WHO approved a malaria vaccine for children – a global health expert explains why that is a big deal

The World Health Organization recommended its first malaria vaccine for children on Oct. 6, 2021 – a breakthrough hailed by the U.N. agency as a “historic moment.”

Approval of the RTS,S/AS01 vaccine, which goes by the name Mosquirix, provides a “glimmer of hope” for Africa, according to Dr. Matshidiso Moeti, WHO regional director for Africa. It will now be rolled out to protect children against one of the world’s oldest and most deadly diseases.

Malaria and global child health expert Dr. Miriam K. Laufer answered The Conversation’s questions about the vaccine and the WHO announcement.

What has the WHO announced?

The WHO has recommended the use of the RTS,S malaria vaccine, which is produced by GlaxoSmithKline. It is the first malaria vaccine to be recommended by the global health body.

It follows a review of two years of piloting studies of the vaccine in three sub-Saharan African countries with a high burden of malaria: Malawi, Kenya and Ghana.

After careful evaluation and extensive discussion, the WHO came to the consensus that the vaccine should be recommended for use in children living in areas of moderate to high malaria burden.

Why is this seen as a major development?

Malaria kills hundred of thousands of children, mostly in sub-Saharan Africa, every year. This is the first time that researchers, vaccine manufacturers, policymakers and advocates have successfully delivered a vaccine that has made it through clinical trials and received not only regulatory approval but also a recommendation from the WHO.

This vaccine prevents about 30% of severe malaria cases that are more likely to lead to death.

Although researchers knew that RTS,S was effective in well-controlled clinical trials, a few questions remained about whether it was feasible for sub-Saharan African countries to safely roll out the four-dose vaccine in a real-world setting. But since 2019, the malaria vaccine implementation program in Malawi, Kenya and Ghana has shown excellent vaccine uptake and a good safety profile. To date, the vaccine has been administered to around 800,000 children in those three countries.

How big a killer is malaria?

Malaria, a parasitic disease transmitted by bites from infected mosquitoes, causes nearly half a million deaths per year, mostly in children in sub-Saharan Africa.

It is a disease that preys on the poorest of the poor. It causes the most disease and death in places where people lack access to basic health care, where housing conditions allow mosquitoes to enter and where inadequate water management provides breeding ground for mosquitoes. Despite international efforts to control it, the burden of malaria has continued and even increased over the past several years.

How effective will the vaccine be compared to other treatments?

We learned through the report of the trials to the WHO that the vaccine will be able to reach all children in areas of moderate to high risk of malaria. This will save lives from the deadly infection, especially among children with limited access to health services.

Prevention is almost always more cost-effective than treating disease, especially with an infection as common as malaria. Drugs are sometimes used to prevent malaria, but they have to be given frequently, which is both expensive and inconvenient.

In addition, the more often a drug is used, the more likely the malaria parasites will develop resistance to the drug.

Why did it take so long to develop a vaccine?

Lack of political will to develop a malaria vaccine certainly played a role in why it took so long. With no real market for a malaria vaccine in resource-rich countries like the U.S., pharmaceutical companies did not have a strong financial incentive to accelerate vaccine development.

But the malaria parasite is also very complex, and the targets of the immune system are diverse, so developing an effective vaccine wasn’t easy.

A vaccine developed against one malaria strain grown in the laboratory generally does not work against many of the malaria parasites that children encounter when bitten by infected mosquitoes, which is why even though RTS,S is a good vaccine, it protects against only 30% of infections.

If you think about this in terms of the COVID-19 vaccine, researchers developed a vaccine against the strain of the disease that was circulating in early 2020. But now we see that the vaccine does not protect people quite as well against the new delta variant. Someday a variant may emerge that completely escapes the vaccine immune response.

For malaria, there are many variants of many different proteins, so finding a vaccine that covers all of these was a huge challenge.

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How your emotional response to the COVID-19 pandemic changed your behavior and your sense of time

The COVID-19 pandemic, now in its 19th month, has meant different things to different people. For some, it’s meant stress over new school and work regimes, or anxiety over the prospect of catching COVID-19 and dealing with the aftereffects of an infection. But for others, it’s created space and freedom to pursue new passions or make decisions that had been put off.

Our upended lives – for better or for worse – also likely influenced our perception of time.

In June 2020, we were part of a team of researchers who presented initial evidence that an individual’s sense of time during the pandemic was closely related to their emotions.

People who reported feeling high levels of stress and nervousness in March and April 2020 also tended to feel that time was passing more slowly, but people who reported feeling high levels of happiness felt that time was passing more quickly. (Yes, believe it or not, there was a good chunk of people who enjoyed their time spent in lockdown.)

It turns out that even during a pandemic, time flies when you’re having fun.

With a year’s worth of data, we were able to see how people’s views on the progress of the pandemic were related to their sense of time, their emotional states and whether they behaved in ways intended to slow the spread of COVID-19.

Where does the time go?

Time is a funny thing. On the one hand, it’s incredibly precise and consistent – an objective measure. Each day on Earth lasts exactly 23.934 hours, the length of time it takes the Earth to rotate once along its axis.

On the other hand, how we feel or perceive time passing is neither consistent nor precise. Many people will probably agree that 23.934 hours seem to pass much faster on a Saturday than on a Monday.

Dr. Gable has spent the past decade exploring how two highly related concepts – emotion and motivation – play a large role.

Motivation is a part of emotion and can either be described as “approach motivation” or “avoidance motivation.” The former is characterized by the tendency to engage with others or pursue goals when we experience positive emotions, such as excitement and joy. The latter refers to the tendency to pull away from others when we experience negative emotions, such as sadness or fear.

Approach motivation is associated with time passing more rapidly, which ultimately results in spending more time engaged with something that makes us feel good.

Avoidance motivation is associated with time passing more slowly, which motivates us to escape from potentially harmful situations.

Under normal circumstances, these relationships help us effectively pursue our goals and maintain our safety. Consider how long you’ll spend absorbed in a good book and how quickly you try to escape from a threatening situation.

But what happens in extreme circumstances? Thanks to a grant from the National Science Foundation, we were able to investigate for the first year of the pandemic how people’s motivations and emotions altered their sense of time.

Initial results

In April 2020, Dr. Gable and his team asked 1,000 Americans about their sense of time and emotional experiences over the previous month.

Almost 50% of these individuals reported that time seemed to be dragging by, which was strongly related to higher levels of stress and nervousness. These respondents also reported practicing social distancing more often. Roughly 25% of participants said time seemed to be flying by, which was associated with feeling happy and glad. The remaining 25% of participants felt no change in their sense of time.

Woman looks at hourglass with map of world dripping through the opening.
The COVID-19 pandemic was an event that touched just about everyone – making it an ideal period to study the relationship between emotion and time.
Klaus Vedfelt/Getty Images

A month later, we contacted the same people and asked the same questions. About 10% of those who had previously reported time passing slowly said it was moving more quickly. And more of them said they felt relaxed and calm.

The rest of the year

With a full year’s worth of data, we were able to analyze the results across 12 months of the pandemic. (The analysis is still under peer review.) We found that individuals who reported being relaxed, happy and confident felt that time was passing more quickly.

In contrast, participants who reported strong feelings of fear, anxiety or anger – or who felt that their lives were out of control – perceived time passing slowly. This sensation of time moving sluggishly was also associated with greater worry about personally getting COVID-19, anxiety about whether a family member would become infected and concern about how the virus would affect personal finances.

We also found an interesting pattern of results related to participants’ beliefs about the dangers of COVID-19 and the ability to address the spread of the virus. Specifically, participants who felt the government could effectively control the pandemic and that there were effective treatments for COVID-19 felt time was passing more quickly. Participants who felt there was an insufficient amount of medical equipment to treat COVID-19 and felt the virus was highly lethal reported time passing more slowly.

Then there’s the way time perception was connected to behavior.

Over the course of the pandemic, we found that when people were feeling time was moving by more quickly, they were more likely to wear a mask. Meanwhile, when people perceived time passing more slowly, they tended to avoid large gatherings.

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Both limit the spread of the virus. So what might explain the likelihood of one behavior over the other?

Individuals wearing a mask are engaging in more approach-motivated behavior, as wearing a mask doesn’t protect the wearer as much as it protects those in their vicinity. The more positive people felt, the more likely they were to wear a mask to protect others around them.

Those who avoid large gatherings are engaging in more self-protective, or avoidance-motivated behavior. It prevents you from getting the virus from other people, with fear and avoidance influencing the behavior.

In other words, if you see a light at the end of the tunnel – through treatments and faith in the government’s responses – you’re more likely to have an upbeat attitude and be more motivated to engage in behaviors that help others. If you feel utterly hopeless or sense foreboding doom, time creeps by. This seems to motivate the impulse to hunker down and protect yourself.

As our understanding and awareness of COVID-19 variants increases, so does our understanding of ourselves and how we behave. These findings may highlight the importance of maintaining good habits and finding hobbies that foster positive emotions. That way you won’t be trapped in a cycle of despair, which is only compounded by the sense that time is creeping by.


Rural Alaska has a bridge problem as permafrost thaws and crossing river ice gets riskier with climate change

America’s bridges are in rough shape. Of the nearly 620,000 bridges over roads, rivers and other waterways across the U.S., more than 43,500 of them, about 7%, are considered “structurally deficient.”

In Alaska, bridges face a unique and growing set of problems as the planet warms.

Permafrost, the frozen ground beneath large parts of the state, is thawing with the changing climate, and that’s shifting the soil and everything on it. Bridges are also increasingly crucial for rural residents who can no longer trust the stability of the rivers’ ice in spring and fall.

The infrastructure bill making its way through Congress currently includes US$40 billion in new federal funds for bridge construction, maintenance and repairs – the largest investment in bridges since construction of the interstate highway system started in the 1950s. In that funding is about $225 million to address 140 structurally deficient bridges throughout Alaska.

Given the high cost to build and maintain bridges in rural Alaska, and the increasing risk to their structures as the climate warms, we believe the bill is a good start but hardly sufficient for a growing rural problem.

Increasing need for bridges as the planet warms

Alaska is warming faster than any other U.S. state. As Alaska’s temperature rises, rivers and lakes are freezing later, thawing earlier and forming thinner ice.

When the ice is unstable or unpredictable, people who rely on crossing the river are stuck and the risk of snowmobile fatalities rises. Rural residents often use rivers to travel between communities, either as icy roads in winter or waterways in summer, and they often have to cross rivers to hunt, gather traditional foods or reach health care facilities.

Alaska has just over 1,600 bridges that are open to the public – the fourth-lowest total of any state, despite being the largest state by land area. Only about 44% of those bridges are considered to be in good shape.

A make-shift barricade blocks a road that has collapsed into water.
Thawing permafrost and erosion conspire to eat away the land beneath a road in the Yup’ik Eskimo village of Quinhagak on the Yukon Delta in 2019.
Mark Ralston/AFP via Getty Images

Building bridges here is an expensive, complex process, and they require long-term maintenance that gets complicated in rural areas. It’s a challenge with two important facets: one is structural, and the other human.

Engineering: The problem of permafrost

From an engineering perspective, bridges are vulnerable to the effects of climate change. They are particularly sensitive to seasonal freezing effects, which can quickly change their mechanical properties and structural integrity.

Alaska has some of the harshest conditions for infrastructure, with temperatures ranging from minus 80 degrees Fahrenheit (minus 62 Celsius) to 100 F (37.8 C). Snowfall can reach 81 feet (24.7 meters) per year in some areas, and an ice-rich permafrost underlies 80% of the state.

One of the most important factors affecting the service life of a bridge is corrosion of the reinforcing steel. As permafrost thaws and water becomes liquid, it can accelerate corrosion and cause other types of damage.

A variety of techniques have been used to minimize the effects of cracking, but damage from freezing and thawing still plays a significant role in limiting the lifespan of a bridge. After a bridge is built, it requires regular monitoring to ensure it remains in good condition. That’s difficult in areas that are remote and where harsh weather can be challenging.

An old silver metal bridge over a dry river bed
This World War II-era truss-style bridge on the Alaska Highway near Tok was recently replaced by a detour.
Alaska Department of Transportation and Public Facilities via AP

Another major engineering challenge for rural areas is human-dependent bridge inspection, which limits how often bridges can be inspected and presents significant safety risks for inspectors. One exciting development in maintenance involves advances in drone technology. Bridge inspections could be done safely by drones and at more reliable intervals, but that too involves investment.

Read more:
Melting Arctic sends a message: Climate change is here in a big way

High costs and better planning

Infrastructure construction, especially in rural Alaska, already comes with a hefty price tag.

The cost of delivering steel and concrete to a remote location, sourcing available local materials and bringing in outside specialized labor can significantly increase the cost of a bridge. For example, the 2015 Construction Cost Survey in Alaska found that home construction, based on materials alone, is three times more expensive in Barrow, a remote community in the North Slope of Alaska, than in Anchorage, the state’s largest city.

Children play basketball and ride bikes on a large wooden platform above the wet ground. Weather-beaten houses stand in the background.
Children play in Newtok, Alaska, in June 2015. The town is losing ground to flooding as permafrost thaws, and many residents have relocated to a new community across the river.
Andrew Burton/Getty Images

In rural Alaska, the process of building bridges is complex and can take many years. It depends on cooperation, often among several communities, navigating state processes and support of political leaders. It’s critical to understand from the beginning how a bridge’s construction will affect community well-being and how communities can work together on funding, design, construction and maintenance.

Our team of engineers and social scientists is working on a guide to successful bridge funding, construction and maintenance for remote areas that establishes a community-driven process.

Alaska has no income tax or statewide sales tax and has been facing a fiscal crisis as state oil revenues have fallen. Federal infrastructure investment could help direct funds to rural bridges that might otherwise continue to deteriorate.

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Winners of 2021 Nobel Prize in Physics built mathematics of climate modeling, making predictions of global warming and modern weather forecasting possible

As a climate scientist myself, I was excited to learn that Syukuro Manabe, Klaus Hasselmann and Giorgio Parisi have been awarded the 2021 Nobel Prize for Physics. I first met Manabe when I was a graduate student in the early 1970s, so I was particularly pleased that the prize recognizes the profound importance of Manabe’s decadeslong work on the creation of climate models, as well as the application of those models to understand how increasing levels of greenhouse gases have led to global warming.

A diagram showing an image of clouds, trees, land, ice and oceans all interconnected.

Climate and weather are influenced by many interconnected systems that all influence one another.
Femkemilene via WikimediaCommons, CC BY-SA

How complicated is the weather and climate system?

Weather is what you see hour to hour and day to day. Weather involves just the atmosphere. Climate is the average weather over decades and is influenced by the oceans and the land surfaces.

Weather and climate are complicated because they involve many different physical processes – from the motion of air to the flow of electromagnetic radiation, such as sunlight, to the condensation of water vapor – across a wide range of spatial and temporal scales.

The system is incredibly complex and interconnected. For example, a cluster of small thunderstorms can influence a weather system that spans a continent.

Before about 1955, weather forecasters extrapolated future weather from changes over the previous days. They used simple but labor-intensive methods that were partly quantitative and partly based on experience.

An drawing of Earth divided into grids and also showing energy interactions.

Climate models take data from today, break it into smaller three–dimensional chunks and run that data through complicated calculations to predict the future.
NOAA via Wikimedia Commons

The birth of climate models

By the late 1950s, it became possible to make forecasts by running weather models on just-emerging but rapidly improving digital computers. A weather model is a system of equations that expresses the physical laws that govern weather. “Running” a weather model means solving the equations on a computer, using data from today’s weather to predict tomorrow’s weather.

Partly because of computer limitations, the first weather models could only cover portions of the Earth – like North America, for example. But by the early 1960s, faster computers made it possible to create models representing the whole global atmosphere.

Manabe led the development of one such model, building an interconnected web of thousands of equations that could simulate climate and climate change.

With this model, Manabe and his colleagues were able to produce fairly realistic simulations of such things as jet streams and monsoons. While modern global weather prediction and climate models are much more powerful, they can be viewed as descendants of Manabe’s early model.

When Manabe began his work in the early 1960s, some scientists had already pointed out the possibility that increasing atmospheric carbon dioxide could lead to global warming. In 1967, Manabe and colleague Richard Wetherald used a simplified version of their climate model to perform the first quantitative study of the effects of increased carbon dioxide in the atmosphere. In addition to confirming that carbon dioxide increases global temperatures, they also found that increased water vapor content in warmer air amplifies overall warming because water vapor itself is a greenhouse gas.

Making predictions

A photo of Syukuro Manabe.

Syukuro Manabe was one of the earliest researchers to use climate models to study global warming.
Bengt Nyman/WIkimedia Commons, CC BY

Climate involves both the oceans and the atmosphere, but early models had not united the two. In 1969, Manabe and his oceanographer colleague Kirk Bryan built the first climate model to include both the oceans and the atmosphere.

Building on that progress, in 1975 Manabe and Wetherald published results from a simulation of global warming using a global climate model. In this simulation, they doubled the molar fraction of carbon dioxide in the atmosphere from 300 parts per million volume to 600 parts per million volume and let the model crunch the numbers.

Nearly 50 years ago, they predicted the overall warming of the Earth’s surface, much stronger warming in the Arctic, a decrease in ice and snow cover, an increase in the average global rate of precipitation and a cooling of the stratosphere. During the 1980s, Manabe’s team also used their models to identify the possibility of increased dryness over some continental regions.

All of those predictions have now come true.

Modern weather and climate models are far more powerful than the models of old and can be used to make both long–term and short–term predictions.

Linking climate, weather and chaos

The work of the other winners of the 2021 Nobel Prize in Physics, Hasselman and Parisi, followed on the heels of Manabe’s early research and shows how large–scale interactions across the globe give rise to the chaotic and hard-to-predict behavior of the climate system on day-to-day time scales.

Parisi studied the role of chaos in a wide variety of physical systems and showed that even chaotic systems behave in an orderly fashion. His mathematical theories are central to producing more accurate representations of chaotic climate systems.

Hasselman filled in another gap by helping to further connect climate and weather. He showed that the highly variable and seemingly random weather of the atmosphere gets converted into much more slowly changing signals in the ocean. These large–scale, slow changes to the oceans in turn then modulate the climate.

In combination, the work of Manabe, Hasselman and Parisi has enabled scientists to predict how the chaotic, coupled behavior of the atmosphere, oceans and land surfaces will change over time. While detailed long-range weather forecasts are not possible, humanity’s ability to understand this complicated system is an incredible achievement. As I see it, Manabe, Hasselman and Parisi are richly deserving of the Nobel Prize in Physics.


What is chaos? A complex systems scientist explains

Chaos evokes images of the dinosaurs running wild in Jurassic Park, or my friend’s toddler ravaging the living room.

In a chaotic world, you never know what to expect. Stuff is happening all the time, driven by any kind of random impulse.

But chaos has a deeper meaning in connection to physics and climate science, related to how certain systems – like the weather or the behavior of a toddler – are fundamentally unpredictable.

Scientists define chaos as the amplified effects of tiny changes in the present moment that lead to long-term unpredictability. Picture two almost identical storylines. In one version, two people bump into each other in a train station; but in the other, the train arrives 10 seconds earlier and the meeting never happens. From then on, the two plot lines might be totally different.

busy indoor train terminal

Who doesn’t meet in the crowd if the train arrives a few seconds sooner?
urbancow/E+ via Getty Images

Usually those little details don’t matter, but sometimes tiny differences have consequences that keep compounding. And that compounding is what leads to chaos.

A shocking series of discoveries in the 1960s and ‘70s showed just how easy it is to create chaos. Nothing could be more predictable than the swinging pendulum of a grandfather clock. But if you separate a pendulum halfway down by adding another axle, the swinging becomes wildly unpredictable.

Chaos is different from random

As a complex systems scientist, I think a lot about what is random.

What’s the difference between a pack of cards and the weather?

You can’t predict your next poker hand – if you could, they’d throw you out of the casino – whereas you can probably guess tomorrow’s weather. But what about the weather two weeks from now? Or a year from now?

Randomness, like cards or dice, is unpredictable because we just don’t have the right information. Chaos is somewhere between random and predictable. A hallmark of chaotic systems is predictability in the short term that breaks down quickly over time, as in river rapids or ecosystems.

panels of a shaded road through four seasons

Chaos can explain why climate is predictable while weather isn’t.
Sören Lubitz Photography/Moment via Getty Images

Why chaos theory matters

Isaac Newton envisioned physics as a set of rules governing a clockwork universe – rules that, once set in motion, would lead to a predetermined outcome. But chaos theory proves that even the strictest rules and nearly perfect information can lead to unpredictable outcomes.

This realization has practical applications for deciding what kinds of things are predictable at all. Chaos is why no weather app can tell you the weather two weeks from now – it’s just impossible to know.

On the other hand, broader predictions can still be possible. We can’t forecast the weather a year from now, but we still know what the weather is like this time of year. That’s how climate can be predictable even when the weather isn’t. Theories of chaos and randomness help scientists sort out which kinds of predictions make sense and which don’t.

Read other short accessible explanations of newsworthy subjects written by academics in their areas of expertise for The Conversation U.S. here.


If you want to support the health and wellness of kids, stop focusing on their weight

Since the pandemic started, people of all ages have gained weight. At the same time, the rate at which youth and young adults are seeking treatment for eating disorders, particularly anorexia nervosa and binge eating disorder, has increased.

While the reasons for these changes are complex, pandemic-related stress and weight bias – the belief that a thin body is good and healthy, while a large body is bad and unhealthy – are prominent contributors.

As researchers who study health behaviors and are also parents of young children, we often see health research and health initiatives that place a disproportionate emphasis on weight.

That’s a problem for two big reasons.

First, it draws attention away from better predictors of chronic disease and strategies to address these factors. Although a high body mass index, or BMI, is one risk factor for various chronic diseases, it is only one of many, and far from the strongest. And while moderate weight loss does reduce chronic disease risk for some people, about 80% of individuals who manage to lose weight regain it. The other 20% describe their ongoing efforts to maintain their weight loss as stressful and exhausting.

Second, disproportionate emphasis on weight reinforces weight bias. Weight bias, in turn, contributes to weight-related discrimination, like bullying and teasing, which is common among youth. Across diverse samples surveyed, 25% to 50% of children and adolescents report being teased or bullied about their body size, and these experiences are linked to disordered eating and depression, as well as poorer academic performance and health.

To best support the physical and emotional health of children during this pandemic, we suggest reducing the emphasis on body size. Below are some specific tips for parents, teachers and medical providers.

1. Stop using the words “fat,” “obese” and “overweight”

When asked, children and adults with larger bodies consistently indicate that these are the least preferred and most stigmatizing terms to talk about body size, while “weight” and “body mass” are the most preferred.

So, consider modeling less stigmatizing language. For example, if your teen refers to her friend as “overweight,” respond by saying, “Yes, your friend does have a larger body.” Likewise, if your doctor refers to your child as “obese,” ask them to share their “body mass index percentile” instead. Or, better yet, ask them not to talk about weight at all – which leads us to our next recommendation.

2. Focus on health behaviors

Physical activity, eating habits and emotional support from friends and family are stronger predictors of disease and death than BMI, and all of these have been greatly affected by COVID-19.

Considering that behavioral weight loss programs are ineffective for the majority of people, we recommend focusing on behaviors that are more easily changed and have stronger influences on health and well-being. Regular physical activity, for example, improves mood and lowers risk for heart disease and type 2 diabetes, even in the absence of weight loss.

Building and sustaining new health behaviors can be challenging. Parents are more likely to be successful if they start by setting realistic goals that include the whole family rather than singling out one child based on their body size.

Like adults, kids enjoy activities more when they have a say in the activity. So let them choose whenever possible. There are additional physical and mental health benefits if these activities are done outdoors.

A father, son and young daughter jump while exercising outdoors together
Parents can help create new health habits by setting realistic goals that include the entire family.
Erin Clark/The Boston Globe via Getty Images

3. Challenge weight biases

Weight bias stems in large part from the belief that individuals are responsible for their body size, and if they are unable to lose weight or keep it off, they are deserving of blame and ridicule. These beliefs may contribute to an increased risk of disordered eating in children through parental behaviors like overly restrictive feeding practices and negative comments about weight.

Parents are also greatly affected by this bias, reporting guilt and sadness for their perceived contributions to their child’s weight.

We suggest that parents challenge weight bias by acknowledging that – quite literally – hundreds of factors outside of a person’s immediate control contribute to body size, including genetics, racism and trauma, and environmental factors, like levels of crime and proximity to green space and recreational facilities.

4. Advocate against weight discrimination

Weight is the No. 1 reason youth are teased, according to a large sample of teenagers in the United States. However, weight bias is lower in schools where body weight is part of anti-bullying policies. Consider talking with your child’s principal, attending the next PTA meeting and advocating for the inclusion of weight discrimination into existing bullying policies.

If your child is being teased, get curious. Ask them how they feel about it. Acknowledge that weight discrimination is a very real phenomenon. Do not take this time to encourage weight loss. Instead, help your child appreciate their body as it is. Then, talk with their teacher. Schools who have teachers who are willing to intervene have less bullying.

And if your child is struggling, consider working with a mental health professional, in-person or remotely. During the pandemic, there has been a twelvefold increase in psychologists in the United States providing care remotely, and although there are some reported challenges – like finding a private, quiet space – youth in treatment for eating disorders describe an appreciation for the accessibility, convenience and comfort of this approach.

[Insight, in your inbox each day. You can get it with The Conversation’s email newsletter.]

5. Help youth be savvy consumers of social media

Youth who spend more time on social networking sites feel more dissatisfied with their bodies and engage in more disordered eating. Furthermore, more than half of adolescents surveyed reported increased experiences with weight discrimination on these sites during the pandemic.

Of course, social media isn’t all bad. Research suggests that it may depend on how youth engage with these sites, with “photo-based activities” being most closely linked to disordered eating symptoms.

Parents can help their children learn to notice when posting and viewing photos or following appearance-focused influencers leaves them feeling bad or comparing their body to others, and encourage them to take a break. They can also suggest that they consider unfollowing those accounts and instead seek out people who inspire them, make them laugh and help them feel empowered.

The last year and a half has been hard. As people consider how to resume some of their pre-COVID activities, it is our hope that food and movement can help families and communities to reconnect and feel good. Our bodies have carried us through an extremely trying time and are deserving of respect and kindness.


Biden restores protection for national monuments Trump shrank: 5 essential reads

On Oct. 7, 2021, the Interior Department announced that President Biden was restoring protection for three U.S. national monuments that the Trump administration sought to shrink drastically: Bears Ears and Grand Staircase-Escalante in Utah, and Northeast Canyons and Seamounts in the Atlantic Ocean. President Trump’s 2017 orders downsizing these monuments, originally created by previous administrations, ignited debate over whether such action was legal. Here are five articles from our archives that examine this controversy.

1. A law rooted in presidential power

Presidents can designate lands as national monuments quickly, without seeking consent from Congress, under the 1906 Antiquities Act. Congress passed the law to protect historically valuable archaeological sites in the Southwest that were being looted.

But as the late John Freemuth, a public policy scholar at Boise State University, observed, presidents soon were using it much more expansively – and affected interests pushed back:

“Use of the Antiquities Act has fueled tensions between the federal government and states over land control – and not just in the Southwest region that the law was originally intended to protect. Communities have opposed creating new monuments for fear of losing revenues from livestock grazing, energy development, or other activities, although such uses have been allowed to continue at many national monuments.”

Freemuth predicted in a 2016 article that “future designations will succeed only if federal agencies consult widely in advance with local communities and politicians to confirm that support exists.”

Read more:
How the Antiquities Act has expanded the national park system and fueled struggles over land protection

2. Can presidents alter monuments their predecessors created?

Many environmental advocacy groups and tribes opposed President Trump’s order to remove large swaths of land from these three monuments and sued to block it. The Antiquities Act is silent on this question. But when The Conversation asked environmental lawyers Nicholas Bryner, Eric Biber, Mark Squillace and Sean Hecht, they argued – based on other environmental statutes and legal opinions – that such acts would require congressional approval:

“Courts have always been deferential to presidents’ use of the law, and no court has ever struck down a monument based on its size or the types of objects it is designed to protect. Congress, rather than the president, has the authority to alter monuments, should it decide that changes are appropriate.”

Read more:
President Trump’s national monument rollback is illegal and likely to be reversed in court

3. Monuments have scenic, cultural and scientific value

National monuments protect many unique resources. For example, Bears Ears conserves land where Indigenous people have lived, hunted and worshiped for centuries. The Bears Ears designation was requested by an intertribal coalition and approved by President Barack Obama after extensive consultation with tribal governments.

Many national monuments contain scenic lands and areas that are critical habitat for endangered species, such as desert tortoises and California condors. The underwater canyons of Northeast Canyons and Seamounts house sponges, corals, squid, octopus, numerous fish species and endangered sperm whales.

Monuments also can have important scientific value. President Bill Clinton designated Grand Staircase-Escalante partly to protect thousands of unique fossil sites, most of which had yet to be studied. Many were located in areas near potential shale gas, coal or uranium extraction zones.

“Decades of ongoing research in this region have literally rewritten what scientists know about Mesozoic life, especially about the ecosystems that immediately preceded the final extinction of the dinosaurs,” Indiana University earth scientist P. David Polly writes. “Paleontologists like me know that the still-pristine Grand Staircase-Escalante region has divulged only a fragment of its paleontological story.”

Read more:
Shrinking the Grand Staircase-Escalante National Monument is a disaster for paleontology

Scientists sitting in the dirt brush soil away from fossilized bones.

Researchers dig for fossils in Utah’s Grand Staircase-Escalante National Monument, which has emerged as one of the most important paleontological reserves in the world.
Utah Museum of Natural History, CC BY-ND

4. How a Native American Interior Secretary sees it

The stark difference between the Trump and Biden administrations’ public land policies can be summed up by comparing their respective interior secretaries.

President Trump chose U.S. Rep. Ryan Zinke of Montana to head the agency, which manages more than 480 million acres of public lands, including national monuments. Zinke, who supported opening public lands for oil and gas development and mining, led a review that proposed shrinking the three monuments Biden has just restored.

President Biden’s interior secretary, former U.S. Rep. Deb Haaland of New Mexico, is the first Native American to head the agency that maintains government-to-government relationships with and provides services to Native American Indian tribes and Alaska Native entities.

“For Native Americans, seeing people who look like us and are from where we come from in some of the highest elected and appointed offices in the U.S. demonstrates inclusion. Indian Country finally has a seat at the table,” writes Arizona State University Indigenous studies scholar Traci Morris.

Read more:
‘Indian Country’ is excited about the first Native American secretary of the interior – and the promise she has for addressing issues of importance to all Americans

Utah Native Americans support President Biden’s decision to restore Bears Ears and Grand Staircase-Escalante to their original boundaries.

5. Monuments aren’t always beloved at first

Some of the most popular U.S. national parks initially were protected as national monuments, then expanded and given national park status by Congress years later. They include Acadia in Maine, Joshua Tree in Southern California, and Arches in Utah.

But a site’s merit may not be obvious at first. As Arizona State University’s Stephen Pyne writes, the first Europeans who explored the Grand Canyon in the 18th and 19th centuries thought it was unremarkable or worse; one called it “altogether valueless.”

Then geologists working for the federal government traversed the canyon, and wrote rapturous accounts that recast it as a marvel – a shift that Pyne calls “an astonishing reversal of perception”:

“The geologic mystery of the canyon is how the south-trending Colorado River made a sudden turn westward to carve its way, cross-grained, through four plateaus. This is also more or less what happened culturally. Intellectuals cut against existing aesthetics to make a place that looked nothing like pastorals or alpine mountains into a compelling spectacle.”

President Theodore Roosevelt agreed. After making multiple visits to the canyon, he designated it as a national monument in 1908.

Read more:
Grand Canyon National Park turns 100: How a place once called ‘valueless’ became grand

Editor’s note: This story is a roundup of articles from The Conversation’s archives.


Flu season paired with COVID-19 presents the threat of a ‘twindemic,’ making the need for vaccination all the more urgent

As winter looms and hospitals across the U.S. continue to be deluged with severe cases of COVID-19, flu season presents a particularly ominous threat this year.

We are researchers with expertise in vaccination policy and mathematical modeling of infectious disease. Our group, the Public Health Dynamics Laboratory at the University of Pittsburgh, has been modeling influenza for over a decade. One of us has been a member of the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices and the CDC’s Flu Vaccine Effectiveness Network.

Our recent modeling work suggests that last year’s tamped-down influenza season could lead to a surge in flu cases this coming season.

Anti-COVID-19 strategies reduced flu too

As a result of the numerous measures put in place in 2020 to curb transmission of COVID-19 – including limiting travel, wearing masks, social distancing, closing schools and other strategies – the U.S. saw a dramatic decrease in influenza and other infectious diseases during the last flu season.

Flu-related deaths in kids dropped from nearly 200 in the 2019-2020 season to one in the 2020-2021 season. Overall, the 2020-2021 flu season had one of the lowest recorded number of cases in recent U.S. history.

While flu reduction is a good thing, it could mean that the flu will hit harder than normal this winter. This is because much of the natural immunity that people develop to disease comes from the spread of that disease through a population. Many other respiratory viruses demonstrated a similar drop during the pandemic, and some of those, including interseasonal respiratory syncytial virus, or RSV, have increased dramatically as schools have reopened and social distancing, masking and other measures have declined.

Deciphering viral transmission

Immunity to influenza involves multiple factors. Influenza is caused by several strains of an RNA virus that mutate at various rates each year, in a manner not unlike the mutations that are occurring in SARS-CoV-2, the virus that causes COVID-19.

The level of a person’s existing immunity to the current year’s strain of flu depends on several variables. They include how similar the current strain is to the one that a child was first exposed to, whether circulating strains are similar to previously experienced strains and how recent those influenza infections were, if they occurred.

And of course human interactions, such as children crowding together in classrooms or people attending large gatherings – as well as the use of protective measures like wearing a mask – all affect whether a virus is transmitted between people.

There are also variables due to vaccination. Population immunity from vaccination depends on the proportion of people who get the flu vaccine in a given season and how effective – or well matched – that vaccine is against the circulating influenza strains.

Health care workers attend to an unvaccinated COVID-19 patient at a medical center in Tarzana, California.
Health care workers treat a 45-year-old unvaccinated COVID-19 patient at a medical center in Tarzana, Calif. The ongoing pandemic, coupled with the looming flu season, could trigger what doctors call a ‘twindemic.’
APU GOMES/AFP via Getty Images

No precedent exists for a ‘twindemic’

Given the limited spread of influenza in the general U.S. population last year, our research suggests that the U.S. could see a large epidemic of flu this season. Paired with the existing threat of the highly infectious delta variant, this could result in a dangerous combination of infectious diseases, or a “twindemic.”

Models of COVID-19 and other infectious diseases have been at the forefront of predictions about the COVID-19 pandemic, and have often proved to be predictive of cases, hospitalizations and death.

But there are no historical examples of this type of dual and simultaneous epidemics. As a result, traditional epidemiological and statistical methods are not well suited to project what may occur this season. Therefore, models that incorporate the mechanisms of how a virus spreads are better able to make predictions.

We used two separate methods to forecast the potential impact from last year’s decrease in influenza cases on the current 2021-2022 flu season.

In recent research of ours that has not yet been peer-reviewed, we applied a modeling system that simulates an actual population’s interactions at home and work, and in school and neighborhood settings. This model predicts that the U.S. could see a big spike in flu cases this season.

In another preliminary study, we used a traditional infectious disease modeling tool that divides the population into people who are susceptible to infection, those infected, those recovered and those who have been hospitalized or have died. Based on our mathematical model, we predict that the U.S. could see as many as 102,000 additional hospitalizations above the hundreds of thousands that typically occur during flu season. Those numbers assume that there is no change from the usual flu vaccine uptake and effectiveness starting this fall and lasting through the flu season.

Individual behaviors and vaccination matter

A typical flu season usually produces 30 million to 40 million cases of symptomatic disease, between 400,000 and 800,000 hospitalizations and from 20,000 to 50,000 deaths.

This prospect, paired with the ongoing battle against COVID-19, raises the possibility of a twindemic overwhelming the health care system as hospitals and ICUs in some parts of the country overflow with critically ill COVID-19 patients.

Our research also highlighted how young children could be particularly at risk since they have lower exposure to previous seasons of influenza and thus haven’t yet developed broad immunity, compared with adults. In addition to the burden on children, childhood influenza is an important driver of influenza in the elderly as kids pass it on to grandparents and other elderly people.

However, there is reason for optimism, since people’s behaviors can change these outcomes considerably.

For instance, our simulation study incorporated people of all ages and found that increasing vaccination among children has the potential to cut infections in children by half. And we found that if only 25% more people than usual are vaccinated against influenza this year, that would be sufficient to reduce the infection rate to normal seasonal influenza levels.

Across the U.S., there is a lot of variability in vaccination rates, adherence to social distancing recommendations and mask-wearing. So it is likely that the flu season will experience substantial variation state to state, just as we have seen with patterns of COVID-19 infection.

All of this data suggests that although vaccination against influenza is important every year, it is of utmost importance this year to prevent a dramatic rise in influenza cases and to keep U.S. hospitals from becoming overwhelmed.

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Indigenous Peoples Day: Why it’s replacing Columbus Day in many places

Columbus Day celebrations in the United States – meant to honor the legacy of the man credited with “discovering” the New World – are almost as old as the nation itself. The earliest known Columbus Day celebration took place on Oct. 12, 1792, on the 300th anniversary of his landing. But since the 1990s, a growing number of states have begun to replace Columbus Day with Indigenous Peoples Day – a holiday meant to honor the culture and history of the people living in the Americas both before and after Columbus’ arrival.

In the following Q&A, Susan C. Faircloth, an enrolled member of the Coharie Tribe of North Carolina and professor of education at Colorado State University, explains the history of Indigenous Peoples Day and what it means to American education.

First, why is Columbus Day a problem?

A statue of Christopher Columbus is vandalized with the word 'murderer' sprayed in red.

A statue of Christopher Columbus is vandalized with the word ‘murderer.’
Nik Wheeler/Corbis via Getty Images

For many Indigenous peoples, Columbus Day is a controversial holiday. This is because Columbus is viewed not as a discoverer, but rather as a colonizer. His arrival led to the forceful taking of land and set the stage for widespread death and loss of Indigenous ways of life.

When did Indigenous Peoples Day come about?

In 1990, South Dakota – currently the state with the third-largest population of Native Americans in the U.S. – became the first state to officially recognize Native Americans’ Day, commonly referred to as Indigenous Peoples Day in other parts of the country.

More than a dozen states and the District of Columbia now recognize Indigenous Peoples Day. Those states include Alabama, Alaska, Hawaii, Idaho, Iowa, Louisiana, Maine, Michigan, Minnesota, New Mexico, North Carolina, Oklahoma, Oregon, South Dakota, Vermont, Virginia and Wisconsin.

How does Indigenous Peoples Day change things?

Indigenous Peoples Day offers an opportunity for educators to rethink how they teach what some have characterized as a “sanitized” story of the arrival of Columbus. This version omits or downplays the devastating impact of Columbus’ arrival on Indigenous peoples. Indigenous Peoples Day is an opportunity to reconcile tensions between these two perspectives.

Research has shown that many schools do not accurately represent Indigenous peoples when they teach history. I think this is true not only on Indigenous Peoples Day, but throughout the school year. Researchers have found that K-12 schools tend to teach about Native Americans as if they existed only in the past. By revising the curriculum to better reflect both past and current histories and stories of Native peoples, educators can more accurately teach students about their cultures, histories and traditions.

Has there been any pushback?

Yes, the shift from Columbus Day to Indigenous Peoples Day has met resistance from communities across the country. In 2021, parents in Parsippany, New Jersey, protested the local school board’s decision to celebrate Indigenous Peoples Day in place of Columbus Day. Among other things, they cited lack of community input, failure to honor the legacy of Italian immigrants and the need for a “more balanced picture of Columbus.” In response, the school board removed the names of all holidays from its calendar. Now the holidays are just referred to as “days off.”

What resources do you recommend for Indigenous Peoples Day?

I would recommend “Lies My Teacher Told Me About Christopher Columbus” by sociologist and educator James Loewen. I would also recommend “An Indigenous Peoples’ History of the United States for Young People” by historian Roxanne Dunbar-Ortiz. These books help illustrate both the impact of the arrival of Columbus on the Indigenous peoples of the Americas and the role of Indigenous peoples in the founding of the United States. This is information that is typically absent in K-12 schools.

Other resources are available from organizations such as the National Museum of the American Indian, Learning for Justice and IllumiNative. These resources include sample lesson plans, books and videos that reflect the diversity of Native American peoples and tribes. For example, one lesson plan from IllumiNative provides opportunities for students to learn about Indigenous Peoples Day and at the same time explore ways to honor and protect the land, air and water. Such lessons are important, as they address the ways in which conservation of natural resources is essential to the economic self-determination and self-sufficiency of Native nations.

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Facebook’s own internal documents offer a blueprint for making social media safer for teens

Right at the time social media became popular, teen mental health began to falter. Between 2010 and 2019, rates of depression and loneliness doubled in the U.S. and globally, suicide rates soared for teens in the U.S. and emergency room admissions for self-harm tripled among U.S. 10- to 14-year-old girls. Social scientists like myself have been warning for years that the ubiquity of social media might be at the root of the growing mental health crisis for teens.

Yet when Facebook CEO Mark Zuckerberg was asked during a congressional hearing in March to acknowledge the connection between social media and these troubling mental health trends, he replied, “I don’t think that the research is conclusive on that.”

Just six months later, The Wall Street Journal reported that Facebook had been doing its own research for years on the negative effects of Instagram, the company’s photo-sharing app popular with teens and young adults. Six internal documents summarizing the research, leaked by a whistle-blower, were posted in full on Sept. 29, 2021.

The details in the 209 pages are revealing. They suggest not only that Facebook knew how Instagram could be harmful, but that the company also was aware of possible solutions to mitigate those harms. Facebook’s own research strongly suggests that social media should be subject to more stringent regulation and include more guardrails to protect the mental health of its users.

There are two primary ways the company can do this: enforcing time limits and increasing the minimum age of users.

A ticking time bomb for mental health

Academic research shows that the more hours a day a teen spends on social media, the more likely she or he is to be depressed or to self-harm.

That’s important because many teens, especially girls, spend large amounts of time on social media.

One study in the U.K. found that one-quarter of 15-year-old girls spent more than five hours a day using social media – and 38% of those girls were clinically depressed. Comparatively, among girls who used social media less than one hour a day, only 15% were depressed.

Although the internal Facebook research didn’t examine links between time on Instagram and mental health, they did ask teens about what were, in their view, the worst aspects of Instagram. One of the things teens disliked the most about the app was how much time they spent on it.

Teens, the report said, had “an addict’s narrative about their use. … They wish they could spend less time caring about it but they can’t help themselves.”

They knew they were spending too much time online, but had a hard time controlling how much time they spent. One-third of teens suggested Instagram should remind them to take a break or encourage them to get off the app.

That would be a step in the right direction, but simple nudges might not be enough to get teens to close the app and keep it closed. And while parents can already set time limits using the parental controls included on most smartphones, many of them don’t know how to use these controls or are unaware how much time teens are spending on social media.

So better regulations might need to put teeth into time limits, such as limiting the number of hours teens under 18 can spend on social media apps. A blackout period overnight might also be useful, as many teens use their smartphones at night when they should be sleeping.

ID, please

One internal Facebook study of more than 50,000 people from 10 countries found that half of teen girls compare their appearance to others’ on Instagram. Those appearance-based comparisons, the study found, peaked when users were 13 to 18 and were much less common among adult women.

This is key, as body image issues seem to be one of the biggest reasons why social media use is linked to depression among teen girls. It also dovetails with research I reported in my book, “iGen,” finding that social media use is more strongly linked to unhappiness among younger teens than older ones.

This suggests another avenue for regulation: age minimums. A 1998 law called the Children’s Online Privacy Protection Rule already sets the age minimum for social media accounts at 13. That limit is problematic for two reasons. First, 13 is a developmentally challenging time, right as boys and girls are going through puberty and bullying is at its peak.

Second, the age minimum is not regularly enforced. Kids 12 and under can simply lie about their age to sign up for an account, and they’re rarely kicked off the platform for being underage. During a Facebook event with Instagram head Adam Mosseri, the young celebrity JoJo Siwa noted she had been using Instagram since she was 8 years old, forcing Mosseri to acknowledge that it’s easy to lie about your age.

The problem is how to enforce an age limit online for a population that is too young for IDs. Raising the minimum age to create a social media account to 16, 17 or 18 could solve two problems at once: It would prevent kids from signing up until they’re a bit more developed and mature, and it would be easier to enforce. For example, potential users might be asked to submit a photo of their state-issued ID, which most teens have by 16.

Verifying age would also make it easier to construct a safer app for younger users that might, say, hide follower counts or restrict access to celebrity accounts, both of which Facebook’s research found negatively impacted girls’ body images.

Curtailing that fear of missing out

It’s tempting to think regulations like these would cause teens to riot in the streets – after all, they love keeping up with their friends on social media. But the teens interviewed by Facebook for its internal research were well aware of social media’s downsides.

“The reason why our generation is so messed up and has higher anxiety and depression than our parents’ is because we have to deal with social media. Everyone feels like they have to be perfect,” one teen girl told the researchers. Other teens have spoken publicly about the negative effects of social media.

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More stringent regulation would help with another issue teens know all too well: the unwritten mandate to use social media or be left out.

“Young people are acutely aware that Instagram can be bad for their mental health yet are compelled to spend time on the app for fear of missing out,” Facebook’s internal research concluded.

If age limits were enforced, the peer pressure of being on social media would vanish; no or few classmates would be there. Regulating time on the app could also help if teens knew their friends wouldn’t constantly be online.

Facebook’s research demonstrates something else: The company was aware of the issues with Instagram but chose not to set these limits itself. Congress is now considering taking action.

Until they do, it will be up to parents and teens themselves to set limits. That won’t be easy, but teens will be safer for it.