Shorter is better

Contrary to a lot of received previous recommendations, the shorter duration of antibiotics prescription and use (3-5) days is overall better than the prolonged use of durations between 7-14 days (JAMA Link).  A so-called narrative review of medical studies (Lee et al.2023) reports more precise results separate for medical indications (pneumonia, sinusitis etc.), which tend to go in the same direction for the majority of indications. In view of the serious issue of antimicrobial resistance, a consequence of overconsumption and too widespread use of antibiotics (also in animal health and food production), the slogan of shorter is better should receive serious attention.
It is not only a medical, pharmaceutical or public health issue. The topic has become an issue of nutrition as well. The food chain contains largely unknown amounts of antibiotics as well, especially if larger amounts of animal or fish products are part of it.
The knowledge from these sciences has still to filter through to the broader public. This means it has become a social science topic as well. The transmission of knowledge and patient expectations on prescriptions, which is also linked to regulations concerning sick leave, make it more difficult to shorten prescriptions of antibiotics. There is a steep challenge to change behaviour according to the new mantra “shorter is better” with respect to antibiotics, even if we know that it is better for all of us in the medium or long term.
(Image: Jan Harmensz. Muller, De keuze van de rechte levensweg 1571-1628, MRBAB, Brussels)

On Resilience

There are at least 2 definitions of resilience: (1) a material definition points at the “ability to return to an original form or position after being compressed, extended or curved, and (2) a immaterial or psychological definition. The latter one describes the ability to recover, be happy or successful anew having overcome a bad or challenging experience. The American psychological literature defines resilience in the shortest form as “positive adaptation despite adversity”. The psychological construct is linked to a positive life span perspective of personal development. Other areas of application range from “resilient investments”, “resilient industries” to single resilient societies or intergovernmental organizations like the European Union or NATO.
The challenges to resilience increase with complexity of societies and social as well as technical systems. As supply chains have become longer in time and travelling longer distances as well, the improvement of resilience has become a steep challenge for globalization. Reorganizing supply chains with “own sourcing” as in countries which are cut-off from international trade will have huge consequences on sending and receiving countries.
Last, but not least, countries like Ukraine demonstrate the fact and virtue of resilience after more than 1000 days of the massive Russian invasion of its country, which threatened its survival. Resilience works best in networks of organizations and countries. Solidarity is a fundamental building block of resilience as well. Donations and funds support activities that foster resilience.

On Dosage

  1. Dosage is key. We all know it from everyday expériences. Certainly from drinking alcohol we know the tricks that dosage can have on us. Consumption in small doses is fine and enjoyable, but larger amounts cause all sorts of trouble. In pharmacology the effect of dosage is applied with particular virtue. Small doses even of a poison can have beneficial effects. More of rhe same might well kill you. The same rationale applies to other fields as well. Physiological training effects depend a lot on the right amount of training and the timings or intervals between training sessions. In managerial, economic or social applications the question is not only about what is the right remedy, but also how much of it. The interest rate decisions of central bankers are mostly concerned with dosage rather than « whatever it takes ». A minimum wage increase is equally about dosage and we all have additional examples.
    Even in art, take painting or music, dose and pose, that is the question. It is quite surprising that such an overarching issue has received rather little attention, comparatively or only among specialists in each field.
    It appears strange, but it is possible to have only a little bit of war, as opposed to comprehensive conflict. The applications of dosage are manifold.
    Learning about dosage might prevent binge learning at first and binge viewing later on. In the age of tiktok and social media, dosage has become a key competence. (Image Extract of Gustave Courbet Die Welle 1870, Alte Nationalgalerie Berlin).

On Intersectionality

Society deals with individualization or individualism in various forms. One way is to take each social group as a specific singular case. This is reasonable and justified in many instances. There are cases where this form of dealing with specific social groups comes to limits. Following the rationale of plurality and individualism it has become common practice to address each target group in a specific manner. Intersectionality, however, acknowledges the overlapping of target groups, which necessitates a more specialized approach to intersecting (social) phenomena. Gender might not be the single most important factor to describe a person, just as age is a concept of various intersections. Chronological age versus age defined through biomarkers demonstrate the variety and potential for intersectionality. The Paralympics 2024 in Paris gave another positive example of intersectionality as extraordinary persons achieved previously unimaginable world records in specicialized disciplines. Individualization and classification is only a first step in the scientific endeavour, the analysis of intersectionality is an additional step to consider in a broad range of fields beyond the social sciences.
(Image: Exposition Isa Genzken 75/75 in Neue Nationalgalerie 2023)

Bi-directional Sleep

For most of us bi-directional sleep is a question of sleeping on the left or right side, or on our back or front, head left or right. In immunology bi-directionality of sleep has another meaning. The immune system is linked to sleep in a bi-directional manner. Good sleep enhances the immune response of cells (direction 1) and infected blood cells for example send a signal to the brain to extend sleep. The study by Huynh et al. (2024) in Nature has demonstrated this bi-directional mechanism. It allowed mice who slept well after an imposed heart attack to recover in a better way than those whose sleep got interrupted during the experiment. The most natural response to a heart attack or acute coronary syndrome is more sleep. This is induced by an inflammatory reaction in the brain, which « orders » your body to increase deep sleep. 😴 Sleep is more than just rest, it may be part of healing. ❤️‍🩹 (people looking at Caspar David Friedrich „Infinite Landscapes“, exhibition Alte Nationalgalerie Berlin 2024)

Water Quality

Obviously, water is not just an issue of quantity, but also quality. The availability of sufficient quantities of water in a region depends on rain, its storage, and the use of these water resources. The quality of water is a subsidiary issue, as lack of inflow causes concentrations of nuisance in water to rise. Global warming will most likely intensity the concern for not only the quantity, but also the quality of water.
Public services are in charge to sample and monitor levels of water quality for consumers. Independent of public, private or public private partnerships in this field there is a need to check from time to time the quality of water. Public institutions do a great job in monitoring water quality, but as science progresses there are new sources of pollution that enter the already complex analysis of water quality. New chemicals and remains of medical or pharmaceutical analyses have been retrieved from water and, sometimes, they have reached critical or unhealthy levels.
More detailed monitoring is necessary and new digital tools allow to improve just this type of monitoring to inform policy makers on shifting patterns.
A project of that type “Urban Green Eye”, for example, allows to monitor the artificialization of previous vegetation to show up on satellite images of Germany. Independent groups, citizens or communities might find it useful to use their own sampling and testing to guard against abuses or dysfunctional public monitoring systems. Start-ups like “Hydroguard” offer services to support activists, communities or public services in their own efforts to ensure water quality.

Public health info

Public services have a premordial role to play in providing reliable and up-to-date information on health issues. It is no longer only in charge of collecting this information, for example on infectious diseases, but public services are in charge of timely disemination of that info as well. This is, of course, were online services and AI come into play. Getting out this info is crucial, but in the age of fake news and the wide disemination of news on social media, public services need to check also what becomes of the news they have published. The Covid-19 pandemic has been a worthwhile experience in this respect. It is important that reliable information is transmitted via trustworthy channels, which have already been established prior to the “next” health crisis. Many innovative tools were presented at the SCCON 2024 and maybe trustworthy video calls with a medical doctor or your pharmacist may constitute a solution to many infectious pandemics. However, trust in the technology is important as well as equipment and identification systems to be sure that your medical doctor you meet online is actually a medical doctor or only a savy pretender. The issue is as old as medical assistance. The RKI in Germany is the reference information for coordinated information on many public health issues like infectious diseases.
(Image: Extract of David Ryckart d.J. 1612-61, Der Dorfchirurg, SPK Gemäldegalerie Berlin)

Risk Takers

We are all risk takers of one form or the another. Those of us who ride motorbikes or enjoy rock climbing have an above average taste for risk taking. Since the publication of „The risk society“ we are aware that collectively as a society we have taken on additional risks like nuclear energy, atomic weapons or the risk associated with silent climate change with the persistent reliance on fossil fuels to a large extent. Holman W. Jenkins (WSJ) has added an additional perspective on risk takers which originates from government policies to encourage building homes in places subject to high risks of flooding. Several policies come to mind that encourage individuals to take high risks and construct and repair buildings in flood prone areas. Government grants, insurance policies and relocation subsidies are at issue here. Regulations like driving licenses try to build on competences to ensure „more rational risk taking“ in people. Teaching about nutrition might alleviate the obesity pandemic as much as awareness of an active lifestyle can avoid a large number of cardiovascular diseases. Risk taking should be to a large extent an individual’s choice with the consequence to live up to the consequences of the risks taken also more an individual’s responsibility. Collective solutions are a powerful way to encourage additional risk taking. The consequences of those well-defined solutions have to be funded collectively as well. A society-wide discussion and voting process on such issues has to be organized and updated from time to time. (Image Skateboard high and long jumps Brussels 2024-10)

Science Fraud

It is a big issue if publications in science in high reputation journals have managed to pass a rather lengthy and thorough peer review process and still contain evidence based on fraudulent data. The worst case scenario that based on this wrong evidence tests of useless drugs are performed on patients in hope of an honest concern for their health. In fact the financial rewards and even academic rewards have been achieved only through the successful publication of a bias introduced into the data and/or analyses of the data. The fraudulent researcher became subsequently Director of the institute of agingwhoch is part of the American National Institute of Health (NIH) and an academic reference in health sciences far beyond the USA. It is the merit of Charles Piller and his team to persist in challenging the treatment recommendations which were concerning Alzheimer and Parkinson diseases. The checks and balances in the academic research have failed and a serious reconsideration of the procedures should follow, not just business as usual. The reputation of scientific research is at stake beyond the natural sciences and medicine, although the normal way of proceeding is just to qualify such events as singularity and specific to a single discipline. Aging is also not just treated by one single discipline. Hence, there is a need to review the review process and publication practices. The Boeing airplane control failures were also indicating that reviews of technology are subject to high risks. Independent checks and control are hard to ensure in advanced subject matters, but sufficient time and resources have to be devoted to the process. (Image Repair Lab Deutsches Technikmuseum DTM2024).

Happy Runner

The happy runner is a nice example of how hard it maybe to experience happiness through running. The so-called runner’s high is available to everybody, if you manage to run long enough already. Most predictions put the threshold distance at about a 1 hour run. The reward for this effort is a special feeling that exceeds the pain or it makes you forget or supress the pain at least temporarily. Special reinforcements can be achieved through the big city runs in exciting places with thousands of people cheering you on. This has become a big business as well. Training for such an event might raise your feeling of happiness substantially. The chemistry of the endogenous production of stimulants of happiness in our body has been enlightened substantially in recent years (partly as doping control). Most of the brain active drugs our body can produce itself, although this involves a lot of physical and mental effort. The rewards are pretty healthy for most runners contributing to their basic level of happiness. Running outside, has contributed more to happiness for me more than the same exercise on a treadmil. Maybe, the environment is part of the happy runner’s high effect.

Happy Biology

At first glance happiness from a biological perspective is easy to understand. Its hormones, stupid, that regulates it all. Only problem, there are many of them that interact and, apparently, a lot depends on the right dosis and duration of exposure or deficiency. Oxytocin deficiency seems to be a corollary of anxiety and lack of pro-social behavior, potentially making people less happy – to put it bluntly. There are other complex interactions between hormones not only in the circadian circle of humans like for cortisol, but also related to differential reactions to stress. Genetics and epigenetics are involved as well stress regulation and early exposition to stress during the life course has longer lasting consequences later on. How much stress is good for you? Climbing Mountains induces physical stress, but most people report lasting happiness referring back to such singular events. Hormones seem to play tricks with us as well.
Some time after the novel “Klara and the Sun“, endocrinologists have documented the positive effect of a robot on oxytocin levels in humans. Improvements to mental health and well-being are apparently easy considering that oxytocin is a driver of feeling happy as well. Maybe we should take our depressors and drivers of oxytocin more seriously to be “biologically” happy.
(Image: Extrait Frans Hals 1660, Catharina Hooft and her nurse. Exhibition Gemäldegalerie Berlin 2024)

Happy Employee

The research on happiness, subjective well-being or overall satisfaction with your life is also an empirical question. Analyses of being happy donot only focus of overall happiness, but look much more into the details of happiness. Beyond the tricky longitudinal observations of happiness it is common scientific practice to deal with subdomains of happiness like satisfaction of employees with their job, satisfaction with one’s job beyond the honeymoon and hangover effect, best known from family studies.
Each of those subdomains has a significant effect on overall happiness. The novel “Happy Life” by David Foenkinos is an interesting example which focuses mainly on the subdomains of job satisfaction, satisfaction with private and romantic partners as the major domains of a happy life. As developed in the novel, people make job changes to re-orientate professional careers or reset their private life. A low point on the happiness scale in one domain might be compensated by higher levels in another domain. These impact from one domaine to another might have substantial time lags involved as well. More drastic resets (à la Foenkinos) can be avoided through focus on other subdomains of overall happiness as well.
How happy are you with your housing situation, neighborhood, your pet, your physical health? There a multiple +/-spill-over effects to overall happiness. Reading a novel might be one as well, just take time reserved to yourself.(Image BnF expo “women in sport”, 20024)

Own Insulin

People who suffer from type 1 diabetes do not produce enough insulin themselves. The World Health organization estimated that „in 2017 there were 9 million people with type 1 diabetes; the majority of them live in high-income countries“ (WHO 2023). The report on successful reprogramming of stem cells of a person to produce insulin again and subsequently transplanting these cells into the same person allowed to produce own insulin again for that same person (Mallapaty, 2024). The hope for millions of people with type 1 diabetes is high that eventually there will be a cure to the disease. Scientists caution that there are no data yet for how long the transplanted own stem cells will produce insulin. Hence, the hope is driving research forward on a promising way forward. The case of type 2 diabetes is very different as additionally the absorption of insulin in the body causes problems. We keep walking and building muscles to facilitate the insulin absorption in the body to guard against the onset of type 2 diabetes. Interaction of diabetes and aging is another topic that needs our attention as rapidly aging societies are at higher risks to face many more people with various forms of diabetes.

Walking Danger

Autumn brings color into nature. This is for some the bright side of life. However, the sun sets much earlier every day and many people begin to walk to school or work and back during the dark time of the day. Unfortunately, this entails an additional danger to those walking the cities as bad light conditions cause many accidents of pedestrians. The statistics provided by Destatis (2024) for Germany show a marked increase of walking accidents from September onwards and lasting throughout winter. Equip yourself with bright colors and reflectors to avoid being a walker in danger or a walking danger. On Sunday it is pretty safe to go for a stroll. City life is less stressful and professionals in a hurry usually take a rest on that day. The conclusion is to choose your track wisely in order to feel safe on weekdays.

Waiting time

A new report by Darzi, a former cancer surgeon and past minister of health in the UK, paints a dismal picture of the British health service (NHS) over the last 15 years under conservative rule. The public service has seen no increase in its budget accounting for population growth and the aging of the population. The service is no longer able “to give patients the timely care they need” (The Guardian 2024-9-12 title page). Increased waiting times lead to an estimated 14.000 premature deaths per year. Darzi presents data that show 300.000 persons had to wait longer than one year for a treatment that should have been performed within 18 weeks.

The staff seems desperate for changes as well as they have to spend more time on management of waiting times, time which is lost for real treatment. The quality of care is another issue which awaits urgent attention. Health cannot wait for most patients, but the neglect of investment in hospitals and people is expensive in the longer run. Even the reform efforts should not wait any longer. Time is a precious good and each life matters. (Image back cover of exhibition catalogue Käthe Kollwitz at MOMA 2024).

Health GDP

A report by the WHO and the World Bank (2023) on universal health coverage and financial hardship has emphasized the difficulties to reach the goals defined by the strategic development goals (SDGs) by 2030 in this policy field. Moreover, the paper by Mazzucato and Ghebreyesus (2024) invites us to reconsider the importance of health in the overall assessment of development and progress. The authors ask us to “rethink the narrow focus on growth in gross domestic product (GDP) that typically dominates economic decision making”. There is of course a long debate on the status of health, GDP or wellbeing as major policy issues or even foundations of the a state’s major objective. For economists the question has been answered for decades to favor GDP growth and more or less the other objectives can be achieved with a time delay. Recently social scientists have highlighted the overall importance of wellbeing or happiness rather than GDP as stated in some constitutions. Health as an overall objective is another challenge to the existing economic framing of societies. In a traditional economic perspective the health sector is part of the GDP increasing public and private sector of the economy with insurers, equipment and persons contributing to it. On the other hand, health enters into the distribution or consumption part of the economy. Each country strikes its own balance between production and consumption. Put simply, in form of an equation where production equals consumption, health enters on both sides of the equation in each country. On the global, scale the distribution between costs and benefits of health have not narrowed over the past. The challenge for the world population remains steep. Considering unequal population growth across continents, the situation might get worse before it hopefully gets better. We still have to continue huge efforts to increase overall health on earth for example through large scale vaccination programs. (Image The tombstone of Molière in Paris 2024)

Desertification

Since 2018 we have evidence of the progression of desertification into some Member States of the European Union. The mediterranean countries are concerned as well as regions of Bulgaria and Romania near the Black Sea. There are multiple sources of desertification. The 3 main reasons of desertification are soil erosion, loss of soil fertility and loss of natural and desirable vegetation besides wind or water erosion and salinization. We also know that man-made climate change is at the root of the past and recent problems. The statistical indicators of land degradation are collected by the European Joint Research Centre and these data show a dismal picture of land degradation in general and desertification as part of this process. A study by Ilea et al. published in Nature 2024 projects an intensification of extreme weather in the coming years. Higher temperatures will most likely enhance desertification and more frequent flooding will contribute to more soil erosion as well. It is a rather strange process that we know we are creating severe problems for some regions which endanger the roots of their existence and yet we do not act upon those undeniable facts (United Nations SDGs list). The amount and dynamics of land deterioration put the global South under severe pressure, but also the wealthy parts of the Mediterranean basin will be affected. It about time to acknowledge that we are all part of the global changes and challenges. (Image palm tree in Paris, Jardin du Luxembourg, 2024)

Heat Stress

Heat causes cardiovascular and pulmonary stress. This has been well-known for a long time. A newly published epidemiological study for Germany reiterates this finding and adds more details to the picture of who is affected most by heat stress and heat-related mortality. Old age and being female increase the heat-related deaths in Germany according to the study by Zhang et al. (2024) published in the Lancet Regional Health. Our body’s thermoregular responses to heat stress like vasodilation or hyperventilation cause additional stress to our cardiovascular and pulmonary system. Excessive sweating and dehydration, possibly increased through medication, amplify heat-related risks. The study corrects the estimates by using fine particulate matter (PM2.5), ozone (O3), and nitrogen dioxide (NO2) data on the district level in the analysis. High concentrations of PM2.5 and NO2 increase heat stress and related deaths as well. Inner cities are, therefore, not the best place to be during the hot season. Most southern European inhabitants of big cities are aware of these health hazards and act accordingly. In Germany it is much less a habit to quit inner cities during the hot days in summer, but climate change will make this a major concern. Greening inner cities is an urgent necessity, which is not just nice to have, but saves lives. (Image Berlin Bears, Berlin City Center 2023)

Paralympic Happiness

It is with great pleasure that we watch the paralympic athletes in Paris compete for Olympic medals. For many the emotions of participation and being applauded by so many people in a sport arena are great experiences. Happiness derives from such great games and audiences. The accomplishments of the athletes and their supporting teams are truly outstanding. The progress towards such high skill levels is remarkable for each of them. The adaptation to what appears to be a handicap with adequate support and technique allows to surpass limitations. Well exercised skills like swimming are possible to be performed with great skill to achieve incredible performances. The Paralympic Games in Paris 2024 are a great reminder that besides the athletes some artists had to struggle with handicaps, but achieved some of the finest pieces of art. Matisse, for example, is called frequently “le peintre-du-bonheur”, the painter of happiness. In his last few years he faced a severe handicap to paint, however the pursuit of abstraction helped him to continue to create masterpieces. The rather radical pursuit of abstraction and maybe simplification are uncovered in the exhibition “Matisse: The red studio” at the “Fondation Louis Vuitton”. This marks an important step in the artistic life course of Matisse and enabled him to continue his work in later life when his health made it very difficult to pursue his artistic work. (Image at Fondation Louis Vuitton 2024-9-1 exhibition Matisse).

Olympics for All

The Paris 2024 Olympic Games and the Paralympic Games have demonstrated the extraordinary competence, professionalism and competitiveness of all athletes. The television spectators and live participants in the events have been involved to a great deal.
After all this hype around sports let us consider the probability of getting involved in physical activities and sports. Additionally, it is of interest, whether people are encouraged to continue sports, maybe at higher ages as well through these sports events like Olympia.
High level athletes are most likely to continue their sports activities. In many countries the extraordinary athletes of the Paralympics faced tough challenges to pursue their sport interests and passion.
However, the public health challenge is the big unresolved issue of how to best raise an awareness for the pleasures and benefits of sport for the masses. (bibliography by BNF “Santé et activité physique). It is not only a matter of suitable infrastructure, but also the question of sports in your neighbourhood. This issue has implications for urban and rural communities and how they organize the practice of sports in an inclusive way. Each step may be a stepping stone into sports for all ages and pathologies.
The pleasure and benefit to walk or something simple as walking to or walking after work, are part of the solution to many public health issues.
The visitors of the Paris Olympics walked a lot.
This fun experience in an enthusiastic city will encourage many to continue the simple exercise without thinking about exercise. This will do the trick. Just do it, without thinking to much about it.

BNF Paris 2024-8

Paris Trees

Preparing metropolitan cities like Paris for the heating up of the globe due to climate change is a huge task. As early as 2020 Paris started an ambitious greening program. 170.000 new trees by 2026 in a densely populated city is a steep challenge. With 114.000 trees planted by 2024 as the Olympic athletes and spectators gathered in Paris the city is right on track. The 2 parks “bois de Boulogne et bois de Vincennes” have jointly 25.000 new or renewed trees. The cemeteries, for example “Père Lachaise” has received new cooling trees as well. Most trees, however, were planted along the notoriously hot and overcrowded “périphérique” with 50.000. Only with the use of a Colbert-like planning exercise and rigorous implementation against even some initial resistance, it is possible to achieve this result and the ultimate objective. Visitors of the Olympic Games already experienced the differences during the summer of 2024. Detailed planning by means of a “Bilan par arrondissement” facilitates monitoring of progress. Publishing the information is part of the communication strategy to keep citizens informed and engaged in this silent transformation for the benefit of inhabitants and visitors. (Image City of Paris webpage 2024)

Burden of Disease

For the planning of health and care systems it is important to measure the so-called burden of disease within societies or related to specific diseases or social groups. A large-scale analysis of several longitudinal data bases of the populations 50 years of age and older shows that we have underestimated the burden of disease to societies of psychiatric disorders, like depression, in most societies.
A meta-study and overview of previous studies showed already that depression (age 60+) is more common in lower-income countries (between 25 and 33% of 60+population age group). High income countries, studied by Wang et al. 2024 in The Lancet Healthy Longevity, have rates of depression well below these levels, but a link to socioeconomic status, inactivity and loneliness is still evidenced. A five-year follow-up of persons aged 50+ years shows that the probability to develop a depression (hazard rate) is twice as high for persons with low socioeconomic status, who were socially
inactive and lonely than for socially active, high socioeconomic status and did not feel lonely at the beginning of measurement. The conclusion of the research highlights the need to develop and implement integrated and simultaneous initiatives to addressed the growing burden of disease related to depression in older persons. (Image, Jules Desbois, “Misery” 1887-89, Musée Rodin, Paris)

Stress Ageing

The relationship between stress and aging is a complex one. Stress is known to accelerate aging and aging caused different reactions to stress. In short causality does not run only in one direction. Additionally new research published in Nature Medicine 2024 demonstrates that different genetic preconditions determine different response patterns to stress and subsequent brain aging. From anecdotal experience we are well aware of different persons coping very differently with stressful situations. Mastering of various coping mechanisms may attenuate the stress experience but the impact on preserving our brain remains an open question. Various other forms of lifestyle conditions like drugs and smoking cause specific forms of brain damage as well. 2 separate forms of dementia can be identified from brain MRI-images as well. The brain is no longer the black box of missing information about what is going on in humans. Put to the right purposes this is good news. (Image: break dance shooting Paris St Denis 2024)

Alzheimer Research

Alzheimer disease has reached unprecedented levels in line with population aging. The study by Martino-Adami et al. 2024 has raised the hope that more people can receive an early diagnosis of Alzheimer and potentially start treatments. The study used plasma biomarkers rather than much more expensive and rare MRI scans for diagnosis. The rather exceptional results allow even to test for severity of Alzheimer according to established evaluation measures. Additionally, the probability of an Alzheimer trajectory on a time scale is feasible. The authors suggest that the data and statistical methods applied allow to identify Alzheimer before the outbreak of impairments. The data sample stems from “patients of advanced age visiting primary care”. This remains a limitation for generalizations, but the hope that other studies test the same approach with samples from younger populations will spur additional investments into such research. The list of institutions and foundations that contributed to make this study possible is really long. Thanks go to all involved, researchers, donors as well as the reviewers and editors of the journal. (Image Paris Metro Help Column 2024)

Paris Experiment

The Olympic Games 2024 were prepared years ago. Already the application procedures to prepare “un dossier” has to bring in lots of ideas and imagination what is desirable and feasible. Paris opted for a celebration of sustainability in a city proud of its medieval heritage and the Haussmann tradition of radical transformations of a city with large boulevards and representative buildings. From the “Arc de Triomphe” the major axes of communication between “arrondissements” become visible. 100 years ago the city had already been transformed according to this master plan. At that time sanitation of a city meant different things than today. The invasion of inner cities by Diesel-driven cars made life unhealthy again. Now, the Olympics gave reasons to restrict cars and lorries passing the inner city and the great boulevards. More tourists need more space and shall keep a much better memory of how pleasant Paris was during the Olympic Games. This could be a game changer for urban development in general. The proportion of pedestrians versus cars has to be shifted in favor of the walking population for many reasons. Tourists will flock to the city, if the overall and shopping experiences are great. Back to the future sounds crazy, but it has an interesting flavor to it for urban renewal and residents as well. (Image Paris 2024-8, b/w color filter applied, enlarge to see vasque)