Tag: public

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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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Holistic public health

Based on case study in Queensland Australia, Boocock et al. (2026) propose the wider application of holistic public health laws. Due to effects of global warming the local burden of disease may rise due to larger scale floods and subsequent growth of for example mosquito populations that transmit infectious diseases. It will be necessary for societies to understand the processes behind the growth of mosquito populations and what can be done to prevent and protect oneself from the consequences. This is not only an environmental issue, but also an issue of continuous learning across all strata of society. Neighborhoods tend to suffer the same impact of chemicals used or the spreading of diseases like Dengue or malaria. The case study makes a convincing argument about the intrinsic relationship between the social and environmental processes at work. 

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Better infrastructure

It doesn’t need much explanation to advocate better infrastructure. Even if we rarely agree on what constitutes better infrastructure, the lack of infrastructure is felt quickly. Almost everything we use on a daily basis like water, food or transportation rely on large scale infrastructure to facilitate individual uses. Companies settle where they spot good locations, most of them are related to infrastructure as well. The basics about infrastructure is the public versus private provision of such infrastructure and related services. Even a country’s defense hinges on good infrastructure to be able to respond quickly at the place where the defense is most needed. Telecommunication and satellites have been recent innovations in the field of infrastructure. Security and cybersecurity in particular are a critical component of infrastructure. The topic is huge. The means to address these issues are likewise of daunting scale. Therefore, it is all the more important to address these challenges.

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Paris Gare

Train stations in metropolitan inner cities are hot spots of traffic and mobility. The number of people passing through these exchanges are impressive. Public transport systems are continuously put to the test of their capacity to handle passengers who want to get from A to B the fastest way possible. In Paris the RER lines, metro and buses to a great job in handling the affluence of passengers. The comparatively small number of passengers arriving and departing nyy taxi, however, still take a disproportionate amount of space. That’s part of the differentiation or inequality of mobility in Paris. Person‘s in need of assistance should have special access to central points of mobility like train stations. Everybody else could rely on shared modes of transportation otherwise the millions of inhabitants will not be able to get around in a comfortable way.

 

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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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Democracy in Korea

For all scholars of the theory of democracy the writings of Alexis de Tocqueville (1835) “De la démocratie en Amérique” are a major point of reference. The comparison of the democracy in America with the French king and both constitutions reveals comparative strengths and weaknesses of political systems. Korea after the 4th of December 2024 is yet another warning of what are the dangers to democratic systems. The attempted “coup d’état” by the president of Korea together with a former defense minister and several hundred soldiers has failed due to the speedy reaction of the elected members of parliament and an attentive and reactive public (Korea Times reports).
Tocqueville (p.130-131, French edition online) states, beyond the separation of powers (John Locke), the importance of the right to nominate key positions in a society also public opinion for the survival of democracy. Modern social media have increased the “reaction time” of public opinion and the “time to action” if need be. The combination of both elements of public opinion ensured that parliamentarians in Korea rushed to parliament and used their potentially last chance to vote against the imposed martial law, which started to seal off parliament already.
Several lessons for democratic systems derive from this. Separation of power remains key for democracy. The distribution of state functions on many shoulders under the control of parliament are essential. Legal mechanisms, in case of a spontaneous attack on the system, have to be able to react fast in order to avoid spreading fake news about legality/illegality of interventions. Public opinion, the people at large, should have their opinions distributed rapidly as well. This is necessary even beyond the traditional media of TV, radio and print. In Korea 2024 the attempted “coup d’état” tried also to block traditional media and prominent figures of the opposition with high power of influencing and reach on social media.
Tocqueville stated already that kings are threatened by revolution. Elected presidents have to fear public opinion. A lesson still valid beyond the US., France and Korea in the 21st century.
(Image: joint exhibition at “Traditional Korean Painting”, Korean Cultural Centre Brussels, 2024)

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Game Tech

Gaming has moved digital and online for a long time. Networked gaming and following the best gamers online on video-platforms like twitch has captured a lot of attention from younger generations. With a real trend of gamification for industry and even public services, the digital gaming sector is moving from backstage to front end of companies and services. Public administration as a game. Enjoy the use of a public service through a game-like experience. Walk around in the metaverse world and get your admin work done. I would love to have such an experience. There are so many applications for gamification that the bottleneck is in the human resources to program all these applications. Coding the digital and virtual worlds to get real stuff done is just around the corner. The SCCON 2024 in Berlin showed these technologies next to each other. 2025 we might see integrated prototypes. I have a digital dream, others call it a vision for public services in the 21st century.

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Citizen Services

In addition to public services there are many citizen initiatives that pick up common interests of citizens. These range from long-term infrastructure projects to daily care and provision in small neighborhoods. Such efforts build on volunteers and the organization of volunteering as an integral part of community life and services. To facilitate these organizational tasks online tools can make a real difference. However, the trust in specific tools beyond the general platforms known for their sketchy treatment of data privacy and protection is low. Therefore it is necessary to rely on trustworthy open source software to support local communities and networks of volunteers in their work and efforts. Secure e-tools for collaboration have an important role to play to reward volunteers with e-learning and being part of or even driver of new digital services. The software „wechange“ offers a platform with several tools for e-organization and communication small communities can set up themselves. Bottom up organizing in addition to the more top down public services complement each other. Going digital is the way forward in both domains.

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Gov Tech

For many years we have believed that technology is something for experts and a special sector of the economy. Private sector companies have taken the lead and innovative applications of e-solutions or web-based applications have moved online to attract huge crowds. Some 20 years later, the scope to move public services online are on top of the agenda as well. Not only in security, defence, infrastructure management and health e-solutions are drivers of innovation and improve the reach out to persons in remote places, where it is hard to keep up equal provision of services otherwise. This is where “Gov Tech” comes into play. Government Technologies I would define as all technolgies that are needed to service your current citizens, past and future citizens as well as “want to be citizens”. This needs a whole of government approach, since there are many cross-cutting issues involved like cyber security and data protection.  “Gov Tech” is no longer just nice to have. It has become a “sine qua non” condition of government. The expectations of people have been shaped by private use and habituation to online access and amenities that government and public services have to follow suit in order to be perceived as similarly close and accessible for people. Besides the technological aspects of hardware and software solutions for gov tech there is the huge issue of taking people with you on that e-journey. Even social policies and social inequality are subject to the e-volution of gov tech. There is a potential to reach more people with the same number of administrators by use of new gov tech solutions. At the same time, the risks to loose people who choose to remain off-line or have no access to online services increases as well. Gov Tech poses multiple challenges as well as interesting solutions. Great to see many regions and states taking these issues very seriously.
(Image: SCCON, Berlin 2024-10).

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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.

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Water as a Service

Most of us are happy to turn on the water tap and enjoy the bubbles of fresh water. In other parts of the world this is considered a luxury and precious good. Public infrastructure takes care of water supply and treats waste water. We hardly even notice. This is changing in many regions of Europe now and Berlin and its surroundings are a good example of the challenges of water as a service. We need to sharpen our awareness that, yes, climate change again, has changed the priorities of water supply. Some East German regions face already a water supply shortage due to lack of rain water and adequate measures to store rather than evacuate rain fall. The German weather service (DWD) offers not only the info on rain fall, but also several indicators on soil humidity from 10cm to 200cm under the surface. These measures are important for crops and agriculture, but also for trees and vegetation in general. The droughts of the last years show a lack of humidity in large parts of East Germany.
This is the starting point for the “citizen science” project in the region of Brandenburg. The “Wassermeisterei” brings together people interested in water management to monitor soil humidity with a shared infrastructure and citizen enthusiasts to raise awareness and draw conclusions on the local preconditions for agriculture and forestry. Knowing about the evolution of water availability over time allows to make more informed judgements about the need and potential of a continuous and improved “water as a service”. The presentation of the project on the e-government fair was a reminder to take water more seriously and to value this crucial resource with more respect.

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Digital Zebra

It is a difficult task in all countries to bridge the digital divide in a society. On the one hand, there are so-called digital natives, those who have grown up with smartphones and notebooks all around them all the time. On the other hand, there are many persons who have not kept track of the digital turn and feel rather lost or are afraid of making mistakes using digital tools. As public services are also moving online, the need for a society-wide comprehensive mastering of digital information and tools have become a sheer necessity. It is much more than just nice to have.
As public services move online like registrations, payments or tax declarations, the need for training and/or assistance of millions of people in a country become a real challenge. This is where the innovative project “digital zebra” in Berlin comes into play. Through the network of public libraries you can get support in person to master your digital challenges.
The name of the project refers to the “zebra crossing” of a road, which assists persons to move from one side to the other side, just like crossing the digital divide. We shall need a lot of those guides and other multiplyers who can assist people to move safely online. Only through this form of taking people with you on the move towards online public services we shall close the gap of the digital divide. It is probably going to widen before we can narrow it again, unless we breeding digital zebras in a rapid way.
(Image: SCCON 2024-10, Berlin)

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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)

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Administration Online

The public administration is more and more moving online. The electronic identity is becoming a reality for all those with a recent personal identity card and who remember where they stored their pin code which came with the card. Moving houses or apartments or car registrations among other official registrations can be carried out online rather than by joining the lengthy queues at your public administration. The “buergerservice.org e.V.” presented the easy steps at the SCCON 2024 in Berlin again to the audiences. The support by the “mobile citizen’s office”, allowed to do the PIN retrieval or change on site and during 2 minutes. This is going to be a game changer for many people who shun away from lengthy admin procedures and push off such registrations due to the time-consuming queueing systems currently in place. Labour shortages are circumvented by e-administration and citizen’s satisfaction with public services increases. More publicity for such e-services and rapid implementation across countries and the EU should bring a about a new e-dynamic drive to old Europe. Employees or civil servants will be pleased to deal with exceptional cases only rather than the bulk of repetitive registrar work. More time will be available to real case management instead of suffering from impatient citizen clients. “Administration as a service” sounds like the new device of digital public management.

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Digital public management

Countries with large public sectors also have specialized research called administrative science. More than 25 years ago the whole discipline has been hooked on the idea of so-called “new public management”, which introduced “management by objectives” and “benchmarking” as new tools into the field of public sector management. In Germany Naschold and Bogumil (2000) have been publishing extensively on the topic.  In 2024 the new public management is well established and the now new challenge is “digital public management”. Berlin just hosted a fair on this topic (SCCON 2024). This allows to speed up administrative procedures, increase the reach of public administration into remote areas and creates new challenges to counter the digital divide of society. The modern public sector may shift from being pushed by private sector companies in terms of digitalization to being a forerunner of digital provision of services. Tax declarations in Germany are a good example, where for many years it is a widespread practice to rely on digital forms of declaration and communication between the tax office and its clients.
Other countries, like Estonia, have taken already many more far reaching forms of digital public management and digital provision of services. The scope of such reforms is huge and the administration of persons in remote areas and aging societies give additional reasons to push ahead with digital public management.
At the time when even emails become outdated among youth, some administrations are proud to feature their latest innovation in digitalization. A machine is opening physical letters and scans the documents automatically and stores them in a secured cloud for example. It is indeed an important “bridging technology” for administrations dealing with a generation of older persons who are used to this form of communicationd by (snail)mail.
Many interesting new digital solutions (hard and software) were on display at the SCCON 2024 and many more are in the pipeline or pilots have been implemented already, well worth studying in more detail.

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Buzzing free

It is always a chance to be in a city that bans cars for some time from streets and bicycles and pedestrians can walk freely in the city. On September 22nd 2024 this is the case in Brussels. In addition, the public transport system allows people to buzz around the city free of charge. Of course this is an invitation to get to know areas of the city where you normally don’t take the time to visit or mix with people. The police used the time to teach children how to cycle in a city in all security and respecting basic rules despite the enthusiasm for speed or going round in circles. Unfortunately, this happens only one Sunday out of 52 in a year. It is just amazing how the feeling of safety on the road changes again. The level of noise and pollution drops to levels of the countryside. Buses and trams pass the city easily and most people get around faster than they do on other days of the year. It is a bit like a coordinated health intervention for the stressed urban survivors. This experience is a modest reminder of how nice it was in Paris during the Olympic Games 2024 when prioritizing mobility beyond cars haa been effectively implemented for several weeks.

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Democracy Enemies

Discussions in the social sciences about the fate of democracy have a long tradition. With the results of participation rates in elections for the European Parliament in 2024 weeks need to take up the challenge again. The book by Bryn Rosenfeld “The Autocratic Middle Class …” stated already in 2020 that autocratic regimes tend tp buy off democratic intentions through providing lots of jobs in the public sector which promise stable living standards and pensions to regime conformity. If the public sector crowds out private sector jobs this creates a tendency to lock in the current political system of autocracy. The analysis, however, lacks the explanation of the micro level sociological mechanism that made the “color revolutions” plausible in many parts of the world. Even the recent success of a government change in Poland in favor of pro European Donald Tusk would have been impossible if the buying of the middle class through public sector jobs is the overriding mechanism to avoid democracy to win the upper hand. Withholding funds to make public sector expansion more difficult or risky in for the longer term stability of an autocratic regime might do the trick. Autocrats have many enemies not only externally. The enemies from inside the society have multiple options for opposition as well. The other perspective that there are many enemies of democracy to be found within the public sector is another known challenge to democracy. Low turnout in Elections is a warning signal that we have to take very seriously and continue to act upon. (Image: Neue Nationalgalerie Berlin 2024 Extreme tension, explation on Ewa Partum)

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Hospital Bias

Asking people about differences between private and public hospitals, you are most likely getting answers that the private hospitals deliver superior patient outcomes. Whereas private hospitals seem to have a positive stigma attached to them, public hospitals commonly have a negative stigma. Scientific evaluations are helpful to set the record straight again. The study published in “The Lancet Regional Health” in 2024 shows that in the simple descriptive statistics on several patient outcome indicators, this is what the data showed between 2026 and 2019. However, a more precise statistical analysis reveals that there is also a selective admission to the private and public hospitals in England. Using so-called instrumental variables approaches that account for the selection process between admission to the 2 types of hospitals (private versus public) most of the differences between the hospital types disappear. The underlying mechanism is a sorting of different patients into the private or public hospitals. Put in easy words, for a routine intervention people tend to chose the private hospital, but the more rare and difficult operations were more likely admitted to public hospitals. The number of co-morbidities (heart disease) is also of importance as they might negatively affect patient outcomes. Jumping to conclusions and reinforcing stigma about public or private provision of services hinders progress and an equitable provision of services.
The analysis of a potential selection bias can reveal the “creaming” effect of private provision of (health) services. Just caring for the “easy” or routine cases and avoiding the more difficult and costly cases has economic advantages, but for society as a whole the costs overall remain the same. A good public service in health is a definite asset.

(Image: Exposition Isa Genzken 2023 in Neue Nationalgalerie Berlin)

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Transparent Publishing

New technology pushes transparency of publishing, journalism and science to new levels. Through the hyperlink structure of texts it is easy to link back to the sources of a text. What used to be long lists of references at the end of a text or in footnotes has become directly accessible through weblinks. Only paywalls may or may not restrict the fast and easy access to original sources. In writing online, this is a major additional feature of publishing in the last few years. Some online journals allow this for quite some time now, but there are lots of printed versions that stick to the read and be stuck approach of publishing.
In teaching I have been an advocate of “read the original sources” as the basic source of inspiration for authors. The transparency of the thought process and the evidence provided in whatever form should be traceable. In publishing this transparency allows to exclude the copying of thoughts or unreflected referencing.
However, the task to check for the validity of weblinks and the updating is an additional task. 500+ blog entries with an average number of 2 weblinks per blog entry makes this a job of its own. Testing of 1000 weblinks is something you need a software or plugin which alerts you to “broken links”. The maintenance of a webpage, therefore, increases substantially as the content increases. Reorganisations of webpages make the follow-up of links sometimes quite hard. Projects like the general archives of the web and webpages are very important to ensure the transparency of publishing in the short, medium and long run. The archives of today look more like machine rooms than the splendid archives or libraries of the past and present.

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AI and PS

AI like in ChatGPT is guided by so-called prompts. After the entry of “what is AI” the machine returns a definition of itself. If you continue the chat with ChatGPT and enter: “Is it useful for public services” (PS), you receive an opinion of AI on its own usefulness (of course positive) and some examples in which AI in the public services have a good potential to improve the state of affairs. The AI ChatGPT is advocating AI for the PS for mainly 4 reasons: (1) efficiency purposes; (2) personalisation of services; (3) citizen engagement; (4) citizen satisfaction. (See image below). The perspective of employees of the public services is not really part of the answer by ChatGPT. This is a more ambiguous part of the answer and would probably need more space and additional explicit prompts to solicit an explicit answer on the issue. With all the know issues of concern of AI like gender bias or biased data as input, the introduction of AI in public services has to be accompanied by a thorough monitoring process. The legal limits to applications of AI are more severe in public services as the production of official documents is subject to additional security concerns.
This does certainly not preclude the use of AI in PS, but it requires more ample and rigorous testing of AI-applications in the PS. Such testing frameworks are still in development even in informatics as the sources of bias a manifold and sometimes tricky to detect even for experts in the field. Prior training with specific data sets (for example of thousands of possible prompts) has to be performed or sets of images for testing adapted to avoid bias. The task is big, but step by step building and testing promise useful results. It remains a challenge to find the right balance between the risks and the potentials of AI in PS.

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Publishing2024

With new channels of publishing online the publishing world continues to change. Scientific research  moves also online and the reach of audiences has become a much more important factor in evaluation of success. Elite circles of in-groups publishing and quoting each other have a harder time to survive. It is a form of democratising the world of research which is by very large amounts financed by public budgets. Public radio and television now start to feel the heat as so-called influencers, some working independently, challenge the world of traditional journalism. The good news is that there are many more people active to produce news and entertainment and the two separate worlds become more and more integrated. Young people who have left the “official” media world, engage with their own peer groups and make their voices heard and more influential.  The quality of the provision of information is, however, a matter of concern. Audiences will have to check even more carefully than before which sources can be trusted. This is not an easy task. Speed of spreading information becomes an additional factor. It has always been like that, but the rhythm of a daily or weekly newspaper was very different from the publishing and consumption of news and information today.
The second factor that has drastically changed is the influence of “external” influences and information as well as disinformation campaigns that have an impact on “internal” reporting and commenting. What used to be the world of professional journalists has become an accessible possibility for many more than journalists. Publishing has become a very different world from the printing days and yet printing remains one important channel of publishing. (Link to own edited volumes of blog post for printing here).
Previously, we prepared the manuscript in paper, nowadays this seems to move online and the edited and sometimes corrected versions will be published in print later on. The challenge to science and journalism is ticking. Not accepting that there is a serious challenge is no solution either. (Image from Exposition “Books that made Europe”, 2016)

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Books

Some say, a book is a book, is a book. This is to reiterate the lasting effect a printed volume might have. Many books are a form of a documentation of facts. Creative writing in whatever form finds most of the time some way into a format of a book. For centuries books have facilitated the diffusion of myths and stories throughout societies including translated versions of the content. 2 aspects are constituent here (1) form and (2) content. Annual book fairs receive most attention for new content within more or less the same rectangular format. There are, nevertheless, interesting variations of the form to be discovered as well. Traditionally book binding was the art that gave shapes to the content. Images in form of film are yet another representation of the book content. All this is “dealt” with at the Frankfurt book fair #fbm23, particularly in form of dealing in and with copyrights. New forms of delivery of content, online or as e-book, have added to the variety of books. Pay as you go or as abonnement with monthly delivery is the old and maybe fashionable new way to digest abundant content. People trust in books. The format as book in general seems to remain an authoritative form to present content, irrespective of the truthful or fictional kind of the content. The more we live in insecure circumstances, the more we tend to be willing to hold on to a pile of paper nicely woven or clued. It is still a very powerful tool to guide imagination for all ages. It allows us to learn at our own rhythm as far as we are willing to go. We are, or seem to be, in control of the process as well as the likely outcome. And yet, the spice of life is the surprise. Book it.

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Polypharmacy

Each specialist treats a person or patient in her/his field of competence to the best of current knowledge. Well, marketing of pharmaceutical products is also a field of special competence. Medical doctors and pharmacists are largely competent intermediaries between the world of medical and pharmaceutical research, commercial interests and patients. As persons age, so-called multimorbidity is creeping into the daily life of many persons. After a certain age (75+), depending on country of residence to some extent, we all become patients. Although the basic problem has been known since the phenomenal rise of the pharmaceutical industry, little research is devoted to patients receiving multiple treatments with medical prescriptions from several specialists. In addition, we know there is a rather severe issue with compliance to prescriptions, for example, taking antibiotics for the whole prescribed period, to name just one. The interactions between several prescriptions and molecules administered to patients are very difficult to monitor and scientific tests of those are expensive and no pharmaceutical company really has an interest in such studies that might further add to the already long list of potential side effects. However, the study published by Daunt et al. (2023) reiterates the warnings that treatment of multimorbidity can have unwanted side-effects we do not really know about. General practitioners will have to take on the role for medical stewardship for their patients. Monitoring a patient’s digestion of a combination of medications becomes a prime role as of the age of 75, the paper specifies. Whereas a common believe tells us, taking more, will help more, the “daunting” truth might be, less can be more. (Source: Daunt, R., Curtin, D., & O’Mahony, D. (2023). Polypharmacy stewardship: A novel approach to tackle a major public health crisis. The Lancet Healthy Longevity. https://doi.org/10.1016/S2666-7568(23)00036-3.

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Splendid Public Libraries to replace Cathedrals

Renovated public libraries are modern showcases of architecture and access to knowledge. Recently the best places add the platform function of people meeting people there not only taking out and bringing back books. The Stockholm city library is an impressive example of all functions.
The library figures also in the list of the 25 best public libraries in the world shown by flavorwire:  http://flavorwire.com/280318/the-25-most-beautiful-public-libraries-in-the-world  You can actually walk up the stairs and access books directly. In the annex building is the international collection with its multilingual treasure as well as the press and journal sections. Impressive is the wide spread audience rather than intellectuals only.
The place is a top place for adult education and lifelong and lifewide learning.