Category: The Conversation

Source: The Conversation – UK – By Toni Beardmore, Lecturer in Human Geography, Aberystwyth University

Many people can recall moments when they have been mocked, judged or subtly excluded because of where they are from, how they speak or because they seem out of place in certain settings. These moments rarely look like overt discrimination. Instead, they might take the form of jokes, assumptions or signals that someone doesn’t belong.

Class-based discrimination might be dismissed as harmless banter or attributed to personality clashes, but research on social interactions shows that what is labelled banter can quickly cross into harmful or exclusionary behaviour.

One reason for this is that class discrimination frequently operates through culture – in the everyday norms and expectations that shape how people are perceived and included – rather than through explicit rules, such as those that define unacceptable conduct. It is therefore rarely recognised as discrimination in the same way as sexism or racism. This makes it both harder to challenge and easier to overlook, even though it remains widespread.

Research on accent bias particularly illustrates this. A 2022 report by the Sutton Trust found that one in four professionals have been mocked or singled out in the workplace due to their accent. Among senior managers from working-class backgrounds, almost 30% had experienced this treatment in the workplace. Similarly, almost a third of university students reported the same in education settings. In social settings, these figures rise to almost half in both professional and student groups.

These findings matter because they show that class-based stigma doesn’t disappear with professional or educational success. Regardless of economic or social mobility, class-based cultural markers such as accent continue to shape how people are perceived and treated.

Research shows that class inequality is not just about material assets and occupation, it’s embedded in more subtle ways. It shapes our confidence our self-worth and our sense of our place in society. This is sometimes referred to as the hidden injuries of class. These injuries arise not from cultural differences themselves, but from the stigma and exclusions attached to them. This covert dimension of class helps explain why class discrimination is often felt, but less often addressed as such.

Discrimination that defies definition

Part of the challenge is that social class is hard to define. Unlike income and occupation, it is not a single measurable attribute. Class is fluid and contextual, shifting across spaces and relationships. Someone might feel working class in a professional space but middle class at home, and vice versa. A person might occupy spaces associated with a higher class, but hold cultural markers associated with groups historically excluded from them.

This fluidity means that class is noticed but not easily stated and measured. It’s signalled through accent, vocabulary, tastes, humour, norms and values and it shapes how people are judged, without those judgements being widely recognised as discriminatory.

Due to class being signalled through cultural markers, subtle judgements about people’s background are often tolerated. Class-based mockery also remains unusually acceptable. While explicit comments about race, disability or religion are widely recognised as harmful, remarks about someone sounding “common”, “too posh” or “out of place” often pass without challenge. This normalisation helps sustain class discrimination by framing exclusion as a personality difference.

Why it matters

The consequences of class discrimination are far from trivial. When people are made to feel out of place at work or in education, it shapes whose voices are taken seriously, who is encouraged to network, who is seen as promotion-ready and who is treated as if they belong. Over time, these patterns produce inequalities in progression, leadership and representation. Because these processes rarely break policy, they remain difficult to challenge through existing frameworks.

This is part of a broader challenge: legal and institutional systems tend to work best when disadvantage is visible, stable and clearly measurable. Class resists these criteria. It shifts across contexts, operates through culture as much as economics, and is often felt before it can be named. The hidden injuries of class, therefore, fall through the cracks between personal experience and institutional accountability.

One reason for this is that, unlike race, gender and disability, social class is not a protected characteristic under the Equality Act. This means there’s no formal duty to monitor class-based disadvantage or discrimination.

This gap has prompted growing calls from professional bodies and advocacy groups to take socioeconomic background more seriously in equality policy. But translating lived experiences of class into fixed legal categories remains difficult, given how fluid class identities are.

Whether or not class becomes formally recognised in law, the underlying issue remains. Many people continue to experience exclusion, stigma and disadvantage linked to background rather than ability or achievement, often in ways that remain invisible to institutions.

Understanding class discrimination therefore requires moving beyond income statistics or occupational categories alone. It means paying attention to how class is lived: how people are read, judged and positioned in everyday interactions. It also means recognising that some of the most enduring inequalities operate not through formal barriers, but through judgements about who belongs and who does not.

Naming these processes does not solve them, but it does make them harder to dismiss. Recognising how class shapes everyday experiences of belonging is a necessary step toward understanding inequalities that persist even when formal barriers have fallen.

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

– ref. Mocking people for their class is discrimination – so why don’t we treat it as such? – https://theconversation.com/mocking-people-for-their-class-is-discrimination-so-why-dont-we-treat-it-as-such-275649

Source: The Conversation – UK – By Steve Schifferes, Honorary Research Fellow, City Political Economy Research Centre, City St George’s, University of London

The decision by the US Supreme Court to rule most of Donald Trump’s “liberation day” tariffs illegal will have far-ranging consequences for the president’s economic agenda. Although the administration will find other ways to increase tariffs, their usefulness as a weapon of economic warfare will be diminished. And the issue – among the most unpopular of the president’s economic policies – will cause him serious political damage.

Trump’s first move following the ruling has been to impose a 15% tariff on all imports. Imposed under a little-used law, the tariff rate is fixed and time-limited to 150 days before needing congressional approval. It would take only a few Republicans to block its extension. And the midterm elections are looming.

Using a flat-rate tariff means that some countries that settled earlier and got a better deal – including the UK – are now worse off, while others that had a higher tariff rate imposed on them have, at least for now, benefited. It also could mean that those that pledged to invest hundreds of billions in the US economy – including Japan and the EU – may now question whether their commitment still stands.

Trump’s ability to threaten instant retaliation to any country that crosses him will also be constrained by the other two legal routes he can use to raise tariffs. Both provisions would require time-consuming, detailed investigations into specific industries or countries, and rates once fixed cannot as easily be changed.

The domestic political fallout from the Supreme Court decision is also substantial. Two thirds of the US public disapprove of Trump’s tariff policy, with large sections believing that his tariffs are inflationary.

Democrats are already calling for the money raised to be returned to consumers. And businesses, including small firms hit hard by the tariffs, are suing the government. If the US government can no longer rely on the income from tariffs – which rocketed to US$287 billion (£211 billion) this year – it would put further pressure on the fast-growing federal budget deficit. This is already US$2 trillion and projected to rise to US$3 trillion by the 2030s, as a result of Trump’s large tax cuts.

Nor have Trump’s tariffs achieved their objectives. The trade deficit was slightly larger in 2025 than the year before, with US$1 trillion more goods being imported than exported. Tariffs have not boosted jobs: manufacturing employment fell by 80,000 and unemployment is up to 4.3% compared to 4% in January 2025.

The bigger problem for the president is the overall performance of the economy. The Republicans have only a narrow majority in the House of Representatives, and most observers are predicting that the Democrats will gain control in November. Trump’s ratings on his performance on the economy have been slipping, with 55% now disapproving. And 65% disapprove of his handling of inflation.

He now faces an uphill struggle in the State of the Union address to convince the public that the economy is back on track under his leadership.

Weak growth and high inflation

There is still debate over how much the tariffs have contributed to inflation, but the US economy is only growing at 2.2% a year, its slowest rate since 2020.

Inflation is the main concern of US voters, with figures putting the rate at 2.9% – well above the Federal Reserve target of 2%. Estimates by economists suggest that companies are increasingly passing on the cost of tariffs to consumers, which may well be driving inflation. Recent job figures may have provided some more positive news, but voter worries about high prices may be hard to shift.

Trump’s next battle is for control of the US Federal Reserve. This independent agency sets short-term interest rates and manages the US currency – Trump wants it to sharply cut interest rates to boost the economy. But Fed chair Jerome Powell is reluctant to cut rates too quickly when inflation is not yet contained.

Powell’s term is due to end in May, and the president has nominated a new chair, Kevin Walsh, who backs his policy of more interest rate cuts. But he will need to convince a majority of the other 11 members of the Fed’s Open Market Committee to go along with these.

Trump, as well as being openly critical of Powell, also fired (in an unprecedented act) Fed governor Lisa Cook, a supporter of Powell who was appointed by President Joe Biden. This decision is being challenged in the Supreme Court, and in a preliminary hearing several judges appeared to be sceptical of its legality – including Brett Kavanaugh, a conservative who voted in favour of Trump in the tariff case.

Financial markets could wobble if Trump succeeds in taking political control of the Fed. Its independence is seen as vital for ensuring non-partisan and credible management of interest rates and inflation. But if Trump does force the Fed to cut rates further, this could add to the inflationary pressures and damage the Republicans’ path to retaining power in the midterms.

After one year back in power, Trump’s failure to deliver his promised transformation of the US economy (and especially to tackle inflation) is having serious political consequences that could damage his freedom of action. The Supreme Court’s ruling has thrown US tariff policy into turmoil and weakened the president’s ability to dictate to other countries on both economic and political issues.

If the Supreme Court also backs the independence of the Federal Reserve, Trump’s bid for complete control of US economic policy will face another major setback. But the most important limit on the president’s powers would be a defeat for the Republicans in the midterm congressional elections in the House of Representatives, leading to a divided Congress that will no longer rubber-stamp Trump’s policies.

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

– ref. The Supreme Court’s ruling leaves Trumponomics facing major challenges – https://theconversation.com/the-supreme-courts-ruling-leaves-trumponomics-facing-major-challenges-276792

Source: The Conversation – UK – By Sara Brown, Grant Chair of Dermatology, Wellcome Trust Senior Research Fellow, University of Edinburgh

Creams marketed to lighten skin tone are being sold illegally on British high streets, including in butchers and specialist food shops. It is an unsettling discovery, but perhaps not a surprising one. Demand for these products is real and the profits are significant. But the ingredients that make them effective are also what make them dangerous.

Healthy human skin comes in a wide range of diverse tones. These can change over time because of illness, hormones, sunlight or ageing. Some people want to lighten their overall skin tone, and “colourism” – discrimination or prejudice that favours lighter skin tones over darker ones – may contribute to psychological distress among people of colour. Others want to fade darker patches.

Acne, eczema and other inflammatory skin conditions can leave areas darker or lighter than the surrounding skin. This is known as hyperpigmentation (darkening) or hypopigmentation (lightening). Hormonal changes can also disrupt pigment, and scars can permanently alter skin colour.

Often, the skin will gradually return to its natural tone. But this can take months or even years. The desire to speed up that process has led to the development of chemicals that reduce or block melanin – the pigment that gives skin its colour.

Some of these chemicals have a powerful effect. Because of the risks, their sale is tightly controlled. Yet concern is growing about products sold in the UK that contain banned ingredients. These include mercury, hydroquinone and strong steroid drugs.

Mercury – sometimes called quicksilver – is a liquid metal once used in thermometers and in hat making. On the skin, it blocks an enzyme needed to produce melanin, which can make the skin appear lighter.

But mercury is highly toxic. It can damage the skin directly and be absorbed into the body, harming the kidneys, liver, lungs, nerves and brain.

Hydroquinone also reduces melanin production in the outer layer of the skin. In the UK it is available only on prescription and can be used to treat conditions such as melasma, a common form of facial pigmentation.

But it must be used carefully. It can irritate the skin and, in some cases, cause a long-term grey-blue discolouration known as ochronosis.

Steroid creams are widely prescribed for inflammatory skin conditions. Stronger forms are available only on prescription because of well-known side-effects, including thinning of the skin and absorption into the bloodstream. There is also increasing concern about “topical steroid withdrawal”, a condition where the skin flares badly after stopping prolonged use of these creams.

Potent steroids can lighten skin quickly by narrowing blood vessels and, over time, by affecting the cells that produce pigment. They are sometimes added to skin-lightening products to reduce irritation from other ingredients. But long-term use can cause acne, stretch marks, diabetes and osteoporosis. In the UK, stronger corticosteroids are only available with a prescription.

The legal products

Not all skin-lightening products are illegal. Some cosmetics are designed to gently reduce dark spots. These may contain antioxidants such as vitamin C, which can reduce pigmentation, or niacinamide (a form of vitamin B3), which can help even out skin tone over time. Others contain retinoids – vitamin A-related compounds – including retinol and retinal. These can gradually improve pigmentation.

There are also prescription-only retinoids, such as tretinoin, which doctors use for acne and certain pigment problems. But all retinoids can irritate the skin. However, irritation itself can trigger further darkening, known as post-inflammatory hyperpigmentation. In other words, a product meant to lighten the skin can sometimes make patches darker.

Under UK law, cosmetic products must list the manufacturer or importer, provide an address and include a full ingredient list. If this information is missing, alarm bells should ring.

Enforcement action has been taken before, with retailers brought to justice. Still, illegal products continue to surface in places that seem safe and familiar.

If a cream promises dramatic lightening, especially at a low price, it is worth asking why. When it comes to skin, safer and slower is usually better than fast and risky. But the message is clear: colourism and unrealistic beauty standards that fuel demand for skin lightening products pose harm for all in our society.

Sara Brown currently receives funding from the Wellcome Trust, UKRI/MRC, British Skin Foundation, Rosetrees Trust, Stoneygates Trust and anonymous donations from people living with eczema. Sara is a medical adviser for Eczema Outreach Support and the Ichthyosis Support Group.

– ref. Skin lightening creams sold illegally on British high streets – the hidden dangers – https://theconversation.com/skin-lightening-creams-sold-illegally-on-british-high-streets-the-hidden-dangers-276309

Source: The Conversation – UK – By Andrew McInnes, Reader in Romanticisms, Edge Hill University

Would Jane Austen have even understood the question of whether she was gay? Michel Foucault, French theorist and author of The History of Sexuality (1976), would answer: “Non”.

Foucault argues that, even though homosexual acts had been performed in the past, homosexuality as an identity did not develop until the later 19th century. Before then, you could do homosexuality, but you couldn’t be a homosexual. That’s because homosexuality as an identity didn’t exist yet.

Anne Lister, a contemporary of Austen’s who wrote coded diaries about her sexual liaisons with women and is now often hailed as the first modern lesbian, might disagree with Foucault. But it is unlikely that Austen thought of herself as gay.

In 1995 the London Review of Books (LRB) ran a review of Deidre Le Faye’s monumental edition of Austen’s letters. The piece, written by US literary critic Terry Castle was called Sister-Sister, but it was cheekily retitled “Was Jane Austen Gay?” on the cover. In her article, Castle suggested that Austen appears mainly dismissive of men in her correspondence, and was similarly dismissive of the various proposals she is said to have received.

Castle’s review, especially the LRB’s provocative retitling, caused a storm in a teacup of Austenian proportions. Readers of the LRB and Austen scholars fell into a fury of scandalised incomprehension, trading competing interpretations of Austen’s private life and public writing.

For Castle, Austen’s most significant relationship was with her sister, Cassandra. Her nuanced argument about the erotics of this relationship was brought to life recently in a collaboration between the LRB and City of London Sinfonia in London’s Covent Garden, the event’s name recalling the LRB coverline for Castle’s essay.

Becoming Jane and friends

A one-off show which was part of the LRB and City of London Sinfonia’s Ideas in Concert series, Was Jane Austen Gay? brought to life Castle’s essay and the tumultuous response to it. Actresses Claudie Blakley, who played Charlotte Lucas in the 2005 Pride and Prejudice, and Lost in Austen’s Jemima Rooper read out Castle’s essay, as well as letters from, to, and about Austen. A concert mixing songs from Austen’s own music collection with modern-day Austen film soundtracks accompanied the staged reading.

The show began and ended with Castle’s bewildered response to the brouhaha that erupted over her argument on Austen’s inner life. “Surely,” bemoans Castle, “literary critics writing in the London Review are still allowed to speculate about such things”. As Blakley and Rooper demonstrated in the reading of Castle’s essay, Castle herself was not above a little childishness – malevolence, even.

She describes – deliciously – Cassandra’s portrait of Jane as having eyes like “small astigmatic raisins”. So mean, and so Austen-like! And she also ventriloquises a taboo wish, which she detects running through writing on Jane and Cassandra: “Why did Jane have to be the one to die?”

Blakley and Rooper performed Castle’s essay in different voices, affecting an American twang for the critic’s rueful response to her British reception. They also alternated between breathless excitement for Jane, mournfulness for Cassandra, and pomposity for Austen’s family biographer James Edward Austen-Leigh.

There were voices, too, from Austen’s fiction, including Northanger Abbey’s Henry Tilney, an “unheterosexual” (to borrow critic D.A Miller’s phrase gentleman with a fondness for fine fabrics, and Emma, erotically enamoured with Harriet Smith.

The evening allowed for a deeper dive into Austen’s letters, as well as a taster of Anne Lister’s, and took great delight in dramatising the aftermath of Castle’s essay, often very funnily. This included a letter from the Independent’s arts correspondent castigating Terry Castle’s prurience, while mistaking her for a man. The LRB editors laconically responded: “We wonder what Ms McDonald would have written had she been alert to the fact that Terry Castle is a woman.”

Alexandra Wood, violinist and creative director of City of London Sinfonia, brought together a wonderful ensemble to provide a musical counterpoint to Blakley and Rooper’s dramatised reading of Castle’s essay. When Blakely and Roper discussed Jane’s flirtatious style in her letters to Cassandra, the music teased and flirted with the audience.

Another letter published in the wake of Castle’s essay, by the great Austen scholar Claudia Johnson – sadly overlooked in this event – begins: “Is she prudish? – is she queer?” Johnson playfully shifts focus from Austen’s sexuality to the oddness of one of her character’s here. Fanny Price is “queer” because she is immune to the dubious charms of Henry Crawford, who is asking these questions about her in Mansfield Park.

Reviewing attitudes to Austen’s sexuality that run the gamut from frigid to lesbian, Johnson defends Castle’s argument that sisterly bonds are among the most powerful in Austen’s writing. She expresses a preference for the naughty Austen glimpsed in her letters to Cassandra and available as a narrative voice – mischievous, stylish, “unheterosexual” – in her novels.

It is a voice that finds excitement and enjoyment by pressing at the confines of the marriage plot, which enforces a kind of normative heterosexuality on proceedings. It laughs at the misunderstandings and miscommunications that seem to bedevil all the actual marriages in Austen’s novels, and sides with characters like Henry Tilney, Emma Woodhouse and Fanny Price, who stand apart from these heterosexual demands, desiring otherwise.

Like Johnson, along with Castle and the organisers of “Was Jane Austen Gay?”, I find this naughty Austen more seductive than alternative visions of her as a heteronormative moraliser. Reading Austen’s novels queerly opens them up as works with surprising and subversive things to say about how to live and think and write. Even if Austen herself did not – and could not – think of herself as a homosexual, her writing invites queer interpretations, celebrating the mischievous, the stylish, and the “unheterosexual”.

Rather than asking “Was Jane Austen Gay?”, perhaps we should ask, “How can we read Austen today?” The original Castle essay and the LRB/CLS event named after it provide ways to do just that, thinking about Austen speculatively, wittily, and musically.

This article features references to books that have been included for editorial reasons, and may contain links to bookshop.org. If you click on one of the links and go on to buy something, The Conversation UK may earn a commission.

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Andrew McInnes received funding from AHRC for his Early Career Researcher Leadership Fellow project, ‘The Romantic Ridiculous’, which ran from 2020-2022.

– ref. Why asking ‘Was Jane Austen gay?’ still causes controversy – https://theconversation.com/why-asking-was-jane-austen-gay-still-causes-controversy-275180

Source: The Conversation – UK – By Dorje C. Brody, Professor of Mathematics, University of Surrey

When deciding whether to invest in environmental projects, it’s important to consider the economic value of any long-term benefits.

Whether climate solutions (such as offshore wind power or solar farms) are recognised as valuable or worthless depends very much on which economic model is used to evaluate it.

If the present value of the benefit (calculated by using a widely accepted financial model called “exponential discounting”) is too small compared to the cost, it may seem to damage the economy too much.

As a mathematician researching in finance, my study shows how it is possible to use another financial model called “social discounting” to value the long-term benefits far into the future. My colleague and I have demonstrated that a perfectly consistent valuation method can be established using social discounting.

Exponential discounting is commonly used to calculate the present value of a future benefit. Banks use this all the time to calculate the value of products linked to interest rates. Exponential discounting tells us how much to put in an account now to reach that future value – it incorporates how, when interests accumulated overnight are instantly put into the account, those interests will accumulate additional interests.

Social discounting is another way of calculating the present value of future, long-term benefits such as the prevention of drought, forest fire, or the submersion of coastal cities.

A recent University of Exeter report titled Recalibrating Climate Risk highlights a range of shortcomings in how traditional economic models are applied to climate issues.

While it makes sense to use exponential discounting if the future beneficiary of the decision made today is the same person who is making the decision, that isn’t always the case when they are different.

The benefits of long-term social projects for sustainable energy or climate change may only arise in 100 years. By using an exponential discounting model, a large benefit occurring in the distant future will be assigned an unfairly low value right now. This won’t be enough to justify the costs involved in funding the project, so the project might not get off the ground.

Given that future generations have no say on choices made by society today, it seems unfair to heavily discount their future benefits. Nevertheless, there is a strong argument, most notably advocated by the climate economist and Nobel laureate William Nordhaus, that investment in climate projects should be treated like any other investment; subject to the usual exponential discounting.

The Nordhaus argument is widely used to evaluate climate policies around the world. For example, a UK thinktank called the Global Warming Policy Foundation has used it to warn the government against investing in safeguarding future generations. Fossil fuel companies employ versions of the Nordhaus argument to deter public investment in climate policy and focus on the short-term benefits of an economy based on fossil fuel extraction.

There is a catch

Leaving aside morale and ethical debates on the use of exponential discounting, a little-known principle in finance shows that the exponential rate of discounting cannot decline over a long time horizon when benefits of climate policies are delivered.

One consequence is that the benefit of long-term social projects to tackle climate change is inevitably heavily discounted in the exponential model. This makes the investment seem less attractive, making it difficult for lawmakers to pass climate bills.

An alternative assessment follows from using social discounting, where the discounting is considerably milder so that the present value of the benefit of a climate policy far in the future may be as significant as the amount of investment required for implementing the policy, making the investment a worthwhile proposition.

In spite of its morale attraction, in the academic literature it was thought for a long time that it is not possible to evaluate future benefits in a consistent way using a social discounting. Without evaluating future benefits in a reliable, consistent way makes it difficult to argue the economic case for a climate investment. But my research shows that it is possible.

There are no economic or financial reasons to circumvent the use of social discounting on the basis of consistency. So it’s time to move on from the old-school economic arguments favoured by the fossil fuel industry and other climate sceptics.

Dorje C. Brody has received funding from UKRI.

– ref. Funding climate projects: our financial model can better illustrate long-term value – https://theconversation.com/funding-climate-projects-our-financial-model-can-better-illustrate-long-term-value-275849

Source: The Conversation – UK – By Frances Hand, DPhil Candidate, Faculty of Law, University of Oxford

In the UK, women have more choices about how to give birth than ever before, from a water birth at home to a caesarean delivery in hospital. But choice does not always mean labour unfolds as initially planned.

First-time mothers are more likely to experience medical interventions during labour. The most common include episiotomies, a cut made at the vaginal opening to widen the passage, and assisted vaginal births using forceps or a ventouse, also known as a vacuum device.

While some procedures, such as caesarean deliveries, are widely understood, others are less familiar. In the UK, doctors must obtain a woman’s consent before carrying out any medical intervention during labour. This involves explaining the risks, benefits and alternatives.

But being asked to absorb new information and make decisions during labour, without prior knowledge of these procedures, can make this process very difficult.

Birth trauma

Experiences such as these can leave women with lasting and complicated feelings about childbirth. Even when mother and baby leave hospital without long-term physical injuries, the psychological impacts can be significant – affecting the mother, her attachment with her baby, and also relationships with loved ones.

To explore this further, our team carried out a retrospective service evaluation at a maternity unit in south-east England. We asked women to look back on their experiences of assisted vaginal births.

Many said the intensity of labour and the need to process unfamiliar information meant the time available to make decisions felt too short. Two-thirds reported feeling under-informed about assisted vaginal delivery, and 11.6% said they consented to interventions they did not fully understand.

One way to better support decision-making during labour may be to provide clearer and more consistent information during pregnancy. Research suggests access to this information can be a lottery. Some people receive detailed explanations from midwives or antenatal classes while others do not, even if they would like that support.

Social media is often used to fill this gap, but it can be difficult to separate reliable advice from misinformation. Birth influencers have gained large followings, despite some sharing inaccurate or potentially harmful claims.

Algorithms may also create the impression that only one type of birth is acceptable or “normal”. In reality, one in five first-time mothers have an assisted vaginal birth. Knowing this might help reduce the feelings of failure that some women report after having an intervention.

Access to reliable, evidence-based information is an important step in reducing the likelihood of women feeling “out of control” during birth, which is a risk factor for birth trauma.

Access to information

Access to information should be a right, not an obligation. Some participants in our evaluation said they would not find additional detail helpful. They felt that in-depth discussions about risks and benefits before labour might feel overwhelming unless the intervention became necessary. Women and birthing people who feel this way should be able to decline that information.

What matters most is the ability to access information for those who want it. Our findings suggest that familiarity with the basics of labour interventions before birth could improve decision-making. If consent discussions arise during labour, there is then more time to focus on the individual’s particular situation.

Participants suggested standardising antenatal education, possibly with input from both midwives and obstetricians, or including clearer discussion of labour interventions during routine antenatal appointments.

However, many maternity units are working with limited staff and heavy workloads, and antenatal appointments are often brief. Any additional discussions about labour interventions would need to be realistic about clinicians’ time and capacity. Alongside our audit with women, we also asked clinicians at the same hospital for their views on improving consent for assisted vaginal birth. This work is now being analysed.

Access to antenatal education plays an important role in helping women prepare for childbirth. Our findings suggest that information about assisted vaginal birth is not equally available to everyone.

Women should be able to learn about these procedures at a time and in a way that suits them. This could support more informed consent conversations during labour, and improve experiences of care overall.

Morganne Wilbourne receives funding from the Kennedy Institute of Rheumatology for her DPhil at the University of Oxford.

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

– ref. Why labour decision-making shouldn’t start in the delivery room – https://theconversation.com/why-labour-decision-making-shouldnt-start-in-the-delivery-room-276030

Source: The Conversation – UK – By Neil Mabbott, Personal Chair of Immunopathology, University of Edinburgh

Vaccines have traditionally worked by teaching the immune system to recognise a specific virus or bacterium – in effect, showing it a wanted poster for a single suspect. But what if one vaccine could protect against dozens of different infections at once? Researchers have now developed a potential candidate for such a vaccine, and a new study in mice, published in the journal Science, has given promising results.

What is this new vaccine, and how does it work?

Most vaccines work by introducing the immune system to a specific pathogen – a weakened version of it, or a key protein from its surface – so that the body can recognise and fight it if encountered later.

This vaccine takes a fundamentally different approach. Rather than targeting any one bug, it contains molecules that mimic the signals the body naturally produces when it is under attack from a virus or bacterium. The effect is to put certain immune cells into a prolonged state of high alert, ready to respond rapidly to a wide range of threats, rather than being trained to spot just one.

However, the consequences to dialling up the immune system beyond its normal state won’t be known until human trials are conducted.

Why is it given as a nasal spray rather than an injection?

The nose, throat and lungs are lined with what scientists call mucosal surfaces – the moist tissues that act as the body’s main point of contact with the outside world, and its first barrier against infection. The immune system in these tissues responds more powerfully when a vaccine is delivered directly to them, rather than into a muscle in the arm.

That principle already underlies the routine flu vaccine given to young children in the UK, which comes as a nasal spray. Research has also shown that COVID vaccines can block infection more effectively in animals when delivered this way, rather than by injection. Spraying the new vaccine into the nose allows it to reach immune cells deep in the lungs.

How can one vaccine protect against so many different pathogens?

The vaccine works by enhancing communication between two key types of immune cell. The first are alveolar macrophages – large cells positioned in the tiny air spaces of the lungs, where they act as a first line of defence against anything harmful that is inhaled. When primed by the vaccine, they are able to engulf and destroy invading pathogens far more rapidly than usual.

The second are T cells, which are pushed to mount faster antiviral responses. Because the vaccine is boosting these general frontline defences rather than targeting any specific pathogen, it can in theory work against a broad range of threats.

In mice, it also appeared to suppress allergic reactions – to house dust mites, for example – because the strong inflammatory immune response it triggers appears to displace the quite different response that drives allergies.

The study was done in mice. How confident are scientists that it will work the same way in humans?

Cautiously hopeful, but not yet confident. There are well-documented differences between mouse and human immune systems, and promising results in animals frequently fail to translate to people. The critical next step will be controlled human infection studies – trials in which healthy volunteers are vaccinated, exposed to a specific pathogen under close medical supervision, and carefully monitored for both safety and immune response.

Could this really replace multiple jabs a year? And which ones, specifically?

Potentially, yes – at least for some. If it proves effective in humans, a vaccine of this kind could in principle replace the need for separate annual jabs against flu, COVID and common cold viruses, all of which are RNA-based viruses, meaning their genetic material is RNA rather than DNA. Whether it would extend to DNA-based viruses – those responsible for chickenpox or hepatitis, for example – is far less certain and would require separate investigation.

How long does the protection last, and would people need a booster?

In mice, protection lasted up to three months. This is considerably shorter than conventional vaccines in humans, some of which offer protection for years or even a lifetime. How long this type of vaccine might provide protection for in humans is not currently known. A similarly short period of protection in humans could be viewed as a real limitation, but not necessarily a fatal one

If the vaccine were given each autumn, it could provide meaningful protection to vulnerable people across the winter months, when respiratory infections peak. Even time-limited immunity, deployed strategically, could save lives.

What are the next steps before this reaches the public?

Demonstrating safety is the immediate priority. Because the vaccine is designed to keep parts of the immune system in a heightened state for an extended period, there is a need to confirm that this does not cause unintended harm to healthy tissue.

Scientists also need to establish that the strong inflammatory response it triggers does not increase susceptibility to other infections – intestinal parasites, for instance – whose biology overlaps with allergic responses.

How the vaccine performs in older people, who are most vulnerable to severe respiratory illness, is another important unknown. During ageing, a low level of background inflammation, known as inflammaging, can also contribute to age-related diseases and reduce immunity to past infections.

How soon could we have this?

The study’s senior author, Bali Pulendran, says that in the best-case scenario a universal respiratory vaccine might be available in five to seven years.

However, progress will depend heavily on how early human trials perform. If the vaccine proves less potent in people than in mice, or if safety concerns emerge, the formulation will need to be revised, adding time at every stage.

A strong early showing, on the other hand, could build momentum. Either way, developing a human-ready formulation, completing safety trials, and testing how effective it is against multiple real-world pathogens is a substantial undertaking that cannot easily be rushed.

Could this work against future pandemic viruses we haven’t even encountered yet?

This is arguably where the potential is greatest. Conventional vaccines against flu and COVID require regular updating because the viruses mutate. And when the vaccine strain does not closely match what is actually circulating, protection can fall short.

A vaccine that places the immune system on broad, non-specific high alert could offer a critical first layer of defence against a new pandemic pathogen, limiting serious illness and death while a targeted bespoke vaccine is developed. In a world still living with the memory of COVID, that possibility alone makes this research worth watching.

Neil Mabbott receives research funding from the UK Biotechnology and Biological Sciences Research Council, the Roslin Foundation, the Creutzfeldt-Jakob Disease Foundation, and Zoetis.

– ref. Universal vaccine to treat colds, flu and COVID developed – and a new study suggests it just might work – https://theconversation.com/universal-vaccine-to-treat-colds-flu-and-covid-developed-and-a-new-study-suggests-it-just-might-work-276558