy – to flood the zone by simply challenging every adverse decision against it in the lower courts – means there are an unprecedented number of cases coming up to the Supreme Court. It just means that there’s utter confusion in the lower courts, and it’s been the subject of a lot of dissatisfaction among lower court judges. It really puts the federal court system into a state of uncertainty and chaos, and obviously it’s not good for the public.

U.S. attorneys are nominated by the president and confirmed by the Senate. Congress limits how long interim U.S. attorneys can serve in these positions. But the Trump administration has circumvented those limits, keeping a number of interim U.S. attorneys on the job past the 120-day limit. These cases have been challenged in court. Why is this conflict notable?

What the president has attempted to do flies in the face of legislation that says that these interim appointments are limited to 120 days. Every court has found that the president’s appointment or attempted appointment beyond the first 120 days is unlawful and unconstitutional. It is a limitation on the president’s power.

If the president’s version were correct, you could just have endless interim appointments without any involvement by the Senate. This is a place where the courts have, in effect, upheld the integrity of the advice-and-consent system and the constitutional role of the Senate.

Trump ordered the Department of Justice to prosecute James Comey and Letitia James, among others. He has also granted massive numbers of pardons and commutations. What are your thoughts on these?

My takeaway as an American citizen and as a former judge is that at bottom, President Trump simply lacks respect for our system of justice.

I don’t think you can find otherwise when on your first day in office you issue over 1,000 pardons for people who were justifiably convicted or pled guilty to what was, by any account, an insurrection on Jan. 6, 2021. He has pardoned countless people since then, including a former president of Honduras who his own administration prosecuted and for which there was abundant evidence that he was a drug trafficker. He’s blowing up boats in the Caribbean without, in my view, any rationale that’s grounded in law. The president believes the law is whatever he says it is at any given moment.

As to the Department of Justice, I think that’s one of the most worrisome things about this administration. There is a seamless interface between the White House and the Department of Justice that is problematic, and it is quite clear that the Department of Justice will do anything that the president wants.

I think we’re in a very, very difficult and dark place when the president by fiat can simply order his attorney general to prosecute a person. And I think every American should worry about a world where that takes place without any buffer.

The administration has a documented pattern of disobeying or sidestepping court orders. Your thoughts?

The way our system is supposed to work is that people can disagree with lower court decisions, but they have to obey them, unless they’re stayed by application to a higher court. The administration seems to have decided that they’re going to write U.S. district judges out of the picture and simply disregard their orders.

When I served as a U.S. District Court judge, I always understood that I had pretty awesome power to do things. That power was to be used sparingly and carefully, but when I ordered something, I expected that that order would be followed.

That is the nature of the rule of law and our system of justice that now has been turned on its head by this administration.

The second point is that I would wish that our Supreme Court
would take a stronger stand against this kind of gamesmanship in the lower courts. Those who serve in the third branch – the nation’s courts – are all in this together. There has to be more attention given to an administration that has really gone rogue in terms of how they treat the orders of U.S. District Court judges.

I don’t think the public has ever heard more from judges or former judges or retired judges than they are hearing right now. That includes you, president of a university, former federal judge, saying things that I think the public isn’t accustomed to hearing from either current or former judges. What’s going on?

What’s happening is that judges who come from all stripes, philosophically and party affiliations, are deeply concerned and offended about the tenor of the times, and they feel the need, as I do, to become active and to rally to the support of our system of justice. Imperfect though it may be, I’ve always regarded it as the fairest and best system in the world.

John E. Jones III is affiliated with Keep Our Republic’s Article Three Coalition.

– ref. As a former federal judge, I’m concerned by a year of challenges to the US justice system – https://theconversation.com/as-a-former-federal-judge-im-concerned-by-a-year-of-challenges-to-the-us-justice-system-271571

Source: The Conversation – USA – By David Toews, Associate Professor of Biology, Penn State

People typically think about evolution as a linear process where, within a species, the classic adage of “survival of the fittest” is constantly at play. New DNA mutations arise and get passed from parents to offspring. If any genetic changes prove to be beneficial, they might give those young a survival edge.

Over the great span of time – through the slow closing of a land bridge here or the rise of a mountain range there – species eventually split. They go on evolving slowly along their own trajectories with their own unique mutations. That’s the process that over the past 3.5 billion years has created the millions of branches on the evolutionary tree of life.

However, new genome sequencing data reveals an unexpected twist to this long evolutionary story. It turns out that the boundaries between species on their own branches of this tree are a little more permeable than previously thought. Rather than waiting around for new mutations to solve a particular problem, interbreeding between different species can introduce ready-made genetic advantages.

Unraveling the story of life, one genome at a time

As an evolutionary biologist, I’ve been studying the stories written in the genomes of animals for over two decades. I focus mostly on colorful songbirds called wood warblers that hail from North, Central and South America. There are approximately 115 species in total, and they come in a dazzling array of bright colors.

Some of these birds might be familiar to you, such as the brilliant Blackburnian warbler (Setophaga fusca), which lights up the tops of the pine trees in the eastern forests of the U.S. and Canada during spring and summer. Other warbler species might be less familiar, like the pink-headed warbler (Cardellina versicolor), which lives only in the highlands of Guatemala and southern Mexico.

The story of these New World warblers was written within the past 10 million years or so – relatively recently in evolutionary terms. They’re all, in effect, “evolutionary neighbors,” sitting next to each other at the tips of the crown of the tree of life. In my team’s most recent work, led by evolutionary biologist Kevin Bennett, we gathered a massive amount of data from warbler genomes – over 2 trillion base pairs, from nearly every species of warbler – to learn more about their evolutionary history.

We found that some species have unexpectedly leaped over evolutionary hurdles by sharing solutions to evolutionary problems. We are now learning from this kind of data that species aren’t just vertical, evolutionary silos, as we once thought. Instead, there is much more horizontal “cross talk” among the branches of the evolutionary tree.

These warblers now join Amazonian butterflies, cichlid fish in Africa, as well as our own hominid lineage, as exemplars of this process of evolutionary sharing.

How does evolutionary sharing actually occur?

Genetic sharing among evolutionary neighbors all happens through hybrids: the offspring produced when individuals from two species mate. Famous hybrids include offspring between polar and grizzly bears – affectionately called “pizzly” bears – as well as mules, the offspring of horses and donkeys.

But unlike mules, which are sterile and cannot reproduce, in instances of natural warbler hybrids, we think these rare offspring can sometimes “backcross”: They breed with one of the parental species, ultimately moving genes across species boundaries. These hybrids are the genetic conduit by which genes are shared across the branches in the evolutionary tree.

But aren’t we all taught in biology class that species can’t interbreed with other species? Isn’t that what helps define a species?

In reality, biology always has its exceptions and fuzzy edges. And this is one: Species result from the very gradual process of speciation, which typically takes millions of years. The taxonomic boxes we humans like to put around “species” don’t typically capture the blurry borders around lineages early in this long process, when otherwise distinct plants and animals can still interbreed.

Indeed, my lab has described many interspecies and intergenus hybrids in warblers, including at least one arising from both. We’ve also identified “hybrid zones” between very closely related species, where hybridization is rampant.

And if the genes within these hybrids are beneficial in the recipient species, they’ll spread – just like a new, beneficial mutation passed to an offspring. In this case, it’s not just a single mutation but can be a whole new complement of mutations in multiple genes.

Shared genes solve ‘evolutionary problems’

Our most recent work in wood warblers shows that the evolutionary solutions they’re sharing are related to their coloration.

In this family of birds, we previously identified genes related to their carotenoid-based coloration. Carotenoid pigments give birds their brilliant orange, yellow and red plumes – colors that are exemplified by the aptly named yellow warbler. But birds, like all vertebrates, can’t synthesize carotenoid pigments on their own. They need to obtain carotenoids from their diet and then chemically process them.

But processing carotenoids appears to be an evolutionary hurdle that not all birds have jumped and a rather difficult problem to solve. Our genome sequencing shows that these warblers have more shared carotenoid genes than other shared genes in their genome, and it’s likely that different versions of carotenoid-processing genes improve the recipients fitness.

One carotenoid-processing gene, called beta-carotene oxygenase 2, or BCO2, has been shared several times within this single family of birds. Moreover, BCO2 appears to be so popular that it shows second-order sharing: passing from one species to another, and then on to a third.

A sign of quality on the mating circuit

My colleagues and I think these genes are so popular because male warblers use these carotenoid colors to attract females that have a discerning eye. Male birds obtain carotenoids from the insects they eat. The idea is that the more colorful a male is, the higher the quality of its diet.

From across the forest, the males’ rich carotenoid colors are signaling that they’d be good dads with good genes. Biologists call this kind of display an “honest signal.” And if males obtain a new gene that allows them to process carotenoids more efficiently, it’s likely to spread faster and farther into the species, as the brighter males will potentially have greater mating success.

Our research with warblers demonstrates how evolution can shuffle genes across the thin lines between species. These close evolutionary neighbors sometimes share DNA, including potentially beneficial mutations, by mating across the species lines defined by humans’ classification systems.

We suspect that the more we look, the more we’ll find this kind of borrowing among evolutionary neighbors. As we unravel the stories told in the genomes of nature’s problem-solvers, it’s likely we’ll find that their threads are deeply intertwined.

David Toews works for Pennsylvania State University. He receives funding from The National Science Foundation.

– ref. Songbirds swap colorful plumage genes across species lines among their evolutionary neighbors – https://theconversation.com/songbirds-swap-colorful-plumage-genes-across-species-lines-among-their-evolutionary-neighbors-268846

Source: The Conversation – USA (3) – By Jill Inderstrodt, Assistant Professor of Health Policy and Management, Indiana University

It’s a rare occasion when my worlds of biomedical informatics and serialized lesbian melodrama fandom collide.

But that’s exactly what happened earlier this summer when two of my favorite actresses appeared on a popular podcast. I was excited to hear them talk about their new book and their history of working together, so I was confused but delighted when their conversation took a turn toward my area of expertise – electronic health records.

One actress noted that on a recent trip to the optometrist, she was asked about her ethnicity. “And I was like, what difference does it make?” she said.

The host chimed in with her experience of being asked similarly personal questions before a mammogram. “Like, it doesn’t matter if I’m married or not. It doesn’t matter if I’m white or Asian, you know?” she remarked.

Listening to the host and actresses question a process that, to me, seems straightforward and purposeful served as a stark reminder of the chasm that often exists between how researchers like me use patient data and a patient’s actual experience of clinical data collection.

For those of us who use demographic data collected during health care encounters to conduct research and design interventions, it does matter whether patients answer their doctor’s demographic questions. But as a patient myself, I can see how these questions might seem unnecessary and even invasive.

So it may help to understand why your doctors collect this data, how researchers use it and what medical discoveries might be possible when we know more about who patients are.

Why your data matters

When you answer the demographic questions your doctor logs in your electronic health record, you’re doing more than disclosing personal information. You’re adding one small piece to a giant puzzle of data that allows researchers like me to see a bigger picture.

Your health information can help us understand who gets sick and why. It might even be used to design real health interventions.

As a researcher focused on improving health and health care for moms and their babies, I consider myself lucky to live in Indiana, a state with one of the nation’s most comprehensive health information exchanges. These exchanges are interconnected networks of hospital system electronic health record databases from all over the state that allow researchers like me to learn about how individuals and groups experience health and medical care.

For example, my colleagues and I in the Indiana University Better AI for a Strong Rural Maternal and Child Health Environment Lab use this data to train machine learning models that predict preeclampsia, a life-threatening condition of high blood pressure during pregnancy, before a mom gets really sick.

We could use only clinical data: diagnoses, labs and vital readings like blood pressure that contribute to the outcome of preeclampsia. But for conditions like preeclampsia, Black moms are diagnosed at higher rates than their white counterparts. Research shows that race and racism can be major contributing factors to this disparity.

In order to predict preeclampsia accurately and use these predictions to help doctors monitor, diagnose and treat the condition, my team needs to factor in other information that can illuminate these different outcomes, called social determinants of health.

Social determinants of health are the parts of ourselves and our environments that drive our health status. Race itself isn’t a social determinant of health, but racism is. This includes structural racism, like a ZIP code’s history of school segregation or redlining. If available, we also include information you might have given at your doctor’s visit, like if you haven’t had enough food to eat in the past month, or if you have a history of intimate partner violence or homelessness.

Because there is more variation within races than between them, race alone actually tells us very little. Including social determinants of health in our datasets provides added context as to how you move about the world, what resources you have access to and how your environment might shape your health.

Putting the pieces together

This is why your cardiologist asks about your marital status. Your response might help researchers understand why single moms are more likely to have cardiovascular disease than their married counterparts. And telling your optometrist your race is one of the only ways to learn what role race might play in patients using weight loss drugs experiencing vision loss.

Other researchers have used data from electronic records to determine how many people in a geographic area or of a certain demographic group have diabetes, to predict dementia and even to track gum disease.

During the COVID-19 pandemic, researchers used data from electronic health records to determine what types of people were getting sick. They investigated COVID-19 patients’ race, geography and insurance status. Researchers continue to use this data to track long COVID, a condition that health professionals still don’t completely understand.

Honoring patient privacy

Of course, these health information exchanges are careful about how and with whom they share patient data. The data is tailored to the needs of the study and shared in compliance with the Health Insurance Portability and Accountability Act, or HIPAA.

For instance, for my most recent preeclampsia study, the health care system sent a dataset that contained limited pieces of personal information, like the baby’s birth date, the mom’s birth date – since we often need to know how old she was when she gave birth – and their ZIP code so we can see trends in preeclampsia across geographic areas.

The data wasn’t allowed out of the health system’s virtual private network, so the data remains within our firewall. This ensures that the data remains safe. And all of this must be approved by our university’s institutional review board, a rigorous process that ensures our research can’t harm participants.

Improving health care for everyone – including you

All of this research drives innovation and serves as a basis for the programs, protocols and policies that improve health – from you as an individual all the way to the national and even global level.

Your doctor can use the information you provide to recommend services or therapies for you. For instance, if your doctor finds out through check-in questioning that you haven’t had enough food in the past month, they can refer you to a nutrition program, sometimes run by the hospital system itself. If you were married at your last appointment but now list your marital status as “separated,” your doctor can check in with you to see if you need any additional mental health or social services.

While it’s normal for these personal questions to feel a little uncomfortable, it helps to remember that there is a good reason your doctor is asking them. Your data can help move medical research forward.

Jill Inderstrodt receives funding from US Centers for Disease Control and Prevention and National Institutes of Health.

– ref. ‘Are you married?’ Why doctors ask invasive questions during treatment – https://theconversation.com/are-you-married-why-doctors-ask-invasive-questions-during-treatment-268268

Source: The Conversation – USA (3) – By Loveline Chizobam Phillips, Ph.D. Candidate, George Mason University

One in 10 babies in the U.S. – nearly 374,000 infants – were born preterm in 2023, meaning before 37 weeks of pregnancy. More than 15% were very preterm, meaning they were born before 32 weeks. A full-term pregnancy lasts 40 weeks.

Florida’s rate is slightly higher, at about 1 in 9 babies born preterm. In an average week, 456 of the 4,257 babies born in the state will be preterm, and 75 of those will be very preterm.

According to the March of Dimes, preterm birth and low birthweight-related health complications cause 37.5% of infant deaths nationwide. This makes preterm birth the second-leading cause of infant deaths, after birth defects. Preterm babies who survive infancy are susceptible to health complications later in life, including cerebral palsy and learning disabilities.

Preterm and low-birthweight babies – those weighing less than 5.5 pounds (2,500 grams) – are far more likely to go to the neonatal intensive care unit, or NICU. Very preterm infants tend to have the longest NICU stays, averaging around 43 days.

Beyond the emotional toll this takes on a family, preterm births and their resulting health complications carry substantial financial costs. The average NICU admission in 2021 cost around US$71,000. And economists estimated the lifetime societal cost of all preterm babies born in 2016, from birth to subsequent disability care, at $25.2 billion.

We are a public policy Ph.D. student and public policy researcher focusing on health policy and population health outcomes.

Recently, we were sifting through the data on preterm and low birthweight rates in the U.S., in search of places that are doing better than average at preventing preterm births. And that is what we found in the Central Hillsborough Healthy Start program, which serves a cluster of Tampa ZIP codes with roughly 177,000 residents.

In 2008, this program published records showing 30% lower preterm and low-birthweight rates among families at highest risk. Peer-reviewed evaluations link participation in the program to substantial reductions in preterm and low-birthweight outcomes.

These remarkable improvements remained consistent through 2020.

When we looked at what this program is doing, we found a set of practices that can serve as a model for other counties in Florida and around the U.S. to lower preterm birth rates, saving money and, more importantly, lives.

Screening for risk factors

The program does early screening for risk factors of preterm birth using Florida’s Healthy Start prenatal risk screen at the pregnant person’s first prenatal visit. This screening has been proven to correctly flag a good share of higher-risk pregnancies, while avoiding many false alarms, helping scarce services reach families who need them most.

This is key, because the risk of preterm birth isn’t spread out evenly across all pregnancies. The neighborhoods that Central Hillsborough Healthy Start serves include many young, Black, unmarried, low-income families that are eligible for Medicaid. All of these factors place them at high risk for preterm birth.

Early screening allows the Healthy Start program to identify mothers at highest risk and tailor its resources to assist them.

Measuring against the rest of the state

The Florida Healthy Start prenatal risk screen is available throughout the state. Florida created Healthy Start in 1991 precisely to reduce infant deaths and low birthweight through universal prenatal and infant risk screening, community coalitions and coordinated services.

While Florida’s preterm birth rate in 2023, the most recent year for which there is data, was 10.7%, Hillsborough County tracked slightly below the U.S. average of 10.4% at about 10.2% of the county’s 16,900 births.

That difference may seem small, but it represents 85 fewer preterm babies in Hillsborough County, and at the average rate of $71,000 per NICU admission, that’s about $6 million in hospital spending avoided in a single year.

In addition, statewide, 14.8% of Black infants were born preterm in 2023, slightly higher than the 14.65% average across the U.S. In Hillsborough County in the same year, it was 13.9%.

Among pregnant women without a partner, participation reduced very preterm births by 52% and halved the rate of very low-birthweight babies – that is, babies weighing less than 3.3 pounds (1,500 grams).

Obese mothers in the program had a 61% lower chance of extremely preterm birth, which means birth before 28 weeks of pregnancy, than comparable women elsewhere in Florida. Even exposure to air pollution, a known risk factor for preterm birth, was less harmful among women in the program.

So what has Central Hillsborough Healthy Start been doing differently?

The Central Hillsborough Healthy Start model

The model used by Central Hillsborough Healthy Start is practical and straightforward.

After early screening, nurses make home visits and help coordinate patient care for mothers in the program.

Central Hillsborough Healthy Start also provides prenatal education, depression screening and programs to help pregnant mothers improve their health and decrease harmful practices such as smoking or substance abuse. These programs are critical, because obesity, diabetes, hypertension and smoking during pregnancy are significant risk factors for preterm births.

The program also helps to connect patients to resources they may need during and after pregnancy by making personal introductions to community partners such as women and infant resource specialists in women, infants and children, or WIC, clinics.

Healthy Start workers also connect patients to interconception care for healthy birth spacing between pregnancies, which can help prevent future preterm births. Studies show that more than 30% of U.S. mothers who give birth preterm conceived their baby less than 18 months after having their previous child.

The Healthy Start staff use Florida’s coordinated intake and referral approach to track referrals and follow up across partners. This is vital to helping the program’s staff see who has been contacted, which services were delivered and whether referrals took place. They can then follow up if necessary.

Stability and sustainability

Central Hillsborough Healthy Start operates through a local nonprofit, REACHUP Inc., in partnership with the University of South Florida and the Hillsborough Healthy Start Coalition.

Its funding comes primarily from the federal government through the Health Resources and Services Administration’s national Healthy Start program. The program’s current federal funding extends into 2029. But proposed changes to the federal budget threaten to eliminate this funding altogether.

The program’s budget is supplemented by local partners, including Hillsborough County, which helps sustain operations despite federal uncertainty.

Locally, the Hillsborough coalition’s portfolio includes programs that work together like one team, sharing information so families keep getting help even when one grant ends. These partnerships with local community organizations allow the program to remain stable.

A model for others

Looking at the data, we believe Central Hillsborough Healthy Start has succeeded by using the same basic approach for everyone, then customizing. Everyone gets screened early and set up with nurse visits. Then, its adds what each family needs so that support fits real life.

The Central Hillsborough story shows that health disparities are not inevitable. And this model can serve as a feasible blueprint for other communities. With early identification, consistent support and sustained investment, the outcomes for mothers and babies can improve dramatically.

Read more stories from The Conversation focused on Florida.

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

– ref. How one Florida program reduced preterm births – and how it could serve as a model for other communities – https://theconversation.com/how-one-florida-program-reduced-preterm-births-and-how-it-could-serve-as-a-model-for-other-communities-268058