tag:theconversation.com,2011:/institutions/university-of-cologne-2576/articlesThe University of Cologne2023-11-20T17:32:12Ztag:theconversation.com,2011:article/2164942023-11-20T17:32:12Z2023-11-20T17:32:12ZNostalgia in politics: pan-European study sheds light on how (and why) parties appeal to the past in their election campaigns<figure><img src="https://images.theconversation.com/files/556651/original/file-20231030-29-e0kxju.jpg?ixlib=rb-1.1.0&rect=71%2C71%2C3336%2C2118&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Unsplash/Jon Tyson</span>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span></figcaption></figure><p>Have you ever felt nostalgic when thinking about the past? Then you are not alone. According to <a href="https://www.bertelsmann-stiftung.de/fileadmin/files/BSt/Publikationen/GrauePublikationen/eupinions_Nostalgia.pdf">survey research</a>, around two-thirds of the European public feel nostalgic.</p>
<p>Nostalgia is defined as a predominantly positive emotion associated with recalling memories of important events, usually experienced with people who are close to us. And these feelings may not be limited to personal experiences: in politics, nostalgia may refer to a longing for a more prosperous past or lost cultural traditions.</p>
<p>Take the Italian far-right party, Fratelli d’Italia (Brothers of Italy), which currently leads the country’s coalition government. The party’s 2022 <a href="https://www.businesspost.ie/analysis-opinion/aidan-regan-meloni-capitalises-on-cultural-nostalgia-in-a-bid-to-make-italy-great-again/">manifesto</a> contained numerous nostalgic references. </p>
<p>One standout claim was that the “natural resources and artistic heritage of the nation are an inheritance to be guarded and enhanced”. Another was that “the elderly represent our history: a heritage of experiences, skills, talents that have helped to the birth and growth of our nation”. </p>
<p>Such statements draw upon a shared pride in the nation’s past to knit together a compelling narrative.</p>
<p>Increasingly, there is evidence that nostalgic feelings can affect our political views. Recent studies on the <a href="https://doi.org/10.1111/1475-6765.12593">Netherlands</a> and <a href="https://doi.org/10.1017/S0007123420000666">Turkey</a> support these findings. </p>
<p>Nostalgic citizens are less satisfied with the government and more likely to vote for radical right parties. In a <a href="https://doi.org/10.1017/S0007123423000571">new publication</a>, we examined the extent to which political parties capitalise on nostalgic rhetoric in their campaigns by analysing <a href="https://doi.org/10.7910/DVN/L198GI">1,650 election manifestos</a> published by parties across 24 European democracies between 1946 and 2018. </p>
<p>Election manifestos, by definition, mostly contain promises for the future. They are a list of pledges a party promises to implement should it be part of a future government. But we also discovered that on average, about 10% of a party manifesto is dedicated to <a href="https://www.journals.uchicago.edu/doi/10.1086/715165">discussing the past</a>.</p>
<h2>Central and Eastern Europe: nostalgia reigns</h2>
<p>We found that parties in central and eastern Europe and southern Europe are more nostalgic than those in northern and western Europe. The average manifesto in central and eastern Europe included 44 nostalgic sentences per 1,000 sentences, while in western and northern Europe, the average manifesto contains fewer than half that.</p>
<p>It’s also notable that many of the most nostalgic parties across the continent are classified as nationalist by researchers at the <a href="https://manifesto-project.wzb.eu/">Manifesto Project</a>. Examples of highly nostalgic nationalist parties include All for Latvia, the Estonian People’s Union, Golden Dawn in Greece, Sweden Democrats and the French National Rally (formerly the National Front). </p>
<p>That said, although nationalists are most prone to nostalgia, nostalgic rhetoric is evident across the political spectrum and was found in eight out of ten manifestos in some form or another. </p>
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<a href="https://theconversation.com/contested-memory-in-giorgia-melonis-italy-how-her-far-right-party-is-waging-a-subtle-campaign-to-commemorate-fascist-figures-211465">Contested memory in Giorgia Meloni's Italy: how her far-right party is waging a subtle campaign to commemorate fascist figures</a>
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<p>It also appears to be cultural conservatism rather than economic conservatism that makes a party more likely to use nostalgia. Nostalgic rhetoric addresses cultural issues much more frequently than economic topics. </p>
<p>This is revealing about nostalgia as a device. Parties seem to strategically employ nostalgic references and choose to <a href="https://doi.org/10.1086/715165">focus on either the past, present or future</a> when talking about a given topic depending on the wider political context. </p>
<p><a href="https://doi.org/10.1177/20531680231197456">Other research</a> shows that parties tend to frame education, economic and environmental policy with a future-related focus, while security, immigration and defence policy are more often referred to with an emphasis on the past.</p>
<h2>Why it matters</h2>
<p>There is nothing inherently wrong with nostalgia, but the use of nostalgia in political campaigning is, by definition, strategic. And its prevalence in the documents we examined suggests parties clearly see it as a useful tool.</p>
<p>But a focus on the past should not replace a critical evaluation of a party’s plans for the future. A nostalgic sentiment, such as “our historic market towns, cathedral cities, and unspoiled countryside are the envy of the world”, is not an electoral pledge. </p>
<p>Its use could therefore be seen as a device to obfuscate when a party lacks concrete solutions or proposals for the future of the nation they seek to govern. Given our propensity towards nostalgia, it could also be used as a narrative device that might provide cover for parties seeking to introduce potentially controversial policies. </p>
<p><a href="https://doi.org/10.1037/pspi0000121">Research</a> on policies such as gun control, immigration and social justice show voters can be swayed in directions they might not normally take if they are presented with nostalgic messaging at the same time. </p>
<p>If socially conservative parties have identified it as a powerful rhetorical device, perhaps socially progressive parties could find a way to use it for more positive reasons as well. Since a significant portion of society has nostalgic feelings, such messages are unlikely to disappear from political discourse anytime soon.</p><img src="https://counter.theconversation.com/content/216494/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Stefan Müller receives funding from the Science Foundation Ireland and the Swiss National Science Foundation.</span></em></p><p class="fine-print"><em><span>This research has been funded by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) under Germany's Excellence Strategy – EXC 2126/1-390838866.</span></em></p>Nationalist parties are the most likely to be found dreaming of a glorious past in their campaign literature, especially in central and eastern Europe.Stefan Müller, Assistant Professor and Ad Astra Fellow, School of Politics and International Relations, University College DublinSven-Oliver Proksch, Professor of Political Science and Chair for European and Multilevel Politics, Cologne Center for Comparative Politics, University of CologneLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2132662023-09-19T13:24:20Z2023-09-19T13:24:20ZChatbots for medical advice: three ways to avoid misleading information<p>We expect medical professionals to give us reliable information about ourselves and potential treatments so that we can make informed decisions about which (if any) medicine or other intervention we need. If your doctor instead “bullshits” you (yes – this term has been used in <a href="https://press.princeton.edu/books/hardcover/9780691122946/on-bullshit">academic publications</a> to refer to persuasion without regard for truth, and not as a swear word) under the deception of authoritative medical advice, the decisions you make could be based on faulty evidence and may result in harm or even death. </p>
<p>Bullshitting is distinct from lying – liars do care about the truth and actively try to conceal it. Indeed bullshitting can be <a href="https://theconversation.com/trump-isnt-lying-hes-bullshitting-and-its-far-more-dangerous-71932">more dangerous</a> than an outright lie. Fortunately, of course, doctors don’t tend to bullshit – and if they did there would be, one hopes, consequences through ethics bodies or the law. But what if the misleading medical advice didn’t come from a doctor?</p>
<p>By now, most people have heard of <a href="https://theconversation.com/unlike-with-academics-and-reporters-you-cant-check-when-chatgpts-telling-the-truth-198463">ChatGPT</a>, a very powerful chatbot. A chatbot is an algorithm-powered interface that can mimic human interaction. The use of chatbots is becoming <a href="https://theconversation.com/everyones-having-a-field-day-with-chatgpt-but-nobody-knows-how-it-actually-works-196378">increasingly widespread</a>, including for <a href="https://www.scientificamerican.com/article/ai-chatbots-can-diagnose-medical-conditions-at-home-how-good-are-they/">medical advice</a>. </p>
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<a href="https://theconversation.com/chatgpts-greatest-achievement-might-just-be-its-ability-to-trick-us-into-thinking-that-its-honest-202694">ChatGPT's greatest achievement might just be its ability to trick us into thinking that it's honest</a>
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<p>In a <a href="https://www.frontiersin.org/articles/10.3389/fpubh.2023.1254334/full">recent paper</a>, we looked at ethical perspectives on the use of chatbots for medical advice. Now, while ChatGPT, or similar platforms, might be useful and reliable for finding out the best places to see in Dakar, to learn about wildlife, or to get quick potted summaries of other topics of interest, putting your health in its hands may be playing Russian roulette: you might get lucky, but you might not. </p>
<p>This is because chatbots like ChatGPT try to persuade you <a href="https://theconversation.com/chatgpts-greatest-achievement-might-just-be-its-ability-to-trick-us-into-thinking-that-its-honest-202694">without regard for truth</a>. Its rhetoric is so persuasive that gaps in logic and facts are obscured. This, in effect, means that ChatGPT includes the generation of bullshit.</p>
<h2>The gaps</h2>
<p>The issue is that ChatGPT is not really artificial intelligence in the sense of actually recognising what you’re asking, thinking about it, checking the available evidence, and giving a justified response. Rather, it looks at the words you’re providing, predicts a response that will sound plausible and provides that response. </p>
<p>This is somewhat similar to the predictive text function you may have used on mobile phones, but much more powerful. Indeed, it can provide very persuasive bullshit: often accurate, but sometimes not. That’s fine if you get bad advice about a restaurant, but it’s very bad indeed if you’re assured that your odd-looking mole is not cancerous when it is.</p>
<p>Another way of looking at this is from the perspective of logic and rhetoric. We want our medical advice to be scientific and logical, proceeding from the evidence to personalised recommendations regarding our health. In contrast, ChatGPT wants to sound persuasive <a href="https://www.embopress.org/doi/full/10.15252/embr.202357501">even if it’s talking bullshit</a>. </p>
<p>For example, when asked to provide citations for its claims, ChatGPT often <a href="https://www.embopress.org/doi/full/10.15252/embr.202357501">makes up references</a> to literature that doesn’t exist – even though the provided text looks perfectly legitimate. Would you trust a doctor who did that?</p>
<h2>Dr ChatGPT vs Dr Google</h2>
<p>Now, you might think that Dr ChatGPT is at least better than Dr Google, which people also use to try to self-diagnose. </p>
<p>In contrast to the reams of information provided by Dr Google, chatbots like ChatGPT give concise answers very quickly. Of course, Dr Google can fall prey to misinformation too, but it does not try to sound convincing.</p>
<p>Using Google or other search engines to identify verified and trustworthy health information (for instance, from the <a href="https://www.who.int/">World Health Organization</a>) can be very beneficial for citizens. And while Google is known for capturing and recording user data, such as terms used in searches, <a href="https://theconversation.com/chatgpt-is-a-data-privacy-nightmare-if-youve-ever-posted-online-you-ought-to-be-concerned-199283">using chatbots may be worse</a>. </p>
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<a href="https://theconversation.com/chatgpt-is-a-data-privacy-nightmare-if-youve-ever-posted-online-you-ought-to-be-concerned-199283">ChatGPT is a data privacy nightmare. If you’ve ever posted online, you ought to be concerned</a>
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<p>Beyond potentially being misleading, chatbots may record data on your medical conditions and actively request more personal information, leading to more personalised – and possibly more accurate – bullshit. Therein lies the dilemma. Providing more information to chatbots may lead to more accurate answers, but also gives away <a href="https://www.frontiersin.org/articles/10.3389/fpubh.2023.1254334/full#B22">more personal health-related information</a>. However, not all chatbots are like ChatGPT. Some may be more specifically designed for use in medical settings, and advantages from their use may outweigh potential disadvantages.</p>
<h2>What to do</h2>
<p>So what should you do if you’re tempted to use ChatGPT for medical advice despite all this bullshit?</p>
<p>The first rule is: don’t use it. </p>
<p>But if you do, the second rule is that you should check the accuracy of the chatbot’s response – the medical advice provided may or may not be true. Dr Google can, for instance, point you in the direction of reliable sources. But, if you’re going to do that anyway, why risk receiving bullshit in the first place?</p>
<p>The third rule is to provide chatbots with information sparingly. Obviously, the more personalised data you offer, the better the medical advice you get. And it can be difficult to withhold information as most of us willingly and voluntarily give up information on mobile phones and various websites anyway. Adding to this, chatbots can also ask for more. But more data for chatbots like ChatGPT could also lead to more persuasive and even personalised inaccurate medical advice.</p>
<p>Talking bullshit and misuse of personal data is certainly not our idea of a good doctor.</p><img src="https://counter.theconversation.com/content/213266/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>What should you do if you’re tempted to use ChatGPT for medical advice? For starters, don’t use it.David Martin Shaw, Bioethicist, Department of Health Ethics and Society, Maastricht University and Institute for Biomedical Ethics, University of BaselPhilip Lewis, Research associate, University of CologneThomas C. Erren, Professor, University of CologneLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1958222022-12-16T11:08:18Z2022-12-16T11:08:18ZFestive bulge: scientists offer advice on how to beat overeating<figure><img src="https://images.theconversation.com/files/498760/original/file-20221203-17-v906i1.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Getty Images</span></span></figcaption></figure><p>Christmas and New Year are holidays with dietary excesses that many of us cannot control. This often leads to the “festive bulge”. As the holidays approach, could there be a recipe to contain this weight gain and pave the way to sustainable nutrition-based health at the same time? </p>
<p>There’s a lot of focus on what we eat and how much we eat – but what about <em>when</em> we eat?</p>
<p>Chrononutrition is the science of how timing affects our responses to nutrients. <a href="https://www.sciencedirect.com/science/article/pii/S0092867415003025?via%3Dihub">Scientific insights</a> into when we eat suggest it may be worth exploring for better health.</p>
<p>While the idea of getting started on <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9370396/">chrononutrition over Christmas</a> can sound challenging, the guilty conscience that tends to follow feasting over the holidays may provide the needed motivation for the year ahead.</p>
<p>So for better health in the new year, why not try out time-restricted eating (TRE)? TRE is a type of <a href="https://theconversation.com/is-intermittent-fasting-actually-good-for-weight-loss-heres-what-the-evidence-says-183500">intermittent fasting</a>: a person eats all their meals and snacks within a particular time window, ranging from six to 12 hours each day. This implies 12 to 18 hours of fasting. </p>
<p><a href="https://theconversation.com/is-body-weight-affected-by-when-you-eat-heres-what-science-knows-so-far-143303">More</a> and <a href="https://theconversation.com/delay-eating-breakfast-and-eat-dinner-early-if-you-want-to-lose-body-fat-new-study-101058">more research</a> suggests that this kind of timing may have a significant influence on our health via <a href="https://pubmed.ncbi.nlm.nih.gov/25404320/">interplays</a> between our <a href="https://pubmed.ncbi.nlm.nih.gov/25815987/">body clocks and nutrition</a>. </p>
<p>As researchers with a focus on circadian biology, we have <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9370396/">identified the festive season</a> as a suitable starting point for a lifestyle change to time-restricted eating. </p>
<h2>What is chrononutrition?</h2>
<p>The basic idea of chrononutrition is that the body’s response to the timing of meals can promote well-being and health via the circadian timing system. This timing system refers to the internal 24-hour mechanism that primes our bodies for the challenges and stimuli of the 24-hour day. This includes when nutrients are likely to be consumed, how they are used within the body at a given time and how the body responds to them at a given time. </p>
<p>A rodent experiment in the <a href="https://academic.oup.com/jn/article-abstract/10/1/63/4725662">1930s</a> led to a focus on counting calories and calorie-restricted eating. This dietary restriction extended the lifespan of rats in this case. It was subsequently shown in a wide range of species. The promise is large: if you eat less, then weight loss, better health and a longer life may follow. </p>
<p>The rodent experiment was followed by research into diets that foster health and prevent disease. Interest in <a href="https://pubmed.ncbi.nlm.nih.gov/3794831/">“meal-timing, circadian rhythms and lifespan”</a> was sparked by Franz Halberg (known as the father of American chronobiology), among others, in the 1980s. </p>
<p>These studies around food and behaviour take <a href="https://pubmed.ncbi.nlm.nih.gov/25404320/">evolutionary considerations</a> into account. For instance, rodents gain fitness when fed in a time-restricted manner. In contrast, human behaviour tends to involve more <a href="https://pubmed.ncbi.nlm.nih.gov/26411343/">erratic eating patterns</a> during the hours when people are awake. </p>
<h2>Lifestyle changes</h2>
<p>So what practical advice can we give on the occasion of Christmas and New Year from the <a href="https://www.nobelprize.org/prizes/medicine/2017/advanced-information/">2017 Nobel Prize-winning field of chronobiology</a>? The field gained recognition for its discoveries into how internal clocks organise our physiology and enable us to live in harmony with the external rhythms of day and night. </p>
<p>Findings from this field point to a simple lifestyle change: limiting when you eat to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4255155/">eight to 10 hours</a> a day could protect you from developing obesity, or even lessen the negative health impacts of existing obesity. And time-restricted eating can work even if practised for only <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4255155/">five days per week</a>. </p>
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<a href="https://theconversation.com/intermittent-fasting-if-youre-struggling-to-lose-weight-this-might-be-why-123498">Intermittent fasting: if you're struggling to lose weight, this might be why</a>
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<p>Importantly, if you can reduce a long habitual eating window (for instance, 15 hours) to a time-restricted eating window of eight hours, you are likely to benefit more than someone who reduces a habitual eating window of 10 hours to eight hours. Reductions in eating-time windows have already <a href="https://www.nejm.org/doi/10.1056/NEJMoa2114833?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed">been found</a> to help some overweight humans lose weight, sleep better and feel more energised.</p>
<p>Granted, much of the evidence comes from animal studies – and humans are certainly not big mice. Nonetheless, there have been no reports of detriments to this practice in humans. However, there has been <a href="https://www.sciencedirect.com/science/article/abs/pii/S0899900722001897?via%3Dihub">one report</a> of possible disadvantages to offspring in a pregnant animal model of time-restricted eating. </p>
<h2>Late breakfast and early supper</h2>
<p>Why not try what some studies suggest and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9370396/">start time-restricted eating over Christmas</a>, or put it on your New Year’s resolution list? </p>
<p>To get started, consider having a late breakfast and an early dinner. Of course, if in doubt about the impact of time-restricted eating – or if you have medical or dietary restrictions, or are pregnant – talk to your doctors first for advice.</p>
<p>Beyond paying attention to calorie intake and food composition, “when we eat” is a relatively simple and potentially sustainable approach.</p><img src="https://counter.theconversation.com/content/195822/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>The festive season provides great motivation to make lifestyle changes around eating habits.Thomas C. Erren, Professor, University of ColognePhilip Lewis, Research associate, University of CologneUrsula Wild, Research Associate, University of CologneLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1798172022-09-22T18:43:11Z2022-09-22T18:43:11ZCovid long : qu’en savent les scientifiques aujourd’hui ?<p>Contaminées par le coronavirus SARS-CoV-2, certaines personnes sont victimes d’affection post-Covid-19, communément dénommée par les patients « Covid long », qui se caractérise par la persistance, des mois voire des années durant, de divers symptômes invalidants. Cette affection peut concerner des patients ayant fait une forme initiale légère comme une forme sévère, voire toucher aussi des personnes qui n’ont présenté initialement aucun symptôme.</p>
<p>En raison du nombre important de patients qui ont été infectés dans le monde par ce coronavirus, le Covid long constitue un problème de santé publique émergent, et un enjeu majeur pour les autorités de santé.</p>
<p>À l’heure actuelle, trois causes principales possiblement impliquées dans le Covid long font l’objet de recherches intensives : la persistance du coronavirus SARS-CoV-2 dans l’organisme des patients, le maintien d’un état inflammatoire après l’infection et la formation de microcaillots.</p>
<p>Deux ans et demi après le début de la pandémie, voici ce que les scientifiques qui étudient ces différentes pistes ont appris.</p>
<h2>Qu’est-ce que le Covid long ?</h2>
<p>Le syndrome du Covid long, aussi connu sous la dénomination de « syndrome post-Covid-19 » ou « PACS » (post-acute Covid syndrome), <a href="https://www.who.int/fr/news-room/questions-and-answers/item/coronavirus-disease-(Covid-19)-post-Covid-19-condition">a été défini fin 2021 par l’Organisation mondiale de la santé (OMS)</a> comme une affection qui apparaît généralement dans les trois mois suivant l’infection initiale au SARS-CoV-2 et se caractérise par des symptômes persistants pendant au moins deux mois. D’une part ces symptômes ne peuvent pas être expliqués par d’autres diagnostics et, d’autre part, ont un impact sur la vie quotidienne. Le Covid long fait partie de la maladie Covid-19.</p>
<p>Si les symptômes principaux sont une fatigue inhabituelle, un essoufflement, un dysfonctionnement cognitif, une anosmie, des troubles du sommeil, plus de 200 symptômes très variés touchant de multiples organes peuvent aussi être observés.</p>
<p>Les malades peuvent aussi ressentir des douleurs thoraciques, musculaires, articulaires, des tachycardies, des troubles digestifs (notamment des diarrhées, des nausées, un ralentissement du transit…), des symptômes ORL tels que de troubles de l’odorat ou des acouphènes, des atteintes oculaires comme une vision floue ou une sécheresse oculaire, des aphtes, des signes cutanés…</p>
<figure><a href="https://twitter.com/SantePubliqueFr/status/1550454824906510337?ref_src=twsrc%5Etfw" target="_blank"><img src="https://images.theconversation.com/files/486165/original/file-20220922-40997-c08j0w.png" width="450"></a></figure>
<p>Soulignons que les patients qui développent une affection post-Covid ou Covid long peuvent faire des rechutes de long terme, souvent majorées en cas de nouvelle infection.</p>
<h2>Plus de 30 % des malades du Covid déclarent des symptômes prolongés</h2>
<p>Le Covid long n’affecte pas tous les patients ayant contracté le Covid-19. Santé publique France a conduit une enquête en population générale entre mars et avril 2022, parmi un échantillon représentatif de la population française. Sur les 25 537 volontaires âgés d’au moins 18 ans qui ont répondu, 33,9 % ont déclaré une infection par le SARS-CoV-2. Parmi ceux infectés plus de trois mois auparavant, <a href="https://www.santepubliquefrance.fr/maladies-et-traumatismes/maladies-et-infections-respiratoires/infection-a-coronavirus/documents/enquetes-etudes/l-affection-post-Covid-19-appelee-aussi-Covid-long-en-france.-point-au-21-juillet-2022">30 % déclaraient avoir des symptômes prolongés</a>.</p>
<p>Selon ces résultats, la prévalence de l’affection post-Covid-19 diminuait avec le temps écoulé. Toutefois, 18 mois après l’infection, plus de 20 % des personnes ayant eu une infection par le SARS-CoV-2 gardaient encore des symptômes. Le nombre de personnes concernées par une affection post-Covid-19 dans la population française a pu être estimé à 2,06 millions de personnes de plus de 18 ans, soit 4 % de la population adulte (intervalle de confiance à 95 % : 3,7 % – 4,2 %).</p>
<p>Par comparaison, au Royaume-Uni, on estime qu’environ <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/bulletins/prevalenceofongoingsymptomsfollowingcoronaviruscovid19infectionintheuk/6may2022">1,7 million de personnes sont touchées</a>, dont <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/bulletins/prevalenceofongoingsymptomsfollowingcoronaviruscovid19infectionintheuk/6may2022">19 % sont victimes d’une forme lourde</a>, qui limite sérieusement leurs activités journalières, voire les empêche de les mener à bien. Seuls 33 % des patients Covid long interrogés estiment que ces symptômes n’ont pas d’impact sur leurs activités journalières. Parmi les patients rapportant des symptômes prolongés au Royaume-Uni, la majorité 47 % ont eu un Covid lors des vagues initiales, 27 % pendant la période de circulation du virus Delta et 19 % pendant la vague Omicron.</p>
<p>D’après une estimation publiée par l’OMS le 13 septembre 2022, plus de 17 millions de personnes ont souffert d’un Covid long en Europe en 2020 et 2021.</p>
<h2>Une majorité de femmes, et une piste allergique voir auto-immune à explorer</h2>
<p>Un point important à souligner est que certains patients peuvent avoir une sérologie négative (autrement dit, on ne trouve pas dans leur sang d’anticorps anti-SARS-CoV-2) et pourtant avoir été infectés par le virus. En effet, il a été montré que certaines personnes <a href="https://search.bvsalud.org/global-literature-on-novel-coronavirus-2019-ncov/resource/fr/covidwho-954408">ne produisent pas d’anticorps anti-SARS-CoV-2 après infection</a> même si leur organisme <a href="https://www.thelancet.com/journals/ebiom/article/PIIS2352-3964(22)00310-3/fulltext">réagit parfois au virus, en déployant des cellules immunitaires</a>, les lymphocytes T, contre ce dernier.</p>
<p>Ce point est essentiel, car il indique que le fait d’avoir un résultat négatif à un test sérologique n’est pas une preuve que l’on n’a pas été infecté. Or le fait que certains patients Covid long aient eu des sérologies négatives a pu jeter le doute sur la véracité de leur syndrome et de leur infection initiale notamment quand ils n’ont pas bénéficié de PCR.</p>
<p>Parmi les patients Covid long figure une <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7833274/">forte proportion de femmes</a>. Des travaux qui restent encore à confirmer semblent également indiquer que les personnes ayant un terrain allergique pourraient être davantage impactées, tout comme les personnes ayant un terrain auto-immun (<em>leur système immunitaire s’attaque à leur propre organisme, ndlr</em>) ou ayant été atteintes par un syndrome de fatigue chronique par le passé.</p>
<p>Rappelons que le Covid long peut toucher non seulement les adultes (avec des patients parfois incapables de reprendre leur travail plus de 2 ans et demi après l’infection initiale), mais aussi les enfants. Chez ces derniers, des cas d’<a href="https://www.inserm.fr/dossier/hypersomnies-et-narcolepsie/">hypersomnie</a> – un besoin excessif de sommeil – ou un décrochage scolaire <a href="https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(22)00154-7/fulltext">ont notamment été décrits</a>).</p>
<h2>Comment évolue le Covid long ?</h2>
<p>Globalement, c’est au cours de la première année qui suit le Covid initial <a href="https://www.nature.com/articles/s41467-022-29513-z">que les symptômes sont les plus importants</a>. Durant la 2<sup>e</sup> année, les patients constatent dans 80 % des cas une amélioration des symptômes (fièvre, sueurs, signes cutanés, toux), peut-être en lien avec une diminution de l’inflammation.</p>
<p>Cependant cette amélioration est très variable d’un patient à l’autre. Elle est lente, incomplète et parfois inexistante pour certains symptômes comme la fatigue post-effort et les troubles neurocognitifs, qui persistent fréquemment encore à deux et à trois ans.</p>
<p>La persistance des symptômes qui s’aggravent parfois à l’occasion de rechutes est une source d’inquiétude faisant craindre, à moyen et long terme, des séquelles sur les organes nobles concernés (cœur, poumons, comme la survenue de maladies neurodégénératives).</p>
<h2>Les causes du Covid long : trois pistes principales</h2>
<p>Il est probable que le ou les mécanismes physiopathologiques (<em>la <a href="https://histoire.inserm.fr/les-domaines-de-recherche/physiopathologie">physiopathologie</a> est la discipline qui étudie les dérèglements des éléments et des fonctions de l’organisme humain, ndlr</em>) initiaux soient similaires entre les patients, mais que la maladie s’exprime différemment en fonction du terrain génétique de chacun, de l’état immunologique de base, de facteurs hormonaux ou encore du variant responsable de l’infection et de la charge virale lors de la première infection…</p>
<p>À l’heure actuelle, trois mécanismes principaux font l’objet de recherches intensives :</p>
<ul>
<li><p>la persistance du coronavirus SARS-CoV-2 dans l’organisme des patients ;</p></li>
<li><p>le maintien d’un état inflammatoire après l’infection au niveau des tissus, notamment des vaisseaux et du tissu cérébral ;</p></li>
<li><p>la formation de microcaillots et/ou de microsaignements.</p></li>
</ul>
<p>Ces trois hypothèses ne sont pas mutuellement exclusives et ne s’opposent pas les unes aux autres.</p>
<p>Les travaux récents que nous allons détailler suggèrent plutôt une possible cascade : la persistance de tout ou partie du virus entraînerait une inflammation des tissus (en attirant les cellules de l’immunité sur place) et une réaction vasculaire avec formation de microcaillots d’où une moins bonne oxygénation intermittente des tissus. De plus, une toxicité directe de la protéine Spike pour certaines cellules n’est pas non plus exclue.</p>
<h2>Persistance virale : une accumulation de preuves</h2>
<p>Il est maintenant parfaitement admis que certains patients n’arrivent pas à se débarrasser complètement du coronavirus SARS-CoV-2 dans le délai habituel de 14 à 21 jours.</p>
<p>Cette persistance de virus dans l’organisme a initialement été constatée <a href="https://www.frontiersin.org/articles/10.3389/fcimb.2022.804175/full">chez les sujets immunodéprimés</a>, en particulier parmi ceux <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8661864/">ayant un déficit profond de l’immunité humorale</a>, la composante de l’immunité qui repose <a href="https://theconversation.com/comment-notre-corps-se-defend-il-contre-les-envahisseurs-143072">sur la production d’anticorps</a>. De ce fait, ils sont dans l’incapacité de produire une bonne réponse en anticorps contre le virus.</p>
<figure class="align-center ">
<img alt="Micrographie électronique à transmission du coronavirus SARS-CoV-2, responsable de la Covid-19." src="https://images.theconversation.com/files/486175/original/file-20220922-7052-uvkzc3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/486175/original/file-20220922-7052-uvkzc3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=421&fit=crop&dpr=1 600w, https://images.theconversation.com/files/486175/original/file-20220922-7052-uvkzc3.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=421&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/486175/original/file-20220922-7052-uvkzc3.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=421&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/486175/original/file-20220922-7052-uvkzc3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=528&fit=crop&dpr=1 754w, https://images.theconversation.com/files/486175/original/file-20220922-7052-uvkzc3.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=528&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/486175/original/file-20220922-7052-uvkzc3.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=528&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Micrographie électronique à transmission du coronavirus SARS-CoV-2, responsable de la Covid-19 (fausses couleurs).</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/nihgov/49666506726/in/photolist-2iERQ6u-2iEP3MV-2iLBJK3-2iH8KzC-2jcerea-2jciuth-2mhKAx4-2iH8Kxi-2iDVeRk-2koRoi7-2jfwm7p-2itgZyx-2jk18mh-2ivWYAQ-2iYmxva-2jk2hum-2jk18s4-2jfwmb2-2j4fdfV-2iERQiZ-2jch9HX-2iCRVRX-2j4fdct-2jfwm3X-2iERQ8d-2iP8B13-2iERQmQ-2itfPmQ-2iDSu77-2iDWFNp-2iDVeVt-2iDSu3E-2iDVeUX-2jk2hXA-2iETgaX-2iG5wss-2ivUoVj-2ivUoW6-2itgZwo-2j4b4fV-2jfzdMX-2iG5wqt-2iYiNki-2iPbjqr-2ivY9Xk-2ivY9VB-2iDVeQd-2iDWFMh-2iDVeTu-2iDSu65">National Institute of Allergy and Infectious Diseases, NIH</a></span>
</figcaption>
</figure>
<p>Dès la fin de l’année 2020, l’Institut Pasteur, en lien avec l’équipe d’Hôtel Dieu a montré que <a href="https://research.pasteur.fr/fr/publication/Covid-19-related-anosmia-is-associated-with-viral-persistence-and-inflammation-in-human-olfactory-epithelium-and-brain-infection-in-hamsters/">l’ARN viral pouvait être retrouvé dans les fentes olfactives</a> de patients Covid long dont les troubles de l’odorat persistaient, plus de 7 mois après l’infection initiale. Ceci suggère que le virus pourrait, à partir de cet emplacement, traverser la lame criblée de l’ethmoïde, une structure osseuse située au-dessus des fosses nasales. Percée de trous, elle laisse passer le nerf olfactif.</p>
<p>De nombreux autres travaux récents démontrent parfaitement aujourd’hui que de l’ARN viral ou des fragments viraux peuvent également persister dans de très nombreux organes.</p>
<p>Une équipe américaine d’anatomopathologistes a notamment mené des autopsies sur les corps de 44 sujets décédés du Covid (certains jusqu’à 230 jours après l’infection). Leurs résultats révèlent que le virus était présent partout, dans tous les organes : <a href="https://www.researchsquare.com/article/rs-1139035/v1">cerveau, muscle, intestin, cœur, articulations</a>… Certes, il s’agissait de patients touchés par des formes graves, mais cela signifie que le virus diffuse largement dans l’organisme et disparaît moins vite qu’on ne l’imaginait.</p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/486177/original/file-20220922-15266-ju771p.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Photo d’une impression 3D d'une modélisation de la protéine Spike, qui se trouve en de nombreux exemplaires à la surface du SARS-CoV-2, permettant au virus de pénétrer dans les cellules humaines et de les infecter." src="https://images.theconversation.com/files/486177/original/file-20220922-15266-ju771p.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/486177/original/file-20220922-15266-ju771p.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/486177/original/file-20220922-15266-ju771p.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/486177/original/file-20220922-15266-ju771p.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/486177/original/file-20220922-15266-ju771p.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/486177/original/file-20220922-15266-ju771p.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/486177/original/file-20220922-15266-ju771p.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Impression 3D d'une modélisation de la protéine Spike, qui se trouve en de nombreux exemplaires à la surface du SARS-CoV-2, permettant au virus de pénétrer dans les cellules humaines et de les infecter.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/nihgov/49644420071">NIH</a></span>
</figcaption>
</figure>
<p>À l’école de médecine de Harvard, des chercheurs ont analysé le sang de 37 patients atteints de Covid long. <a href="https://www.medrxiv.org/content/10.1101/2022.06.14.22276401v1">Ils ont notamment retrouvé la protéine Spike du SARS-CoV-2 dans le plasma de deux tiers d’entre eux</a>, à distance de l’infection et souvent à plusieurs reprises alors qu’elle disparaît rapidement chez les patients ne présentant pas de symptômes prolongés. Cela signifierait que, quelque part dans leur organisme, un réservoir de virus persisterait, et que le virus a trouvé un moyen de passer dans le sang. Ces résultats, qui reposent sur une technique de détection ultra-sensible (la technique SIMOA), laissent entrevoir l’espoir d’un marqueur de diagnostic plus fiable du Covid long, qui pourrait se faire par une simple prise de sang.</p>
<p>Une équipe de l’Université de Stanford a également mis en évidence des fragments d’ARN du SARS-CoV-2 dans les selles jusqu’ à <a href="https://www.cell.com/med/pdf/S2666-6340(22)00167-2.pdf">7 mois après l’infection</a>. De l’ARN était détecté chez 49 % des patients (sur 113 patients étudiés) au cours de la première semaine suivant le diagnostic. À 4 mois, il n’y avait plus d’excrétion d’ARN dans le pharynx, alors que 13 % des patients continuaient à excréter de l’ARN du SARS-CoV-2 dans les selles. C’était encore le cas de 4 % d’entre eux à 7 mois. Leurs symptômes gastro-intestinaux, qui se traduisaient par des douleurs abdominales, des nausées, des vomissements, étaient associés à l’excrétion fécale d’ARN SARS-CoV-2.</p>
<p>Les travaux d’une équipe de l’Université d’Innsbruck ont par ailleurs révélé la présence de fragments d’ARN du SARS-CoV-2 dans l’intestin de la majorité des patients ayant une <a href="https://www.gastrojournal.org/article/S0016-5085(22)00450-4/fulltext">maladie inflammatoire de l’intestin</a> et ayant eu un Covid aigu jusqu’à 6 mois plus tôt.</p>
<p>Cette démonstration de la persistance de fragments viraux soulève diverses questions, dont celle de savoir s’ils proviennent de virus entiers capables de se reproduire. Des travaux récents commencent à apporter une partie des réponses.</p>
<h2>Un virus qui serait capable de persister et se répliquer</h2>
<p>Plusieurs résultats démontrent que l’ARN viral qui persiste à distance de l’infection initiale est, au moins dans les premiers mois du Covid long, bel et bien capable d’amorcer une réplication.</p>
<p>Les chercheurs ont en effet détecté dans les tissus d’un certain nombre de patients atteints de Covid long la présence non seulement d’ARN génomique (qui constitue le génome entier du virus), mais aussi d’ARN subgénomique, autrement dit d’ARN en train d’être produit. Avec le temps, cet ARN subgénomique a tendance à complètement disparaître : les chercheurs de l’Université de Stanford cités précédemment ont établi qu’à 7 mois de l’infection initiale, il n’était plus retrouvé que dans les selles de 0,7 % de patients.</p>
<p>Par ailleurs, dès 2020, chez des patients atteints de Covid aigu, les vétérinaires de Maisons-Alfort avaient montré que des chiens « détecteurs » étaient capables d’identifier dans la sueur des <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0243122">composés volatils organiques (VOCs) très spécifiques du virus</a>. Ces molécules pourraient correspondre soit à des protéines du virus synthétisées dans l’organisme et émises dans la sueur, soit à des protéines de l’hôte synthétisées en réaction à la présence de virus.</p>
<p>L’application de cette technique aux patients Covid long a permis de démontrer que les chiens étaient aussi capables de détecter ces VOCs spécifiques <a href="https://www.vet-alfort.fr/images/actus/2022-04-04_-_Publication_Covid_long/Screening_for_SARS-CoV-2_Persistence_in_Long_Covid_Patients_using_Sniffer_Dogs_and_Scents_from_Axillary_Sweats_Samples_publi%C3%A9.pdf">chez un certain nombre de patients Covid long</a> (souvent les plus sévères) ce qui constitue un autre argument de poids en faveur d’une réplication au moins intermittente du virus au cours du Covid long.</p>
<figure class="align-center ">
<img alt="Micrographie électronique à balayage colorisée d'une cellule apoptotique - autrement dit, mourante - (en vert) fortement infectée par des particules virales du SARS-COV-2 (en violet)." src="https://images.theconversation.com/files/486176/original/file-20220922-13134-2unqug.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/486176/original/file-20220922-13134-2unqug.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=510&fit=crop&dpr=1 600w, https://images.theconversation.com/files/486176/original/file-20220922-13134-2unqug.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=510&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/486176/original/file-20220922-13134-2unqug.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=510&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/486176/original/file-20220922-13134-2unqug.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=641&fit=crop&dpr=1 754w, https://images.theconversation.com/files/486176/original/file-20220922-13134-2unqug.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=641&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/486176/original/file-20220922-13134-2unqug.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=641&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Micrographie électronique à balayage colorisée d'une cellule apoptotique - autrement dit, mourante - (en vert) fortement infectée par des particules virales du SARS-COV-2 (en violet).</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/nihgov/49665964103/">National Institute of Allergy and Infectious Diseases, NIH</a></span>
</figcaption>
</figure>
<p>Cependant, de nombreuses autres questions doivent encore être résolues. On ne sait pas encore, par exemple, dans quelles cellules se cacherait le virus ou les fragments viraux. Il pourrait s’agir de <a href="https://www.frontiersin.org/articles/10.3389/fimmu.2021.746021/full">cellules de la lignée monocytaire</a>, voire de cellules endothéliales… On trouve toutefois des cellules porteuses du récepteur ACE2 (utilisé par le virus pour l’infection) dans de nombreux tissus de l’organisme, ce qui signifie que d’autres cellules pourraient constituer des réservoirs viraux.</p>
<p>D’autres questions demeurent en suspens : quelles sont les conséquences de cette persistance virale ? Quels dégâts occasionne-t-elle dans l’organisme ? Ces dégâts sont-ils réversibles ?</p>
<p>Le 8 Septembre 2022, a été lancée <a href="https://lc19.org/introducing-lcri/">« The Long Covid Research Initiative »</a>. Forte d’une première dotation de 15 millions de dollars émanant de fonds privés, cette initiative de recherche mondiale, impliquant des scientifiques et cliniciens d’<a href="https://lc19.org/team/">institutions prestigieuses</a> ambitionne notamment d’éclaircir le rôle de la persistance virale, en identifiant les réservoirs du virus, en décryptant les mécanismes du Covid long et en menant des essais thérapeutiques.</p>
<h2>Second mécanisme impliqué dans le Covid long : l’état inflammatoire</h2>
<p>Les examens biologiques dits « de routine » des patients Covid long sont généralement peu perturbés et semblent indiquer à tort que ces patients n’ont pas de trouble organique. Ils révèlent néanmoins fréquemment un discret syndrome inflammatoire.</p>
<p>Celui-ci est attesté par une <a href="https://pubmed.ncbi.nlm.nih.gov/33285216/">augmentation modérée de la ferritine</a> (une protéine de la réponse inflammatoire dont la concentration sanguine augmente en cas d’activation des macrophages), et par la présence d’autoanticorps peu spécifiques (appelés facteurs antinucléaires), comme on en voit dans d’autres infections virales chroniques (hépatite C, VIH).</p>
<p>Ce constat a conduit les scientifiques à suivre la piste d’une inflammation « à minima », qui se situerait au niveau tissulaire. Ils ont notamment pu démontrer que les patients Covid long ont un profil immunitaire très particulier, rappelant celui qui est observé dans les infections virales chroniques.</p>
<p>Des chercheurs de l’Université d’Atlanta ont aussi montré que les cellules immunitaires (qui interviennent dans la coordination de la réponse immunitaire, la mémorisation des infections et la destruction des cellules infectées) <a href="https://www.nature.com/articles/s41590-021-01113-x">sont dans un état d’activation légèrement excessive</a>.</p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1481749773539774464"}"></div></p>
<p>En outre, on trouve dans le sang des patients Covid long des <a href="https://www.nature.com/articles/s41590-021-01113-x">messagers chimiques impliqués dans l’inflammation (appelés cytokines)</a>, tels que les interférons β et α, deux molécules qui sont généralement sécrétées en réaction à une infection virale.</p>
<p>Dans le sang de ces patients <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8083585/">sont aussi détectés des messagers chimiques impliqués dans l’inflammation vasculaire</a>, comme le facteur de croissance de l’endothélium vasculaire (Vascular Endothelial Growth Factor ou VEGF).</p>
<p>Chez certains sujets, en particulier ceux ayant un terrain allergique, on constate aussi une <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7529115/">activation de certaines cellules de l’immunité innée</a> appelées <a href="https://www.medecinesciences.org/en/articles/medsci/full_html/2018/02/medsci20183402p145/medsci20183402p145.html">mastocytes</a>. Ces cellules immunitaires interviennent dans les processus inflammatoires et certaines sont impliquées dans les réactions allergiques. Leur activation excessive et permanente est à l’origine d’une perte de contrôle pouvant affecter de nombreux organes plus ou moins gravement (syndrome d’activation mastocytaire).</p>
<h2>Le problème de l’inflammation chronique</h2>
<p>Cet état inflammatoire chronique peut se produire dans tous les tissus. Ses conséquences, qui varient en fonction des organes touchés, sont encore mal comprises. Au niveau digestif, l’inflammation chronique peut avoir un impact très délétère : les patients <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9177081/">digèrent très mal et deviennent intolérants à de multiples aliments</a>.</p>
<p>Mais le plus préoccupant survient lorsque le cerveau est touché. Une neuro-inflammation associée à une activation microgliale (<em>les <a href="https://www.medecinesciences.org/en/articles/medsci/full_html/2011/07/medsci2011278-9p719/medsci2011278-9p719.html">cellules de la microglie</a> sont des cellules immunitaires qui résident dans le cerveau et la moelle épinière, ndlr</em>) pourrait expliquer les troubles neurocognitifs rencontrés chez de nombreux patients. Ses conséquences, bien étudiées chez l’animal, sont cependant moins claires chez l’être humain, puisqu’on ne peut avoir directement accès au cerveau pour mener des expérimentations.</p>
<p>Certaines techniques d’imagerie (comme la Tomographie par Émission de Positons, aussi appelée TEP-Scan) ont toutefois permis de révéler que plusieurs zones du cerveau de patients Covid long <a href="https://doi.org/10.1007/s00259-021-05215-4">présentaient au repos une diminution de consommation de glucose</a> (on parle de zones hypométaboliques). Ce type d’anomalies individuelles n’est pas rapporté dans les pathologies psychiatriques, et a fortiori psychosomatiques.</p>
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<p>Les zones cérébrales touchées sont les régions profondes du cerveau : régions olfactives, circuit limbique, l’amygdale impliquée dans la régulation des émotions, l’hippocampe impliqué dans les processus de mémorisation, et plus en arrière le tronc cérébral impliqué dans les comportements autonomes involontaires (tels que la respiration, le rythme cardiaque, le sommeil, la digestion, mais aussi les voies de la douleur) et enfin le cervelet impliqué dans l’équilibre. Ces anomalies sont d’autant plus sévères que les symptômes sont nombreux.</p>
<p>Une étude a montré que ce profil était encore retrouvé chez environ 50 % des patients Covid long à 11 mois post-infection. Cet examen s’avère utile pour aider au diagnostic différentiel, et identifier chez certains patients d’autres causes à leurs symptômes qu’un Covid long.</p>
<h2>Les microcaillots, troisième mécanisme impliqué dans le Covid long</h2>
<p>On sait que la <a href="https://www.biorxiv.org/content/10.1101/2021.10.12.464152v1">protéine Spike peut induire un état procoagulant</a> : chez les patients atteints de Covid sévère, les thromboses sont fréquentes <a href="https://jhoonline.biomedcentral.com/articles/10.1186/s13045-020-00954-7">et peuvent entraîner leur décès</a>. C’est la raison pour laquelle l’Organisation mondiale de la Santé, tout comme la plupart des autorités de santé nationales, recommande fortement de prescrire des anticoagulants à tous les patients atteints par une forme sévère de Covid.</p>
<p>Si les recherches sont moins avancées dans le domaine du Covid long, il a été montré que certains <a href="https://ashpublications.org/bloodadvances/article/5/3/756/475081/Sustained-prothrombotic-changes-in-Covid-19">patients Covid long sont sujets aux caillots sanguins</a> (<a href="https://www.sciencedirect.com/science/articla/pii/S0049384821005491">état « pro-thrombotique »</a>) et <a href="https://pubmed.ncbi.nlm.nih.gov/34731533/">sont atteints d’endothéliopathie</a> (maladie des petits vaisseaux), en lien avec la sévérité de leurs symptômes. De nombreux cas de patients souffrant de thromboses, et notamment d’embolies pulmonaires, ont également été rapportés.</p>
<p>Mais les poumons ne sont pas les seuls organes touchés. Une hypothèse est que des microthromboses inflammatoires ou des microhémorragies pourraient survenir aussi au niveau des autres organes, dans les petits vaisseaux appelés capillaires distaux. Ceci pourrait entraîner une mauvaise oxygénation tissulaire et expliquer les épisodes brutaux de malaises, de douleurs (musculaires, cardiaques) ou de brouillard cérébral dont se plaignent les patients Covid long.</p>
<p>Ces microthromboses pourraient être initialement réversibles. Cependant, en cas de répétition des épisodes, elles pourraient conduire <a href="https://cardiab.biomedcentral.com/articles/10.1186/s12933-021-01359-7">à la constitution de zones moins bien irriguées – de façon irréversible – ou de petits hématomes</a>. Ceci est particulièrement préoccupant si ces microthromboses surviennent dans le cerveau.</p>
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<p>En outre, il ne faut pas négliger l’implication potentielle d’autres facteurs, qu’ils soient génétiques, hormonaux (expliquant peut-être que les femmes sont plus atteintes) ou autres (comme une toxicité directe des fragments viraux par un mécanisme encore non élucidé).</p>
<p>Des essais thérapeutiques débutent dans certains pays, afin d’essayer de contrer ces phénomènes par différentes techniques encore mal éprouvées. Le recours aux anticoagulants fera par exemple l’objet d’un essai clinique au Royaume-Uni. D’autres pistes vont tester les antihistaminiques, et prochainement les antiviraux. Certaines équipes vont tester quant à elles de façon moins conventionnelle le recours à l’oxygénothérapie hyperbare ou à l’aphérèse, une technique qui consiste à épurer le plasma des produits prothrombotiques. À l’heure actuelle, ce type d’approche, dont les effets potentiels risquent de ne pas se maintenir, ne fait l’objet d’aucun essai en France.</p>
<h2>Des conséquences psychologiques fréquentes</h2>
<p>Dans le Covid long comme dans toute maladie chronique, il existe une composante psychologique. Devoir vivre soudainement avec des symptômes handicapants et prolongés peut engendrer des conséquences en termes de dépression voire d’anxiété.</p>
<p>Par ailleurs, le virus pourrait lui-même être à l’origine, de par son tropisme cérébral direct ou indirect, de modifications d’humeur : une irritabilité et une émotivité inhabituelle sont ainsi rapportées par de nombreux patients.</p>
<p>Une revue de littérature portant sur 57 études comprenant plus de 250 000 survivants du Covid-19 a révélé que les symptômes résiduels à plus de 6 mois comprenaient des <a href="https://pennstate.pure.elsevier.com/en/publications/short-term-and-long-term-rates-of-postacute-sequelae-of-sars-cov-">troubles pulmonaires, neurologiques, mais aussi mentaux</a>. Dans les travaux portant sur les troubles psychiatriques, environ 1 patient sur 3 souffrait d’anxiété généralisée, 1 sur 4 de troubles du sommeil, 1 sur 5 de dépression, et 1 sur 8 présentait un trouble de stress post-traumatique.</p>
<p>L’attention est aujourd’hui également attirée <a href="https://pubmed.ncbi.nlm.nih.gov/33486531/">sur le risque accru de suicide</a> que courraient les patients Covid long.</p>
<h2>Quid de la piste psychosomatique ?</h2>
<p>À l’heure actuelle, la piste <a href="https://www.mayoclinic.org/diseases-conditions/conversion-disorder/diagnosis-treatment/drc-20355202">psychosomatique</a> unique (qui attribuerait au Covid long une cause essentiellement psychique) ne peut donc plus être considérée comme une explication au Covid long. Outre qu’à ce jour il n’existe pas vraiment de travaux scientifiques pour soutenir cette hypothèse, elle ne prend plus suffisamment en compte la série de données scientifiques récentes que nous venons de détailler.</p>
<p>Il est certain que lorsque les symptômes sont nombreux, invasifs et handicapants, ils focalisent l’attention des patients, qui peuvent alors également ressentir une anxiété relative à cet état et une appréhension devant le risque d’aggravation ou de rechutes dont ils témoignent</p>
<p>De plus, le risque existe d’ignorer des manifestations pathologiques parfaitement curables, telles qu’un <a href="https://www.frontiersin.org/articles/10.3389/fphys.2020.614590/full">syndrome d’hyperventilation</a>, une péricardite, une gastroparésie.</p>
<h2>Quelles sont les approches thérapeutiques possibles ?</h2>
<p>Même si les pistes physiopathologiques commencent à se dessiner, il persiste beaucoup d’incertitudes sur l’enchaînement des causes du Covid long. Ceci a freiné considérablement le développement de traitements dits « curatifs ».</p>
<p>Les recherches actuelles laissent entrevoir la découverte de marqueurs biologiques de Covid long qui rendraient possible la réalisation d’études interventionnelles</p>
<p>Dans l’attente, les recommandations existantes sont celles de traiter les symptômes et d’éviter les situations risquant de réactiver la maladie (efforts trop importants ou réinfections par exemple). Pour lutter contre les conséquences de l’inflammation chronique et du syndrome d’activation mastocytaire, des protocoles thérapeutiques évaluant l’impact des antihistaminiques vont notamment être mis en place.</p>
<p>Pour contrer l’état prothrombotique, l’intérêt des anticoagulants ou d’anti-inflammatoires actifs au niveau vasculaire va être testé. Les essais cliniques en cours établiront également si l’aphérèse a un intérêt dans ce contexte.</p>
<p>La rééducation occupe aussi une place primordiale dans la prise en charge : rééducation respiratoire en cas de syndrome d’hyperventilation, olfactive en cas de troubles de l’odorat, neuropsychologique ou orthophonique en cas de troubles cognitifs ou du langage, ergothérapie ou encore d’une réadaptation globale par l’activité physique adaptée dès que le patient s’en sent capable. Proposer une prise en charge psychologique, voire psychiatrique, quand celle-ci est nécessaire peut être pertinent.</p>
<p>Un point crucial sera la mise à disposition de traitements antiviraux efficaces, pouvant être administrés de façon prolongée, ou qui soient suffisamment puissants pour éradiquer ou contrôler le virus. Un traitement antiviral qui pourrait être disponible de façon plus large au début de l’infection pourrait également fortement limiter le risque de développement d’un Covid long. Des essais dans ce sens devraient prochainement être mis en place. Enfin, un vaccin immunogène, capable de limiter la transmission du virus, et pas seulement d’éviter les formes graves comme les vaccins actuels, est également indispensable.</p>
<p>Surtout, en attendant de disposer de traitements efficaces et de mieux comprendre les conséquences à moyen et long terme du Covid long, que ce soit pour les patients ou, plus largement, pour la société dans son ensemble, il est indispensable de limiter les risques d’infection, et donc la circulation du coronavirus SARS-CoV-2. D’autant plus que des infections répétées majorent le risque de Covid long.</p>
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<p><em>Les auteurs remercient pour leurs commentaires et interventions constructives lors de la révision de cet article : Lisa Chakrabarti, chercheuse en Immunologie à l’Institut Pasteur, Yousra Gabr, médecin généraliste, Jérôme Larché, praticien hospitalier spécialiste de médecine interne et médecin référent régional du réseau de prise en charge du Covid long pour l’ARS Occitanie, Émilie Seyrat, ingénieure en physico-chimie, Catherine Tourette-Turgis, maîtresse de conférences au CNAM, Alain Trautmann, directeur de recherche émérite en immunologie au CNRS, ainsi que l’association ApresJ20.</em></p><img src="https://counter.theconversation.com/content/179817/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Les auteurs ne travaillent pas, ne conseillent pas, ne possèdent pas de parts, ne reçoivent pas de fonds d'une organisation qui pourrait tirer profit de cet article, et n'ont déclaré aucune autre affiliation que leur organisme de recherche.</span></em></p>Les patients atteints de « Covid long » subissent, des mois ou des années durant, des symptômes très invalidants. Que sait-on de ce syndrome, qui peut être réactivé par une nouvelle infection ?Dominique Salmon, Médecin spécialiste en maladies infectieuses, Professeur des Universités, présidente du groupe de travail sur le Covid long à la Haute Autorité de Santé, Université Paris CitéClara Lehmann, Professeur des Universités - Praticien Hospitalier, infectiologie - German Center For Infectious Research (DZIF), University of CologneEric Guedj, Professeur de Biophysique et Médecine Nucléaire, Aix-Marseille Université (AMU)Françoise Linard, Psychiatre spécialiste des maladies infectieuses - Service des maladies infectieuses et tropicales hôpital Tenon et hôpital Hôtel-Dieu (AP-HP), Alliance Sorbonne Paris Cité (ASPC)Jean-Marie Renaudin, Praticien Hospitalier, Allergologue, Université de LorraineMayssam Nehme, Physician and researcher, Division of Primary Care Medicine, Hôpitaux universitaires de GenèvePatricia Lemarchand, Professeure des Universités (biologie cellulaire) - Praticien Hospitalier (pneumologie), Université de NantesLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1698162021-12-15T22:02:37Z2021-12-15T22:02:37ZSupport and collaboration with health-care providers can help people make health decisions<figure><img src="https://images.theconversation.com/files/437711/original/file-20211215-25-1nxtdxn.jpg?ixlib=rb-1.1.0&rect=282%2C67%2C3403%2C2084&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Shared decision-making is a patient-centred approach to health choices that considers a patient's values as well as clinical evidence.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><p>The COVID-19 pandemic has resulted in an unprecedented <a href="https://blogs.lse.ac.uk/politicsandpolicy/science-society-covid19/">interest in science</a>, as people everywhere were <a href="https://penntoday.upenn.edu/news/decision-making-and-anxiety-time-covid-19">faced with making decisions</a> that affected their health. These included decisions such as following public health protective measures, getting vaccinations and accessing health-care services.</p>
<p>All of this has taken place in rapidly evolving, uncertain environments. The events related to the COVID-19 pandemic have highlighted the importance of <a href="https://www.cdc.gov/vaccines/vac-gen/evalwebs.htm">what constitutes credible information</a> or evidence (research-based information) and how evidence is communicated and used to make decisions. At the start of the pandemic, <a href="https://doi.org/10.1038/s41591-021-01293-x">little was known about COVID-19</a>, and making health decisions was a challenge.</p>
<p>The <a href="https://theconversation.com/omicron-faq-how-is-it-different-from-other-variants-is-it-a-super-variant-can-it-evade-vaccines-how-transmissible-is-it-160359">ongoing pandemic</a> has given rise to what is characterized as an “<a href="https://iris.paho.org/bitstream/handle/10665.2/52052/Factsheet-infodemic_eng.pdf">infodemic</a>” due to the sheer quantity of information available, including the rapid spread of misinformation or fake science reporting. From media outlets reporting in a 24/7 news cycle to the reliance on social media influencers, in many instances with a strong editorial bias, the information environment <a href="https://theconversation.com/people-want-to-use-bleach-and-antiseptic-for-covid-and-are-calling-us-for-advice-168660">is bewildering and difficult to navigate</a>.</p>
<p>The amount of information can pose <a href="https://doi.org/10.1098/rsos.201199">daunting challenges</a> to those who are seeking information to make informed health-care decisions. For example, misinformation has been found to negatively affect people’s <a href="https://doi.org/10.1038/s41562-021-01056-1">willingness to get vaccinated</a> and can lead to <a href="https://doi.org/10.1177%2F0033354919874074">risky behaviours</a>. </p>
<p>Making decisions that impact health has been a nearly universal experience during the pandemic: it affected everyone. Often these decisions were made <a href="https://doi.org/10.1186/s12913-021-07019-6">without support from health-care providers</a>. Our health systems have been challenged to better support people to make health-care decisions, such as <a href="https://doi.org/10.1001/jama.2020.27121">exploring options</a> to determine how to <a href="https://voxeu.org/article/how-nudge-covid-19-vaccination-while-respecting-autonomous-decision-making">support informed, values-based COVID-19 vaccination decisions</a>.</p>
<p>We are members of an interdisciplinary, international team of patient partners, health-care providers, educators and researchers that include the perspectives of patients in a leadership capacity. We have been seeking to understand and advance an approach to preparing patients for health decisions called shared decision-making.</p>
<h2>Support for people to take charge of their health</h2>
<p>“Shared decision-making” is when a person experiencing a health issue <a href="https://doi.org/10.1016/j.pec.2005.06.010">works together</a> with their health-care providers to make decisions about <a href="https://www.kingsfund.org.uk/sites/default/files/Making-shared-decision-making-a-reality-paper-Angela-Coulter-Alf-Collins-July-2011_0.pdf">screening, treatments or managing chronic conditions</a>. Shared decision-making upholds <a href="https://www.who.int/news/item/28-05-2016-world-health-assembly-adopts-framework-on-integrated-people-centred-health-services">person-centred care</a> and supports people to take an active role in their health-care decisions. </p>
<p>Standard care provides patients with evidence-based information about health choices. However, with shared decision-making, the person’s individual preferences, beliefs and values are considered in making health decisions, as well as clinical evidence.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/437710/original/file-20211215-13-wza95z.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Nurse sitting by patient's bed in hospital" src="https://images.theconversation.com/files/437710/original/file-20211215-13-wza95z.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/437710/original/file-20211215-13-wza95z.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/437710/original/file-20211215-13-wza95z.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/437710/original/file-20211215-13-wza95z.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/437710/original/file-20211215-13-wza95z.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/437710/original/file-20211215-13-wza95z.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/437710/original/file-20211215-13-wza95z.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Shared decision-making upholds person-centred care and supports people to take charge of their health.</span>
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<p>Importantly, shared decision-making is a process that supports people to understand the risks and benefits of different options through <a href="https://www.nice.org.uk/about/what-we-do/our-programmes/nice-guidance/nice-guidelines/shared-decision-making">discussion and information sharing</a> with their health-care providers. </p>
<p>In fact, shared decision-making has been called “<a href="https://projects.iq.harvard.edu/files/shared_decision_making/files/sdm_pinnacle_of_patient_centered_care.pdf?m=1446225643">the pinnacle</a>” of person-centred care. A key feature of shared decision-making is the <a href="https://doi.org/10.1007/s11606-012-2077-6">exploration of patient values and priorities</a> and it can be facilitated by using evidence-based decision support tools and approaches. </p>
<h2>Decision coaching</h2>
<p>Patient decision aids and decision coaching support people to have an active role in making decisions. <a href="https://doi.org/10.1002/14651858.CD001431.pub5">Decision aids</a> include <a href="https://decisionaid.ohri.ca/AZinvent.php">booklets, videos and online tools that</a> make the decision clear, provide options and the pros and cons, and help people clarify what matters to them. </p>
<p>They may be used by patients alone or in consultation with a health-care provider. They have been shown to help people feel more knowledgeable, better informed and clearer about their values. In addition, people probably have a more active role in decision-making and more accurate risk perception.</p>
<p>Our team viewed it as important to determine the unique contribution of decision coaching, an intervention with strong potential to help people prepare for health-care decisions. <a href="https://doi.org/10.1002/14651858.CD013385.pub2">Decision coaching</a> is delivered by trained health-care providers to support people facing decisions, with or without the use of an evidence-based tool (such as a patient decision aid).</p>
<p>We conducted a systematic review to <a href="https://www.cochrane.org/CD013385/COMMUN_decision-coaching-people-making-healthcare-decisions">assess the effects of decision coaching</a>. The review included 28 studies that covered a range of medical conditions with treatment and screening decisions. </p>
<p>While further research is needed on many outcomes, we found that decision coaching may improve participants’ knowledge (related to their <a href="https://doi.org/10.1016/j.pec.2013.10.031">condition, options, outcomes, personal values, preferences</a>) when used with evidence-based information. Our findings do not indicate any significant adverse effects (for example, decision regret, anxiety) with the use of decision coaching.</p>
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<p>Although we began our systematic review before the COVID-19 pandemic, our exploration of decision coaching is even more relevant given the decision demands of the pandemic and accompanying <a href="https://theconversation.com/should-children-get-the-covid-19-vaccine-153431">difficulty of the decisions</a>.</p>
<p>Experiences with the COVID-19 pandemic have shown that, in rapidly changing complex health-care environments, strategies that <a href="http://rimed.org/rimedicaljournal/2020/09/2020-09-10-commentary-knopov.pdf">uphold person-oriented health care</a> are critical. Shared decision-making tools and approaches, ideally using decision aids and decision coaching, can contribute to shaping person-centred health-care services that puts people first and upholds the principle of “<a href="https://ugc.futurelearn.com/uploads/files/19/40/19408460-e688-4a99-84bb-d5114eca9c97/2.3_Making-shared-decision-making-a-reality-paper-Angela-Coulter-Alf-Collins-July-2011_0.pdf">no decision about me, without me</a>.” To make the best health decisions for themselves and their families, people need support and opportunities to work with trusted health-care providers. </p>
<p><em>Maureen Smith, chair of the Cochrane Consumer Network Executive, co-authored this article.</em></p><img src="https://counter.theconversation.com/content/169816/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Janet Jull has received funding from the Canadian Institutes of Health Research and Ontario Institute for Cancer Research to conduct studies about shared decision making and decision coaching.</span></em></p><p class="fine-print"><em><span>Dawn Stacey receives funding from the Canadian Institutes of Health Research and the Canadian Cancer Society to conduct studies about decision coaching. </span></em></p><p class="fine-print"><em><span>Sascha Köpke receives funding from German Ministry of Research & Education, German Ministry of Health, German Innovation Fund (federal funding), German Statuary Health Insurance ("Techniker Krankenkasse").</span></em></p>Shared decision-making upholds person-centred care and supports people to take charge of their own health: their views, input and experiences are important contributors to health plans.Janet Jull, Assistant Professor, School of Rehabilitation Therapy, Queen's University, OntarioDawn Stacey, Chair professor, School of Nursing, L’Université d’Ottawa/University of OttawaSascha Köpke, Professor, Institute of Nursing Science, University of CologneLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1697912021-10-28T16:58:40Z2021-10-28T16:58:40ZWhy the idea of ‘African time’ keeps on ticking<figure><img src="https://images.theconversation.com/files/428769/original/file-20211027-15-1m3camx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">GettyImages</span> </figcaption></figure><p>“African time” delivers more hits on internet searches than “African nature” or “African people”. This shows that people seem to need to feed a stereotype. </p>
<p>As anthropologists, we’re interested in why this need exists and what impact it has on people’s lives.</p>
<p>Various scholars have discussed the idea of an African sense of time. Following the Kenyan-born philosopher <a href="https://philpapers.org/rec/MBITCO">John Mbiti</a>, some have suggested that Africans have no concept of the future. Others have claimed that the “relaxed” African attitude towards time, of being late and being focused on the ancestral past, prevents economic development. While such generalisations are discredited in science, they seem to live on among policy makers, state planners and NGO workers. </p>
<p>In our recent <a href="https://www.tandfonline.com/doi/full/10.1080/00020184.2021.1942786">paper</a>, we looked at examples of this stereotyping and tried to explain why it happens. We believe it is connected to the ways in which state and non-state planners try to make sense of the diverse expectations and orientations of citizens. </p>
<p>Our discussion builds on an idea that comes from political scientist <a href="https://yalebooks.yale.edu/book/9780300078152/seeing-state">James C. Scott</a>. He argued that administrators seek to make the messiness of everyday life “readable” so that they can deal with it more easily. The effect is that diverse ideas about the future are streamlined and merged into national plans, project plans and budget periods.</p>
<h2>Why time matters</h2>
<p>We are part of a larger research team at the University of Cologne in Germany. With our African counterparts, we have carried out ethnographic field research in the Kavango-Zambezi region in southern Africa. And we are now expanding our work to eastern Africa. We primarily accompany people in their everyday lives, seeking to tie the abstract topic of time back to the ordinary situations that we all share.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/428175/original/file-20211025-21-s05w3f.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A young girl sitting on a stone in a patchy football pitch." src="https://images.theconversation.com/files/428175/original/file-20211025-21-s05w3f.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/428175/original/file-20211025-21-s05w3f.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/428175/original/file-20211025-21-s05w3f.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/428175/original/file-20211025-21-s05w3f.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/428175/original/file-20211025-21-s05w3f.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/428175/original/file-20211025-21-s05w3f.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/428175/original/file-20211025-21-s05w3f.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A girl watches a football game in Namibia.</span>
<span class="attribution"><span class="source">Thomas Widlok, Joachim Knab</span></span>
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<p>The idea of African time is not merely a philosophical interest. It has become an integral part of state politics, specifically identity politics. States not only introduce clock time and standardised calendars. They also expect their citizens to contribute to development goals. The state tries to commit everyone to national targets, deadlines, plans and procedures. They achieve this with the help of project spreadsheets, media announcements, meeting schedules, work packages and other tools. </p>
<p>States are keen to streamline commitment to future national goals. In our experience from southern Africa, the role of NGOs in this process is often to harmonise the time-frames of marginalised citizens with those of state planning. Citizens navigate seasonal uncertainty, engaging in everyday improvisation to earn a living. To survive, they often need to revise their personal plans and timelines. State and NGO workers, by contrast, are expected to administer, control and direct the lives of people in a linear fashion. They set goals and execute planned projects.</p>
<p>We investigated examples from present-day Namibia. Here, as elsewhere, the state is instrumental in creating age brackets that define when citizens qualify for state services, including education, school feeding and pension payments. The state also sets the time frame for distributing drought relief and other benefits. It also decides when citizens have to provide services to the state – like paying tax, or getting tested for diseases. Individuals usually have a variety of personal plans and agendas. But from the state’s perspective, that is irrelevant. Everyone needs to follow the “proper procedures” of accountancy and policy implementation. </p>
<p>Moreover, most African states publish national “visions” for the future. Marginalised citizens have to comply with the expectations written in such visions, if they want recognition and assistance. Only certain linear timeframes can be “read” by the state (past-present-future, plan-execution, before-after). But other timeframes exist. Some are tuned to seasonal cycles, others are task-oriented rather than clock-oriented. They don’t sit easily with government’s expectations. </p>
<p>All this serves to reproduce the old expectation that all Africans follow a stereotypical “African time”. One way of time organisation is set as the standard, and all other forms are treated as problematic and special. </p>
<h2>Choose your time</h2>
<p>We aren’t attacking or recommending specific strategies of how to organise diverse expectations and aspirations into “future planning”. Our research reminds us that using multiple ways of considering time, and different ways of timing what we do, works well, as people move from one situation to another. </p>
<p>Previously, scholars believed that every “culture” used a specific time frame. But it’s evident that social agents (individuals and groups) possess multiple ways of dealing with time. In our everyday lives, we all choose from this repertoire, according to different situations and circumstances. The state (and NGOs) erode this diversity when they streamline time. It is neither right nor necessary.</p>
<p>“African time” is one option in a repertoire that is available not only to Africans but to everyone else. As a stereotype, it is used to discredit alternative forms of organising things, which depart from the dominant visions of development. We show that the state and other powerful players are not neutral in this. Their interests lie in getting things “lined up” and organised “according to plan”. But opening up the future for everyone starts with opening up to the diverse ways of thinking about time.</p><img src="https://counter.theconversation.com/content/169791/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Thomas Widlok and Joachim Knab receive funding from Deutsche Forschungsgemeinschaft (German Research Council)</span></em></p>Africans are stereotyped as having no regard for time and timing. This is a myth.Thomas Widlok, Professor for the Anthropology of Africa, University of CologneJoachim Knab, PhD-student in Social and Cultural Anthropology, University of CologneLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1624552021-07-08T14:57:26Z2021-07-08T14:57:26ZResolving tensions between global development goals and local aspirations<figure><img src="https://images.theconversation.com/files/406517/original/file-20210615-3654-1swehwf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Women with a loads on their heads crossing river Niger using the railway bridge at Jebba. </span> <span class="attribution"><span class="source">Jorge Fernández/LightRocket via Getty Images</span></span></figcaption></figure><p>The Sustainable Development Goals – a set of<a href="https://sdgs.un.org/goals">17 globally agreed-upon targets</a>for the year 2030 – are clearly listed and appear to be easy to subscribe to. However, development planning and the implementation of development projects are never straightforward.</p>
<p>Trade-offs between the 17 goals have to be considered. The pursuit of one goal may negatively affect the achievement of another. For instance, raising farmer incomes may lead to<a href="https://doi.org/10.1016/j.gfs.2020.100439">unaffordable food</a>for the urban poor. How should development actors decide on priorities and how should they handle such trade-offs?</p>
<p>As the goals are so broad and multi-faceted, many development agencies focus on specific niches – such as wildlife conservation – that they feel passionate about or think they can contribute most to. Politicians need to prioritise available funds and often choose high visibility, prestige mega-projects such as highways, railway lines or airports.</p>
<p>As a result, the<a href="https://theconversation.com/not-just-farmers-understanding-rural-aspirations-is-key-to-kenyas-future-129909">breadth of local people’s aspirations</a>, as recipients of envisioned development, are rarely considered. People implementing projects often fail to consider the full consequences of their actions.</p>
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Read more:
<a href="https://theconversation.com/with-construction-paused-lets-rethink-roads-and-railway-projects-to-protect-people-and-nature-137672">With construction paused, let's rethink roads and railway projects to protect people and nature</a>
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<p>In<a href="https://doi.org/10.1057/s41287-021-00407-y">our study</a>we reflected on aspirations from two ends of the spectrum. The top-down “visions for development” are set by politicians and technocrats and other development planners in line with the sustainable development goals. At the other end of the spectrum, communities on the ground also have their own aspirations for the future. Using several examples from Africa, we found that these aspirations may not always align and are sometimes in conflict.</p>
<p>We concluded that development goals must be contextualised. They must be embedded in a firm understanding of how people live and, more importantly, how they would like to live.</p>
<h2>Mismatched aspirations</h2>
<p>To fight poverty, one of the key goals, governments<a href="http://hdl.handle.net/10986/5991">often pursue</a>infrastructure projects to connect people and attract private sector investments in previously hard-to-reach places. These affect whole communities and cannot entirely be tailored to each individual’s vision for the future.</p>
<p>In Kenya, for instance, a new railway line cuts across grazing lands and forces pastoral communities to adopt sedentary lifestyles. As this<a href="https://doi.org/10.1057/s41287-021-00397-x">prevents</a>livestock from roaming, pastoralists have to purchase feed, which affects their livelihoods.</p>
<p>Similarly, roads are meant to<a href="https://doi.org/10.1596/978-0-8213-6807-7">support market linkages</a>for remote rural farms to improve their income opportunities. Roads do appear to deliver on this promise, benefiting both richer and poorer households.</p>
<p>But roads aren’t good for everyone. Connecting communities to roads can fundamentally affect their preferred livelihoods, values and knowledge. For example, some groups in the northern drylands of Kenya have seen<a href="https://doi.org/10.1057/s41287-021-00396-y">their pastoral lifestyles restricted</a>as previously communal rangelands became fragmented and turned into a contested resource for private use. Some gave up their traditional way of life, leaving them worried for the future.</p>
<p>The issues become even more complex when the development goals pursued are aimed at outcomes that don’t benefit people directly. For instance, wildlife conservation is one component of SDG 15 which focuses on the protection, restoration and sustainable use of terrestrial ecosystems. As much as wildlife conservation is needed in global terms, it often causes<a href="https://theconversation.com/global/topics/human-wildlife-conflict-23033">conflict with local communities</a>. Attempts have been made to mitigate these effects and generate local support. One example of this is the<a href="https://doi.org/10.1057/s41287-021-00403-2">wildlife corridor</a>in Tanzania’s Kilombero valley. It sought to create new farming systems that allowed wildlife movement at the same time as farming.</p>
<p>However, it<a href="https://doi.org/10.1057/s41287-021-00403-2">failed to deliver</a>on the ground. The lack of recognition of local power relations and exploitation by some groups increased tensions and undermined the project. This has led to declining support for the project over time.</p>
<p>The<a href="https://doi.org/10.1057/s41287-021-00402-3">Kavango-Zambezi Transfrontier Conservation Area</a>, in the case of north-eastern Namibia, faces similar problems. It was designed to combine nature conservation and rural development. Infrastructure investments were made to connect to the global tourism industry worth more than<a href="https://www.statista.com/topics/962/global-tourism/#dossierSummary">US$9 trillion</a>and enable communities to benefit more from wildlife tourism.</p>
<p>But this top-down vision has, so far,<a href="https://doi.org/10.1057/s41287-021-00402-3">helped very few residents</a>. Payments for conservancy management or wages from the few low-paid jobs have left the local population disillusioned. Businesses outside the conserved region have ended up with most of the additional value created.</p>
<h2>Aligning goals</h2>
<p>It’s clear from these examples that planners need to consider how their aspirations match the aspirations of their intended target populations. Working towards a common aspiration involves negotiating trade-offs and non-dogmatic approaches that allow localised compromise.</p>
<p>To navigate these issues, it is important to consider everyone’s aspirations. Development planners must ensure that they have all the necessary information at hand. This includes data, such as economic statistics on GDP and employment. But, because these are more readily available, they must make sure they don’t have undue influence.</p>
<p>People’s voices, aspirations and dreams – less readily accessible – must be taken just as seriously. For example, in Kenya’s arid North, the Turkana County Integrated Development Plan incorporates a distinct understanding on how various sectoral <a href="https://doi.org/10.1057/s41287-021-00410-3">plans affect each other</a>. It also integrates views from communities not only for planning but also for progress monitoring.</p>
<p>This highlights how properly thought out engagement processes can fill this gap by allowing people’s voices to be heard and to be incorporated into planning and action.</p><img src="https://counter.theconversation.com/content/162455/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Kai Mausch received funding from multiple organisations that fund international agricultural research.</span></em></p><p class="fine-print"><em><span>David Harris received funding from multiple organisations that fund international agricultural research. </span></em></p><p class="fine-print"><em><span>Javier Revilla Diez receives funding from Deutsche Forschungsgemeinschaft (German Science Foundation).</span></em></p>Broader local engagement and inclusion of multiple voices could improve development projectsKai Mausch, Senior Economist, Center for International Forestry Research – World Agroforestry (CIFOR-ICRAF)David Harris, Honorary Lecturer, Bangor UniversityJavier Revilla Diez, Professor, University of CologneLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1243312019-11-08T16:09:45Z2019-11-08T16:09:45ZWhat the fall of the Berlin Wall and German unification have meant for educational inequality<figure><img src="https://images.theconversation.com/files/300887/original/file-20191108-194650-ektgls.jpg?ixlib=rb-1.1.0&rect=39%2C124%2C5165%2C3331&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/berlin-germany-nov-2-children-visit-204360967?src=61bf7f9d-f078-4d28-8e51-86df9a3bbe9e-1-52">shutterstock/gary yim</a></span></figcaption></figure><p>When the <a href="https://theconversation.com/history-didnt-end-with-the-fall-of-the-berlin-wall-but-only-now-is-the-new-battleground-clear-125768">Berlin wall fell 30 years ago</a>, on November 9 1989, it marked the end of a 40-year divide between Germany’s communist East and the free market system of the West. For people living either side of the wall, this split led to differences in many areas of life, including education. So while the West German system sorted children into different schools from an early age, based on <a href="https://www.ifo.de/DocDL/dicereport109-rr1.pdf">academic achievement</a>, East German children attended comprehensive school until they were <a href="https://mpra.ub.uni-muenchen.de/31853/1/MPRA_paper_31853.pdf">16 years-old</a>. </p>
<p>Most of these children in East Germany would then join the workforce and enter a job training programme, although a small number of students were allowed to continue in upper secondary schooling and onto university. As equality was a stated aim of <a href="https://www.nuffield.ox.ac.uk/Users/Goldthorpe/Market%20vs%20Meritocracy%20Dec08.pdf">socialist countries</a>, East Germany prioritised working-class children in this process. </p>
<p>In West Germany the selective system meant that only those children considered most academically capable were able to complete what’s known as the “Abitur”. These are exams equivalent to A-levels. Students needed (and still need) to pass these exams to be able to go to university.</p>
<h2>The move to one system</h2>
<p>In 1990, the German Democratic Republic (the former East Germany) reunited with West Germany – and, as part of that reunification the east agreed to an economic, social, and political union that saw them adopt West German systems. In education, this meant using West Germany’s system of early ability tracking. This did not allow for “positive discrimination” of working-class children. </p>
<p>In our recent study, published in <a href="https://www.sociologicalscience.com/articles-v6-1-1/">Sociological Science</a> we wanted to look at how the two education systems compared. We were especially interested in how a child’s family background influenced their educational attainment in both the West and East German education systems. </p>
<p>Existing <a href="https://www.sociologicalscience.com/download/vol-4/january/SocSci_v4_54to79.pdf">evidence</a> from former socialist countries shows that once a free market economy is in place, people are less socially mobile. That is, their occupations are more likely to mirror those of their parents. </p>
<p>In our study we looked at the long-term trends in educational inequality across East and West Germany. To do this, we used data from three large-scale surveys on the family background and educational attainment of Germans born between 1929 and 1993 – this includes people in the education system long before and after German reunification. Specifically, we looked at the successful completion of the Abitur by both parents and their children.</p>
<h2>Educational inequality</h2>
<p>What we found was a greater similarity between the educational attainment of parents and children in West Germany than in East Germany – highlighting how educational inequality was stronger in the West. This may not be entirely surprising as policies implemented in East Germany had the goal to improve educational outcomes for disadvantaged students. Indeed, in the west, students from higher educational backgrounds were far more likely to take and pass the exam than in the east. It seems that East Germany mainly achieved lower levels of inequality by limiting educational opportunities for students from those higher educational backgrounds. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/300888/original/file-20191108-194669-1sokcx2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/300888/original/file-20191108-194669-1sokcx2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=405&fit=crop&dpr=1 600w, https://images.theconversation.com/files/300888/original/file-20191108-194669-1sokcx2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=405&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/300888/original/file-20191108-194669-1sokcx2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=405&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/300888/original/file-20191108-194669-1sokcx2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=509&fit=crop&dpr=1 754w, https://images.theconversation.com/files/300888/original/file-20191108-194669-1sokcx2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=509&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/300888/original/file-20191108-194669-1sokcx2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=509&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">The Berlin Wall separated Communist-controlled East Germany from West Berlin.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/berlin-wall-separated-communistcontrolled-east-germany-244390639?src=b4c11359-05f0-4915-9973-180ef3a7a924-1-35">Shutterstock/Everett Historical</a></span>
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</figure>
<p>As time went on, the East German state enforced “positive discrimination” to a lesser extent. Those who benefited from this process became part of the socialist elite and wanted their children to be equally successful. This meant that over time, educational inequality also increased throughout East Germany. </p>
<p>As a result, East Germany was increasingly unable to provide equal educational opportunities or fulfil its aim of a fair society. Nevertheless, educational inequality remained at a lower level in East Germany than in West Germany before reunification. </p>
<h2>Perils of the selective system</h2>
<p>After the fall of the Berlin Wall – when West Germany’s selective systems were adopted on a wider scale – educational inequality in East Germany increased to West German levels. So the gap between children from higher and lower educational backgrounds in attaining the Abitur became strikingly similar in both East and West Germany. </p>
<p>It seems then that transforming a comprehensive school system into a selective school system increased inequality. This is a finding that echoes other <a href="http://www.forschungsnetzwerk.at/downloadpub/Age_of_Selection_Counts.pdf">research</a> in this field. The reason for this is likely down to highly educated families in the former East Germany seizing new opportunities and freedoms presented by the fall of the Berlin Wall. In the newly established selective education system, they made immediate use of their resources and knowledge to improve their children’s prospects. </p>
<p><a href="https://epi.org.uk/publications-and-research/grammar-schools-social-mobility/">Research in England</a> has also shown that the attainment gap between children eligible for free school meals and those who are not is wider in <a href="https://theconversation.com/grammar-schools-damage-social-cohesion-and-make-no-difference-to-exam-grades-new-research-93957">selective areas</a>. </p>
<p>Our study supports the idea that comprehensive schooling is better suited to tackling educational inequalities than selective education – as education systems that offer many educational choices may always favour middle-class families.</p><img src="https://counter.theconversation.com/content/124331/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>When the wall fell – education equality did too.Markus Klein, Senior Lecturer in Human Development and Education Policy, University of Strathclyde Katherin Barg, Lecturer in Education, University of ExeterMichael Kühhirt, Lecturer in Sociology, University of CologneLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/985182018-08-15T10:20:56Z2018-08-15T10:20:56ZFinding nostalgia in the pixelated video games of decades past<figure><img src="https://images.theconversation.com/files/231779/original/file-20180813-2906-f0h17k.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Instruments of nostalgia and psychological well-being?</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/manitou-springs-cousa-september-6-2016-756724900">Brian Kenney/Shutterstock.com</a></span></figcaption></figure><p>Every day, it seems, new ultra-high-resolution video games are released, <a href="http://recipp.ipp.pt/bitstream/10400.22/8209/1/DM_JoanaOsorio_2015_MEI.pdf">syncing with players’ social media accounts</a> and <a href="https://www.playstation.com/en-us/explore/playstation-vr/">ready for virtual reality headsets</a>. Yet old games from the 1970s and 1980s <a href="http://time.com/money/4352311/old-video-games-worth-money/">are still in high demand</a>. The Nintendo Corporation has moved recently to both quash and exploit that popularity, <a href="https://motherboard.vice.com/en_us/article/bjbped/nintendos-offensive-tragic-and-totally-legal-erasure-of-rom-sites">shutting down websites hosting old games’ code</a> while planning to <a href="https://www.gamespot.com/articles/nintendo-switch-online-service-offers-20-free-nes-/1100-6458799/">release its own back catalog on a new platform</a>. </p>
<p>Fans of Nintendo-made games may end up OK, but fans of other legacy games may lose much more than a retro way to have fun: They could find themselves without a powerful link to their personal pasts.</p>
<p>Playing old video games is not just a <a href="http://time.com/5220092/steven-spielberg-on-the-glories-and-limits-of-nostalgia-ready-player-one/">mindless trip down memory lane</a> for <a href="https://www.wired.com/2015/08/geeks-guide-gamer-stories/">lonely and isolated gamers</a>. The <a href="http://www.theesa.com/wp-content/uploads/2018/05/EF2018_FINAL.pdf">average age of a U.S. gamer is 34</a>, and many popular retro game titles have been around for 20 years or more. It seems <a href="https://www.popmatters.com/141240-the-retirement-of-a-gen-x-gamer-or-my-8-bit-childhood-2496029806.html">Generation X-ers could be returning to their cherished childhood properties</a>. </p>
<p>In fact, emerging media psychology research, <a href="http://dx.doi.org/10.17645/mac.v6i2.1317">including our own work</a>, suggests that video game nostalgia can make people feel closer to their past, their friends and family, and even themselves. </p>
<h2>The popularity of retro video games</h2>
<p>The earliest video game consoles emerged in the 1970s, <a href="http://www.digitalspy.com/gaming/retro-gaming/feature/a616235/magnavox-odyssey-retrospective-how-console-gaming-was-born/">marked by the 1972 release of the Magnavox Odyssey</a>. The arcade classic “Pong” was so popular in 1973 that <a href="https://www.vanityfair.com/culture/2011/03/pong-excerpt-201103">machines each collected about US$200 a week in quarters</a>. Many 1990s gamers remember fondly the “<a href="https://www.harpercollins.com/9780062276711/console-wars/">console wars</a>” in which major game developers would battle publicly – for example <a href="https://www.youtube.com/watch?v=65E53rNC1io">Sega claiming to do what “Nintendon’t.”</a></p>
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<iframe width="440" height="260" src="https://www.youtube.com/embed/65E53rNC1io?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">TV ads from the throwback days of the ‘console wars.’</span></figcaption>
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<p>It may be a bit of a surprise to find out how popular retro and classic games are. Older games feature pixel-based graphics that <a href="https://www.howtogeek.com/341543/why-do-old-game-consoles-look-so-bad-on-modern-tvs/">can look fuzzy on modern televisions</a> and can be <a href="https://www.youtube.com/watch?v=ut3n8-9JM5o">frustrating to play for even experienced gamers</a>. Yet in 2016, Nintendo released a <a href="https://www.nintendo.com/nes-classic/">NES Classic Edition</a> console and <a href="https://venturebeat.com/2018/06/25/nes-classic-edition-in-stock-retail-june-29/">sold out all 2.3 million of them</a> in just three months. The company <a href="https://www.polygon.com/2018/5/13/17350662/nes-classic-edition-release-date-2018-for-sale">made more and began selling them in June 2018</a>. </p>
<p>Other similar retro consoles are popular too. A quick search of eBay and Amazon reveals hundreds of retailers selling original and refurbished older video game systems. These older games pale in comparison to modern games that immerse players in <a href="https://www.guerrilla-games.com/play/horizon">lush, photo-realistic and smoothly interactive worlds</a>. And yet they’re very popular. The people who play them are clearly getting something compelling – though it’s probably not graphics or a deep storyline.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/229691/original/file-20180728-106511-n0ir3t.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/229691/original/file-20180728-106511-n0ir3t.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/229691/original/file-20180728-106511-n0ir3t.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=445&fit=crop&dpr=1 600w, https://images.theconversation.com/files/229691/original/file-20180728-106511-n0ir3t.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=445&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/229691/original/file-20180728-106511-n0ir3t.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=445&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/229691/original/file-20180728-106511-n0ir3t.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=559&fit=crop&dpr=1 754w, https://images.theconversation.com/files/229691/original/file-20180728-106511-n0ir3t.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=559&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/229691/original/file-20180728-106511-n0ir3t.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=559&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Released in December 2016, ‘Super Mario Maker’ allowed players to create their own Mario levels, selling 6 million units worldwide. Mario-themed games have sold over 550 million copies since the character’s introduction, in 1981.</span>
<span class="attribution"><span class="source">Nintendo</span></span>
</figcaption>
</figure>
<h2>The psychology of nostalgia</h2>
<p>As a psychological principle, nostalgia can be best understood as a <a href="http://doi.org/10.1037/a0025167">bittersweet mix of positive and negative emotions</a> that arises when thinking of meaningful events in one’s own past, and <a href="http://dx.doi.org/10.1016/bs.aesp.2014.10.001">tends to be tied intimately to social relationships</a>. </p>
<p>So far, researchers have identified two ways to trigger nostalgia: external triggers and internal distress. External triggers might include things such as <a href="https://doi.org/10.1080/09658211.2013.876048">smells</a> and <a href="https://doi.org/10.5130/csr.v19i1.3074">tastes</a> and even references to media content, <a href="https://doi.org/10.1016/0148-2963(96)00023-9">such as movie titles</a> or <a href="https://doi.org/10.1177%2F0146167213499187">music</a>. Internal triggers are brought about by feelings of <a href="https://doi.org/10.1037/0022-3514.91.5.975">loneliness</a> or even <a href="https://doi.org/10.1037/a0030442">boredom</a>. </p>
<p>Regardless of the trigger, nostalgia has a number of psychological benefits. It can <a href="https://doi.org/10.1080/15298868.2010.521452">help people feel better about themselves</a> and <a href="https://doi.org/10.1111/j.1467-9280.2008.02194.x">make them feel less alone</a>. For these reasons, nostalgia <a href="https://doi.org/10.1111/spc3.12070">can promote mental health and well-being</a>. Clinical studies have suggested that <a href="https://doi.org/10.1177%2F1471301218774909">nostalgia might help protect against dementia</a>.</p>
<h2>Nostalgia in video games</h2>
<p>Can video games really evoke nostalgia? Forums online <a href="https://www.reddit.com/r/retrogaming/">debate the issue furiously</a>, <a href="http://www.computerspielemuseum.de/1210_Home.htm">museums chronicle the history of video games</a> with an eye toward bygone days, and the topic comes up <a href="http://www.psychologyofgames.com/2013/11/the-psychology-of-video-game-nostalgia/">in popular podcasts</a>. </p>
<p>Players’ <a href="https://doi.org/10.1080/08824096.2017.1383236">relationships with the characters they’ve played in the past</a> – Mario, Sonic and scores of others – can play an important role in invoking nostalgia. One reason for this is <a href="https://doi.org/10.1016/j.chb.2015.07.030">players have complex social relationships with those characters</a>, either by seeing them as their friends, or even as extensions of themselves. </p>
<p>In <a href="http://dx.doi.org/10.1037/ppm0000208">our own research</a>, we asked 582 participants, mostly from the United States, to respond to a survey on “how people think about certain gaming experiences.” Specifically, gamers were randomly assigned to write one of four essays: about past or recent video game experiences, playing either alone or with others. The essays were designed to help participants immerse themselves in the memories, so that they could later answer questions about the <a href="http://selfdeterminationtheory.org/">intrinsic psychological needs</a> satisfied by those experiences.</p>
<p>As we expected, people who wrote about the older memories experienced stronger feelings of nostalgia than the people who wrote about recent ones. Those essays about older, more nostalgic memories were also more likely to have discussions of challenge and enjoyment as core to their experience, and tended to recall memories from the writer’s childhood. Social memories essays were also more nostalgic, but only when those memories were associated with a greater sense of belonging with people from the past. Some of these essays, especially those about family and friends, were emotionally powerful – one participant wrote (edited slightly, to protect their identity) that “My dad died when I was 10 so playing Mario Kart with him is one of my best memories that I have.” </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/231526/original/file-20180810-2894-17maqpt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/231526/original/file-20180810-2894-17maqpt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/231526/original/file-20180810-2894-17maqpt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/231526/original/file-20180810-2894-17maqpt.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/231526/original/file-20180810-2894-17maqpt.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/231526/original/file-20180810-2894-17maqpt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/231526/original/file-20180810-2894-17maqpt.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/231526/original/file-20180810-2894-17maqpt.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">In our research on video game nostalgia, gamers made fond references to friends and family in their social memories of gaming.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/smiling-family-sitting-on-couch-together-364445456">wavebreakmedia/Shutterstock.com</a></span>
</figcaption>
</figure>
<h2>Nostalgic gaming and well-being</h2>
<p>Perhaps more interesting? Memories of video games were enough to induce nostalgia that, in turn, made those people feel a little closer to those around them right now. </p>
<p>The study has limitations – the largest being that participants did not get to play their older games, so we don’t know if their nostalgic memories would be the same if they actually replayed the games – but it helped us better understand gaming nostalgia and its potential effects. Our findings have also been corroborated by other research on gaming nostalgia, such as work on active players of “Pokémon Go.” In that study, playing the game resulted in feelings of nostalgic reverie, <a href="https://doi.org/10.1080/15213269.2017.1305280">which in turn was positively connected to resiliency</a>, or the ability to cope with challenging times in life. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/231527/original/file-20180810-2924-1ty4aw6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/231527/original/file-20180810-2924-1ty4aw6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/231527/original/file-20180810-2924-1ty4aw6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/231527/original/file-20180810-2924-1ty4aw6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/231527/original/file-20180810-2924-1ty4aw6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/231527/original/file-20180810-2924-1ty4aw6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/231527/original/file-20180810-2924-1ty4aw6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/231527/original/file-20180810-2924-1ty4aw6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Can ‘Pokémon Go’ be therapeutic? Emerging research suggests that the nostalgia that players attached to the game can help them cope with daily struggles.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/bangkok-thailand-july-22-2016-charmander-456596296">Wachiwit/Shutterstock.com</a></span>
</figcaption>
</figure>
<p>Research into the psychology of video game nostalgia is relatively new. However, the results of this work suggest that games can be nostalgic, and that this nostalgia can be therapeutic. For example, we already know that <a href="https://doi.org/10.1089/cpb.2009.0010">playing games at work can aid in psychological recovery</a> from stress; it might be that playing nostalgic games could intensify this process. It could also be possible to use the popular video games of yesterday as health interventions to delay the onset of dementia, following a line of research showing video games to have <a href="https://doi.org/10.1109/SeGAH.2017.7939279">cognitive</a> and <a href="https://dx.doi.org/10.1089/g4h.2014.0005">physical</a> health benefits for older populations. </p>
<p>As gamers age, understanding gaming nostalgia will help us better examine the wide range of experiences that they have with one of the <a href="https://www.gamecrate.com/statistically-video-games-are-now-most-popular-and-profitable-form-entertainment/20087">most profitable and popular form of entertainment media today</a>.</p><img src="https://counter.theconversation.com/content/98518/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Tim Wulf receives funding (PhD Scholarship) from the foundation of German Business (Stiftung der Deutschen Wirtschaft). </span></em></p><p class="fine-print"><em><span>Nicholas Bowman does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>As retro video games become more popular, research suggests players could be looking for nostalgia – and the psychological benefits it brings.Nicholas Bowman, Associate Professor of Communication Studies, West Virginia UniversityTim Wulf, Ph.D. student in Media Psychology, University of CologneLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/867122017-12-13T11:43:17Z2017-12-13T11:43:17ZRwanda’s agricultural revolution is not the success it claims to be<figure><img src="https://images.theconversation.com/files/198988/original/file-20171213-27562-13vsuak.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">More than 70% of Rwanda's population are subsistence farmers.</span> <span class="attribution"><span class="source">Shutterstock/Sarine Arslanian</span></span></figcaption></figure><p>The Rwandan government –- supported by major international donors –- has high ambitions to modernise and professionalise its agrarian and land sector to reduce poverty and create economic growth.</p>
<p>But, the sector faces some big challenges. There is a high incidence of landlessness, especially among the poorest who, when confronted with unforeseen costs, are <a href="https://www.researchgate.net/publication/264425800_Introduction_-_Understanding_Structural_Transformation_in_Africa">often forced</a> to sell land. This is a problem because <a href="https://www.weforum.org/agenda/2016/04/5-things-to-know-about-rwanda-s-economy/">more than</a> 70% of the population are subsistence farmers, meaning they grow the food they eat. Rwanda is also <a href="https://www.pri.org/stories/2010-12-02/rwanda-tackles-population-growth">one of</a> the most densely populated countries in the world. On average households typically have just 0.75 hectares. </p>
<p>The government’s reforms fit into a <a href="https://www.un.org/press/en/2004/sgsm9405.doc.htm">broader call</a>, spearheaded by the UN in the early 2000s, to implement a “Green Revolution” in sub-Saharan Africa. The idea behind this is that land tenure would be formalised. This would increase security and <a href="https://www.brookings.edu/blog/africa-in-focus/2015/12/30/considering-land-tenure-security-for-structural-transformation-of-african-agriculture/">encourage</a> farmers to invest in their land. </p>
<p>Investments would be made in modern inputs – like seeds and subsidised fertilisers – and commercialisation would increase the production of selected crops. As a result, smallholder farmers should <a href="http://www.tandfonline.com/doi/full/10.1080/13892240902909064">profit</a> as they are integrated into commercial commodity chains. At a national scale this would lead to an increase in food security, exports and growth.</p>
<p>However, several <a href="http://www.sciencedirect.com/science/article/pii/S0305750X12003105">studies</a> in sub-Saharan Africa have uncovered considerable negative effects of Green Revolution policies. These have affected large sections of rural populations, especially poorer groups. </p>
<p>This article combines the findings of nine academic researchers who conducted in-depth <a href="http://roape.net/2017/10/18/rwandas-green-revolution/">research</a> on the impact of Rwanda’s policies. The research found that Rwanda’s land and agricultural policies diminished land-tenure security, excluded vulnerable groups from taking part in the agricultural programs and caused food insecurity for many small-scale farmers. </p>
<p>This challenges the Rwandan government’s position, which <a href="http://www.statistics.gov.rw/publication/evolution-poverty-rwanda-2000-2011-results-household-surveys-eicv">portrays</a> the agricultural sector reforms as hugely <a href="http://www.statistics.gov.rw/publication/rwanda-poverty-profile-report-results-eicv-4">successful</a>, and claims that these have <a href="http://www.statistics.gov.rw/publication/poverty-trend-analysis-report-201011-201314">resulted</a> in poverty reduction and increased agricultural productivity.</p>
<p>The government relies heavily on quantitative indicators to make these claims. But we do not feel they tell the full story. </p>
<h2>Impact of agricultural policies</h2>
<p>We studied three of Rwanda’s agricultural policies in depth: land registration, the crop intensification programme and the promotion of farmer cooperatives. </p>
<p><strong>Land registration:</strong> The government assumed that official land registration and titling would improve land-tenure security. But our <a href="http://www.tandfonline.com/doi/abs/10.1080/03066150.2014.910765">studies</a> <a href="http://www.focusonland.com/countries/curbs-on-land-use-rights-in-rwanda-the-bundle-of-rights-in-context/">show</a> that the new law has led to a perceived loss of control, tenure security and choice for smallholders. This is because the 2005 <a href="http://admin.theiguides.org/Media/Documents/organic%20land%20law.pdf">Organic Land Law</a> states that land belongs to the government and may be reallocated if it is not used according to state policies. Evidence from our research has shown that local administrators frequently threaten farmers with <a href="https://www.hrw.org/news/2017/03/31/rwanda-government-repression-land-cases">expropriation</a> in rural areas. Urbanisation policies also involve expropriation, often without adequate compensation.</p>
<p><strong>Crop intensification:</strong> This <a href="http://www.minagri.gov.rw/index.php?id=31">programme</a> started in 2007 with the aim of transforming Rwanda’s family-run farms into professionalised businesses. This meant that instead of sowing different crops at different times of year for household consumption, production is focused on maximising the output of single crops in each growing season. This means their surplus can be sold. Research shows that the programme has sometimes been counter productive, leaving people less secure in terms of food and income. </p>
<p>The model is too simple. Rwanda is a hilly country with many differences in growing conditions, landscapes and farmers’ socioeconomic backgrounds. For example, farmers have suffered crop failures because they have planted crops prioritised by the government that <a href="https://academic.oup.com/afraf/article/113/450/108/48396">are not</a> suited to specific regions. Or farmers’ crops were destroyed because they weren’t the approved ones. </p>
<p><strong>Co-operatives:</strong> The Rwandan government wants farmers to organise themselves into <a href="http://www.rca.gov.rw/spip.php?article15">cooperatives</a>, creating a top-down governance structure that coordinates agricultural production. Membership is sometimes mandatory. Studies found several problems with the model, including high entrance fees which exclude the poorer and more vulnerable farmers. </p>
<h2>The state’s use of statistics</h2>
<p>Despite these negative outcomes, the Rwandan government has used <a href="http://www.tandfonline.com/doi/abs/10.1080/03056244.2016.1214119?journalCode=crea20">statistics to</a> validate claims of increased agricultural productivity and poverty reduction. </p>
<p>Although statistics are often presented as an unbiased representation of reality, several <a href="https://academic.oup.com/afraf/article-abstract/109/434/77/72195">authors</a> <a href="http://www.cornellpress.cornell.edu/book/?GCOI=80140100939320">highlight</a> that this is not the case. For instance, the government uses quantitative indicators – like crop production – to show that productivity has improved. But this does not adequately capture the impact of agricultural and poverty reduction policies. These overlook the actual experiences of the rural population and does not prove any causal relation between the reforms and the outcome. </p>
<p>On top of this, different data sources <a href="http://roape.net/2017/06/28/evidence-mounts-poverty-inflation-rwanda/">contradict</a> each other with no way of telling which dataset is more reliable. The Rwandan government and international donors refer to the most optimistic, but least reliable statistics, as the example below concerning agricultural yields suggests.</p>
<p>We sought to shed some light on this. Based on an analysis of various data for 2010/11 – 2013/14, we argue that: </p>
<ul>
<li><p>Yields probably increased over the period of the implementation of the agricultural reforms. But agricultural and household surveys indicate that this increase was <a href="http://www.tandfonline.com/doi/abs/10.1080/00220388.2016.1146703?journalCode=fjds20">less</a> than what the most optimistic, but least reliable, data source suggests (<a href="http://www.tandfonline.com/doi/abs/10.1080/00220388.2016.1146703?journalCode=fjds20">statistics</a> from the Food and Agricultural Organisation). Productivity did go up, but not by as much as the government claims. </p></li>
<li><p>Poverty <a href="https://www.wider.unu.edu/publication/growth-and-poverty-sub-saharan-africa">decreased</a> significantly between 2005/06 and 2010/11, from 56.7% to 44.9%. But seasonal effects played a partial role as 2010/11 was a good agricultural season (due to favourable weather conditions) whereas 2005/6 was not.</p></li>
</ul>
<p>For the period 2010/11 – 2013/14, the Rwandan government’s calculations suggest that poverty decreased from 44.9% to 39.1%. However, <a href="http://roape.net/2017/06/28/evidence-mounts-poverty-inflation-rwanda/">our analysis of the same data</a> suggests poverty increased by 1.2%. This discrepancy can be attributed to a different assumption about the inflation rate, a key parameter for poverty estimates. The inflation rate assumed by the National Institute of Statistics of Rwanda was 16.7%, a more realistic inflation estimate is 30% –- much higher. </p>
<p>The research presented shows that a deeper understanding is needed on the relationship between government policies and rural realities. It is dangerous, and too simplistic, to draw a direct causal link between rural reforms and poverty reduction.</p>
<p>Unfortunately, there is limited space for contestation in Rwanda. But to effectively engage local society in policy planning, processes need to be inclusive of people with diverse circumstances and perspectives. They must acknowledge and respond to negative impacts by adapting regulations or providing additional support to those in need. This includes independent research, monitoring and evaluation for a realistic, qualitative assessment of rural Rwandans needs and challenges.</p><img src="https://counter.theconversation.com/content/86712/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Margot Leegwater receives funding from the Belgian National Scientific Research Fund (FNRS) </span></em></p><p class="fine-print"><em><span>An Ansoms receives funding from the Belgian National Scientific Research Fund (FNRS) and from the Academy for Research and Higher Education (ARES). </span></em></p><p class="fine-print"><em><span>Aymar Nyenyezi Bisoka receives funding from the Belgian National Scientific Research Fund (FNRS) and from the African Peacebuilding Network of the Social Science Research Council in the USA.</span></em></p><p class="fine-print"><em><span>Chris Huggins received an Ontario Graduate Scholarship, and a small grant from the Land Deal Politics Initiative, which enabled him to conduct and write-up research in Rwanda. </span></em></p><p class="fine-print"><em><span>He is affiliated with the European Network for Central Africa. </span></em></p><p class="fine-print"><em><span>Johanna Treidl previously received a PhD-scholarship from a research project, funded by the German Ministry for Education and Research (BMBF).</span></em></p><p class="fine-print"><em><span>Jude Murison, Julie Van Damme, Neil Dawson, and Sam Desiere do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Findings from several scientific studies show the real impact of Rwanda’s agricultural policies and the challenges it faces.Margot Leegwater, Postdoctoral researcher, Université catholique de Louvain (UCLouvain)An Ansoms, Professor in Development Studies, Université catholique de Louvain (UCLouvain)Aymar Nyenyezi Bisoka, Assistant professor, Université de MonsChris Huggins, Assistant Professor, L’Université d’Ottawa/University of OttawaGiuseppe Cioffo, Programme and Policy Officer, Université catholique de Louvain (UCLouvain)Johanna Treidl, PhD student, University of CologneJude Murison, University of AntwerpJulie Van Damme, Post Doctoral Researcher, Université catholique de Louvain (UCLouvain)Neil Dawson, Research fellow in international development, University of East AngliaSam Desiere, Senior research fellow, KU LeuvenLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/784352017-08-15T01:20:39Z2017-08-15T01:20:39ZAre men seen as ‘more American’ than women?<figure><img src="https://images.theconversation.com/files/172255/original/file-20170605-31028-11j2uv9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Protesters hold signs at the Chicago Women's March in January 2017.</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/usachicago/31672543383">John W. Iwanski</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc/4.0/">CC BY-NC</a></span></figcaption></figure><p>Women make up <a href="https://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?pid=ACS_14_5YR_DP05&src=pt">50.8 percent</a> of the U.S. population and have equal voting rights, yet are politically underrepresented. The country has never had a female president or vice president. Only 3.5 percent of Supreme Court justices have been women, and women make up only <a href="https://fas.org/sgp/crs/misc/R44762.pdf">20 percent of Congress</a>.</p>
<p>Studies have shown that within a country, groups with more power often <a href="http://www.jstor.org/stable/2749514">feel greater ownership over it</a>. Because they control actual resources, like money, and symbolic resources, like writing history, they’re better able to shape the culture in their image. For example, because Christianity is the most prominent religion in the United States, Christmas is a federal holiday.</p>
<p>Because men hold more power than women in the United States, we wanted to explore a simple question: Would people tend to think of men as “more American” than women? And, if so, how does this influence the way American women identify with their country?</p>
<h2>A masculine national ethos</h2>
<p>We tested these questions in <a href="http://journals.sagepub.com/doi/full/10.1177/0361684317707710">two studies</a>. </p>
<p>First, we looked at the connection between national identity and gender-specific traits, asking 382 American adults the extent to which they thought of certain traits as “American.” Among these traits, some were stereotypically feminine (helpful, friendly) while others were stereotypically masculine (outgoing, ambitious). (We used results from <a href="http://journals.sagepub.com/doi/full/10.1177/0361684316634081">previous studies</a> to designate certain traits as “masculine” or “feminine.”)</p>
<p>We found that both men and women rated masculine traits – like “independent” and “competitive” – as significantly more American than feminine ones. </p>
<p>Because attaching gender stereotypes to certain traits can be relatively subjective, we also asked our subjects to simply tell us how central they thought masculinity and femininity were to American identity. Sure enough, people thought masculinity was more important than femininity. </p>
<p>Finally, participants listed five people they considered examples of Americans. They could include anyone, from celebrities (Oprah) to historical figures (George Washington) to family members (my dad). The participants were seven times more likely to list a man than a woman.</p>
<p>Building on the results of our first study, we asked participants questions about their identity: how important their gender was to them, and how important they felt it was to be an American. </p>
<p>Their answers revealed that the more men identified with their gender, the more they identified as American. This association wasn’t as strong for women.</p>
<h2>A roadblock to political power</h2>
<p>Our research suggests that group memberships – in this case, gender – play a big role in determining who is viewed as a “true” American. Yes, all citizens technically have equal standing under the law. But because the nation’s identity seems to elevate masculinity, the interests of women – even though they’re numerically equal with men – might not be adequately represented or addressed. </p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/181832/original/file-20170811-14040-bgb9wj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/181832/original/file-20170811-14040-bgb9wj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/181832/original/file-20170811-14040-bgb9wj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=778&fit=crop&dpr=1 600w, https://images.theconversation.com/files/181832/original/file-20170811-14040-bgb9wj.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=778&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/181832/original/file-20170811-14040-bgb9wj.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=778&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/181832/original/file-20170811-14040-bgb9wj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=977&fit=crop&dpr=1 754w, https://images.theconversation.com/files/181832/original/file-20170811-14040-bgb9wj.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=977&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/181832/original/file-20170811-14040-bgb9wj.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=977&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Can patriotism be aligned with femininity?</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/patriotic-woman-holding-american-flag-saluting-484242937?src=L7V-NmT-b3dLtyuCOgNzLA-4-1">Everett Collection</a></span>
</figcaption>
</figure>
<p>And because women identify with the nation less if they think they don’t fit a masculine representation of a U.S. citizen, it also might help explain why <a href="http://onlinelibrary.wiley.com/doi/10.1111/j.0092-5853.2004.00069.x/full">they’re more hesitant to run for political office</a>.</p>
<p>Meanwhile, the country’s preference for masculine traits could explain why the female candidates who do run face an uphill battle. In order to demonstrate patriotism, women might feel the need to act masculine. But this creates a Catch-22, with female candidates <a href="https://www.researchgate.net/profile/Laurie_Rudman/publication/260794203_Reactions_to_vanguards_Advances_in_backlash_theory/links/0a85e5324bfbe463bf000000/Reactions-to-vanguards-Advances-in-backlash-theory.pdf">risking backlash</a> for acting in ways that violate stereotypical expectations. </p>
<h2>Can this change?</h2>
<p>One reason men might be viewed as more American is because <a href="http://psycnet.apa.org/journals/psp/53/3/451/">we see male political leaders representing the country in domestic and foreign affairs</a>. For citizens, this exposure connects “male” with “America.” But if more women appear as representatives of American policy and interests, ideas of national identity might accordingly shift.</p>
<p>Studies have shown that female politicians in the U.S. <a href="https://academic.oup.com/poq/article-abstract/55/2/180/1810869/WOMEN-CANDIDATES-IN-THE-NEWS-AN-EXAMINATION-OF">receive less media coverage</a> than their male counterparts; those that do appear tend to be described and depicted through the lens of <a href="https://www.cambridge.org/core/journals/politics-and-gender/article/gender-candidate-portrayals-and-election-campaigns-a-comparative-perspective/8A5043A6EFB2D46A138874AB77793C22">gender stereotypes</a>: weak and emotional, with an emphasis on their <a href="http://journals.sagepub.com/doi/abs/10.1177/0002764202238491">role as a wife or mother</a> and on their <a href="http://www.tandfonline.com/doi/abs/10.1080/10510970903109904">appearance</a>. Rarely do they appear as independent, strong leaders. </p>
<p>A national ethos that incorporates the positive traits that tend to be associated with each gender could create a stronger society, in which the needs of men and women are voiced, valued and addressed equally. </p>
<p>We’re already starting to see <a href="https://www.buzzfeed.com/rubycramer/emilys-list-expands-after-16000-women-reach-out-about?utm_term=.rbqEzdrdj&bftwnews#.qszE56862">more female candidates throw their hats into the ring</a>. If more win – which will increase the visibility of women in the public sphere – masculinity’s grip on national identity might loosen.</p><img src="https://counter.theconversation.com/content/78435/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>In the first study of the relationship between gender and national identity, the authors wonder if the answer might explain why the country still hasn’t had a female vice president or president.Laura Van Berkel, Postdoctoral Researcher, University of CologneLudwin Molina, Associate Professor of Psychology, University of KansasSahana Mukherjee, Assistant Professor of Psychology, Gettysburg CollegeLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/784392017-07-28T14:38:23Z2017-07-28T14:38:23ZBeing a working mother is not bad for your children<figure><img src="https://images.theconversation.com/files/180196/original/file-20170728-11509-7x6dsi.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption"></span> <span class="attribution"><span class="source">Albina Glisic via Shutterstock</span></span></figcaption></figure><p>The question of whether mothers should work or stay at home in their children’s early years has always been a hot potato in the media, provoking strong emotions and headlines including: <a href="http://www.huffingtonpost.ca/lydia-lovric/working-mothers-childcare_b_7835022.html">Sorry working moms, daycare is bad for your kid</a> or <a href="http://www.telegraph.co.uk/finance/economics/11130051/The-case-for-working-mothers-your-kids-will-be-just-fine.html">The case for working mothers: your kids will be just fine</a>.</p>
<p>The possible benefits and risks of mothers’ working on children’s well-being is highly politicised and is the perennial subject of heated scientific and public debate. As <a href="https://wol.iza.org/key-topics/childcare-policy-and-maternal-employment">policies</a> designed to bring mothers into the workforce are on the increase – and pressure on women from all sides continues to mount – it is important to know how the children of working mothers are actually faring.</p>
<p>Whether mothers decide to stay at home or go back to work after they’ve given birth, how old their child is when they decide to return to work and how many hours they are working are all important factors in the <a href="https://www.jstor.org/stable/23723386?seq=1#page_scan_tab_contents">developmental environment</a>. </p>
<p>By bringing in money and raising the overall <a href="http://onlinelibrary.wiley.com/doi/10.1111/1467-8624.t01-1-00511/abstract">family income</a>, working mothers may be able to provide a more stimulating and safer environment for their children. This isn’t just a matter of more expensive toys or learning material but also better living conditions, better nutrition and reduced <a href="http://onlinelibrary.wiley.com/doi/10.1111/j.1467-8624.1994.tb00768.x/abstract">family stress</a>. </p>
<p>However, long working hours and <a href="http://www.sciencedirect.com/science/article/pii/S0272775712000763">work-related stress</a> could have an impact on the quality and quantity of interactions mothers can have with their children – interactions that are crucial for developing <a href="https://sharpbrains.com/blog/2006/12/18/what-are-cognitive-abilities/">cognitive skills</a> and <a href="http://journals.sagepub.com/doi/abs/10.1177/0956797613488145">language growth</a>.</p>
<h2>A dynamic perspective</h2>
<p>In our recent <a href="https://osf.io/preprints/socarxiv/brscf">study</a> – published in the journal <a href="http://onlinelibrary.wiley.com/doi/10.1111/cdev.12796/abstract">Child Development</a> – we looked at 2,200 children of the <a href="http://growingupinscotland.org.uk/">Growing Up in Scotland study</a>, who were born in 2005/2006 and were followed from roughly 10 months old until around their fifth birthday. The mothers’ employment history and other family characteristics were collected through yearly surveys throughout the first five years of the child’s life. </p>
<p>As a measure of their vocabulary at the age of five, children were asked to name objects from a picture booklet. Reasoning ability at age five was established by asking children to find similarities between a given image and objects displayed in a picture book. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/180197/original/file-20170728-31781-mjnes0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/180197/original/file-20170728-31781-mjnes0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/180197/original/file-20170728-31781-mjnes0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/180197/original/file-20170728-31781-mjnes0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/180197/original/file-20170728-31781-mjnes0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/180197/original/file-20170728-31781-mjnes0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/180197/original/file-20170728-31781-mjnes0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">New research shows that whether or not a woman works in the first five years of her child’s life has no bearing on the development of vocabulary and reasoning.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/child-529603528">Shutterstock</a></span>
</figcaption>
</figure>
<p>Unlike most previous <a href="http://onlinelibrary.wiley.com/doi/10.1111/1467-8624.00457/abstract">research</a> which measured women’s employment at a particular time, for example when their child was a year old, our study captured maternal employment throughout their child’s first five years and the effect this had on the child’s development.</p>
<p>We found that a mother’s employment history doesn’t have a positive or negative <a href="https://osf.io/preprints/socarxiv/brscf">impact</a> (see page 22) on a child’s reasoning ability or vocabulary at five years old. The reason for this is that children’s cognitive and language skills are <a href="https://www.nap.edu/catalog/9824/from-neurons-to-neighborhoods-the-science-of-early-childhood-development">shaped</a> by individual traits and environmental conditions that can change many times throughout childhood. Therefore, development and well-being at a certain age are the result of children’s cumulative experiences over their first few years, not simply a result of a single snapshot moment.</p>
<p>Given that circumstances can change many times over – with mothers going in and out of employment or changes in pay, working hours and conditions – the constantly evolving nature of child development is important to consider when it comes to measuring any effect.</p>
<p>Any impact of a mother’s employment on children’s cognitive skills and language growth, via family income or parent-child interactions, is likely to <a href="http://onlinelibrary.wiley.com/doi/10.1002/9780470147658.chpsy0114/abstract">unfold</a> only if mothers continue to be employed for a longer period of time. Long-term stability in any status may also help families to develop strategies that work for their specific child, whereas frequent changes may be harmful in establishing a <a href="http://onlinelibrary.wiley.com/doi/10.1111/j.1467-8624.2005.00835.x/abstract">routine</a> that works.</p>
<p>Our study advances the existing research by measuring both the complexity of mothers’ work history and their typical employment patterns – distinguishing between full-time employed, part-time employed, or not working, in each year.</p>
<h2>Women making it work</h2>
<p>We did find <a href="https://osf.io/preprints/socarxiv/brscf">small differences</a> (see page 22) in cognitive ability and vocabulary growth between children whose mothers followed different employment patterns. But for the most part, these differences seem to be driven by other characteristics, such as mothers’ education or the number of siblings, which influence a mother’s decision to work in the first five years after birth.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/180201/original/file-20170728-30401-1vjpd8n.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/180201/original/file-20170728-30401-1vjpd8n.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/180201/original/file-20170728-30401-1vjpd8n.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/180201/original/file-20170728-30401-1vjpd8n.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/180201/original/file-20170728-30401-1vjpd8n.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/180201/original/file-20170728-30401-1vjpd8n.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/180201/original/file-20170728-30401-1vjpd8n.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Women go to great lengths to ensure they combine their careers with their children’s developmental needs.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/670592491?size=huge_jpg&src=lb-59856941&sort=newestFirst&offset=1">Shutterstock</a></span>
</figcaption>
</figure>
<p>In other words, children with similar family characteristics develop comparable cognitive and vocabulary abilities even if their mothers’ work histories differ vastly in the first five years after birth.</p>
<p>Both the exaggerated claims of benefits and the harmful effects of working mothers on their children are not supported by our research, at least when it comes to early language acquisition and reasoning ability. We found that mothers manage to combine their careers with careful consideration of their children’s development – and that being in employment itself is not a major driver of differences in children’s outcomes.</p>
<p>From a policy perspective, these results support the role of initiatives that aim to raise the rates of mothers in work, such as the plan to increase provision of free early learning and childcare to 1,140 hours by 2020 in <a href="https://news.gov.scot/speeches-and-briefings/ministerial-statement-expansion-of-free-early-learning-and-childcare">Scotland</a>. </p>
<p>All policies that enable women to choose whether they go back into work or not should be encouraged. However, it’s the ability to make choices that work for the individual that matter – pressure on women one way or the other is not going to improve the development of their children.</p><img src="https://counter.theconversation.com/content/78439/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>When it comes to children’s well-being and development, it’s not whether a woman works or not that matters but how she makes her choices work for her family.Markus Klein, Lecturer in Human Development and Education Policy, University of Strathclyde Michael Kühhirt, Lecturer in Sociology, University of CologneLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/761932017-04-27T06:38:30Z2017-04-27T06:38:30ZStudy: mothers are less wealthy than women without children<figure><img src="https://images.theconversation.com/files/165636/original/image-20170418-32696-1pk9dmj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Having children can drastically change women's economic and financial status.</span> <span class="attribution"><a class="source" href="https://pixabay.com/de/familie-f%C3%BC%C3%9Fe-closeup-blau-baby-boy-1966496/">kathrinpie/pixabay</a></span></figcaption></figure><p>The direct and indirect costs of having children can be high and, in <a href="http://www.jstor.org/stable/20616467?seq=1#page_scan_tab_contents">many societies</a>, women most often <a href="http://www.asanet.org/sites/default/files/savvy/images/members/docs/pdf/featured/motherwage.pdf">shoulder these costs</a>. </p>
<p>In a <a href="https://doi.org/10.1093/esr/jcx046">recent research</a> study, we measured the gender-specific economic impact of parenthood in Germany. Our finding: mothers may end up with less accrued wealth than women without children.</p>
<p>German men, who are comparable in other characteristics such as education and age, on the other hand, show <a href="https://doi.org/10.1093/esr/jcx046">similar amounts of personal wealth</a> regardless of whether they have children. </p>
<h2>Mothers accrue less wealth</h2>
<p>The research, which was conducted in Germany, looked at 28,650 individuals to assess women’s personal wealth over the course of a decade, from 2002 to 2012. For the purposes of our study, personal wealth refers to all economic assets that subjects own solely as well as their individual share of assets jointly owned with somebody else.</p>
<p>We found that each year after a woman’s first child is born, she accrues only about 98 cents for each €1 of wealth that childless women gain. This small difference adds up over time. After being a mother for 50 years, a mother’s personal wealth is roughly 60% lower than for a German woman who does not have children, everything else remaining equal.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/165626/original/image-20170418-32716-1pyl13a.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/165626/original/image-20170418-32716-1pyl13a.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=460&fit=crop&dpr=1 600w, https://images.theconversation.com/files/165626/original/image-20170418-32716-1pyl13a.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=460&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/165626/original/image-20170418-32716-1pyl13a.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=460&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/165626/original/image-20170418-32716-1pyl13a.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=578&fit=crop&dpr=1 754w, https://images.theconversation.com/files/165626/original/image-20170418-32716-1pyl13a.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=578&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/165626/original/image-20170418-32716-1pyl13a.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=578&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Graph showing gender gap in wealth after parenthood.</span>
<span class="attribution"><span class="source">Lersch/Jacob/Hank</span></span>
</figcaption>
</figure>
<p>This gap in capital is largely related to employment. German mothers accumulate less wealth because they are likely to <a href="https://doi.org/10.1093/esr/jcv015">stop paid work to care for their young children</a> and, as children get older, <a href="http://www.oecd-ilibrary.org/docserver/download/0116011ec013.pdf?expires=1492503434&id=id&accname=ocid41021573&checksum=4DD8ED23BAB98F3527AF0BB0F80F1A4B">return to work part-time</a>. </p>
<p>Without full-time employment, women have less income to put into savings. Employment gaps may also reduce long-term earning potential because <a href="https://doi.org/10.1177/0003122414545986">career advancement becomes less likely</a>. </p>
<p>According to our study, women’s male partners do not appear to fully compensate for these losses in wealth by sharing financial resources within the couple. </p>
<p>The loss in personal wealth is <a href="https://doi.org/10.1093/esr/jcx046">greater</a> the younger a woman is when she becomes a mother. The difference may be due to the fact that career interruptions early in one’s working life are especially harmful.</p>
<p>Mothers additionally accrue less wealth if they are unmarried when they give birth; a difference that holds for both single mothers and those living with their partners. This finding suggests that married fathers may be <a href="http://faculty-staff.ou.edu/A/Kermyt.G.Anderson-1/papers/Hofferth_Anderson_JMF2003.pdf">more willing to compensate</a> for their spouses’ income losses, and that married mothers and fathers are more likely to <a href="http://onlinelibrary.wiley.com/doi/10.1111/j.1741-3737.2011.00836.x/full">share their incomes</a>.</p>
<p>By middle life (ages 40 to 60), mothers and fathers show the greatest discrepancy in wealth (see above graph). By older age, these inequalities decrease.</p>
<h2>Why wealth differences matter</h2>
<p>The reduced wealth of mothers as compared to fathers and to women without children has many important implications. </p>
<p>Financial assets and savings are resources that can be tapped to weather rainy days, independent of current income. Wealth can also be passed on to the next generation or invested in education and, thereby, affect the well-being of children.</p>
<p>For a woman living with a more wealthy partner, having little wealth may seem less important. But, as we know, couples <a href="https://www.econstor.eu/bitstream/10419/90067/1/dp7637.pdf">do not always fully share</a> their wealth. </p>
<p>And, in any case, <a href="https://osf.io/preprints/socarxiv/yqgdm/">inequalities in personal wealth within the same household</a> also hurt women. <a href="https://osf.io/rmu5p/">German women reported lower subjective well-being</a> if they had less wealth than their partners, and studies from Ecuador and Ghana have shown that the <a href="http://genderassetgap.org/sites/default/files/women%27swealthandintimate.pdf">risk of intimate partner violence increases</a> when women’s personal capital is less than that of their partners. Although we do not know whether those findings would apply in Germany or other countries. </p>
<p>Finally, economic inequality between mothers and fathers can affect children. When mothers have relatively more resources, the <a href="https://notendur.hi.is/helgakr/micro/R_Lundberg_Pollak_Wales_1997_JHR_Do_husbands_and_wives_pool_their_resources.pdf">well-being of children is improved</a>. If couples separate, gender inequalities within couples may ultimately contribute to inequalities between ex-partners.</p>
<h2>International differences</h2>
<p><a href="https://doi.org/10.1093/esr/jcx046">Our research</a> examined the wealth consequences of parenthood in Germany, where women have achieved equal status compared to men in many respects. Nonetheless, a <a href="https://doi.org/10.1093/esr/jcv015">traditional division of labour</a>, where men are the main breadwinners, still dominates here. </p>
<p>Other research, though based on less adequate data, has also found a wealth gap between genders in the <a href="http://www.soc.duke.edu/%7Elkeister/singlefemalesandwealth.pdf">United States</a>. Complementary evidence on income inequalities between mothers and fathers have additionally been found in many countries around the world, including <a href="https://doi.org/10.1093/cje/bes044">China</a>, <a href="https://doi.org/10.1093/esr/jcl029">Japan</a>, <a href="http://www.mcser.org/journal/index.php/mjss/article/viewFile/208/193">Nigeria</a> and the <a href="https://doi.org/10.1093/cje/23.5.543">United Kingdom</a>. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/166845/original/file-20170426-2822-acq5z9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/166845/original/file-20170426-2822-acq5z9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=402&fit=crop&dpr=1 600w, https://images.theconversation.com/files/166845/original/file-20170426-2822-acq5z9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=402&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/166845/original/file-20170426-2822-acq5z9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=402&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/166845/original/file-20170426-2822-acq5z9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=505&fit=crop&dpr=1 754w, https://images.theconversation.com/files/166845/original/file-20170426-2822-acq5z9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=505&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/166845/original/file-20170426-2822-acq5z9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=505&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">A mother’s wealth decreases further in countries that have greater gender inequality.</span>
<span class="attribution"><a class="source" href="https://pixabay.com/fr/birmanie-de-l-homme-bagan-femme-636373/">Schmid-Reportagen/Pixabay</a></span>
</figcaption>
</figure>
<p>Gender-based wealth inequality as a result of parenthood may be weaker in more egalitarian societies, <a href="http://www.jstor.org/stable/10.1086/588485?seq=1#page_scan_tab_contents">such as Sweden</a>. </p>
<p>Wealth inequalities between mothers and fathers – and, more generally, between women and men, even within married couples – are stronger in countries in which women and men do not have equal legal status. </p>
<p>In Ghana, for example, where women’s contributions to marital assets are not recognised, married women own only <a href="http://genderassetgap.org/sites/default/files/property%20rights%20and%20the%20gender%20distrubution">about 20% of household assets</a>. Similar inequality exists in some parts of <a href="http://genderassetgap.org/sites/default/files/property%20rights%20and%20the%20gender%20distrubution">India</a>. </p>
<p>By contrast, <a href="http://genderassetgap.org/sites/default/files/property%20rights%20and%20the%20gender%20distrubution">in Ecuador</a>, where women’s legal status is more equal to men’s, wealth inequalities within married couples are negligible.</p>
<h2>Economic well-being of women and men</h2>
<p>The finding that, in relatively gender-equal Germany, women end up with less personal wealth after becoming mothers as compared to both childless women and to men suggests the need for a proactive government response.</p>
<p>Currently, ambiguous policies continue to <a href="https://academic.oup.com/esr/article-lookup/doi/10.1093/esr/jcv015">hinder female employment</a>. One approach for tackling mothers’ economic disadvantages is to encourage maternal full-time employment, for instance, by providing better access to childcare. </p>
<p>Recent policy <a href="http://ec.europa.eu/social/main.jsp?langId=en&catId=1135&newsId=2737&furtherNews=yes">reforms in Germany</a> toward this goal may decrease disadvantages in the future. But wealth accumulation is a slow process, and these changes will take time to have any effect. </p>
<p>In the meantime, mothers will continue to struggle to save up for that rainy day.</p><img src="https://counter.theconversation.com/content/76193/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Philipp M. Lersch receives funding from the German Research Foundation (DFG). </span></em></p>The economic costs of having children are more often shouldered by women, so mothers tend to accumulate less capital over time.Philipp M. Lersch, Postdoctoral Researcher in Sociology, University of CologneLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/725552017-02-14T02:16:07Z2017-02-14T02:16:07ZWhy you should donate your data (as well as your organs) when you die<figure><img src="https://images.theconversation.com/files/156417/original/image-20170210-23328-116jk5h.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">There's more you could donate besides blood, organs and tissue.</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/pulmonary_pathology/5613144555/in/photolist-9y1Qjp-3PK6Rd-bRGom4-r2FB5B-qKpPwe-7JPvZS-y5njxP-rZfQZJ-gVcmAW-oAPbZJ-kzDwqt-a3qrXQ-7qzoQT-5ZcEji-5ZgLqb-7cYqsF-jpKdRE-giYGjX-7RQTLk-gj6ncf-bZgHXb-5ZcB9R-7qznRa-p57MjY-brqv5i-gj7brK-bEM4i-kudxg6-pq4b4w-gj6Lds-2BdCgE-Dh5Z6c-5oiRLb-afVUQ-6f1tbu-45NJoy-5ZgQN1-5ZgR61-5ZgMG9-5ZgNdJ-5Zczxx-c7Zyy5-5ZgQsd-5ZcyY8-fqi5rK-5ZgLWw-5ZcBp2-5ZcASp-5ZcAja-5ZcDJB">Cropped from pulmonary_pathology/flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span></figcaption></figure><p>Most people are aware they can donate their organs when they die. Doing so is very important: <a href="http://www.bmj.com/content/351/bmj.h6244">Each deceased donor can save several lives</a> if he donates his organs and tissue and they are used for transplantation. <a href="https://smw.ch/en/archives/article/?tx_ezmjournal_articledetail%5Bidentifier%5D=smw.2017.14401&tx_ezmjournal_articledetail%5Blist%5D=1">Support for organ donation</a> among members of the public is very high – <a href="http://journals.lww.com/transplantjournal/Fulltext/2015/07000/Factors_Affecting_the_Decision_to_Grant_Consent.19.aspx">at over 80 percent in some countries</a>, even if many people have not yet gotten around to registering as an organ donor. </p>
<p>But organs aren’t the only thing that you can donate once you’re dead. <a href="http://www.onlinelibrary.wiley.com/doi/10.15252/embr.201541802/abstract">What about donating your medical data?</a></p>
<p>Data might not seem important in the way that organs are. People need organs just to stay alive, or to avoid being on dialysis for several hours a day. But medical data are also very valuable – even if they are not going to save someone’s life immediately. Why? Because medical research cannot take place without medical data, and the sad fact is that most people’s medical data are inaccessible for research once they are dead. </p>
<p>For example, working in shifts can be disruptive to one’s circadian rhythms. This <a href="http://monographs.iarc.fr/ENG/Monographs/vol98/mono98.pdf">is now thought by some to probably cause cancer</a>. A large cohort study involving tens or hundreds of thousands of individuals could help us to investigate different aspects of shift work, including chronobiology, sleep impairment, cancer biology and premature aging. The results of such research could be very important for cancer prevention. However, any such study could currently be hamstrung by the inability to access and analyze participants’ data after they die. </p>
<h2>Data rights</h2>
<p>While alive, people have certain rights that allow them to control what happens to data concerning them. For example, you can control whether your phone number and address are publicly available, request copies of data held on you by any public bodies and control what Facebook displays about you. When you are dead you will no longer be able to do any of these things, and control of your digital identity after death is a controversial topic. For example, families often cannot access deceased relative’s iTunes purchases, or access the dead person’s Facebook page to indicate that he or she is now deceased. </p>
<p>When it comes to medical records, things become even more complicated. While alive, many people give their consent to participate in medical research, whether it’s a clinical trial of a new drug or a longitudinal study based on medical records. Without their informed consent, such research cannot normally take place. Medical confidentiality is rightly regarded as extremely important, and it can be suspended only with patient consent. </p>
<p>In most jurisdictions, the same applies once persons are dead – with the added problem that consent cannot be obtained from them at that point. </p>
<p>But it would be a serious mistake to assume that everyone wants such strict data confidentiality to persist after death. Just as in life, some people would provide their data for medical research in order to develop new treatments that could help save people’s lives. </p>
<p>Recognizing this fact, some countries do allow researchers to use deceased person’s data. In the United Kingdom, medical records remain confidential for a century after a patient’s death, but permission can be sought from the Public Records Office to <a href="https://www.mrc.ac.uk/documents/pdf/personal-information-in-medical-research">use data from deceased persons in research</a>. </p>
<p>However, the U.K. has one of the most permissive systems in the world regarding use of data after death. In contrast, German researchers face considerable hurdles. First, they must use prove that the individual’s right to privacy is less important than the potential benefit to society from the research – a difficult thing to prove given that no researcher knows until the study is conducted what the benefit will be. Second, they have to use anonymized data if at all possible; this means that lots of valuable background data about patients might not be available because any potential identifiers are removed. Third, researchers have to prove there is no other way to answer the research question. And fourth, they have to prove that the person could not be asked for consent.</p>
<p>In the United States, researchers are encouraged to share data by the <a href="https://en.wikipedia.org/wiki/America_COMPETES_Act">America COMPETES Act</a>. However, this law relates to data already in use by researchers, rather than than enabling access to the medical records of deceased individuals, which normally remain confidential after death.</p>
<h2>Our proposal</h2>
<p>These are massive hurdles for researchers to deal with. Even if they can overcome all of them, doing so wastes both time and money. Wouldn’t it be a lot easier if people could sign up to be data donors the same way that they can register as organ donors? That way, consent would exist for researchers to use data posthumously. Sadly, systems are not really in place to do this in any country that we are aware of. </p>
<p>As researchers in medicine and ethics, we have found the rules governing data sharing in several countries to be inadequate. We think countries should create national databases of data donors, which could be used both for living patients to control how their medical data are used and shared, and for them to indicate whether they wish to continue sharing data after death. </p>
<p>People should be able to indicate which type of projects they wish to share data with, which parts of their medical records they are happy to share and whether they are willing to share data in a nonanonymized manner. They should also be able to give “broad consent” to future use of data if they wish. </p>
<p>Data donation after death should be discussed to avoid data dying along with patients, in turn leading to other deaths by setting back medical science.</p><img src="https://counter.theconversation.com/content/72555/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Most people know they can donate their organs after they pass away. But what about their medical data? For National Donor Day, we suggest countries create national databases of data donors.David Martin Shaw, Bioethicist, Department of Health Ethics and Society, Maastricht University and Institute for Biomedical Ethics, University of BaselJ. Valérie Gross, Physician, Research Associate, University of CologneThomas C. Erren, Professor, University of CologneLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/581052016-04-21T07:35:35Z2016-04-21T07:35:35ZParis climate deal signing ceremony: what it means and why it matters<p>The world took a collective sigh of relief in the last days of 2015, when countries came together to adopt the historic <a href="http://unfccc.int/paris_agreement/items/9485.php">Paris agreement</a> on climate change.</p>
<p>The international treaty was a much-needed victory for multilateralism, and surprised many with its more-ambitious-than-expected agreement to pursue efforts to limit global warming to 1.5°C.</p>
<p>The next step in bringing the agreement into effect happens in <a href="http://unfccc.int/paris_agreement/items/9511.php">New York on Friday 22 April</a>, with leaders and dignitaries from more than 150 countries attending a high-level ceremony at the United Nations to officially sign it.</p>
<p>The New York event will be an important barometer of political momentum leading into the implementation phase – one that requires domestic climate policies to be drawn up, as well as further international negotiations.</p>
<p>It comes a week after scientists took a significant step to assist with the process. On April 13 in Nairobi, the Intergovernmental Panel on Climate Change <a href="http://www.ipcc.ch/news_and_events/pdf/press/160414_pr_p43.pdf">agreed</a> to prepare a special report on the impacts of global warming of 1.5°C above pre-industrial levels. This will provide scientific guidance on the level of ambition and action needed to implement the Paris agreement.</p>
<h2>Why the ceremony?</h2>
<p>The signing ceremony in New York sets in motion the formal, legal processes required for the Paris Agreement to “enter into force”, so that it can become legally binding under international law.</p>
<p>Although the agreement was adopted on December 12 2015 in Paris, it has not yet entered into force. This will happen automatically 30 days after it has both been ratified by at least 55 countries, and by countries representing at least 55% of global greenhouse gas emissions. Both conditions of this threshold have to be met before the agreement is legally binding.</p>
<p>So, contrary to some <a href="http://www.businessgreen.com/bg/feature/2441333/-the-hard-work-starts-now-the-paris-agreement-one-month-on">concerns</a> after Paris, the world does not have to wait until 2020 for the agreement to enter into force. It could happen as early as this year.</p>
<h2>Signing vs ratification</h2>
<p>When a country signs the agreement, it is obliged to refrain from acts that would defeat its object and purpose. The next step, ratification, signifies intent to be legally bound by the terms of the treaty.</p>
<p>The decision on timing for ratification by each country will largely be determined by domestic political circumstances and legislative requirements for international agreements. </p>
<p>Those countries that have already completed their domestic processes for international agreements can choose to sign and ratify on the same day in New York.</p>
<h2>Who is going to sign and ratify in New York?</h2>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/119527/original/image-20160420-25615-3dqt0v.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/119527/original/image-20160420-25615-3dqt0v.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/119527/original/image-20160420-25615-3dqt0v.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=904&fit=crop&dpr=1 600w, https://images.theconversation.com/files/119527/original/image-20160420-25615-3dqt0v.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=904&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/119527/original/image-20160420-25615-3dqt0v.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=904&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/119527/original/image-20160420-25615-3dqt0v.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1136&fit=crop&dpr=1 754w, https://images.theconversation.com/files/119527/original/image-20160420-25615-3dqt0v.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1136&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/119527/original/image-20160420-25615-3dqt0v.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1136&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Early adopter: the Maldives.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/nattu/3330157153">Nattu</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<p>It is perhaps no surprise that the countries which are particularly vulnerable to the impacts of climate change and who championed the need for high ambition in Paris will be first out of the gate to ratify in New York.</p>
<p>Thirteen <a href="http://unohrlls.org/about-sids/">Small Island Developing States (SIDS)</a> from the Caribbean, Indian Ocean and Pacific have signalled their intent to sign and ratify in New York: Barbados, Belize, Fiji, Grenada, Maldives, Marshall Islands, Nauru, Palau, Samoa, Saint Lucia, St Vincent and the Grenadines, the Seychelles and Tuvalu. </p>
<p>While these countries make up about a quarter of the 55 countries needed, they only account for 0.02% of the emissions that count towards the required 55% global emissions total.</p>
<h2>Bringing the big emitters on board</h2>
<p>China and the United States have recently <a href="http://www.nytimes.com/2016/04/01/world/asia/obama-and-president-xi-of-china-vow-to-sign-paris-climate-accord-promptly.html?_r=0">jointly announced</a> their intentions to sign in New York and to take the necessary domestic steps to formally join the agreement by ratifying it later this year. Given that they make up nearly <a href="http://unfccc.int/ghg_data/items/9354.php">40%</a> of the agreed set of global emissions for entry into force, that will go a significant way to meeting the 55% threshold.</p>
<p>We can expect more announcements of intended ratification schedules on 22 April. Canada (1.95%) has <a href="http://www.theguardian.com/environment/2016/apr/19/justin-trudeau-to-lobby-for-quick-approval-of-paris-climate-deal">signalled</a> its intent to ratify this year and there are early signs for many others. Unfortunately the European Union, long a leader on climate change, <a href="http://www.eenews.net/stories/1060035780">seems unlikely</a> to be amongst the first movers due to internal political difficulties, including the intransigence of the Polish government. </p>
<p>The double threshold means that even if all of the SIDS and <a href="http://unohrlls.org/about-ldcs/">Least Developed Countries</a> (LDCs) ratified, accounting for more than 75 countries but only around 4% of global emissions, the agreement would not enter into force until countries with a further 51% of global emissions also ratified.</p>
<p>Consequently, many more of the large emitters will need to ratify to ensure that the Paris agreement enters into force. This was a key design feature – it means a small number of major emitters cannot force a binding agreement on the rest of the world, and a large number of smaller countries cannot force a binding agreement on the major emitters.</p>
<p>The 55% threshold was set in order to ensure that it would be hard for a blocking coalition to form – a group of countries whose failure to ratify could ensure that an emissions threshold could not be met in practice. A number much above 60% of global emissions could indeed have led to such a situation.</p>
<p>The countries that appear likely to ratify this year, including China, the USA, Canada, many SIDS and LDCs, members of the <a href="http://www.thecvf.org/">Climate Vulnerable Forum</a> along with several Latin American and African countries – around 90 in all – still fall about 5-6% short of the 55% emissions threshold.</p>
<p>It will take one more large emitter, such as the Russian Federation (7.53%), or two such as India (4.10%) and Japan (3.79%) to get the agreement over the line. The intent of these countries is not yet known.</p>
<h2>Why is early action important?</h2>
<p>The Paris agreement may be ambitious, but it will only be as good as its implementation. That will depend on the political momentum gained in Paris being maintained. Early entry into force for the treaty would be a powerful signal in this direction.</p>
<p>We know from the <a href="http://climateactiontracker.org/">Climate Action Tracker analyses</a> that the present commitments are far from adequate. If all countries fully implement the national emission reduction targets brought to the climate negotiations last year, we are still on track for temperature increases of around 2.7°C. Worse, we also know that current policies adopted by countries are insufficient to meet these targets <a href="http://climateactiontracker.org/">and are heading to around 3.6°C</a> of global warming.</p>
<p>With average global annual temperature increase <a href="http://climateanalytics.org/hot-topics/global-warming-reaches-1c-above-preindustrial-warmest-in-more-than-11000-years">tipping over 1°C</a> above pre-industrial levels for the first time last year, it is clear that action to reduce emissions has never been more urgent. </p>
<p>We are already seeing more evidence this year: increases in <a href="http://www.noaa.gov/11th-straight-month-globe-was-record-warm">the monthly global averages of February and March 2016 far exceeded 1°C</a>, record <a href="http://www.smh.com.au/environment/climate-change/the-great-barrier-reef--93-hit-by-coral-bleaching-surveys-reveal-20160419-goa6jw">coral reef bleaching</a>, heatwaves, and unprecedented <a href="http://www.climatecentral.org/news/greenlands-melt-season-started-nearly-two-months-early-20237">early melting of the Greenland ice sheet this northern spring</a>.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/119529/original/image-20160420-25621-iwliqr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/119529/original/image-20160420-25621-iwliqr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/119529/original/image-20160420-25621-iwliqr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=454&fit=crop&dpr=1 600w, https://images.theconversation.com/files/119529/original/image-20160420-25621-iwliqr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=454&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/119529/original/image-20160420-25621-iwliqr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=454&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/119529/original/image-20160420-25621-iwliqr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=571&fit=crop&dpr=1 754w, https://images.theconversation.com/files/119529/original/image-20160420-25621-iwliqr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=571&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/119529/original/image-20160420-25621-iwliqr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=571&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Huge swathes of the Great Barrier Reef have suffered coral bleaching in 2016.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/oregonstateuniversity/24577819729/in/photolist-DrRKwz-fbVfp6-8EqTPR-7WZuVs-du9G6x-bzDCgU-7s2jDE-7WWjZF-8vQ8vf-7WWk8K-ci9WoS-pyjVnG-fkRkgj-7WZy2w-7WWgtr-dufkmC-7WZBbh-nA8vHF-di3w7r-67gUD-gG5VM5-67gSh-8g1Zq5-8fXHy6-pykqn8-8QHvPH-q82zTg-du9Jdz-5ESE7-7WWjCg-pyfrJ3-neu3pL-fuYQ2q-fuYPXh-iyXXMh-AuYDX1-fuJwVz-7qLU1m-9qBu39-fuJwRz-FJ4T3y-ASnyzH-xJ6DnL-EWNGrW-Fs8wLC-FLoCAX-FPXsGE-FSfgsD-FLo4k8-FSfjM4">University of Oregon</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span>
</figcaption>
</figure>
<p>Early entry into force will unlock the legally binding rights and obligations for parties to the agreement. These go beyond just obligations aimed at delivering emissions reductions through countries’ <a href="http://unfccc.int/focus/indc_portal/items/8766.php">Nationally Determined Contributions</a> to the critical issues of, for example, adaptation, climate finance, <a href="https://theconversation.com/rich-and-poor-countries-face-off-over-loss-and-damage-caused-by-climate-change-51841">loss and damage</a>, and transparency in reporting on and reviewing action and support.</p>
<p>The events in New York this week symbolise the collective realisation that rapid, transformative action is required to decarbonise the global economy by 2050. </p>
<p>Climate science tells us that action must increase significantly within the next decade if we are to rein in the devastating impacts of climate change, which the most vulnerable countries are already acutely experiencing.</p>
<p><em>For an up-to-date picture of which countries have ratified the Paris Agreement, see <a href="http://climateanalytics.org/hot-topics/ratification-tracker">our Ratification Tracker</a>.</em></p><img src="https://counter.theconversation.com/content/58105/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Damon Jones works for Climate Analytics, a non profit science based institute with headquarters in Berlin. Climate Analytics has received research grants, Foundation and German Government International Climate Initiative funding for research and activities related to this article. </span></em></p><p class="fine-print"><em><span>Bill Hare works for and owns shares in Climate Analytics, a non profit science based institute with headquarters in Berlin. Potsdam Institute for Climate Impact Research (PIK) and Climate Analytics have received research grants, Foundation and German Government International Climate Initiative funding for research and activities related to this article.</span></em></p>The signing of the Paris agreement is the first step towards making it a reality.Damon Jones, Lecturer, University of CologneBill Hare, Visiting scientist, Potsdam Institute for Climate Impact ResearchLicensed as Creative Commons – attribution, no derivatives.