Tag: medication

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Climate Anxiety

The events of several wildfires and a too hot summer in 2026 have raised the level of anxiety related to climate change for many people. From the field of economics we know that the fear of an economic recession can be as bad for the economy as a statistical economic downturn. The anxiety about climate related bad events can trigger or worsen symptoms of depression. The research by Zacher and Kühner (2026) shows that psychological evidence supports this hypothesis. The 1 year follow-up clarified, that the opposite direction of causality is not supported by the data analysis. A pre-existing depression is not worsening due to climate change. The consequence of these results is that the total number of persons with depression is likely to increase with an additional source of depression, for example after experiencing a wildfire. Oceans are warming and the number of injuries on beaches due to poisoning from algae or medusaes (jellyfish) become more frequent as well. Lots of sources for increasing climate related anxieties. In the economic costs of global warming and climate change we frame this as second round effects of climate change.

young curious boy touching jellyfish on beach

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Fountain of youth

The fountain of youth is such an old dream of humans that we are no longer surprised to witness perpetual reincarnations of the same theme again and again. The painting by Cranach the elder (1646) “Fountain of youth” (image below, Gemäldegalerie Berlin) sets the scene for what has become a billion dollar business nowadays. Whereas the old dream was about rejuvenation and cure from disabling diseases, we have become a bit more moderate in ambition to be happy about a halt to aging. Promises are reiterated and made in building on an army of influencers who push many remedies that lack rigorous scientific tests. Two studies published open access in “The Lancet Healthy Longevity” (Witham, McDonald 2026 and Duremdes Nava et al. 2026) provide evidence that in case of obesity and diabetes there are no easy or quick fixes available yet. Healthy longevity still relies mainly on lifestyle (changes), more exercise and careful nutrition rather than additional medication. Medium and long-term consequences of inactivity and unhealthy diets are to easily disregarded or their value discounted. How much are you willing to pay for an additional year of healthy living at age 30 or 70? Simple economics, but quite a successful business model as well.

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Medication adherence

In the broad range of medico-pharmaceutical science the topic of medication adherence is an uncomfortable issue. In the ideal scenario people would adhere 100% to the prescription. In the real world of not-optimal behavior and circumstances, people deviate substantially from what is best for or even good for them. Even in the tax-based health system of Denmark with relatively easy access to medication, a long-term study revealed the difficulties encountered to adhere to essential medications for persons with Type 2 diabetes. Nielsen et al. (2026) analyzed a cohort of 80.000 persons who newly acquired Type 2 diabetes of which about 25% showed a low adherence to medication plans with hazard rate of 1,27 to suffer a cardiovascular event. High adherence persons did not suffer such an event in the following 220 days over the 10 years of observation. A sedentary lifestyle or obesity increase the risk of type 2 diabetes and beyond medical treatments additional behavioral challenges like medication adherence make it clear, we do not live in the best scenario to fight type 2 diabetes.

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Preventable Asthma Burden

The global burden of disease data, analyses and projections allow us to identify more clearly the parameters to influence and prevent rising global burdens of disease. Among the so-called non-communicable (i. e. not infectious) diseases Asthma plays an important role.  Heat waves (wild fires) and air pollution (road transport, heating emissions) are major contributors to the burden of disease. In addition to the health related suffering of a population, the economic losses for groups of countries have been estimated by a recent study (Chen et al. 2026).  For the UK another study showed that 2/3 of asthma attributed deaths were preventable. This raises our awareness to the fact that adequate health care systems and the distribution as well application of asthma medications can help a great deal to lower also the economic impacts due to uncontrolled asthma. The labour-induced costs (lost years of production) are likely to be higher in the low-income countries, whereas capital-induced costs (in form of opportunity costs of health expenditure) accrue more in the higher- income countries. With the successive heat waves in 2026 and continued global warming, the estimated global burden of asthma is most likely a lower bound estimate of the economic impact. A focus on asthma prevention becomes a pressing concern today to prepare for the future.

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Cardiac arrest detection

The number 1 cause of death is cardiac arrest in the modern world. Hence, the interest in the detection of cardiac arrest could save many lives. For assistance to arrive and intervene in time an alert needs to be issued as soon as possible. With early detection by nearby persons and skilled intervention the survival chances are about 50% of cases. The “silent” at home cardiac arrest is an important health and survival issue. The availability of wrist bands and watches which can issue alerts in combination with smartphones has risen considerably in recent years. Therefore, the improvement of reliable algorithms which interpret these data can realistically save lives as the delays can potentially be shortened for professional helpers to arrive. The study by Edgar et al. (2026) tested such a device and were able to show the very low number of false alarms issued by this device (about 1 out of 40). Extrapolated to millions of cases the challenge to a health care system is steep. However, we have to deal with such socio-economic issues of digital devices in medicine in the coming years more often.

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The next big challenge in medicine and public health seems to be the multiple long-term conditions. Many people do not suffer from just one medical condition, but several ones at the same time. Diabetes is one such condition which frequently comes along in combination with other conditions. The definition of Multiple long-term conditions comprises 2 and more conditions like cardiovascular, metabolic, respiratory or cancer, to name just a few of the more common ones. Our health and care systems are little prepared for adequate treatments as this involves a coordinated intervention and poly-pharmaceutical therapy. Changes in a single condition have repercussions in the condition and treatment. This makes adequate treatment a resourceful process with limited knowledge about the multiple interactions and intervening parameters. Add, for example, depression to any of the above mentioned conditions and the behavioral assumptions of correctly taking prescribed medication becomes a major issue for patients. The challenge for aging societies and societies with more people suffering from early onset of obesity and diabetes increases in the coming decades. There are several teams that address these challenges in research which gives hope to all those suffering already from Multiple long-term conditions.

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Exercise and neurons

The neurons in the brain have an active part even in training effects of physical exercise. Morgan Kindel et al. (2026) have accomplished a rigorous test that demonstrates the involvement of brain neurons when mice were exercising repeatedly. Training effects were larger if the neurons of brain cells were involved as well. The cell’s learning ability encodes the experience of exercise and is prepared for a repetition of the exercise. This is roughly what happened in their experiments in my own words. Runners might know the effect that running on track or treadmill uses up less calories than running cross-country where the brain is more challenged to avoid missteps or loss of orientation. However, the latter are different tasks whereas the former experiments demonstrate that the brain is involved in physical exercise even if we do not notice it. Exercise might spur brain plasticity just by doing it. Hence, just do it.  

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Time to prevent

If we take a medical life course perspective, we shall become aware that for each event there shall be a time to prevent it. From a scientific and socio-economic point of view, this is the crucial time to prevent failure of an organ, duration of an illness, death or an otherwise disruptive event. Taking our lung or liver as examples we intuitively know that there is a long time spell during which we have a chance to work on prevention. The monitoring of the early onset of disease is (Ge et al. 2026), potentially, a very cost-saving way as well in addition to avoid humans suffering later on in multiple ways. From a theoretical point of view it will be interesting to “think intervention as prevention” already, rather than the predominant way of intervention “post-hoc”, which means after the onset of disease. This implies a rather complete overhaul of medical research just as much as social research to guide policy makers interested in the “survival” of our social security systems as we know them currently in Europe. (Image is illustration in book on fairy tales: Beckmann in exhibition at Kunstbibliothek Berlin, 2026)

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Illness duration

The focus in medical analyses is primarily put on the diagnosis of illness. This is the best strategy, if the onset of an illness has a precise beginning and ending. In all processes, where either the beginning and/or the ending is less well-defined as precise point in time, the progression, as phase in or phase out of illness, is also of substantive interest. A duration analysis can inform about the potential presence of a co-morbidity in case, for example, an infection continues beyond the normally expected duration.
Financial pressures in the medical systems makes it necessary to release patients in a timely fashion. Therefore, has become more important to monitor patients even after release from hospital. Digital devices can support such a monitoring.
The study by Josi Levi and co-authors (2026) shows that smartphones or just the monitoring of the number of steps of patient offers a rather reliable indicator on the health status towards the end. The information that a patient has recovered to the normal level of activities as before the onset of the illness works quite well as indicator of recovery. A more precise measure of the duration of an illness is important for patients, care persons, the health system overall. The duration is one of the cost-intensive factors of any illness and it is surprising how little we know about the issue of time and duration in many health processes.

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Polypharmacy issues

As we age, we become more likely to confront polypharmacy issues. Polypharmacy is defined as taking 5 or more medications per day. The study reported in The Lancet healthy longevity by Payne et al. 2025 had participants with a median of 4 health conditions and a median of 8 prescriptions. Even a comprehensive set up which involved several experts from medical doctors and pharmacists did not manage to achieve a significant improvement in polypharmacy outcomes in this experimental study with otherwise carefully matched intervention and control group. However, the mental health (measured in patients as “health-care-related quality of life”) slightly increased and the “treatment burden” experienced by patients was slightly reduced.
In combination with a previous study the probability of errors in nurses, who are the prime persons responsible for the administration of medications in institutionalized settings, the reduction of potentials for errors like they are to be found in polypharmacy should continue to be a prime target of this research in future. Together with the knowledge about the prevalence of functional illiteracy at older ages, polypharmacy remains a critical issue on the public health agenda beyond the experimental settings in this study.

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Sponge Mofs

Many people might have come across “SpongeBob” as a TV-series. Well, in 2025 it is time for an update. The Nobel Committee has awarded the Chemistry prize not to SpongeBob, but the research linked to the sponge-like Mofs, i.e. metal-organic frameworks to Kitagawa, Robson, Yaghi. These Mofs have in fact properties  similar to a sponge or cages in some applications. They consist of porous materials, which have large surface areas in relation to their apparent volume. Due to the modelling of network structures the surface of a grid can be expanded drastically.
Due to the application of such modelling techniques, the combinations of materials/organics and, thereby, the applications to modern technological challenges have increased tremendously. The exponential growth of research papers based on these foundations largely justify this honourable award. Not only the potential of carbon capture, but also the storage capacity of batteries as well as medical applications might benefit from this basic research and findings, eventually.
Playing around with a sponge, doing your dishes – also for men, or watching Spongebob might be considered differently from now on. Maybe, just start with a virtual visit of the Nobel museum for further inspiration.

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Scienceploitation

Science can be exploited to make unjustified profits from referring incorrectly to it. Social sciences, like economics may be used by banks to sell you products that refer to science only as part of their arguments if the science based inference fits their purpose. Scienceploitation is very common in the field of para-medicine and para-pharmaceutical products. Health promises sell. The time until an ineffective treatment reveals the unrealistic promise to be unachievable considerable profits have accumulated on the side of the selling company. Science has a hard time to counter the perils of scienceploitation. Advanced knowledge can be used and abused as any other method of convincing people to buy or subscribe to a product. The responsibility of the scientific community consists also in finding ever new ways to counter scienceploitation. AI will pose additional challenges as well as opportunities.  

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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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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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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 Witches

Medical and chemical authorities have been questioned for many centuries. As far back as Friedrich Spee (1591-1635) in the early 17th century there were even among the clergy men with enlightened views on what might be helpful ways to assist people on their journey to better health or simply pain relief. This did include many unhelpful or detrimental methods as well. Scientific rigor was not well established at that time, which opened up many doors for alternative diagnosis and treatment. From a historical and sociological perspective the closing procedures of professional organizations are interesting as well as opposition to them. Early moderators between hardliner positions are rare at the times of forceful and fierce competition between opinions and doctrines that characterized medieval history. In the absence of an independent judiciary earlier moderation could be influential in specific instances. A testimony for can be found in a documentation of the biography of Friedrich Spee and the society that promotes the memory of such exemplary behavior.

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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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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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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.

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Health data

2025 will be a crucial year for health data across the EU. Germany introduced the electronic patient card, which can store basic information to then access data in the health insurance cloud for medical doctors, hospitals and other related health services. Potentially this is a great step ahead as some tests do not have to be repeated if they had been completed recently before already.

In pseudomised form, research may draw samples from such databases to enhance our science based understanding of disease. The evaluation of public health interventions becomes easier and medium and long term efficiency of measures can be assessed in many instances.
The Belgian research using health data has met to discuss the potential and limitations to link health data to other data sources to allow more complete and more complex analyses of health and disease processes. Another extensive data source sits on our smartphone. Collection of steps walked, sleep patterns or heart beats give valuable insights into a person’s own contribution and care about personal health. Although data are frequently incomplete, researchers are used to estimate missing data on the basis of existing or comparable person’s data. The basis for improving health for all are quite promising, data handling and linking them will be a challenge to the competence of all stakeholders and everyone involved in better health. It will be stressful before it becomes a routine.

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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)

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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).
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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)

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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).

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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.

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Back pain

Most people know some form of back pain. This is understandable as an ever increasing share of people work in seated positions and spend additional leisure time in a similar position (gaming). Recurrent back pain is a frequent diagnosis. An Australien study has found a rather simple remedy for the widespread pain. The WalkBack experiment succeeded to significantly reduce recurrent lower back pain in study participants. Individualized and progressive walking accompanied by an education program did the trick. Keep on walking and try to extend the range of the exercise. It’s amazing to witness how the human body adapts to being challenged. Learning about the mechanics at work like the release of own personal “pain killers” hormones helps to trust in your body’s positive response to each dose of the challenge to pain. Do not walk too quickly too far. Stretching is a must and not an option. Go for it. Modern technology (in any smartphone) supports your efforts with counting your steps and measuring distances. Keeping track of a “pain diary” might give you guidance not to overdo the exercise and pause activities. Join a group of friends or people who are like-minded and get adequate shoes and clothes to feel comfortable while walking and afterwards as well.

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Patient Empowerment

The empowerment of patients is a well-established practice in the treatment of diabetes. Measuring your own blood sugar and adjusting your medication to the self-monitored data is common practice. For patients with high blood pressure this patient empowerment is less prevalent. A medical study carried out in Valencia (Spain) by Martínez-Ibáñez et al. (2024) has tested the effects of such a self-monitoring and self-medication experiment.
The results publishes in (JAMA) gave rise to considerable attention in the profession as the empowerment of patients is one way out of the likely increasing shortage of medical professionals in aging societies. Whereas other studies found that total costs to the medical system might increase, the study in Spain provides evidence of the cost-reduction effect of such an empowerment. 24 months after the beginning of the trial. After the establishment of a “medication based on an individualized prearranged plan used in primary care” the self-administering participants achieved a significant decrease in their blood pressure that lasted until the end of the study after 2 years. The drop-outs of the study seem to follow a random pattern.
The conclusion gives support to the potential of patient empowerment in the widespread treatment of higher blood pressure beyond the regular visits of medical doctors. The monitoring of changes in lifestyle add to this to keep the costs of health care under control in aging societies.

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Weight Stigma

The fashion industry has for a long time produced images of mostly women and men that did not correspond to the normal weight distribution of people. Skinny models were present across all media. The so-called social media of today amplify this trend further. The “Barbie hype” has reinforced the idea of low weight as a socially desirable norm. In scientific research the term coined for this phenomenon is “internalized weight stigma” (IWS). A study shows (Highes et al. 2024) it affects more women than men and more people who are described as socioeconomically disadvantaged adults. Pressure to lose weight originates from multiple sources and social media platforms have given rise to bullying. A major outcome of IWS is eating disorders as eating is often wrongly associated to be the only cause of higher weight. It is not. Many other factors contribute to the actual weight of a person. Even the overuse of the body mass index (BMI) as short hand version to define overweight or obesity is misleading for persons with strong muscles. Just fixing on one parameter of body shape or weight tends to reinforce weight stigma. “Keep walking” and a regular healthy diet, this avoids to internalize a weight stigma. Exercise is fun, the more you do it in a group, the easier it is to get going regularly. We ought to keep trying and eventually it will become a routine.

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Causal Benefit Model

In the field of medicine we move more and more towards precision medicine. Previously, the term of personalized medicine was used which suggested to a certain degree that a personalization might be feasible. The budget constraints have forced us to change the term to avoid unrealistic, untenable promises. In the field of cardiology scientific advances advocate to shift from a risk-based model of treatment to a causal benefit model. (Kohli-Lynch et al. 2024 Link). Long-term benefits of a treatment are more promising, if the treatment addresses the causal mechanisms at work. It is wide spread practice to deal with general risk profiles as guidelines as the precision medicine based on a causal benefit model is far more laborious since to search the causal mechanism at work requires additional testing of hypotheses. This becomes immediately clear if genetic causes enter into consideration. Nevertheless, medical research advances more and more in this direction. Genetic testing has been shown to be useful in analyzing and treating issues like sudden cardiac arrest (in survivors). We are somehow aware that genetics may play a role here, but we shall need a lot of additional studies to make the causal benefit model a feasible option for widespread applications. Targeting research in this field will offer new avenues for precision medicine in the 2020s.