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VR in pain management, and mental health treatment Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link The potential of virtual reality (VR) in healthcare Last updated: 27/03/25, 15:44 Published: 06/03/25, 08:00 VR in pain management, and mental health treatment Introduction The term 'extended reality' (XR) consists of three concepts: augmented reality, mixed reality and virtual reality (VR). The Oxford English Dictionary defines VR as a 'computer-generated simulation of a lifelike environment that a person can interact with in a seemingly real or physical way'. When you think of VR, you might think of headsets, goggles and gaming. However, you might not know that VR can have huge potential in healthcare as a non-pharmacological intervention. Research has shown that active VR, where patients interact and engage more with the virtual environment, becoming immersed, works better than passive VR, where patients just view content. In this article, I will look at the use of VR in two cases: for pain management and mental health treatment. VR for pain management VR-based treatments for pain management work by attention modulation, also known as focus-shifting, providing distraction analgesia (pain relief) by shifting a patient’s focus away from the pain to the virtual environment. To access the VR set-up, patients use a head-mounted display (HMD) and hardware. VR uses technology that stimulates the senses, particularly sight, sound, and touch, reducing the amount of pain a patient feels by changing the pain intensity; it is especially useful when a patient experiences sharp and sudden pain, including pain during labour or post-surgery. Additionally, VR changes how the brain processes pain by affecting the pain-control system, which includes regions like the periaqueductal grey (PAG) and the anterior cingulate cortex (ACC). Specifically for chronic pain (persistent pain that lasts for more than three months), VR can help patients develop techniques to manage their pain better over time, such as by improving their physical abilities, like moving their arms or legs more easily and improving their muscular endurance. For example, Merlot et al. (2023) found that for women with endometriosis-related pelvic pain who used Endocare (a VR software designed to reduce pain for those with endometriosis), women reported that it reduced pain intensity, with Endocare's maximum pain reduction being 51.58% compared to 27.37% in the sham control group. VR for mental health treatment VR-based treatments have also proven to be effective in treating mental health conditions, helping patients to manage conditions such as anxiety and depression. This is because they can replicate a negative environment within a controlled and safe VR setting, helping patients manage and confront their triggers. The Institute for Health Metrics and Evaluation has stated that as of 2019, 301 million people were living with an anxiety disorder, and 58 million of them (about 20% of those with anxiety) were children and adolescents. Regarding depression, the statistic was 280 million people, including 23 million (nearly 10% of those with anxiety) children and adolescents. For anxiety, VR-based treatments use exposure treatment, where patients are confronted with the stimuli, but the expected outcome does not occur. Repeating the exposure leads to patients’ anxiety decreasing over time since their perception of the stimuli leading to the feared outcome does not come true. For example, someone with a fear of heights would undergo VR-based exposure treatment where they would be exposed to heights. They would be guided through a learning process, and after multiple exposures, they would think of heights as being safe, leading to less fear of heights overall. For depression, VR-based treatments use behavioural activation so that individuals can reconnect with activities they enjoy. This can help patients develop and learn coping strategies, improving their mood and reducing depressive symptoms. VR-based treatments will be particularly helpful for children and adolescents. The statistics by the Institute for Health Metrics and Evaluation clearly show that a high percentage of those with mental health conditions are young people, and general research has shown that they will be less likely to seek professional help and receive appropriate care. VR could help this group by becoming a more appealing therapy method, especially through gamification, making children and adolescents more motivated and more likely to participate in treatment. This method would provide an immersive environment and could be a personalised form of therapy. Implications for the future It is important to note that there are still limitations stopping a wider roll-out of VR within healthcare. For example, VR can cause cybersickness, the virtual equivalent of motion sickness, resulting in nausea, disorientation, and headaches. In addition, within the use of VR for young people, more research needs to be conducted on whether gamified therapies are safe and effective. Nevertheless, these limitations can be mitigated. Technology is advancing rapidly, and newer hardware have a better field of vision and refresh rates of visual content. The VR environment is also being designed better, accounting for individual patient preferences. With further research, scientists can examine in more detail the factors that make VR-based therapies effective and implement them in a way that addresses ethical concerns and increases their effectiveness. Written by Naoshin Haque Related articles: Clinical scientist computing / Smart bandages / Emojis in healthcare Project Gallery

Behaviours in birds, mammals, and invertebrates Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link Same-sex attraction in non-human animals Last updated: 17/06/25, 11:20 Published: 11/09/25, 07:00 Behaviours in birds, mammals, and invertebrates Biased science communication can have detrimental consequences. For example, facts about animal reproduction have been twisted to justify discrimination against the LGBTQIA+ community. Some people call homosexuality a “Darwinian paradox”, because it does not fit their preconceived belief that an animal’s job is to stay alive and make babies. This belief ignores how some animals, like humans, have complex social structures and do things just for fun. Same-sex sexual behaviours (SSSB) have been observed in 1500 animal species, none of whom do it to make babies. This article describes some of these behaviours in birds, mammals, and invertebrates. Same-sex sexual behaviour (SSSB) in birds The first recorded example of SSSB in non-human animals comes from Aristotle about 2300 years ago. He wrote about male pigeons, partridges, and quails mating with other male conspecifics. Since then, same-sex relationships have been recorded in other bird species. Greylag geese form “gander pairs” of two males, whose behaviours resemble pairs of opposite-sex mates. In Oahu, Hawaii, female-female Laysan albatross pairs looked after 31% of nests between 2004 and 2007. These pairs, one of which is pictured in Figure 1 , were equally good at raising chicks as male-female pairs. SSSB was also observed in unbonded king penguins, meaning penguins which had not committed to a mate for that breeding season. Using DNA to assess individual sex, 26.4% of courtship displays between unbonded king penguin couples were same-sex. There was also one male-male and one female-female pair of bonded king penguins, but both couples broke up and re-bonded with opposite-sex mates in the same season. The most famous same-sex bird couple is Roy and Silo from Central Park Zoo. They were a pair of chinstrap penguins who raised a chick named Tango when given a fertile egg. This family was the subject of a children’s book ( Figure 2 ) and an American culture war. Thus, many bird species pair with individuals of the same sex in captivity and more importantly, in the wild. SSSB in mammals Humans are not the only mammals to mate with individuals of the same sex. Male bats from the Myotis genus have been observed getting intimate with each other, and Mytois lucifugus releases sperm during this activity. In another bat species called the Bonin flying fox, males groomed each other in a way scientists perceived as sexual. Japanese macaques have monogamous female-female pairs called consortships, in which females carry out the same mating behaviours seen with male-female pairs. SSSB in insects In addition to birds and mammals, some insects conduct sexual activities to others of the same sex. In a 2012 study, 16% of male field crickets did courtship displays to and/or tried to mate with another male. The authors conducted experiments to rule out some leading Darwinian causes of SSSB, such as establishing dominance relationships (similar to an ‘alpha male’) or defusing hostile encounters. SSSB is well studied in flour beetles, where the males mount other males and release capsules of sperm like they would to females. In these beetles, the sexes are sexually dimorphic - distinguishable by appearance, smell, and/or sound - so a male beetle is intentionally choosing to mate with another male. When 59 male damselflies were offered a male and female in the same cage, 10 approached and began mating with the male. More damselflies chose the male over the female after spending a few days in a male-only population, perhaps because they were used to only having males to choose from. Therefore, analogies to both homoromantic and homosexual partnerships in humans exist in insects. Conclusion Since mammals, birds, insects, and molluscs all have evidence of SSSB in the wild, it is normal and certainly not unnatural for humans to do the same. These behaviours range from preferentially approaching the same sex to intentional, intimate actions. All the papers I used in this article are over a decade old, with the earliest evidence of non-human same-sex behaviour being 2300 years old. This means using biology to justify homophobia is very outdated, and factually incorrect. Written by Simran Patel REFERENCES Young LC, Zaun BJ, VanderWerf EA. Successful same-sex pairing in Laysan albatross. Biol Lett [Internet]. 2008 Aug 23 [cited 2025 Feb 1];4(4):323–5. Available from: https://royalsocietypublishing.org/doi/10.1098/rsbl.2008.0191 Richardson J, Parnell P, Cole H. And Tango makes three. First Little Simon board book edition. New York: Little Simon; 2015. 1 p. Sugita N. Homosexual Fellatio: Erect Penis Licking between Male Bonin Flying Foxes Pteropus pselaphon . Pellis S, editor. PLoS ONE [Internet]. 2016 Nov 8 [cited 2025 Feb 1];11(11):e0166024. Available from: https://dx.plos.org/10.1371/journal.pone.0166024 Bailey NW, French N. Same-sex sexual behaviour and mistaken identity in male field crickets, Teleogryllus oceanicus . Animal Behaviour [Internet]. 2012 Oct [cited 2025 Feb 1];84(4):1031–8. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0003347212003508 Huber R, Martys M. Male-male pairs in Greylag Geese ( Anser anser ). J Ornithol [Internet]. 1993 Apr [cited 2025 Feb 1];134(2):155–64. Available from: https://link.springer.com/10.1007/BF01640084 Levan KE, Fedina TY, Lewis SM. Testing multiple hypotheses for the maintenance of male homosexual copulatory behaviour in flour beetles. J of Evolutionary Biology [Internet]. 2009 Jan [cited 2025 Feb 1];22(1):60–70. Available from: https://academic.oup.com/jeb/article/22/1/60-70/7324140 Pincemy G, Dobson FS, Jouventin P. Homosexual Mating Displays in Penguins. Ethology [Internet]. 2010 Dec [cited 2025 Feb 1];116(12):1210–6. Available from: https://onlinelibrary.wiley.com/doi/10.1111/j.1439-0310.2010.01835.x Riccucci M. Same-sex sexual behaviour in bats. Hystrix, the Italian Journal of Mammalogy [Internet]. 2010 Sep 24 [cited 2025 Feb 1];22(1). Available from: https://doi.org/10.4404/hystrix-22.1-4478 Van Gossum H, De Bruyn L, Stoks R. Reversible switches between male–male and male–female mating behaviour by male damselflies. Biol Lett [Internet]. 2005 Sep 22 [cited 2025 Feb 1];1(3):268–70. Available from: https://royalsocietypublishing.org/doi/10.1098/rsbl.2005.0315 Vasey PL, Jiskoot H. The Biogeography and Evolution of Female Homosexual Behavior in Japanese Macaques. Arch Sex Behav [Internet]. 2010 Dec [cited 2025 Feb 1];39(6):1439–41. Available from: http://link.springer.com/10.1007/s10508-009-9518-2 Project Gallery

Healthy heart, healthy mind Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link How does physical health affect mental health? Last updated: 16/10/25, 10:20 Published: 30/01/25, 08:00 Healthy heart, healthy mind Introduction Over the last decade, maintaining good mental health has become an increasing global priority. More people are committing time to self-care meditation, and other cognitive practices. We have also seen a rise in people taking care of their physical health through exercise and clean eating. This is fantastic – people are making time for one of the most important aspects of life, their health! But with the fast-paced nature of modern lifestyles, it is hard to devote separate time each week to purely mental and physical wellbeing. What if there were ways we could enhance both physical and mental wellbeing at the same time? Are both forms of health completely distinct from one another, or could a change in one have an effect on the other? If you’re looking for ways to improve your self-care efficiency, this may be the article for you! Healthy heart, healthy mind Physical health is a lot easier to define, on account of it being largely visible. Mental health on the other hand lacks much of a concrete definition. What is widely agreed is that emotions and feelings play a large part in making up our mental health. Emotions are largely determined by how we feel about our current internal and external environment, meaning bad bodily signs (as part of our internal environment) will have a negative effect on our overall mood. This is why being ill puts us in such a bad mood – even a blocked nose can annoy us by affecting how we do everyday activities. Poor fitness levels are likely no different – not being the most physically capable and finding everyday physical tasks challenging will likely have an effect on your mood and your confidence. Recent studies have backed up this idea, namely that signs of bodily inflammation are associated with increased risk of depression and negative mood. The role of neurotransmitters So being physically fit is associated with having better mental health, but does that mean exercise itself is mentally health as well, or is it just the effect of exercise that makes us happy? In other words, we seem to enjoy the result, but do we enjoy the process too? Studies have found that exercise increases dopamine levels in the brain. Dopamine is a neurotransmitter (a chemical messenger in the brain) that signals reward and motivation, similar to when we earn something for the work we put in ( Figure 1 ). Exercise is therefore seen as rewarding to the brain. There is also a lot of evidence suggesting exercise increases serotonin levels in both rats and humans. Serotonin is also a neurotransmitter, associated with directly enhancing mood and even having anti-depressant effects. Experiments in rats even suggest that increases in serotonin can decrease anxiety levels. Now, this does not mean exercise alone can cure anxiety disorder or depression, but could it be a useful variable in a clinical setting? Clinical uses Studies in depressive patients suggest that, yes, exercise does lead to better mental and physical health in patients with depression. This pairs well with another common finding that depressed patients are very rarely willing to complete difficult tasks for reward. So even on an extreme clinical scale, mental ill-health can have very damning consequences on maintaining good physical health. On the other hand, simple activities such as light jogs or walks may be the key to reversing negative spirals and getting on the right track towards recovery ( Figure 2 ). Conclusion and what we can do So far we have pretty solid evidence that mental health can impact physical health and vice versa, both negatively and positively. Going back to the introductory question, yes! We can find activities that improve both our physical and mental health. The trick is to find exercises that we find enjoyable and rewarding. On the clinical side, this could mean that physical exercise may be as effective at remitting depressive symptoms as antidepressants, likely with a lot fewer side effects. With that said, stay active and have fun, it helps more than you think! Written by Ramim Rahman Related articles: Environmental factors in exercise / Stress and neurodegeneration / Personal training / Mental health awareness REFERENCES Nord, C. (2024) The balanced brain . Cambridge: Penguin Random House. Osimo, E.F. et al. (2020) ‘Inflammatory markers in depression: A meta-analysis of mean differences and variability in 5,166 patients and 5,083 controls’, Brain, Behavior, and Immunity, 87, pp. 901–909. doi:10.1016/j.bbi.2020.02.010. Basso, J.C. and Suzuki, W.A. (2017) ‘The effects of acute exercise on mood, cognition, neurophysiology, and neurochemical pathways: A Review’, Brain Plasticity , 2(2), pp. 127–152. doi:10.3233/bpl-160040. [figure 1] DiCarlo, G.E. and Wallace, M.T. (2022) ‘Modeling dopamine dysfunction in autism spectrum disorder: From invertebrates to vertebrates’, Neuroscience & Biobehavioral Reviews, 133, p. 104494. doi:10.1016/j.neubiorev.2021.12.017. [figure 2] Donvito, T. (2020) Cognitive behavioral therapy for arthritis: Does it work? what’s it like?, CreakyJoints. Available at: https://creakyjoints.org/living-with-arthritis/mental-health/cognitive-behavioral-therapy-for-arthritis/ (Accessed: 06 December 2024) Project Gallery

The effect on sleep on nutrition (nutrition timing) Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link The interaction between circadian rhythms and nutrition Last updated: 27/04/25, 11:20 Published: 01/05/25, 07:00 The effect on sleep on nutrition (nutrition timing) The circadian system regulates numerous biological processes with roughly a 24-hour cycle, helping the organism adapt to the day-night rhythm. Among others, circadian rhythms regulate metabolism, energy expenditure, and sleep, for which meal timing is an excellent inducer. Evidence has shown that meal timing has a profound impact on health, gene expression, and lifespan. Proper timed feeding in accordance with the natural circadian rhythms of the body might improve metabolic health and reduce chronic disease risk. Circadian rhythms Circadian rhythms are controlled by the central clock of the brain, which coordinates biological functions with the light-dark cycle. Along with meal timing, circadian rhythms influence key elements of metabolism such as insulin sensitivity, fat storage, and glucose metabolism. When meal timing is not synchronised with the body's natural rhythm, it can cause circadian misalignment, disrupting metabolic processes and contributing to obesity, diabetes, and cardiovascular diseases. Literature has indicated that one should eat best during the daytime, particularly synchronised with the active phase of the body. Eating late at night or in the evening when the circadian rhythm of the body is directed towards sleep could impair metabolic function and lead to weight gain, insulin resistance, and numerous other diseases. Also, having larger meals in the morning and smaller meals later in the evening has been linked to improved metabolic health, sleep quality, and even lifespan. A time-restricted eating window, in which individuals eat all meals within a approximately 10–12 hour window, holds promise for improving human health outcomes like glucose metabolism, inflammation, harmful gene expression, and weight loss ( Figure 1 ). It is necessary to consider the impact of meal timing on gene expression. Our genes react to a number of stimuli, including environmental cues like food and light exposure. Gene expression of the body's metabolic, immune, and DNA repair processes are regulated by the body's circadian clock. Disturbances in meal timing influence the expression of these genes, which may result in greater susceptibility to diseases and reduced lifespan. Certain nutrients, such as melatonin in cherries and grapes, and magnesium in leafy greens and nuts, can improve sleep quality and circadian entrainment. Omega-3 fatty acids in fatty fish and flax seeds also have been shown to regulate circadian genes and improve metabolic functions. Other species Meal timing is quite varied among species, and animals have adapted such that food-seeking behavior is entrained into circadian rhythm and environmental time cues. There are nocturnal animals which eat at night, when they are active ( Figure 2 ). These nocturnal animals have evolved to align their meal time with their period of activity to maximise metabolic efficiency and lifespan. Meal timing is optimised in these animals for night activity and digestion. Humans, and most other animals, are diurnal and consume food during the day. In these animals, consuming most of their calories during the day is conducive to metabolic processes like glucose homeostasis and fat storage. These species tend to have better metabolic health when they are on a feeding regimen that is synchronized with the natural light-dark cycle. Conclusion Meal timing is important in human health, genetics, and life expectancy. Synchronising meal times with the body's circadian rhythms optimises metabolic function, reduces chronic disease incidence, and potentially increases longevity by reducing inflammatory genes and upregulating protective ones. This altered gene expression affects the way food is metabolised and metabolic signals are acted upon by the body. Humans naturally gravitate towards eating during daytime hours, while other creatures have feeding habits that are adaptively suited to their own distinct environmental needs. It is important to consider this science and incorporate it into our schedules to receive the best outcome from an activity that we do not normally think about. Written by B. Esfandyare Related article: The chronotypes REFERENCES Meléndez-Fernández, O.H., Liu, J.A. and Nelson, R.J. (2023). Circadian Rhythms Disrupted by Light at Night and Mistimed Food Intake Alter Hormonal Rhythms and Metabolism. International Journal of Molecular Sciences , [online] 24(4), p.3392. doi: https://doi.org/10.3390/ijms24043392 . Paoli, A., Tinsley, G., Bianco, A. and Moro, T. (2019). The Influence of Meal Frequency and Timing on Health in Humans: The Role of Fasting. Nutrients , [online] 11(4), p.719. Available at: https://www.ncbi.nlm.nih.gov/pubmed/30925707 . Potter, G.D.M., Cade, J.E., Grant, P.J. and Hardie, L.J. (2016). Nutrition and the circadian system. British Journal of Nutrition , [online] 116(3), pp.434–442. doi: https://doi.org/10.1017/s0007114516002117 . St-Onge MP, Ard J, Baskin ML, et al. Meal timing and frequency: implications for obesity prevention. Am J Lifestyle Med. 2017;11(1):7-16. Patterson RE, Sears DD. Metabolic effects of intermittent fasting. Annu Rev Nutr. 2017;37:371-393. Zhdanova IV, Wurtman RJ. Melatonin treatment for age-related insomnia. Endocrine. 2012;42(3):1-12. Prabhat, A., Batra, T. and Kumar, V. (2020). Effects of timed food availability on reproduction and metabolism in zebra finches: Molecular insights into homeostatic adaptation to food-restriction in diurnal vertebrates.Hormones and Behavior, 125, p.104820. Project Gallery

An analysis of risk and protective factors Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link Postpartum depression in adolescent mothers Last updated: 24/06/25, 16:39 Published: 10/07/25, 07:00 An analysis of risk and protective factors Impact and prevalence According to the DSM-5, postpartum depression (PPD), also known as postnatal depression, is characterised by psychological and physical symptoms – including anhedonia, depressed mood and abnormal differences in sleep patterns – with a postpartum onset within one month after childbirth. Long-term effects of PPD, which are the same for adult and adolescent mothers, include weaker attachment between the mother and the child and developmental delays in children. Whilst treatment methods for postnatal depression have been more thoroughly investigated in adult mothers than in teenage mothers, prevalence rates of postpartum depression are found to be higher in adolescent mothers, with teenage mothers being twice as likely to be depressed as adult mothers. Postpartum depression in adolescent mothers is a prominent concern, as studies have found that up to 57% of teenage mothers report moderate to severe symptoms of PPD. Risk and protective factors A definite risk factor for postpartum depression in teenage mothers is a lack of social support. Research shows that adolescent mothers face more challenges but have fewer resources and less social support than adult mothers. This is prominent in Barnet et al.’s (1996) research, which found that adolescent mothers who received emotional support from either their mother or the baby’s father were less likely to exhibit depressive symptoms postpartum. Others support this research and suggest that social support has a direct effect on PPD in teenage mothers. Additionally, a lack of wider social support results in stigma, with a common assumption being that young mothers are incompetent parents and that children should not raise other children. Thus, another aspect of the lack of social support that might lead to PPD is stigma. However, an abundance of social support can also be detrimental, as it might make the young mothers feel incapable or inadequate, also leading to postnatal depression. Therefore, it is vital to determine the appropriate amount of support required for adolescent mothers. Another important risk factor affecting adolescent mothers that leads to postpartum depression is stress, which can be, but does not have to be, caused by a lack of social support. Research shows that higher stress levels are positively associated with depressive symptoms, and teenage mothers who reported higher stress levels displayed higher levels of PPD than adolescent mothers with lower stress levels. Therefore, in order to reduce the rate of postpartum depression in adolescent mothers, interventions should focus on decreasing the mothers’ stress levels. A crucial protective factor for PPD in adolescent mothers is self-esteem. Logsdon et al. (2005) found that lower self-esteem was predictive of postnatal depression in teenage mothers, and Caldwell & Antonucci (1997) found that self-esteem has a strong negative correlation with PPD symptoms in adolescent mothers. Therefore, higher self-esteem can shield young mothers from postpartum depression. Conclusions Overall, adolescent mothers are a particularly vulnerable population due to the additional challenges they face and the common lack of preparation for motherhood amongst teenage mothers. Social support, both a lack thereof or an excess amount, is commonly identified in the literature as a key risk factor for PPD in young mothers, as well as stigma and stress. High self-esteem and confidence in one’s own parenting skills are prominent and promising protective factors. The few interventions that are present demonstrate a promising start towards developing ways to tackle PPD in adolescent mothers. However, there has not been an extensive meta-analysis evaluating existing interventions, a clear limitation and a gap in the literature that should be addressed in future research. Written by Aleksandra Lib Related articles: Depression / Depression in children / Childhood stunting / Gynaecology REFERENCES American Psychiatric Association (APA). (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Barnet, B., Joffe, A., Duggan, A. K., Wilson, M. D., & Repke, J. T. (1996). Depressive symptoms, stress, and social support in pregnant and postpartum adolescents. Archives of pediatrics & adolescent medicine , 150 (1), 64-69. Caldwell, C. H., Antonucci, T. C., Jackson, J. S., Wolford, M. L., & Osofsky, J. D. (1997). Perceptions of parental support and depressive symptomatology among black and white adolescent mothers. Journal of Emotional and Behavioral Disorders , 5 (3), 173-183. Deal, L. W., & Holt, V. L. (1998). Young maternal age and depressive symptoms: Results from the 1988 National Maternal and Infant Health Survey. American Journal of Public Health, 88 , 266–270 Dinwiddie, K. J., Schillerstrom, T. L., & Schillerstrom, J. E. (2017). Postpartum depression in adolescent mothers. Journal of Psychosomatic Obstetrics & Gynecology , 39 (3), 168–175. Field T. (1992). Infants of depressed mothers. Development and Psychopathology, 4 , 49-66. Logsdon, M. C., Birkimer, J. C., Simpson, T., & Looney, S. (2005). Postpartum depression and social support in adolescents. Journal of Obstetric, Gynecologic & Neonatal Nursing , 34 (1), 46-54. Radke-Yarrow, M., Cummings, E. M., Kuczynski, L., & Chapman, M. (1985). Patterns of attachment in two- and three-year-olds in normal families and families with parental depression. Child Development, 56 , 886-893. Schmidt, R. M., Wiemann, C. M., Rickert, V. I., & Smith, E. O. B. (2006). Moderate to severe depressive symptoms among adolescent mothers followed four years postpartum. Journal of Adolescent Health , 38 , 712–718. Project Gallery

How colonialism, interventionism and health are interwoven Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link How colonialism and geopolitics shape health injustices: a deep, critical reflection Last updated: 23/10/25, 10:16 Published: 16/10/25, 07:00 How colonialism, interventionism and health are interwoven This is the final article (article no. 7) in a series about global health injustices. Previous article: Addressing the health landscape in Bangladesh's Rohingya community Introduction Welcome to the reflective article of the Global Health Injustices Series. Before I begin, I want to thank Jana Antar again for her contributions to the Lebanon and Syria article, and Dr Nasif Mahmood for his contributions to the Rohingya people in Bangladesh article. Writing and researching about these different countries was an incredible experience. Although I initially planned for this series to go beyond ten articles, focusing on the most enduring and neglected injustices was vital, particularly as the world is becoming more dynamic with geopolitical power shifts. With this in mind, I want to emphasise that each vulnerable population faces unique challenges, but they have challenges shared with others that are not mentioned in this series. I wanted to address these injustices because they are urgent and demonstrate how interconnected global struggles truly are. Through writing this last article, I deepened my understanding of how colonialism, interventionism, and health are interwoven. How the past impacts present reality (colonialism) The injustices we see in news headlines, social media, or the ones we directly experience should not be understood as isolated examples ( Table 1 ). Instead, they stem from European colonialism and later foreign interventionism, shaping how regional governments were created. The ongoing Gaza genocide and expanding illegal settlements pushing out Palestinians in the West Bank are due to Israel’s brutal military occupation and apartheid for 70+ years, and its acts, including the Nakba. Sudan had external rulers (notably Egypt and the British Empire) contributing to its civil wars through political destabilisation, among other factors. This similarly happened in Yemen, though it is also important to note that foreign intervention from the United States (US) and Saudi Arabian governments contributed to the country's existing crises. Lebanon and Syria were divided up and governed by Britain and France after the Ottoman Empire collapsed shortly after World War 1, a significant event leading to political destabilisation and ongoing catastrophes, which also happened to Palestine. In Kashmir, the people’s plight erupted through the British Empire partitioning the Indian subcontinent into multiple nations in 1947 (India, West Pakistan becoming Pakistan and East Pakistan becoming Bangladesh), with Kashmir being a disputed territory between Pakistan and India. As for the Rohingya population and Bangladesh, civil wars during the 20th century and ensuing persecution by the government of Myanmar have contributed to their crises. Therefore, it is clear that all of these events I summarised showcase how their root causes lead to the substantial effects of the current daily injustices. Moreover, what connects these substantial injustices and many others worldwide traces back to the consequences of European colonialism; these powers dispossessed indigenous peoples of their lands and resources through violence, subsequently broken treaties, or legal frameworks that did not identify Indigenous land tenure systems. While they did disrupt indigenous governments, some recent injustices prevail because post-colonial elites embraced or exacerbated these exploitative systems. This severed deep cultural, spiritual, and economic ties that indigenous communities had with their land. For example, Canada’s colonial legacy, notably its Indian Residential Schools, involved forcibly removing children from their families, leading to negative outcomes for the Indigenous communities. Moreover, it is vital to acknowledge the impact of settler colonialism on Indigenous communities globally across South America, Africa, Asia and the Aboriginal people of Australia and New Zealand. If we do not critically think and learn about these past events, how will we improve our present reality and build a future for everyone? Table 1: Summary of the historical and modern perpetrators of injustices affecting the countries/communities explored in the Global Health Injustices Series Country/ community explored in the Global Health Injustices Series Main perpetrator(s) of their injustices Palestine Israel + foreign military aid from the US, UK + other countries Sudan RSF + other local political factions with foreign military aid from the UAE + other countries Yemen Houthis + other local political factions + foreign Interventionism from Saudi Arabia + US + foreign military aid Lebanon Local political factions + US, UK + other countries Syria Local political factions + US, UK + other countries Kashmir Indian + Pakistani militaries + foreign military aid Rohinyga Government of Myanmar + foreign military aid Bangladesh UK via the partition of Subcontinental India (1947), contributing to later injustices Current major health problems Health is essential in global injustices because it is a mirror and a driver of the disparities among various populations. Accessing quality healthcare is usually affected by factors, such as race and ethnicity, which accentuate deep-rooted inequalities. For example, communities with lower incomes encounter challenges, ranging from a lack of healthcare infrastructure to environmental hazards, leading to worse health outcomes. Therefore, tackling them is essential for achieving justice, as improved health outcomes can empower marginalised groups. Aside from warfare being a major determinant of health and injustice, I want to highlight migration as a significant co-occurring determinant. Although research is expanding, the bidirectional relationship between migration and health remains inadequately incorporated into practice and laws. Migration is a complicated and heterogeneous multiphase process ( Figure 1 ). Meanwhile, collecting migration data remains difficult due to polarised political views, unwillingness to finance research on discriminatory laws, varying migration definitions, and limited comparable global data. Unfortunately, political rhetoric and media depictions form incorrect assumptions, stereotypes, and negative views of migrants and refugees, leading to a weakened understanding of the severity and positive aspects of migration. Also, this manifests into hatred and scapegoating of migrants and refugees through their “perceived” impact on countries like employment and healthcare. In reality, accessing employment and healthcare is very difficult for them, leading to negative health outcomes. Thinking more broadly, health behaviours are not solely individual choices, but are deeply rooted in and affected by social, cultural, and political environments. For example, when looking at politics and health through a framework ( Figure 2 ), it is clear how politics is influential through labour markets and welfare states, leading to socioeconomic, income and wealth inequalities and poor health. One systematic review found that a generous welfare state is typically associated with positive population health outcomes, with the Nordic model as an example. This suggests that political leaders are vital in affecting agendas, encouraging intersectoral partnerships, and showing political will to promote health equity. Another review supported the benefits of a generous welfare state through maternal and child health outcomes. Therefore, health and politics are intertwined, as addressed in previous articles through specific contexts. Now I will discuss it more broadly. Current major geopolitical problems Geopolitical dynamics are crucial to shaping the lives of vulnerable populations by influencing their access to security, resources, and fundamental human rights; this is impacted by governments, policies, geographies, and the relationships and interests between countries. In countries or regions plagued by continuous conflict or authoritarian governments, these communities often find themselves at greater risk of challenges like displacement, violence, and systemic discrimination. Moreover, the complicated relationship between global and local power systems results in specific communities being neglected, as more powerful geopolitical interests repeatedly overshadow their needs. To truly support these communities, it is vital to consider how foreign interventionism from countries like the US and the UK impacts the Palestinians, Sudanese, Lebanese, Syrian, Yemeni, Kashmiri, and the Rohingya populations. Foreign interventionism, which typically occurs through militarism, is characterised as the international and social relations of training for and executing organised political violence; this is a pervasive feature of geopolitics, rising into civilian domains by shaping countries and regions. Then, humanitarianism is typically seen as an unbiased moral discourse centred on universal humanity and aid. Yet, it is historically linked to militarism, particularly in Western countries and has deepened in recent decades. Humanitarian standards, like International Humanitarian Law (IHL), are supposed to limit wars’ consequences, but IHL may implicitly tolerate particular levels of ‘collateral damage’ as allowable. IHL is embedded in a hierarchy that determines who can be saved and who cannot, possibly causing inequalities and unstable power relations tied to imperial dynamics. Hence, I see Western humanitarianism as deeply entangled with militarism because of how it can serve to justify and expand political violence across diverse countries and regions, as seen in modern news headlines. More importantly, this dynamic drives a vicious cycle of violence, where armed conflicts cause vulnerability by destroying infrastructure, destabilising nations and other negative consequences, like climate change and rising extremism, leading to civil wars and genocide. Moving forward To truly move forward, adopting a multifaceted approach (e.g. decolonising global health) to addressing all the injustices and health disparities is vital; this can work, but I think that should involve giving all the most vulnerable communities their autonomy, liberation and fundamental human rights. There is the notion of peace plans coming from Western governments like the US, yet that cannot start without putting those directly experiencing war, genocide, displacement, ethnic cleansing and other atrocities as the central voice in those conversations. Moreover, we should highlight those most accountable for making amends. For example, they should allow a right to return and a payment of extensive reparations to the displaced Palestinians, Sudanese, Lebanese, Syrian, Yemeni, Kashmiri, and the Rohingya populations to their homelands, among numerous others. The big question is whether these suggestions will become tangible realities. Although reparations and the right to return may seem distant from contemporary political realities, they are moral imperatives for real justice to occur. Continuously raising awareness and rallying support for affected communities so they can tackle their needs and challenges is important. There is also advocacy, which is vital in showcasing the issues they encounter, which can pave the way for significant policy changes. Moreover, the participation of local and international non-governmental organisations (NGOs), like Amnesty International, is crucial for enforcing ongoing solutions, as they better grasp the vulnerable communities’ needs. When these efforts are done collaboratively, fostering a more supportive environment for those needing it most is vital. Unfortunately, NGOs cannot replace genuine international political will because their impact will always be limited without structural change. Importantly, recognising how interconnected everyone is as a global community is crucial. Engaging in different cultures and experiences should foster empathy and build a collective strength to face challenges, notably climate change and warfare driven by the weapons industry. Uniting and sharing knowledge can encourage real change and all countries actually following international law, which requires powerful countries to be held responsible in ways that have been avoided so far; this should involve acknowledging that the vulnerable communities have a right to resist and defend themselves against their oppressors. Conclusion The global health injustices seen today have historical roots in European colonialism, which has stripped indigenous global communities of their homelands and disrupted their cultural connections. Furthermore, they are influenced by many factors. Moreover, health behaviours are influenced by the broader social, cultural, and political landscapes. Geopolitical dynamics impact vulnerable populations by undermining their security, access to resources, and fundamental human rights; foreign interventionism via militarism makes them worse. Humanitarianism with militarism can reinforce cycles of violence by legitimising unequal power dynamics despite its good intentions. To effectively tackle the global health injustices, uplifting vulnerable communities by prioritising their human rights is vital. The perpetrators should pay reparations and grant the right of return to the most impacted. As individuals, we must raise awareness and push for policy changes. Local and international organisations are pivotal in understanding and addressing community needs. With everything said, I enjoyed writing this series because it showed me how connected all these injustices are and how we can act, listen and reflect together. Ultimately, we must focus on all the countries and communities highlighted in this series, as well as others currently facing injustices like the Uyghurs in China and Afghanistan. We must open our eyes, hearts, souls, and minds to nurture global connections and share knowledge for impactful change. Written by Sam Jarada Related articles: How does physical health affect mental health? / Beyond medicine: health through different stances / Regulation and policy of stem cell research REFERENCES Banat BYI, Entrena-Durán F, Dayyeh J. Palestinian Refugee Youth: Reproduction of Collective Memory of the Nakba. Asian Social Science. 2018 Nov 29;14(12):147.2. Amiad Haran Diman, Miodownik D. Bloody Pasts and Current Politics: The Political Legacies of Violent Resettlement. Comparative Political Studies. 2023 Aug 13;57(9). Abubakar M, Yahaya TB. Secession and border disputes in Africa: The case of Sudan and South Sudan border. African Journal of Political Science and International Relations. 2021 Oct 31;15(4):131–8. Tamer Abd Elkreem, Jaspars S. Sudan’s catastrophe: the role of changing dynamics of food and power in the Gezira agricultural scheme. Disasters [Internet]. 2024 Oct 30 [cited 2025 Sep 18];49(1). Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC11603519/ eClinicalMedicine. Under the shade of world events: a never-ending crisis in Yemen. EClinicalMedicine [Internet]. 2023 Oct 1 [cited 2025 Sep 18];64:102302–2. Available from: https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(23)00479-0/fulltext Bordón J, Eyad Alrefai. Saudi Arabia’s Foreign aid: the Singularity of Yemen as a Case Study. Third World Quarterly. 2023 Jul 14;45:1–18. Osman O. Western Domination, Destructive Governance, and the Perpetual Development Crisis in the Arab Region. World review of political economy. 2024 Apr 15;15(1). Huber D, Woertz E. Resilience, conflict and areas of limited statehood in Iraq, Lebanon and Syria. Democratization. 2021 Jun 25;28(7):1–19. Gupta H. 1947 Partition of India and its lessons. Journal of Family Medicine and Primary Care [Internet]. 2024 Jul 26 [cited 2025 Sep 18];13(8):3471–2. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC11368293/ Jong K de, van, Ford N, Kamalini Lokuge, Fromm S, Galen R van, et al. Conflict in the Indian Kashmir Valley II: psychosocial impact. Conflict and Health [Internet]. 2008 Oct 14 [cited 2025 Sep 18];2(1). Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC2577626/ Project Gallery

How your gut is your second brain (an opinion piece) Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link Microbes in charge Last updated: 16/06/25, 16:09 Published: 26/06/25, 07:00 How your gut is your second brain (an opinion piece) Imagine this: you have just won ten million dollars in the lottery, or you have just eaten the most delicious, warm, chocolate brownie. In these situations, our brains produce chemicals called neurotransmitters, which give us these great feelings of pleasure and happiness. Now, imagine this: you're about to sit an exam. In this situation, our brains, instead, produce different chemicals, making us feel stressed and anxious. Our emotions control the highs and lows of life. I have always heard that the brain inside all of us controls everything that we feel, think and do. However, I've always found it strange that every feeling, thought, and behaviour is controlled by a three-pound, soggy lump of cells inside our heads, until I learned about gut microbiota. We each have a second brain, which controls as much of our physical and mental functions as the brain in our heads, and plays a role in preventing diseases. This second brain is our gut microbiota. However, we have completely underestimated their role as the second brain. I learned this first through the intriguing story of the rat. If the rat becomes colonised with the microbe Toxoplasma gondii, a fascinating thing happens: they lose their fear of cats. The cat's smell was chosen as a measure. The infected rat preferred the areas that had the smell of cats. So, the microbes take control of the brain and change the way you think. In another study, a research group at University College Cork in Ireland fed Lactobacillus rhamnosus , a good bacteria—or 'probiotic' you can usually find in yoghurt—to one of two groups of mice. The probiotic mice were much more likely to succeed in the face of adversity tests than those not treated with the probiotic. They repeated a similar study in humans, with the probiotic-fed humans displaying improved resilience to negative emotions compared to those without the probiotic. As I mentioned earlier, neurotransmitters are these chemicals that can change how we think, behave, and feel. As it turns out, neurotransmitters are also produced in our gut, 50% of the dopamine and 90% of serotonin (nature's antidepressant): two neurotransmitters that drastically affect your mood, happiness and pleasure. According to some studies, dopamine also plays a role in memory and learning, so gut microbiota controls how you think and behave and is also involved in cognitive functions like memory and learning. Let’s now turn to mental health! One study by Venket Rao studied 39 individuals with chronic fatigue syndrome (a syndrome characterised by severe anxiety, depression, and long-term exhaustion), split the individuals into two groups. The first group received a bacterial strain for two months while the other group received only a placebo. The group that received the bacterial strain showed a significant decrease in anxiety with respect to the other group. Noticeably, there is a vital link between the gut microbiota and the immune system. 70-80% of immune cells are present in the gut. Additionally, studies have shown that Germ-free mice have fewer immune system structures in their intestines than wild-type mice. These immune structures in the gut are referred to as the gut-associated lymphoid tissues (GALT) and Peyer's patches. Another study explored the gut microbiota of 42 patients affected by Rheumatoid Arthritis and 10 healthy controls. They observed that rheumatoid arthritis patients have a higher population of Lactobacillaceae family and the Lactobacillus genus, and fewer Faecalibacterium , a butyrate producer. Butyrate is the fuel source for our intestinal cells to produce mucin, which then repairs the intestinal lining and mucosal membrane and reduces inflammation. Our gut and brain are physically and biochemically connected in several ways. First, our intestines are physically linked to our brain through the vagus nerve, which sends signals in both directions. Interestingly, even if this is cut off (severed), our intestines can continue to function fully without a connection to the brain, suggesting they have a mind of their own. Secondly, our brains are made up of a hundred billion neurons, which continuously send messages to tell our bodies how to work and behave. Well, interestingly, our guts have a hundred million neurons. Our gut microbiota, the unsung hero behind our feelings, thoughts, immune system and behaviour - proving that sometimes, it's not just all in our heads, but in our "guts" too! Written by Prabha Rana Related articles: The gut microbiome / The dopamine connection REFERENCES Webster J. P. (2007). The effect of Toxoplasma gondii on animal behavior: playing cat and mouse. Schizophrenia bulletin , 33 (3), 752–756. https://doi.org/10.1093/schbul/sbl073 Bravo, J. A., Forsythe, P., Chew, M. V., Escaravage, E., Savignac, H. M., Dinan, T. G., Bienenstock, J., & Cryan, J. F. (2011). Ingestion of Lactobacillus strain regulates emotional behavior and central GABA receptor expression in a mouse via the vagus nerve. Proceedings of the National Academy of Sciences of the United States of America , 108 (38), 16050–16055. https://doi.org/10.1073/pnas.1102999108 Strandwitz P. (2018). Neurotransmitter modulation by the gut microbiota. Brain research , 1693 (Pt B), 128–133. https://doi.org/10.1016/j.brainres.2018.03.015 Rao, A. V., Bested, A. C., Beaulne, T. M., Katzman, M. A., Iorio, C., Berardi, J. M., & Logan, A. C. (2009). A randomized, double-blind, placebo-controlled pilot study of a probiotic in emotional symptoms of chronic fatigue syndrome. Gut pathogens , 1 (1), 6. https://doi.org/10.1186/1757-4749-1-6 Wiertsema, S. P., van Bergenhenegouwen, J., Garssen, J., & Knippels, L. M. J. (2021). The Interplay between the Gut Microbiome and the Immune System in the Context of Infectious Diseases throughout Life and the Role of Nutrition in Optimizing Treatment Strategies. Nutrients , 13 (3), 886. https://doi.org/10.3390/nu13030886 Round, J. L., & Mazmanian, S. K. (2009). The gut microbiota shapes intestinal immune responses during health and disease. Nature reviews. Immunology , 9 (5), 313–323. https://doi.org/10.1038/nri2515 Picchianti Diamanti, A., Panebianco, C., Salerno, G., Di Rosa, R., Salemi, S., Sorgi, M. L., Meneguzzi, G., Mariani, M. B., Rai, A., Iacono, D., Sesti, G., Pazienza, V., & Laganà, B. (2020). Impact of Mediterranean Diet on Disease Activity and Gut Microbiota Composition of Rheumatoid Arthritis Patients. Microorganisms , 8 (12), 1989. https://doi.org/10.3390/microorganisms8121989 Han, Y., Wang, B., Gao, H., He, C., Hua, R., Liang, C., … Xu, J. (2022). Vagus Nerve and Underlying Impact on the Gut Microbiota-Brain Axis in Behavior and Neurodegenerative Diseases. Journal of Inflammation Research , 15 , 6213–6230. https://doi.org/10.2147/JIR.S384949 Project Gallery

Psilocybin's active metabolite, psilocin, acts as a serotonin receptor agonist Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link The promising effects of magic mushrooms for depression Last updated: 17/02/26, 21:22 Published: 19/02/26, 08:00 Psilocybin's active metabolite, psilocin, acts as a serotonin receptor agonist This is Article 2 in a series on psychiatric disorders and the brain. Previous article: Inside out: the chemistry of depression . Next article coming soon. What is psilocybin? Psilocybin is a naturally occurring psychedelic tryptamine alkaloid found in over 200 species of mushrooms (Psilocybin mushrooms), commonly known as magic mushrooms or shrooms. Upon ingestion, the body converts psilocybin into its active metabolite, psilocin, which acts as a serotonin receptor agonist, primarily impacting 5-HT2A receptors. What is psilocybin useful for? In recent years, clinical research has shown that psilocybin-assisted therapy, can quickly and meaningfully reduce symptoms of depression, often within days rather than weeks, when given in a safe, controlled medical setting with psychological support. Importantly, these studies don’t just look at mood while someone is under the influence. They measure long-term changes weeks or months after treatment. Studies, such as Gukasyan et al. , 2022 and Goodwin et al. , 2022, have shown that 1-2 doses of psilocybin plus therapy have led to sustained reductions in depressive symptoms that last at least 8-12 weeks, and in some cases 12 months later. Research has also demonstrated potential benefits for individuals whose depression has not responded to conventional antidepressant treatments. A large phase II double-blinded trial, by Griffiths et al. , 2016, involving people with treatment-resistant depression found that those given a therapeutic dose (25 mg) of psilocybin had noticeably greater improvement in their depression scores compared with a very low dose (10 mg). Scientists, for example Daws et al. , 2022, believe psilocybin works differently from standard antidepressants. It appears to temporarily increase connections between different parts of the brain and may help break rigid patterns of negative thinking that are typical in depression. If psilocybin is effective, why is it not currently used in treatment for depression? Psilocybin remains classified as a Schedule I controlled substance under the United Nations 1971 Convention on Psychotropic Substances, meaning it is considered to have a high potential for abuse and no accepted medical use. For psilocybin to become an approved clinical treatment for depression, it must be rescheduled through formal regulatory review, a process that involves extensive clinical testing and bureaucratic steps. In many countries, including the United States, rescheduling controlled substances can be slow and complex. For example, in 2022-2023, the U.S. government reviewed the scheduling of marijuana (cannabis) after presidential direction to federal agencies, but a final rescheduling decision was still pending as of late 2025. According to the U.S. Drug Enforcement Administration, Schedule III drugs are defined as substances with moderate to low potential for physical and psychological dependence, whereas Schedule I substances are defined as having no currently accepted medical use and a high potential for abuse. Because psilocybin is still Schedule I in most jurisdictions, it cannot yet be prescribed as a mainstream treatment for depression, despite promising clinical trial results. Written by Chloe Kam Related article: What does depression do to your brain? Project Gallery

Looking at how income and housing are linked to health Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link Socioeconomic Health Inequalities Last updated: 05/03/26, 14:50 Published: 05/02/26, 08:00 Looking at how income and housing are linked to health This is Article no. 2 in a series on health equalities. Previous article: What are health inequalities? Next article: Ethnic inequalities . Welcome to the second article in a series of articles about health inequalities. This article will look more in detail at what socioeconomic health inequalities are. Introduction Socioeconomic factors refer to the circumstances in which people are born, grow, live, work, and age. These conditions are often considered the wider determinants of health, and are a fundamental cause of health inequalities. These inequalities are not accidental; they are the result of underlying structural disparities, occurring as a result of unequal distribution of resources and opportunities in society. Addressing these disparities requires coordinated, cross-government action across a wide range of policy areas, including prevention and focused work on the wider determinants of health. How income is linked to health Poverty and financial insecurity have a significant negative impact on health, as living on a low income is a source of stress. It also affects an individual's ability to afford health-improving goods, from nutritious food to gym memberships. Across the income spectrum, lower incomes are associated with worse self-reported health. Data from the Department for Work and Pensions’ Family Resources Survey 2023/24 shows that 43% of people on the lowest income rate their health as fair, bad or very bad, compared with 31% in the middle (the fifth income decile) and 15% on the highest incomes. The Health Foundation has visualised this in Figure 1 . The impact on health is even greater when low pay persists for generations: children from households in the bottom fifth of income distribution are over 4 times more likely to experience severe mental health issues compared to those in the highest fifth. Furthermore, Black, Asian and Minority Ethnic (BAME) individuals are disproportionately affected and are more likely to live in poverty, have low incomes, and lower levels of wealth compared to White individuals. How housing links to health The places where people live and age can significantly influence their health. Affluent areas have more access to green and other public spaces, clean air, and affordable and active travel. In contrast, deprived areas often have less access to green space, higher concentrations of fast-food outlets, and limited availability of affordable and healthy food. Individuals living in deprived areas will most likely have poor-quality and overcrowded housing conditions, associated with an increased risk of cardiovascular and respiratory diseases, depression and anxiety. They may also experience fuel poverty, so they cannot afford to heat their home. BAME households are more likely than White households to live in overcrowded homes and to experience fuel poverty. Health outcomes and projections The consequences of socioeconomic inequalities can be seen in differences in health outcomes. People in more deprived areas experience major illness earlier in life and die younger: in England, individuals in the 10% most deprived areas are expected to develop major illness 10 years earlier compared to those in the 10% most affluent areas. They are also over three times more likely to die prematurely before the age of 70. This inequality is projected to continue through to at least 2040, with no expected improvement. These findings are supported by research which looked at the impact of socioeconomic factors on the COVID-19 pandemic. Results showed that unequal access to healthcare amplified COVID-19 cases. It meant that a significant portion of cases, which could have been prevented through timely diagnosis, treatment, and resource distribution, contributed to an overall case rate that was 6-fold higher than it otherwise might have been. Additionally, a small group of long-term conditions contributes to most diagnosed health inequalities: chronic pain, chronic obstructive pulmonary disease (COPD), type 2 diabetes, cardiovascular diseases (CVD), and anxiety and depression. The prevalence of these conditions is 1.5 times higher in the 10% most deprived areas compared to the least deprived areas. The Health Foundation has visualised this in Figure 2 . Conclusion Socioeconomic health inequalities are fundamentally caused by the structural inequalities discussed throughout this article. Actions to address these disparities must be specifically targeted in the most deprived areas, which often see a disproportionate impact on BAME individuals. The next article in this series will look more in detail at ethnic health inequalities, so watch out for that! Written by Naoshin Haque Related articles: Gentrification in the context of health / Global Health Injustices (series) Project Gallery

Discussing an upcoming biotech thriller book Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link ‘The Molecule’ by Dr Rick Sax and Dr Marta New Last updated: 02/01/26, 18:11 Published: 08/01/26, 08:00 Discussing an upcoming biotech thriller book Science, to some extent, is very black and white. You carry out experiments; you analyse the data, and you could use numerous techniques to get results. Although there is a range of techniques you could use to analyse and interpret the data, if it has been carried out correctly, the results should be reproducible. 1 + 1 will always equal 2, a eukaryote will always have a nucleus, and pure water will always have a boiling point of 100ºC. Once again, science is entirely black and white. But after an hour of conversation on a cold London afternoon, this writer can conclude that the life of a scientist does not have to be as black and white as their research. This is confirmed by looking at the fascinating lives of Dr Marta New and Dr Rick Sax. Dr Marta New Dr. Marta New's career spans the intersection of science and business, beginning with her PhD in Microbiology and Immunology from the University of Illinois Chicago. Demonstrating her versatility, she pursued an MBA at Northwestern University's Kellogg School of Management just two years later. Recognizing her passion extended beyond academia, Dr. New ventured into the business world, where she has held various influential roles. Her career includes positions as a venture capitalist at ARCH Venture Partners, board observer for numerous biotech companies, and strategic advisor to pharmaceutical firms. Dr. New's expertise lies in translating scientific breakthroughs into viable business opportunities, particularly in the areas of drug discovery and development. Currently, she is the founder and CEO of Radyus Research, a company focused on accelerating drug discovery through innovative AI-powered platforms. In this role, Dr. New continues to drive innovation and strategic growth in the biotech and pharmaceutical sectors, leveraging her unique blend of scientific knowledge and business acumen. Dr Rick Sax Dr. Rick Sax is a distinguished figure in the pharmaceutical industry with over 30 years of experience in senior leadership positions. His career spans across major pharmaceutical companies, including Merck & Co. and AstraZeneca, where he held executive roles in clinical development. At Merck, Dr. Sax led cardiovascular drug development and served on key business strategy teams. At AstraZeneca, he took on various leadership positions, including Vice President for U.S. Clinical Research and roles in global Medical Sciences. Dr. Sax later joined Quintiles (IQVIA) as Senior Vice President for Integrated Clinical Services, where he played a crucial role in developing innovative approaches to clinical program design and drug development strategies. His expertise encompasses drug research and development, clinical program design, translational medicine, and the application of information technology in clinical research. Currently, Dr. Sax serves as an advisor to biotechnology startups and consulting firms, leveraging his extensive experience to improve pharmaceutical R&D efficiency and productivity. Through their amazing expertise they have joined hands to write a biotech thriller called the ‘The Molecule’. What is the inspiration behind the novel The Molecule ? Science thrives on curiosity, discovery, and the pursuit of knowledge, often driven by a passion to understand the unknown. On the other hand, business is fueled by profit, efficiency, and the drive to deliver tangible results in the shortest possible time. The challenges can be immense in the biotech industry, where these two worlds must collide. Transforming a scientific breakthrough into a marketable product requires more than just innovation; it demands strategic thinking, financial acumen, and a deep understanding of the regulatory environment. The journey from lab bench to market shelf is fraught with obstacles, including securing funding, navigating complex regulations, and managing stakeholders' expectations with very different goals. In their new novel, The Molecule , authors Rick Sax and Marta New delve into the intricate world of drug development, breaking the conventional notion that this process is solely the domain of academia. The book explores the multifaceted journey of a startup company navigating the complex path of science, regulation, and industry. When asked about the inspiration behind the book, Rick and Marta emphasised their desire to shed light on the complex interplay between scientific innovation and the financial forces that drive it. They wanted to illustrate that drug development is a scientific endeavour and a battleground where researchers, regulators, and industry professionals often find themselves at odds. While The Molecule is a work of fiction, it brings a deep emotional resonance. The authors were keen to portray the technical challenges of developing a new drug and the human element—the hopes, fears, and sacrifices of those involved. Rick and Marta crafted a narrative that captures the struggles and triumphs, emphasising the complex journey of bringing a new drug to market. The book goes beyond the laboratory, vividly depicting the stages a startup company must navigate to succeed. It paints a realistic picture of the hurdles and setbacks often encountered along the way, making it a compelling read for anyone interested in the intersection of science, business, and human emotion. This biotech thriller also serves as a reminder that the fusion of science and business, though complex, is essential for driving progress and bringing life-changing innovations to the world. What is the drug development process, and what are the challenges? As mentioned, drug development is a long, arduous, and multifaceted journey. A journey that, in reality, is not limited to academia or clinical research. We must remember that drug development translates an idea into a drug in the market, a process that spans more than simple laboratory experiments. The book The Molecule gives us a glimpse of this process. As it turns out, there is a lot more that happens even before clinical trials begin. Unsurprisingly, the process of drug development began before "development". Instead, it starts as drug "discovery". Here, scientists wear their thinking hats to try and understand a disease, hoping to discover new insights or technologies that provide an approach to treatment. As Marta neatly outlined, scientists at this stage are surrounded by numerous questions, such as the drug's mechanism of action, how it works, etc. However, this discovery is not a finished product but rather a technology. Different questions must be asked to translate a fresh-off-the-lab technology into a marketable drug. Namely, "Is it safe and is it efficacious?" Next, the drug development journey will continue into the preclinical stage. Those who work in preclinical drug development may be familiar with the abundance of cell cultures and animal models used in this stage. Indeed, the preclinical stage often follows either or both in vitro and in vivo testing. Marta also highlighted another key factor, reproducibility. Crucially, a reproducible study refers to a repeated study done under different conditions or parameters and by other researchers where the results or analyses are the same or in agreement. Any study can be vulnerable to biases. Therefore, a reproducible study ensures fair, correct, and trustworthy results that allow scientists the confidence that the drug is safe before it enters clinical trials. Furthermore, testing the potential drug with a "standard of care" is equally essential. This means testing the candidate against an existing drug for the same disease. The process seeks to observe efficacy, whether the experimental drug is more efficacious than an already marketed drug. In other words, if the drug is working. As you can see, much work must be done before drug development reaches human testing. Preclinical studies may vary in size, but they are crucial in defining how safe the drug is before it is tested on people. Therefore, Rick and Marta emphasise that the preclinical stage must follow good practice and the correct guidelines, collecting data to paint a detailed pict ure before being given to the regulatory bodies. Upon the success of preclinical research and the approval of human testing by the regulatory bodies, a process that can take up to 5 years, we finally arrive at clinical trials. In short, clinical trials will further test the candidate drug on human subjects for safety and efficacy, dosage, side effects, and adverse reactions. As the trial progresses, the group size of each phase also increases, and as the number of human subjects increases, so does the cost. Rick and Marta explained that labs or smaller companies will usually carry out the preclinical research, but will search for larger pharmaceutical companies as partners to continue clinical trials. The drug development process is complex and concerns a multidisciplinary team of scientists, corporate partners, and regulatory bodies. However, this process is necessary to create a safe and effective drug that can change lives. Many science and STEM students gravitate only towards science and their respective passionate fields and, unfortunately, tend to find business intimidating. So, what would be your advice for these students to begin learning more about the business side of STEM and building their own start-up? The ideal way to answer this question is to consider it in two different parts: exploring a new passion (the world of business) and the advice to learn more. In many ways, one may always feel the vulnerability of exploring the unknown. Perhaps that is why we live following our passions: there is a certain security in their reliability and certainty for enjoyment and happiness. A safety blanket, so to speak. However, this very blanket could be the culprit that slowly suffocates all possibilities of growth, keeping you safe, secure, and immovable. By reading through their novel, The Molecule , and doing a Google search of these two writers' incredible lives, any reader can surely understand how to grow in pharmacology; there needs to be a specific element of business. Of course, for many, the thought of entering the clutches of the world of business, a world of numbers, negotiations, and a lack of laboratory equipment and sterilisation, might seem daunting. However, it is essential for any reader to understand that if they wish to enter the world of drug development, they will not find this door in academia. Instead, the key to drug development is built when different skill sets, areas of knowledge, and technical expertise come together through the work of a multipurpose team. This delicate and intricate process centres on the team, a team that requires multiple disciplines to work in harmony and in an environment where creativity may flourish. However, how can one go from understanding the importance of business in drug development to taking the first steps into this new, terrifying, and exhilarating world? The simple answer to this is explored in The Molecule . To succeed in the unknown, one must find a good mentor. Someone you truly believe in to show you the way. Of course, there should always be some caution in ensuring the right mentor is found. However, this should not hinder any keen reader from trying, as every experience can be an opportunity for growth. Furthermore, there are many positive stories of successful mentorships, as seen through Dr Sax’s personal experience. In the beginning, like many in STEM, he considered pharmacology “the dark side”. At the time, he worked at Cornell University Medical Centre, living the life many could only dream of. He spent his days working as a triple blend between a physician, a researcher, and a teacher – his passions. When first approached by a mentor on the possibility of pharmacology, a scene was conjured. A scene that showed the fiery pits of hell with the personification of pharmacology itself as a fearful villain pushing one into damnation. However, the support and encouragement from this mentor were the tiny pushes that convinced him to try, leading him to where he is today. There are many ways to find these mentors. Through academia, students can take advantage of programs such as hosting entrepreneurial activities, wet labs, organised panels, and events, such as “speak to a member of the industry”. Even exploring master programs in drug development could be a step forward in matching a student with potential mentors. Moreover, outside of the academic halls, there are many opportunities to form connections. By browsing LinkedIn groups, forums, and Reddit posts, you can find your people and see their steps. Following Dr. New’s humbling words, “It is important for students to remember they are not the first in the history of civilisation to think of entrepreneurship, and it is online where they can find signatures of the work others have done". "Your people" will be the ones that share your confusion, fear, perhaps lack of expertise, love for adrenaline, and a good challenge. Once you find them, everything will start flowing. Furthermore, consider how the real world works: if you want something, you need to go get it, be it with cold reach outs into the unknown and follow-up emails. On average, it takes 6 follow-up emails until someone replies to you. Hence, whatever you are doing, selling, or asking, do it 6 times before you give up. What vision do you see for the future of the biotechnology industry? When posed this question, both Fredrick and Marta conveyed that the future of biotechnology is heavily unpredictable, primarily due to the variability in the success of biotech startups. Moreover, one significant factor influencing this unpredictability is the funding which these firms receive. However, the changes in focus to new trends in biotechnology show great promise for how this large industry may grow and develop. For instance, a new trend is the considerable focus on rare diseases and targeted therapies for specific mutations such as the ALMK-14 mutation in lung cancer. There is also a significant focus on looking at disease subcategories and honing in on the specific type of disease. For example, instead of broadly targeting lung cancer, there is a trend towards addressing specific forms such as small cell lung cancer and non-small cell lung cancer. This precise approach aims to focus on specific characteristics of each disease’s subtype, for example, some forms of lung cancer may be more aggressive than others. Moreover, both Marta and Richard both highlighted the intertwining of biotechnology with other fields, specifically artificial intelligence (AI). An interesting example of this is utilising AI to develop targeted therapies for molecular markers of disease which may have been identified by lab techniques such as Next Generation Sequencing (NGS). Finally, the industry encompasses a wide range of professions from smaller pharmaceutical companies to larger pharmaceutical firms each with different focuses. Due to these varied focuses, the industry will likely develop and progress in diverse ways, reflecting the various aims of these firms. This diversity further reinforces the unpredictability of the industry’s future but also makes it an interesting field to watch. A massive thank you to Nick Johnstone for giving Scientia News this opportunity; it means a lot. We have learnt so many new things and it has been very inspiring talking to Rick and Marta. For more information, visit the following hyperlinks: Dr Rick Sax ( research ) Dr Marta New Nick Johnstone ( author ) Written by Inês Couto André, Jeevana Thavarajah, Stephanus Steven & Harene Elayathamby Related book reviews: Intern Blue , The Emperor of All Maladies Project Gallery