Category: health

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Maison de santé 1861 Berlin

In the middle of the 19th century Berlin was a small city. The area of Schöneberg (pritty hill) was still perceived as the rural outskirts and featured the first botanical garden next to the town center. A little bit more outside of Berlin the “Maison de santé” was founded as early as 1861 to cure mainly respiratory diseases and what later became the first private clinic proposing a new way to treat psychiatric disorders. Dr. Eduard Levinstein was the founder and the clinic had continued its operations for almost 50 years with his wife and sons taking the lead later on. Prof. Wilhelm Griesinger, known for the scientific approach of psychiatry was a proponent of the non-restrained approach to psychiatric disorders, which allowed persons move more freely while being supervised. The documents and the publication (1877) shown in the exhibition at Museum Schōneberg demonstrate the scientific approach to the treatment of addictions, most notably morphine, which had been widely used during the war of 1870 as tranquilizer and pain relief. The wave of addictions needed hospitals and clinics to treat these addictions. The “Maison de santé” had been established as a retreat and cure for other addictions as well. The memory of the early scientific approaches is an inspiring place and reminder to take care of all forms of addiction. Taking care of body and mind is still the state of the art approach today.

The Exhibition catalog is forthcoming, but the visits and material on display of interest beyond the inhabitants of the „Pritty Hill“. Exhibition catalog is forthcoming

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Robot assistant

Adjustment processes on the labour market take their time. This means that care workers are in short supply in most countries of the OECD. Engineers as well. There are so many robots, care robots I mean, still to develop that the shortage of engineers give little hope that we shall have affordable solutions in this area for the next few years. The issue is mainly about integrating and enhancing already existing solutions. If you are a mechanical engineer you can put together motorised mechanical pieces, small motorised electric devices and, for example, small infrared emitting and receiving devises.
All this is child’s play these days (see image below). The assembling of a small Robot assistant that follows movements or can escape from a small labyrinth makes such simple structures transparent for learners and users. There is nothing magical about it, just adding together small pieces and the electronic devices to steer the movements. The learning tool from KOSMOS has been on the market for 5 years. It is a helpful device to explain basics through hands-on experience. The limits of robotics equally become more evident. Our own health and safety is concerned with larger devices cohabiting with us. A robot assistant can take on easy tasks like to follow me through my living space in old age carrying a mobile phone, keys or an emergency device. More sophisticated tasks need more sensors and AI to train the most needed and best routines. For many years this needs our input and our control as well as supervision of such devices. Most robots will operate as assistants with us in the driving seat or the boss.
This is yet another element of the “all electric society“. We are moving towards the use of more electronics assisting us from year to year.

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Archi health

The links between architecture and human health are manifold. There are direct effects of healthy versus unhealthy materials in construction. For the purpose of making buildings fire proof or more resistant to heat asbestos had been used for decades which still causes health hazards nowadays in the removal of this cancerous material. Paint has to be chosen wisely as well as isolation materials. Indirect or second round effects of materials have to be considered additionally. Cement in construction uses a lot of energy in its production and has only been recycled since a few years in significant amounts. Room climate or even psychological effects of architecture have been considered to be important more seriously in recent years. A new discipline entitled “neuro-architecture” may be developed soon. Schools, sports facilities, hospitals or community centers benefit from healthy architecture. Cost benefit analyses which take into account long term effects and even recycling of materials shift the balance much in favor of health considerations also in architecture. “Fast and dirty” will be much more expensive than “slow and healthy”. Future generations will be thankful. (Image: Spreewald Primary school Berlin).

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Health Systems

Comparing health systems across the EU can be complex at times. However, there seems to be a consensus that the Irish health system is an oddity within the European health systems. On the one hand Ireland is a rather wealthy country in terms of GDP, but the primary care system excludes a high percentage of people from access to it. The scientific journal “The Lancet Regional Health” published a paper and comment on this rather unique exception to the rule to offer a universal health care system to its citizens. The controversy is about the coverage of costs of a visit to a general practitioner. More and probably earlier visits to a GP reduce the (over)burdening of
hospitals later during the life course. Prevention helps a great deal to lower overall costs of a health system.
The roots of the Irish health system have been built upon “subsidiarity”, which means that the public support system should only step in, if the individuals or families are unable to cover costs by themselves. Poor households had to apply for a card giving them access to medical care free of charge. Building hospitals was the next challenge and local communities managed to raise funds in support of such additional structures. In 2025 it can be very costly to enlarge the coverage to a universal access to primary care and the challenge to attract sufficient numbers of general practitioners is a very European one. In this respect Ireland is just like any other European country again.
The question of how to best achieve a universal health care system remains an important one. Apparently, you can be rather “health poor” in an otherwise “economically rich” country.

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Biased Results

The use of statistics in presenting results of research is common practice. Empirical studies are summarized using statistics and statistical methods based on samples of bigger populations are cost efficient. However, care needs to be exercised when interpreting results to guard against inappropriate conclusions derived from biased estimates. Since the topic has been highlighted and methods proposed to handle them, these methods were deemed worthy of a Nobel prize.  The basic problem of a bias due to a selective sample has been demonstrated by Stockwell et al. (2024). The authors investigate the old question, whether a little bit of alcohol consumption (per day) could be beneficial for our health. The statistical issue which needs careful examination is the construction of the control group against which the results are compared. Apparently many studies have biased control groups which included persons in the not drinking control group who had stopped drinking for bad health previously. Compared to those persons with other health conditions those drinking a little bit compared rather well. But of course such individuals should not be present in a control group. Of the control group is biased due to many persons with below average health the groups of interest consuming higher levels of alcohol do not perform so badly. Hence, interpretation of results from medical or social science studies has to consider carefully the actual or potential sources of bias. Not really a new results in statistics, but still not well known or understood by the public at large. Drug consumption as well as studies of this consumption could deserve the same sticker: handle with care. (Image: Extract from Tenier II David, Les fumeurs, also entitled Chanson à boire, 17th century, Paris Petit Palais).

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Tariffs Trade Deficits

US Tariffs target the US trade deficits across the globe. For a start on the topic it is helpful to take a look at the data. The US bureau of census publishes this time series regularly. Currently, you can compare monthly or annual data across countries from 1985 to 2025. The worsening of the trade balance is obvious just looking into some examples like trade with the EU, China, Japan, South Korea or Switzerland. we might calculate some rough indicators of trade deficits of the US with countries by the size of the country, which would make Switzerland look really bad relative to many much more populous countries. This probably explains why Switzerland is threatened by higher tariffs than the EU. However, this hints towards the “hidden” agenda of tariffs on countries. The major targets are multinational companies that produce in countries outside the US and particularly in those with low corporate taxes, like Ireland and Switzerland. Importing products from such countries worsened the US trade balance over decades.

Another factor to study more precisely is the sectoral pattern driving the trade deficits with countries. Exports in for example health-related products have soared due to Covid-19 pandemic starting in 2019. Where did the US buy face masks, ventilators, medicines and pharmaceuticals?  These countries will now also be penalized by higher tariffs. The tariffs topic is a complex interconnected business issue, which is not solved by blunt measures. The real danger is that with each month trust in US will erode further. For decades this has been an underestimated currency of international business. Eroding trust is likely to be the major fallout of the tariff and trade deficit nexus. It takes decades to build, but can be destroyed within a few days or weeks. (Image: Mont des arts Brussels February 2024, celebration of surrealism).

 

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Private Intimacy

Intimacy has been reserved for private affairs for centuries. Although in the medieval ages formally the right of so-called noble men could be very far-reaching into intimacy of families when the permission to marry was quite restrictive. The private intimacy is the central theme of the Paris exhibition at MAD (Link) « Private Lives ». The organization into 14 almost private rooms around a larger center piece on design leads us through the major topics of intimacy. Maybe as a surprise to some, the exhibition starts with the major actors of change related to privacy and intimacy, i. e. women. Opening up enclosures gave women more room for intimacy and at the same time it made intimacy a conscious choice and decision. “A room of one’s own” is an important step in personal development of children particularly with respect to one’s intimate life. Restrooms are another issue of intimacy, just consider recent adaptations tor m/f/d people. A whole set of accessories are on display which previously were intimate products or even secrets prepared for public viewing. Of course odors are part of the experience with a test space of noble perfumes. The various manifestations of sexuality has brought about a growing number of pleasure objects, which might also be criticized as a growing commodification of intimacy as well. The connected bedroom and the risk of surveillance are raised to warn on overexposure on social networks. Intimacy in prisons or community shelters closes the exhibition before the final highlight the room on “conversations with oneself”. A whole literary form of keeping an intimate journal has arisen from the conversations not intended to be shared with others, at least not during one’s lifetime. After a person’s death for some persons of public interest even their private intimate journals will be published shifting the balance between the private and public parts of intimacy. (Image below from exhibition, photo bottom left, Matisse painting on wall while in bed in old age). 

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Intimate change

Society changes and with it so does intimacy. The major changes pass through the behavioral changes of persons and sooner or later the whole society adopts such changes as the new normal. Trends of individualization have moved over centuries as the exhibition in the Museum of decorative art (MAD) in Paris demonstrates. At the same time the changed individual approaches to intimacy have become more widely spread quickly over time. Social media have accelerated such new trends again. Social class is yet another intervening variable in this context which created different speeds of adjustment as well as sustaining differences in kind. 

Religious beliefs and practices have made claims about how individuals should handle intimate relationships and affairs. Legal issues are defined by each society to guide moral practices as well. Hence, the sociology of intimacy is a huge topic and comparing societies an interesting topic. The development of intimacy over a person’s life course, however, is given little attention due to a lack of adequate longitudinal data. From the exhibition we are encouraged to think about the relationship of hygiene and intimacy. Bathrooms accompany us throughout our lives and privacy was originally a bourgeois concept. Over the life course we move from dependency to independence and maybe dependency again in very old age. The images (below) from the MAD exhibition range from basics of bath tubs to a painting of Edgar Degas in the background. Instagramer or YouTuber share lots of images and stylized arrangements of bathrooms on social media. It seems that intimacy is moving further into the public domain. 

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Guidelines Follow-up

The are many professional organisations which agree after thorough discussions on guidelines how to conduct professional services. As long as we have such guidelines, the adherence to the guidelines is an issue as well. This is part of a research program of organisational sociology, but there is a rather strange paradox in this field of compliance with guidelines. In the most highly educated professions like medical doctors, the rate of compliance to guidelines is below average. A study of 20+ years ago published in the JAMA Journal: Cabana et al. (1999) “Why Don’t Physicians Follow Clinical Practice Guidelines?” highlighted this paradox among medical doctors. The lack of awareness of existing or changed guidelines is one of the major reasons mentioned in this respect. Self-efficacy is also an issue, but mentioned less frequently for not following guidelines.
Besides a professional bias, related to the above average educational attainment of physicians, (believed) superior coping mechanisms compared to the average population might be at work. Mastering advanced technology might lead to a behavior that assumes to be able to handle higher risks as well.
For a profession that is used to confront issues of life and death on a regular basis some adherence to a very specific medical guideline might appear a negligible risk. However, maybe comparable to some cases among politicians or priests a logic: “rules or guidelines are for others to follow” rather than the physicians bear obvious risks to these persons themselves, but even to others in specific circumstances like the spreading of infectious diseases.
Drug or substance abuse has been evidenced before in relationship with specific professions or in historical time periods. We should take care to repeat similar studies (Cabana et al. (1999) every now and again.

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Law and Legality

Some persons consider themselves to stand above the law or push all interpretations of regulations beyond usual understanding of it. Even after a person has been dealing with pharmaceuticals or drugs used also for doping purposes, the conviction of such a person may take several years if not decades. In France, Mr Bernard Sainz seems to be a good example of such a relentless case of practicing para-medical consultations to assist mainly cyclists in endeavors to win championships or professional status. Le Monde  and Cash investigation have raised awareness of the public for such dubious practices. The “French Federation du cyclisme” and medical doctors association fight a continued legal battle against this persons exercising illegally such doping assistance. 

With apparently 56 legal procedures in connection with this person, the legal system has to bear the majority of costs of such illegal practices.

The reach of such dubious practices might be extended if the systems beyond doping, but for assisted euthanasia cannot be controlled effectively. Hence, the precursor cases of positive stimuli like doping pose similar challenges to the legal system as “negative stimuli” weakening persons as assistance to die. The end of a life course is not only a medical issue. Society-wide debates need to take place in order to organize a large consensus on the implications more liberal practices shall entail. 

(Image: Palais de Justice, Paris 2025)

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La défense Végétale

Greening a metal and concrete block and buildings is a big challenge. The logic of unrealistic growth and big business has left liabilities for future generations. More vegetation in inner cities is part of our responsibility towards future generations. Therefore, urban planning has started in Paris to get rid of concrete walls and floors.

Eventually the district might have a more human touch which attracts citizens and new businesses and services. The adaptation of the infrastructure to facilitate mobility with bicycles and secured pedestrian paths has started but will take a lot of time before people adopt again these more healthy modes of transport. The big boulevards reserved for polluting transport is no longer adequate in combination with residential living spaces.

It will take a change of a whole generation to accomplish such a fundamental change. The reduced demand for office space due to more employees choosing to work from home contributes to such a change as well. Many other cities go ahead with similar changes (Copenhagen, Berlin). In combination with the „All electric society“ there are fundamental changes at work which will make inner cities more attractive again. Ease of clean transportation and other infrastructure for urban lifestyles ensures that cities remain strong points of attraction. They keep pulling people from nearby and far away towards them, if we like it or not.

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Hands-on AI

The use of AI in translation and to streamline texts and preparation of communication has become a common experience. The applications in medical fields are less well known. Scans and checking of skin cancer could be a game changer for many who live far away from the next medical doctor. AI assisted brain surgery is another issue, but a very specialized application. The interface of AI and robotics might be another game changer as such applications where you train the robot with for example weight lifting and transportation charges can contribute to alleviate human skeletons. Handheld devices can guide the robot and data from sensors will complement the learning of the tasks through assistance from AI. Applications are manifold and we have not even seen the most promising ones. The application potential in warfare are particularly troublesome as humans do not necessarily enter into the concern of AI-assisted weaponry. In the social sphere trust is a crucial behavioral and ethical concern. These issues AI can only learn from us. Any attempts to do without human input and control is doomed to fail. We are not indispensable yet, we are simply turning more and more into responsible, supervisory roles. 

(Image: Acatech exhibition with hands-on AI applications, Berlin in collaboration with IQZ and DTM, German museum of technology.)

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More eCooking

Cooking powered by electricity rather than fossil fuels like gas is an efficient and smart solution. Through the daily cooking activities over the course of a year the savings due to eCooking add up quite a bit. Even compared to an ordinary electric stove the eCooking by induction technology saves almost an additional 10+ percentage of energy as you heat the pot or pan directly rather than an in-between metallic element, which stores heat even after you have switched it off already for a while. In private kitchens the induction option is straightforward. In professional settings the change to induction eCooking needs careful planning. The health aspect of no burnt gas emissions in the kitchen is, however, a strong argument in favor of eCooking as well.
If we apply this logic to low-income countries and cooking in schools or other institutions as well as companies, the environmental and economic benefits add up quickly. In rural areas where no electricity grid is available or stable enough, the decentralized provision of electricity through for example solar energy creates a cost-effective alternative. In urban areas with high levels of various kinds of pollution the “clean” alternative could make a considerable difference as well.
The eCooking evidence is another pillar of the “all electric society” of the 21st century.
(Image: Rirkrit Tiravanija, untitled (Café Deutschland) and extract from “Freiheit kann man nicht simulieren“, Berlin Martin Gropius Bau, 2024-2025)

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Suicide Prevention

The annual mortality statistics and special reports on suicidal tendencies are a tough reading. OECD Statistics give a at least an approximate, comparative perspective. Reporting routines and medical confirmation of a suicide or suicidal behavior still vary quite a bit between countries. Nevertheless, the usually reported incidents per 100.000 persons remain rather abstract.
Absolute numbers speak a clear language. For example in Germany there were about 10.300 recorded suicides in 2023, France had to mourn about 9200 in 2022. To put the size of the problem in perspective it is helpful to know that in Germany all other not aging related causes of death like traffic accidents, drugs or murder make up for around 7.000 deaths per year. The targeting of resources and prevention efforts on these vulnerable people seems inevitable. However, we see only limited additional efforts to curb the problem.
A more detailed analysis of the frequencies reveals the gender and age differences. More men commit suicides and older (very old) people have higher risks. The oldest age group of men is most at risk.
Since the Covid-19 pandemic young women show rising trends in many countries again of suicidal attempts and self-inflicted wounds. Despite a continuing effort of research (Links) there is no single cause to explain the occurrences.
As a working hypothesis, which awaits empirical tests, I would look into societal factors that stigmatize persons who are made to believe or feel like they are beyond the normal spectrum of society. The lack of acceptance of diversity concerning gender, age, ethnicity, body shapes or mental states like anxiety. Poverty might cause immense distress and suffering. Large shifts in wealth in both directions cause additional risks.
It seems as if our minds and society are constantly in a kind of „regression towards the mean“ posing challenges to those furthest away from the average or perceived norms. Percentile ranks or percentile scores are commonly used to express a person’s position in a frequency distribution. For example you are better/lower than 90% of persons of your age group. Such statements might cause further distress for persons. However, summarising across several (psychological) measurements, they may yield encouraging indications as well. Actual and perceived positions in such percentile ranks add another “social risk” as perceived positions may govern behavior.

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Blue Sky

In the period of romanticism the associations with a blue sky were very different from today. Getting out into the sun was a kind of privilege for the “leisure class”, of people who could afford to enjoy time outside for boating, walking or other pleasures. In our technology-driven 21st century the associations with Blue Sky are more like a technically enhanced view through for example “Windows” at the news and opinion platform or “Bluesky”.
Several scientific websites that report data on blue skies and air quality more generally across the world report indicators like ozone values O3, sun intensity, micro particles 2.5µm and 10µm, Nitrogen Dioxid NO2 to name the mostly quoted indicators. Hence, just enjoying the blue sky outside isn’t the same as it was before. People working outside in the sun or at times of a blue sky but with high air pollution levels are incurring severe medium-term health risks. The Ozon layers at very high altitudes protect our skin and eyes against high UV-radiation, but O3 on the ground is tough for eyes and lungs.
Technology has come with many blessings, but the negative effects on a global scale become also more evident. Getting used to a particular lifestyle, which produces lots of emissions of aggressive fine particles will make it more difficult to just simply enjoy a blue sky.
In consideration of all these background data with regional variations, we surely need an AI-system which we can ask for advice, whether we should go outside and enjoy the blue sky with or without respiratory mask.
Romanticism has led us all the way to Californication and dangerous enshittification of the air that surrounds us. Youth and the next generations will have very different associations with Blue Sky than we have the chance to, at least, have had.

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Mindmap Me

Tools like artificial intelligence allow all sorts of transformations and depictions. The photo editing tools are widespread and particularly popular among the young users. My own transformative exercises, latest with www.bairbe.me, have yielded interesting insights, well worth an intergenerational playmate. For the guys there is the www.yobrick.com version for brick gamers.
The App “Canvas” allowed me to delve deeper into my own mind by giving instructions of how to create an image of the structure of the blog entries on this webpage. Of course, it is not (yet) a real AI-generated content map, but it is only a matter of time until such tools will exist. After all, this would be just an arranged and rearranged list of contents using the hyperlink structure of the texts as well.
For the time being, I derive my own structure of the blog entries by topics, categories and tags including the hyperlinks or internal referrals. Interlinkages are mostly stated explicitly. However, there are many implicit links, which are obvious to some, but not others. AI-systems could use occurrences of words,  synonyms and antonyms . Colors in addition to bubble sizes and (in)direct lines may complement such mindmaps. This can help to reveal another, additional layer to connections between categories or tags. The Ai-generated image shown below was created with the APP Canvas as a first approximation and AI-augmented test version in form of abstract images).
Next steps on the way to understand human intelligence and, maybe, augment it with a next generation AI-system would use a colored-3D version of such a mindmap and use the chronological evolution of the blog posts in a kind of evolutionary animation. This should allow us to go beyond the usual psychological classification of fluid and crystallized intelligence. We might come to grips what it means to be “in a Paris state of mind” or when hallucinations become overwhelming.

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Existence as Eggsistence

Artists have their own ways of hallucinating. They don’t need an AI to generate ideas beyond the normal, even allowing for 2 standard deviations off the usual. As a result of the thorny question about your existence, Ram Katzir came up with the impressive statement about his „eggsistence“ being subjected to a squeezed experience. Ever increasing shares of the labor force would subscribe to this statement about the modern workplace. Each turn of the screw risks to crack up the egg‘s shell. Rather focus on the egg, try to get a grip on the screw. There are thousands if not millions who crack up under the excessive pressure of economic and political circumstances. The new platforms of food, grocery and parcel delivery at home have become the latest example of AI-assisted and algorithmicly managed screws. What is driving your eggsistence. It is about time to  ask fundamental questions again. (Image: Eggsistence, by Ram Katzir 2021 in Brussels, Galilas Collection Belgium)

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Holocaust Remembrance

The 80th anniversary of the liberation of the concentration camp Auschwitz-Birkenau marks a very special kind of remembrance. As the number of survivors of Nazi-terror and genocide is shrinking the testimony of survivors is becoming more rare and more precious. According to the “Jerusalem Post” on 2025-1-28 (p. 9) the number of survivors that came back to the site of horrific crime has shrunk from 300 ten years ago to 50 in 2025. The strength and courage to continue to testify amidst having reached 90+ or even 100+ years of age is a “living memorial” of its own kind.
Many television stations across Europe have followed the example set by this special Holocaust remembrance day and focused equally on recorded testimonies or additional live interviews of survivors. Please keep repeating these testimonies to confront people with the outcome of Nazi-terror in Europe. The choice this year was a courageous one. Instead of speeches of sorrow and lip service to fight antisemitism by acting politicians, the focus on the testimony of survivors in public, on TV and to large audiences will encourage others to continue to give testimonial of these horrors.
(Image: extract of Pressreader newspaper titles 2025-1-27)

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Synthetic opioids

Across the globe there are many tough lessons to be learned about synthetic opioids. These psychoactive substances fall under special legislation and can only be used with medical prescriptions. The strength of these substances is usually compared to heroin and the risk of addiction to these substances is very high.
A recent paper in International Review of the Armed Forces Medical Services (2024) has highlighted also “the abuse of the synthetic opioid U-47700” at times of military conflict. The power of these drugs to suppress the feeling of pain is helpful for medical operations. The abuse, however, may consist in the use of the drug to “keep fighting whilst pain is suppressed”. Such use of synthetic opioids increases the risk for addition and the fatal consequences of overdoses. The reporting of such occurrences in a specialized medical journal is an important warning against the conscious and willingness to abuse the drugs for war purposes.
The finding reminds us of the abuse that was already widely spread during the Nazi led 2nd World War (“Der totale Rausch“). The addictive potential was experiences even after the war time in terms of active combat was over. The costs to society of such abuse as well as use of supply chains of provision of opioids during peace times remain a problem for many years after the war. After a war, the war on drug abuse continues. Fighting addiction is a lengthy and painful process.

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Defence Spending

As in research there are many dual use products, which can be part of defence spending. Robotics in production or rockets to launch satellites for telecommunication are such examples. Much less known to the public is the amount of military spending that goes into medical developments that benefit both the military as well as the civil population. Countries build a whole ecosystem round the provision of medical services for defence purposes , which consists not only of a sufficient number of qualified persons, but also companies that provide specialised products. Most of them have civil applications as well after minor adaptations.
Oxygen provision was a prominent example of a product that has civil and military uses in treatment of respiratory infections or contaminations. A mobile transportable operation table is another element of daily rescue services as well as potential use in situations of conflict, just like anesthesia machines. An increase in spending on such infrastructure and the necessary long-term training of persons operating and maintaining these medical applications take time and considerable financial resources.
The current debate in Europe and NATO neglects the considerable time delays in production and provision of the equipment. Research on “Skill Needs in OECD countries” has shown the substantial delays between sudden skill needs and the time to train high-skilled persons.
The International Review of the Armed forces Medical Services is a journal dedicated to publish up-to-date information on needs of medical products and persons trained to use them in special emergencies. The need to safe lives in extreme and dangerous conditions needs preparation of thousands of specialists. Of course we hope that such an incidence will not happen. The persons and material have an obvious potential to serve the civilian population in more peaceful times as well. The unfortunate “hog cycle” in skill provision is not a problem for dual use products or services.
(Image: edited extract of a mobile operation table)

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Obesity Revised

The scientific paper on a revised definition of obesity was produced by the special Commission on Obesity. It appeared in The Lancet Diabetes & Endocrinology in 2025-1. The previously common practice by medical doctors was to classify person in the obesity category based mainly on the simple calculation of the body mass index (BMI = weight/height²). A BMI  > 30 put persons into the obese category and stigma.
Since the Covid-19 society-wide testing experience, we are all familiar what it means if you get misclassified and have to live with the consequences (exclusion from work or events etc.). The simplifying and summarizing BMI calculation and classification has also produced many wrong classifications. For example, persons with a lot of muscles (just watch this at any fitness studio) will have a high weight relative to their body height², but they are likely to be more healthy than many other light weight, but seriously stressed persons.
In empirical test theory such cases are the so-called false positive cases, i.e. classified as obese, but not a medical problem at all. Medical doctors and health insurances should not finance special treatments for these persons, which foregoes treatment of other more needy persons.
With new expensive drugs on the market to treat obesity it is even more important to test with more precision the normal, pre-clinical and clinical status of obesity. Fatty tissue or muscles, that is the relevant question. Fatty tissue in muscles is the next level testing issue.

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Enshittification

Don’t laugh. This is a very serious scientific term to describe the way social media function in the 21st century. The scientific reference goes back to 2025 and article in “Science” by Kai Kupferschmidt. Twitter, now eXit, like most other social media platforms uses algorithms that select posts for you from the millions of posts that are likely to induce a reaction from you, which prolongs your time on the platform. Additionally, eXit Twitter applies an algorithm that prioritizes accounts with already a huge followership, which makes these accounts even bigger. The result is an increasing inequality in attention to info, facts, fake news, but also revenue for the platform owners through more advertisements. As hate speech and fake news are commonly perceived as shit, many social media are happy to spread more shitty things on their platforms as this generates more money for the platform as well. In short, enshittification happens sooner or later to most platforms and we all suffer from this. As user of these platforms, it is hard to escape from this process, as most platforms tend to “convert” to enshittification at some later point in their life cycle, unlike babies who manage to quit this phase after a few months. A move to Bluesky might be indicated, but there is no guarantee that the same process will just happen again. Mastodon is another small twitter-like platform that like Bluesky offers a more open approach to its governing algorithms and a more controlled access in the registration process.
To avoid enshittification, we have to be ready to move away from one platform to another one, just like changing bank accounts or club memberships. Make sure to take most of your friends with you and there are already tools for this online as well. Enjoy the safe online life again on another platform or consume more of the traditional media like newspapers, radio or tv with proven quality. (Image: extract from Jan Steen, 1625-1679, The Rhetoricians – “In liefde vrij”, MRBAB)

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Science and Fiction

We associate with science and fiction the extrapolation of scientific trends into some futuristic settings. The most striking examples of science fiction in novels or video use some scientific findings (dinosaurs, genetic engineering) and project this knowledge into another fictional setting. The usual personal relationships follow rather predictable plots of romance, deception, violence or war.
The novel “Wellness” (Hill 2024) is also a kind of science fiction as it is based on social science evidence and builds its fictional plot firmly embedded into the social and psychological research. The attachment of references (and defending the print of those in translation) underlines the commitment to write a new type of “social science fiction”.
In this innovative style the scientific basis of psychology and sociology is then extrapolated into a fictional arrangement. Research on subjective well-being with the U-shaped form over the life course and the extrapolation of the placebo effect, which is instrumentalized for a business, derive from key topics in the social sciences. In fact, the novel and the background scientific literature in the bibliography could well figure in a social science course at university entry level. These readings constitute a 360-degree-view on personal development and social structures. Of course, social sciences move on and add new evidence on an almost daily basis, but the selection and arrangement of the characters create an innovative social science fiction, without some unrealistic technological extrapolation.
It strangely feels like we are already part of this social science fiction (compare “Klara and the sun” by Ishiguro) as politicians advocate and campaign with placebo topics in elections and project us into some more happy past or future.
The social science fiction of Nathan Hill resembles for me the great utopian novel by George Orwell “1984” published in 1948. A title “2032” instead of “Wellness” could have worked quite well, as the first edition of Nathan Hill’s social science fiction was published already in 2023. (Image: Extract of: Lo Spagnolo, 1665-1747, Hecuba makes Polymnestor blind, MRBAB).

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Not learning

For decades our attention has been focused on how learning works. However, at the beginning of 2025 it might be more important to shift our focus of learning research on “not learning”. Recent research on learning includes the study of “social learning” of mice (Winiarski et al. 2025) and the related brain mechanisms that are involved in social learning like the prelimbic cortex.
For our human societies we also rely to a great deal on social learning. In mice, however, the disruption of the prelimbic cortex causes mice to no longer seek “social information related to rewards” from other mice. In Eco-HAB cages these mice follow their scent capabilities to “sort” their information seeking from for example higher “social status animals”. This tested reward seeking behavior allows clues to how learning works. The intervention to disrupt the synaptic plasticity in a later phase of the experiment reveals less social learning from the network social information and fewer contributions to the social network.
Only intact neural plasticity in the prelimbic cortex ensures the maintaining of the social structure. Of course it is highly questionable, whether these results based on animal experiments tell us anything about social structure and social learning in other mammals, but there might be reasons to search for explanations of “no social learning” in humans as well.

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Wellness Sickness

There appears to be some kind of a relationship between the 2 conepts of wellness and sickness. Some would argue that the more sick you are, the more you seek wellness. Sickness seems to be the precursor of wellness for many people. Wellbeing or happiness are even higher order concepts which are only indirectly related to wellness. In an almost 600 pages science and fiction novel, Nathan Hill (Link) constructs his plot based on the psychological research on the placebo effect. With a sufficient aura around a pseudo-medication administered in a wellness clinic, the clients or some figure near the 50% random positive effects are treated with at least no negative side effects. On page 152 we find the more explicit description of how to induce a placebo effect in participants. Context, expectations, faith, symbols, metaphors and story are all ingredients for a placebo effect to work. Sometmes without knowing we receive a treatment in our childhood or throughout the life course that we work on using placebo effects to overcome them. The novel by Hill (2024) is a well researched psychological as well as sociological fiction including a bibliography, which reminds us „If you cling too hard to what you want to see, you miss what’s really there.“ (p. 496).

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Investment Disinvestment

Asume we live in a world of fixed amounts of investments. The option to invest in a new project or product will automatically reduce the amount of investment in another product. The investment decision, therefore, is subject to opportunity costs. A recent study by Naci et al. (2025) applies this rationale to the investment in new drugs compared to financing other traditional treatments. The results for the U.K between 2000 and 2020 revealed that the „quality-adjusted life-years (QALYs)“ is not in favor of the investment in new drugs. The relatively small numbers of beneficiaries of the new drugs is compared to the many other persons who could have benefited from the less costly previous treatment. Investment in one new drug causes disinvestment in other ones. The overall balance for the UK turned out to be negative. Particularly the disinvestment in prevention of diseases appears to have very detrimental effects in view of the results based on this study. Preventative measures are relatively cheap compared to the estimated 20.000 pounds for one additional quality adjusted year of life for a new drug. The message is: choose your health investments wisely to avoid ever rising health costs and health insurance. (Image: rest room Belgium)

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No tobacco Sweden

Sweden is the forerunner as country with the lowest number of smokers across Europe and probably even the world with only 5% of the population 16 years and older. The success of these public health policies is due to banning smoking not only form pubs and restaurants, but also outside in the surroundings of public spaces like schools, playgrounds, train stations and sports facilities. These policies work quite well and the effects of discouraging smoking in public is reduced to a minimum rather than the normal encounter.
Health of the other persons and children passing through these areas is not the only goal. A new estimate of lost days or years due to smoking based on a study from England shows that “each cigarette smoked reduces the smoker’s life by about 20 minutes (17 for men, 22 for women, LINK to study). Of course, there is a huge variance and other work and life conditions that play an important role as well, but the broad average estimate is a nice way of talking about statistics. The basis of the estimate is for those who stop smoking and not those reducing their tobacco intake by some percentage or replacement product.
In the Belgian football stadium (image below 2024) in Brussels the No tobacco sign is well placed to make parents of children and youth understand the challenge ahead. Good resolutions are assisted by gentle regular reminders as well.

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Air Concept

Well yes, this is the latest fart in design and architecture. The Berlin International University of Applied Sciences composed an exhibition on “Air Architectures” which takes air seriously. The international group of 7th semester students took Air Architecture seriously and developed their ideas in the context of a curated exhibition. Nice semester project.
Air is a fundamental precondition for humans to (co-)exist. The biology of air (breathing) or the chemistry of air (fine particle matter) have been studied extensively. The physics of air flows in cities receive more attention as well in architecture. Interior design has yet a lot to contribute in the age of heat pumps and air conditioning.
Let’s think architecture from the perspective of air and air flow. Depending on our cultural background we might have very different associations with air. Indian or Chinese practices like yoga or Tai Chi teach us to take air more seriously than Western practices. Most architecture in cold countries of the northern hemisphere aim to keep air to the outside of buildings. Yet, the percentage of humidity of air is a serious concern of architecture as well. Air flow and quality then becomes a key issue of construction and architecture, somehow through the back door.
Maybe in approaching architecture we might think first of what is or has been the architect’s concept of air or aerodynamics. 100 years after the death of Gustave Eiffel and the Olympic Games in Paris, we still gain from thinking about air (not only air pollution) and its dynamics. Looking forward to the next generation of air architects.
(Image: Exhibition, Air architectures, at Berlin International, University of Applied Sciences 2024-12)

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Kids Space

Political claims to reserve more space for kids in cities have a tough time. Kindergardens or child care in general are scarce and the lobby for kids is often limited in time and extent, since it is the parents that usually are the ones to advocate while their children are small. Jointly parents and children of young age experience the tough atmosphere to find, preserve or extend the space for kids.
The Gropius Bau in Berlin has opened up an exhibition space reserved to children 3+ as part of an art project “BauBau” designed by Kertin Brätsch 2024. A colorful room and installations as “loose parts” are the starting point to delve into a real/fantastic world were kids reign. There are a few so-called “playworkers”, who accompany the endeavours, if need be. At the end of the day the room was still in pretty good shape I would say assuming that “children set the tone and decide what happens in this place”. Safe and supportive environments for children are scarce and parents are always challenges in their attention to watch out for risks of all sorts in public city spaces.
Even if the “play space” is free of charge, it takes parents or kindergarden managers to reserve the space.
An early experience of a museum from the inside is likely to have lasting effects on children and the parents. They might have fond memories of a museum as an exciting space also for them. It constitutes a nice continuation of the outdoor “radical playground” project during summer 2024.

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Health Tech

Health technology assessment (HTA) is an interesting scientific field. The new digital opportunities allow people to participate in medical and medication trials in their homes or even in bed. Their health data and the administration of medication is also encouraged and sometimes supported through digital devices. The pharma and health industries have many devices ready to go. The differences to the traditional forms of medical trials, however, is an issue as we want to compare the results from both kinds of trials. Participants of trials, might prefer or struggle with these novel kinds of study designs. In any case the results will be impacted in several forms (Study Link). In the best of all worlds for the researcher the effects will cancel out each other, but is rather unlikely. Some participants will reach more positive effects with the use of digital tools, whereas others are challenged and might even abandon during the trial. Monitoring during the study (for example through digital inhalors) is another advantage of such distributed trials. Rather than taking adherence to a trial medication for granted, digital tools allow a more precise monitoring of subgroups as well. Data and effort invested in the trial is preserved through the easier access to person’s information, assuming continuous readiness to stay on in the trial.
Our own smartphones are still underexploited in terms of health monitoring and use in research designs. The possibilities to link data to other external data sources shall further advance the research potentials in many interesting ways. Data protection and data security become even more important with the ever smarter phones and connected devices.