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Hysterectomy is one of the most common inpatient surgeries. Currently, nearly one in three Canadian women aged 60 and older have had their uterus removed.

While this rate is falling, mainly due to greater use of non-surgical treatments for many gynecological conditions, hysterectomy appears to be normalized in Canada. Many women and some physicians view hysterectomy as a routine part of aging or natural step after childbearing.

This cultural acceptance is a problem because, in the long term, hysterectomy appears to be associated with an increased risk of heart problems and other chronic illnesses.

In Canada, approximately 35,000 hysterectomies are performed annually. The majority are for non-cancerous conditions such as abnormal uterine bleeding, fibroid growths, and pelvic organ prolapse.

In Alberta, the rate of hysterectomy is more than 20 per cent higher than the national rate (328 versus 269 per 100,000 adult women), and Canadian Institute for Health Information (CIHI) data shows the province has had a comparatively higher rate since 2010.

Hysterectomy and education

Within our team of medical professionals and health researchers, we know hysterectomy can have long-term health consequences and that it is overused in certain patient populations. Our research focuses on female reproductive health across the lifespan, with an overarching vision to make the future of women’s health a priority. We want to understand who is most at risk for poor health outcomes and identify strategies to reduce avoidable harm.

In a recent study, we investigated whether women with lower levels of education were more likely to have a hysterectomy, and at what ages.

Data show the relationship between education and the likelihood that a woman will have a hysterectomy.
(Brennand, McDonagh Hull, Scime), Author provided (no reuse)

We analyzed data from Alberta’s Tomorrow Project, a large, long-term study tracking health and chronic illness in Albertans. We studied almost 35,000 women over a 15-year period. The findings were stark: 29.7 per cent of women with a high school diploma or less had a hysterectomy, compared to 14.7 per cent with a university degree.

After we accounted for several social and medical factors, it appeared that women with a high school education were roughly 1.7 times as likely to have a hysterectomy than those with a university education. Even women with a college degree were approximately 1.6 times as likely to have a hysterectomy than those who were university educated.

We also found that less education meant women were more likely to have surgery at a younger age, and before menopause. This timing is important because when performed before natural menopause, hysterectomy appears to increase the risk of cardiovascular disease, osteoporosis and earlier onset of menopause symptoms.

Social disparities

Our findings raise important questions about social disparities in Canadian medical care. We know that women with lower levels of education often face economic challenges that can limit access to alternative treatments.

For example, if employment does not provide extended health benefits to cover the costs of medical management, women may view surgery — which is covered by Canada’s universal health-care system — as their only viable option. Moreover, they may have less access to health-care providers who are familiar with newer, non-surgical treatments, or who are willing to offer them.

Women with precarious employment or multiple roles at work and home may not be able to cope with unpredictable symptoms, such as unpredictable uterine bleeding, leading them to choose a more definitive treatment earlier.

Our research also questions whether health-care providers may be more likely to recommend surgery to women with less education, possibly due to biases or assumptions about women’s ability to afford or manage non-surgical treatments.

It is also possible that women with less education may have lower health literacy, affecting their ability to make informed decisions, or to participate in shared decision-making. Being less likely to question a doctor’s recommendations or seek second opinions could lead to a higher likelihood of surgery.

Despite medical advances reducing the need for hysterectomy, there are significant variations in its use across different groups of women.
(Brennand, McDonagh Hull, Scime), Author provided (no reuse)

It is evident that despite medical advances reducing the need for hysterectomy, there are significant variations in its use across different groups of women. This suggests some surgeries are not driven by medical necessity and may be avoidable. Our study adds to growing evidence calling for greater attention to the social determinants of female reproductive health. We expect it will require multiple approaches to address these disparities.

To begin with, it is essential to improve information about, and access to, non-surgical treatments for all women, including tailoring this as needed for those with less education. One potential area of improvement is Canada’s recent commitment to federal coverage for birth control, since this can provide excellent treatment for conditions such as heavy uterine bleeding.

Investment in pelvic floor physiotherapy is also necessary to ensure non-surgical treatment for pelvic organ prolapse is available to everyone.

Secondly, there is an urgent need for increasing awareness among health-care providers about the importance of shared decision-making and addressing unconscious bias.

Lastly, interventions to improve health literacy among women with lower education levels are critical to enable patients to be more active participants in their health-care decisions. It could also reduce the likelihood of experiencing a potentially avoidable hysterectomy and subsequent long-term health issues. Läs mer…

With this year’s annual United Nations Framework Convention on Climate Change Conference of the Parties (COP29) summit set to take place in a little over a month in Azerbaijan, the world’s attention once again turns to climate change, resource security and the goals of sustainable development.

The aims of sustainable development are to build a system that meets the needs of society without compromising the ability of future generations to fulfil their own. The UN adopted 17 sustainable development goals in 2015 and real progress has been made in advancing some of them. But can true sustainable development be achieved, and how might it work in practice?

I am an engineer with experience in mining and geotechnics. To help answer these questions, I have been researching the interplay between sustainability challenges in the natural resource sector, the evolving concept of the circular economy and the implications of economic models founded upon sustained growth.

Read more:
Mining the depths: Norway’s deep-sea exploitation could put it in environmental and legal murky waters

Striking a balance between resource extraction and environmental sustainability is essential for the continued existence of human societies and the risks of biodiversity loss must be accounted for in all resource extraction activities. At the same time, the need to protect the rights of all people — including Indigenous rights — remains paramount.

To help better understand the nuances of sustainable development, in my forthcoming research I propose a model of the impact(s) of human activities on the Earth’s planetary boundaries, which I refer to as the (un)sustainable machine.

Sustainable mining requires looking at the practices required to ensure long-term economic development remains in equilibrium with environmental and social considerations. The (un)sustainable machine model describes the delicate balancing acts at play, highlighting the intricate relationship between what drives minerals demand and consumption and how these forces impact Earth’s planetary boundary.

(Un)sustainable development

While progress may be being made in some areas of sustainable development — particularly around areas of poverty and malnutrition — as a planetary system, the report is much less positive. Take, for example, the issue of recycling.

The (un)sustainable machine model and its components.
(Davide Elmo), Author provided (no reuse)

Can recycling keep up with increased demand and counter resource extraction? Over 3.3 billion tonnes of metals are produced globally each year, and most demand predictions show rising consumption of metals in the coming decades.

Models developed by the World Bank indicate that by 2050, secondary supply (recycling) for aluminum, copper and nickel could meet about 60 per cent of the demand. Despite the enthusiasm among researchers and economists, however, these long-term projections indicate the difficulty of transitioning to a circular economy. Indeed, these predictions show that a 40 per cent unmatched demand must continue being supplied by primary sources like mining.

Read more:
Slow mining could be a solution to overconsumption in an increasingly fast-paced world

In my model, recycling is represented as a set of springs resisting the extraction of additional mineral resources. To achieve 100 per cent recycling of the entire spectrum of the mineral resources, our economy needs to solve problems that are not achievable with today’s technology. Furthermore, when developed on an industrial scale, recycling plants raise some of the same environmental challenges of large mineral processing and smelting plants.

Amidst this backdrop, the circular economy has presented itself as a transformative solution predicated on keeping products and materials in use, and regenerating natural systems. It challenges the linear extract-produce-dispose approach and questions the sustainability of perpetual economic growth, especially in a world with finite resources and known environmental constraints. Analogous to the (un)sustainable machine model, I also propose the model of the (un)sustainable cone of demand and consumption.

The (un)sustainable cone of demand and consumption and its (conceptual) implications for Earth’s planetary boundaries.
(Davide Elmo)

The (un)sustainable cone model highlights the discrepancy between an economic concept based on the idea of a closed-loop system (circular economy) and the current financial framework based on the idea that infinite growth is possible. The larger the unbalanced cross-sectional area of the (un)sustainable cone of demand and consumption, the larger the stresses imposed upon Earth’s planetary boundaries.

A different path?

To remain within Earth’s planetary boundaries requires solutions beyond simple technical means. Actions by a few individuals are not sufficient. As engineers, we often believe it is possible to develop solutions to mitigate the anthropogenic impacts on Earth’s planetary boundaries. However, by doing so, we fail to realize that finite barriers to growth remain and that our engineering solutions may in time become part of the problem.

Read more:
GDP is not enough to measure a country’s development. What if we used the Sustainable Development Goals instead?

It is essential for individuals who are not economists or environmental scientists to think about the meaning of sustainability in the context of extracting mineral resources. At the same time, economists and social-environmental scientists need to recognize that when it comes to mineral resources, policies and permitting regulations should not be addressed separately from the technical and economic aspects of mining engineering problems.

To paraphrase the work of eminent American social scientist Garrett Hardin:

Therein is the tragedy. Each financial market is locked into a system that compels it to increase its value without limit – in a world with finite resources. Earth’s ruin is the destination toward which all companies rush, each pursuing its own best interest in a market that (only) believes in the benefits of the shareholders.

Simply put, while both policy and technology are necessary to achieve true sustainability, unless our efforts are unified across discipline and economies, there is little hope for staying within the finite bounds of what our planet can provide. Läs mer…

If your jaw dropped as you watched the latest AI-generated video, your bank balance was saved from criminals by a fraud detection system, or your day was made a little easier because you were able to dictate a text message on the run, you have many scientists, mathematicians and engineers to thank.

But two names stand out for foundational contributions to the deep learning technology that makes those experiences possible: Princeton University physicist John Hopfield and University of Toronto computer scientist Geoffrey Hinton.

The two researchers were awarded the Nobel Prize in physics on Oct. 8, 2024, for their pioneering work in the field of artificial neural networks. Though artificial neural networks are modeled on biological neural networks, both researchers’ work drew on statistical physics, hence the prize in physics.

The Nobel committee announces the 2024 prize in physics.
Atila Altuntas/Anadolu via Getty Images

How a neuron computes

Artificial neural networks owe their origins to studies of biological neurons in living brains. In 1943, neurophysiologist Warren McCulloch and logician Walter Pitts proposed a simple model of how a neuron works. In the McCulloch-Pitts model, a neuron is connected to its neighboring neurons and can receive signals from them. It can then combine those signals to send signals to other neurons.

But there is a twist: It can weigh signals coming from different neighbors differently. Imagine that you are trying to decide whether to buy a new bestselling phone. You talk to your friends and ask them for their recommendations. A simple strategy is to collect all friend recommendations and decide to go along with whatever the majority says. For example, you ask three friends, Alice, Bob and Charlie, and they say yay, yay and nay, respectively. This leads you to a decision to buy the phone because you have two yays and one nay.

However, you might trust some friends more because they have in-depth knowledge of technical gadgets. So you might decide to give more weight to their recommendations. For example, if Charlie is very knowledgeable, you might count his nay three times and now your decision is to not buy the phone – two yays and three nays. If you’re unfortunate to have a friend whom you completely distrust in technical gadget matters, you might even assign them a negative weight. So their yay counts as a nay and their nay counts as a yay.

Once you’ve made your own decision about whether the new phone is a good choice, other friends can ask you for your recommendation. Similarly, in artificial and biological neural networks, neurons can aggregate signals from their neighbors and send a signal to other neurons. This capability leads to a key distinction: Is there a cycle in the network? For example, if I ask Alice, Bob and Charlie today, and tomorrow Alice asks me for my recommendation, then there is a cycle: from Alice to me, and from me back to Alice.

In recurrent neural networks, neurons communicate back and forth rather than in just one direction.
Zawersh/Wikimedia, CC BY-SA

If the connections between neurons do not have a cycle, then computer scientists call it a feedforward neural network. The neurons in a feedforward network can be arranged in layers. The first layer consists of the inputs. The second layer receives its signals from the first layer and so on. The last layer represents the outputs of the network.

However, if there is a cycle in the network, computer scientists call it a recurrent neural network, and the arrangements of neurons can be more complicated than in feedforward neural networks.

Hopfield network

The initial inspiration for artificial neural networks came from biology, but soon other fields started to shape their development. These included logic, mathematics and physics. The physicist John Hopfield used ideas from physics to study a particular type of recurrent neural network, now called the Hopfield network. In particular, he studied their dynamics: What happens to the network over time?

Such dynamics are also important when information spreads through social networks. Everyone’s aware of memes going viral and echo chambers forming in online social networks. These are all collective phenomena that ultimately arise from simple information exchanges between people in the network.

Hopfield was a pioneer in using models from physics, especially those developed to study magnetism, to understand the dynamics of recurrent neural networks. He also showed that their dynamics can give such neural networks a form of memory.

Boltzmann machines and backpropagation

During the 1980s, Geoffrey Hinton, computational neurobiologist Terrence Sejnowski and others extended Hopfield’s ideas to create a new class of models called Boltzmann machines, named for the 19th-century physicist Ludwig Boltzmann. As the name implies, the design of these models is rooted in the statistical physics pioneered by Boltzmann. Unlike Hopfield networks that could store patterns and correct errors in patterns – like a spellchecker does – Boltzmann machines could generate new patterns, thereby planting the seeds of the modern generative AI revolution.

Hinton was also part of another breakthrough that happened in the 1980s: backpropagation. If you want artificial neural networks to do interesting tasks, you have to somehow choose the right weights for the connections between artificial neurons. Backpropagation is a key algorithm that makes it possible to select weights based on the performance of the network on a training dataset. However, it remained challenging to train artificial neural networks with many layers.

In the 2000s, Hinton and his co-workers cleverly used Boltzmann machines to train multilayer networks by first pretraining the network layer by layer and then using another fine-tuning algorithm on top of the pretrained network to further adjust the weights. Multilayered networks were rechristened deep networks, and the deep learning revolution had begun.

A computer scientist explains machine learning to a child, to a high school student, to a college student, to a grad student and then to a fellow expert.

AI pays it back to physics

The Nobel Prize in physics shows how ideas from physics contributed to the rise of deep learning. Now deep learning has begun to pay its due back to physics by enabling accurate and fast simulations of systems ranging from molecules and materials all the way to the entire Earth’s climate.

By awarding the Nobel Prize in physics to Hopfield and Hinton, the prize committee has signaled its hope in humanity’s potential to use these advances to promote human well-being and to build a sustainable world. Läs mer…

Book cover of ‘Urban Mobility: How the iPhone, COVID, and Climate Changed Everything,’ edited by Shauna Brail and Betsy Donald.
(University of Toronto Press)

Canadian cities are falling behind globally when it comes to efficiently moving people. Long commute times, high congestion rates and infrastructure that is vulnerable to climate change are symptoms of a mobility crisis.

Mobility is an essential public good, and modern policies aim to move people in a safe, efficient, accessible and non-polluting way. However, the COVID-19 pandemic exposed and worsened existing vulnerabilities in Canada’s urban mobility systems, undermining progress toward these goals.

Our new book, Urban Mobility: How the iPhone, COVID, and Climate Changed Everything, explores how technology, the pandemic and climate change have shaped, and continue to shape, urban mobility, particularly for those with inadequate transportation networks.

Population growth outpacing transit

One of the primary challenges Canadian cities face is that they have grown faster than their sustainable transportation options. While urban populations have expanded, investment in public transportation has not kept pace, resulting in a gap between capacity and potential.

The COVID-19 pandemic also impacted city life in profound ways, and urban life and economies in Canada are still being affected to this day. Remote work became the norm for many, reducing the number of people commuting and causing a significant drop in public transit ridership.

Additionally, the shift to hybrid work has permanently altered how Canadians engage with their cities. People are shopping online more, using public transit less, and central business districts and physical retail spaces are seeing less foot traffic.

Urban economies, which have been designed to rely heavily on the movement and presence of large numbers of people through public transit and local businesses, are still grappling with this new reality. Activity levels, for instance, are down by about 20 per cent from pre-pandemic levels in many downtown spaces still.

A man shops for shoes at the McArthurGlen Designer Outlet on Boxing Day in Richmond, B.C., on Dec. 26, 2023.
THE CANADIAN PRESS/Ethan Cairns

Tech platforms and mobility

Digital platform firms like Zoom, Uber, Amazon and Instacart adapted quickly during the pandemic, offering safe work-from-home options, private transportation and online shopping services to people. These platforms disrupted the traditional urban economic model, which relies on transit, physical stores and foot traffic.

Ride-hailing services drew passengers and their fares away from local economies into foreign-owned ride-hailing companies. Transit systems not only depend on the massive built public infrastructure, but also passenger fares and other government funding to maintain the public system over time.

In addition, these tech platform companies come with equity and accessibility concerns. Research on the use of ride-hailing and public transit during the pandemic found that its usage in Toronto was clearly organized along class, neighbourhood and social lines. People identifying as one or more of the following were more likely to continue riding transit during the pandemic: low-income, immigrant, racialized, essential workers and car-less, in large part because other options were not available to them.

Similarly, in Calgary, private technology experiments in electric scooters privileged wealthier neighbourhoods. Electric scooters were used more in wealthier neighbourhoods, and as poverty levels increased at the neighbourhood level, the use of them dropped. The researchers concluded that greater attention needs to be paid to ensuring all communities, regardless of economic status, have access to micro-mobility options.

Canada has a history of importing technological solutions, rather than creating its own. Montréal, however, offers a successful example with its Bixi bike program, the third largest bike share system in North America after New York and Chicago, with 11,000 bikes and almost 900 stations. A non-profit runs the program, Rio Tinto Alcan provides aluminum for the bikes and Cycles Devinci manufactures them in Saguenay-Lac-Saint-Jean.

Canadian cities need to build innovation opportunities that promote economic development and improve mobility at the same time. Canada’s technology sector is woefully undersupported at present.

Bixi bikes stand on Sainte-Catherine Street in Montréal in August 2019. The City of Montréal bought the bike sharing system in 2014 and created a non-profit entity to run the bike sharing operations.
(Shutterstock)

Climate crisis intensifying challenges

The third, and perhaps most pressing challenge facing Canadian cities is the growing climate crisis. Cities are both instigators and victims of climate change. They contribute significantly to greenhouse gas emissions, but are also heavily impacted by severe weather events, heat waves and other side effects.

These impacts are becoming increasingly concerning with the intensification of wildfires, urban flooding and other extreme weather events.

By the end of the 20th century, most large Canadian cities were heavily investing in strategies to encourage people to use alternatives to cars, such as transit, light rail, biking and walking.

However, shifting priorities, ideologies and budgetary adjustments led to government cutbacks to transit funding and a lack of new transportation innovation. In Ontario, for example, the government continues to push unrealistic road-building ideas at the expense of more active transit options.

This failure to effectively move people around has left an opening for new mobility experiments led by private companies, but some of these programs don’t really integrate well into the Canadian urban mobility ecosystem. Many of these mobility options — such as ride-hailing — are also costly and exclusive. Others, like electronic scooters, can lead to e-waste.

Building a better future

The disruptions caused by technology, the pandemic and climate change are reshaping how people and goods move in cities. To build a better future, Canadian cities must address the interconnected challenges of three transitions: digital, health and environmental.

While all sectors need to invest, strong leadership and policy action from governments at all levels is needed to create a more climate-friendly, economically vibrant and equitable urban mobility future. Governments will need to embrace bold, innovative solutions that address all three of these challenges.

This means policy frameworks that reduce carbon emissions through climate action plans, leveraging political will and funding in efforts to shift away from private automobiles and toward transit, bike lanes and pedestrian pathways, and experimenting with digital mobility services while still prioritizing sustainability. Läs mer…

Deki, a 23-year-old resident of the remote town of Armidale, NSW, has been sleepless with excitement since the Bhutanese embassy in Canberra announced an upcoming visit from Bhutan’s fifth monarch, King Jigme Khesar Namgyel Wangchuck.

King Jigme Khesar will be visiting from October 10 to 16. It will be his first time in Australia, as well as the first ever visit from a Bhutanese head of state.

According to Bhutan’s ministry of foreign affairs and external trade, the king will meet with Australian government officials, business leaders and the Bhutanese community during his trip. Audiences with the king are scheduled in Sydney on October 12, Canberra on October 13, and Perth on October 16.

Deki will be travelling to Sydney by train on October 11 with about 60 people from Armidale’s Bhutanese community. The journey will take more than eight hours. Some residents will fly on the morning of October 12.

The Armidale residents have practised dances to present to the royal entourage. Their enthusiasm is palpable. With more than 35,000 Bhutanese people living in Australia, the embassy received an overwhelming number of registrations for the royal audience.

Chhimi Dorji, president of the Association of Bhutanese in Perth, said many Bhutanese residents applied for leave the moment the royal visit was announced. He said the community’s overwhelming excitement signifies a deep love and respect for the king.

Khesar Namgyel Wangchuck poses with his wife, Queen Jetsun Pema, after their wedding ceremony on October 13 2011.
Kevin Frayer/AP

A deep reverence for the king

Devotion to the king is ingrained in Bhutanese society; he is even considered a sacred figure. This love and respect stems from a view of the monarchy as a symbol of pride and unity.

My ongoing research on language and politics in Bhutan – as well as the many years I spent working there as a journalist – has revealed a genuine admiration for the king among the public. Research participants in rural Bhutan told me politicians should learn from the king in order to serve their people.

In 2008, King Jigme Khesar facilitated Bhutan’s transition from an absolute monarchy to a democratic constitutional monarchy. As party politics fragmented the small nation and divided people along party lines, the monarchy was seen as a beacon of hope.

The Bhutanese public’s devotion to its king defies theories which claim that the concept of the monarchy more broadly is becoming obsolete.

Serving the people

One reason King Jigme Khesar is so revered is because of his role in helping to build and advance Bhutan. During the pandemic, he was hailed for implementing pandemic response strategies and for visiting every nook and corner of the country to comfort citizens.

He has also implemented programs that provide important public services. For instance, Desuung, a volunteer training program that started in 2011, delivers volunteers for a variety of projects such as disaster operations and charity events. Another national service program, Gyalsung, was started this year.

Residents of Gengu in eastern Bhutan queue for the COVID vaccine as part of the country’s widely praised pandemic response.
UNICEF Bhutan/EPA

Currently, the king is planning to develop the world’s first mindfulness city in Gelephu – a southern plain in Bhutan spanning more than 1,000 square kilometres – with hopes to attract foreign investment and encourage emigrated Bhutanese people to return.

Ahead of the royal visit, Sydney resident Tshering Palden said he and his children were clearly excited to greet King Jigme Khesar.

Besides other things, I am excited to hear about the developments around Gelephu Mindfulness City and how Bhutanese living abroad like me can be part of His Majesty’s brain child and the long-term nation building […]

Foreigners are also intrigued and very interested to know about the project and ask us a lot about it.

The Australian dream

As a landlocked country that really only made itself known to the world in 1999 (after internet and television were finally introduced), Bhutan is something of an enigma.

It is touted as the world’s happiest country, largely due to its uptake of a unique metric called “gross national happiness” in the 1970s. In 1972, King Jigme Singye Wangchuck (King Jigme Khesar’s father) proclaimed the country’s gross national happiness was an even more important measure of progress than gross domestic product (GDP).

Today, however, the tiny Himalayan country of about 800,000 people faces an existential crisis due to widespread unemployment and huge numbers of youth and young professionals moving overseas for a better future.

Australia remains a top destination for Bhutanese residents – and currently has more Bhutanese diaspora than any country in the world. Bhutan is also said to be Australia’s 14th largest source country for international students.

But despite living so far away, Bhutanese diaspora in Australia remain deeply rooted to their identity, culture and devotion to the monarchy. Most of them still celebrate the king’s birthday on February 21 each year, as well as Bhutan’s National Day on December 17.

Meanwhile, Deki – who has portraits of Jigme Khesar in her home in central Bhutan – says being able to meet the king will be a “dream come true”. Läs mer…

In a recent TikTok video, Australian media personality Abbie Chatfield shared she was starting a vaccine to protect against urinary tract infections (UTIs).

Huge news for the UTI girlies. I am starting a UTI vaccine tonight for the first time.

Chatfield suffers from recurrent UTIs and has turned to the Uromune vaccine, an emerging option for those seeking relief beyond antibiotics.

But Uromune is not a traditional vaccine injected to your arm. So what is it and how does it work?

First, what are UTIs?

UTIs are caused by bacteria entering the urinary system. This system includes the kidneys, bladder, ureters (thin tubes connecting the kidneys to the bladder), and the urethra (the tube through which urine leaves the body).

The most common culprit is Escherichia coli (E. coli), a type of bacteria normally found in the intestines.

While most types of E. coli are harmless in the gut, it can cause infection if it enters the urinary tract. UTIs are particularly prevalent in women due to their shorter urethras, which make it easier for bacteria to reach the bladder.

Roughly 50% of women will experience at least one UTI in their lifetime, and up to half of those will have a recurrence within six months.

UTIs are caused by bacteria enterning the urinary system.
oxo7051/Shutterstock

The symptoms of a UTI typically include a burning sensation when you wee, frequent urges to go even when the bladder is empty, cloudy or strong-smelling urine, and pain or discomfort in the lower abdomen or back. If left untreated, a UTI can escalate into a kidney infection, which can require more intensive treatment.

While antibiotics are the go-to treatment for UTIs, the rise of antibiotic resistance and the fact many people experience frequent reinfections has sparked more interest in preventive options, including vaccines.

What is Uromune?

Uromune is a bit different to traditional vaccines that are injected into the muscle. It’s a sublingual spray, which means you spray it under your tongue. Uromune is generally used daily for three months.

It contains inactivated forms of four bacteria that are responsible for most UTIs, including E. coli. By introducing these bacteria in a controlled way, it helps your immune system learn to recognise and fight them off before they cause an infection. It can be classified as an immunotherapy.

A recent study involving 1,104 women found the Uromune vaccine was 91.7% effective at reducing recurrent UTIs after three months, with effectiveness dropping to 57.6% after 12 months.

These results suggest Uromune could provide significant (though time-limited) relief for women dealing with frequent UTIs, however peer-reviewed research remains limited.

Any side effects of Uromune are usually mild and may include dry mouth, slight stomach discomfort, and nausea. These side effects typically go away on their own and very few people stop treatment because of them. In rare cases, some people may experience an allergic reaction.

How can I access it?

In Australia, Uromune has not received full approval from the Therapeutic Goods Administration (TGA), and so it’s not something you can just go and pick up from the pharmacy.

However, Uromune can be accessed via the TGA’s Special Access Scheme or the Authorised Prescriber pathway. This means a GP or specialist can apply for approval to prescribe Uromune for patients with recurrent UTIs. Once the patient has a form from their doctor documenting this approval, they can order the vaccine directly from the manufacturer.

Antibiotics are the go-to treatment for UTIs – but scientists are looking at options to prevent them in the first place.
Photoroyalty/Shutterstock

Uromune is not covered under the Pharmaceutical Benefits Scheme, meaning patients must cover the full cost out-of-pocket. The cost of a treatment program is around A$320.

Uromune is similarly available through special access programs in places like the United Kingdom and Europe.

Other options in the pipeline

In addition to Uromune, scientists are exploring other promising UTI vaccines.

Uro-Vaxom is an established immunomodulator, a substance that helps regulate or modify the immune system’s response to bacteria. It’s derived from E. coli proteins and has shown success in reducing UTI recurrences in several studies. Uro-Vaxom is typically prescribed as a daily oral capsule taken for 90 days.

FimCH, another vaccine in development, targets something called the adhesin protein that helps E. coli attach to urinary tract cells. FimCH is typically administered through an injection and early clinical trials have shown promising results.

Meanwhile, StroVac, which is already approved in Germany, contains inactivated strains of bacteria such as E. coli and provides protection for up to 12 months, requiring a booster dose after that. This injection works by stimulating the immune system in the bladder, offering temporary protection against recurrent infections.

These vaccines show promise, but challenges like achieving long-term immunity remain. Research is ongoing to improve these options.

No magic bullet, but there’s reason for optimism

While vaccines such as Uromune may not be an accessible or perfect solution for everyone, they offer real hope for people tired of recurring UTIs and endless rounds of antibiotics.

Although the road to long-term relief might still be a bit bumpy, it’s exciting to see innovative treatments like these giving people more options to take control of their health. Läs mer…

In dusty factories, cramped internet cafes and makeshift home offices around the world, millions of people sit at computers tediously labelling data.

These workers are the lifeblood of the burgeoning artificial intelligence (AI) industry. Without them, products such as ChatGPT simply would not exist. That’s because the data they label helps AI systems “learn”.

But despite the vital contribution this workforce makes to an industry which is expected to be worth US$407 billion by 2027, the people who comprise it are largely invisible and frequently exploited. Earlier this year nearly 100 data labellers and AI workers from Kenya who do work for companies like Facebook, Scale AI and OpenAI published an open letter to United States President Joe Biden in which they said:

Our working conditions amount to modern day slavery.

To ensure AI supply chains are ethical, industry and governments must urgently address this problem. But the key question is: how?

What is data labelling?

Data labelling is the process of annotating raw data — such as images, video or text — so that AI systems can recognise patterns and make predictions.

Self-driving cars, for example, rely on labelled video footage to distinguish pedestrians from road signs. Large language models such as ChatGPT rely on labelled text to understand human language.

These labelled datasets are the lifeblood of AI models. Without them, AI systems would be unable to function effectively.

Tech giants like Meta, Google, OpenAI and Microsoft outsource much of this work to data labelling factories in countries such as the Philippines, Kenya, India, Pakistan, Venezuela and Colombia.

China is also becoming another global hub for data labelling.

Outsourcing companies that facilitate this work include Scale AI, iMerit, and Samasource. These are very large companies in their own right. For example, Scale AI, which is headquartered in California, is now worth US$14 billion.

Cutting corners

Major tech firms like Alphabet (the parent company of Google), Amazon, Microsoft, Nvidia and Meta have poured billions into AI infrastructure, from computational power and data storage to emerging computational technologies.

Large-scale AI models can cost tens of millions of dollars to train. Once deployed, maintaining these models requires continuous investment in data labelling, refinement and real-world testing.

But while AI investment is significant, revenues have not always met expectations. Many industries continue to view AI projects as experimental with unclear profitability paths.

In response, many companies are cutting costs which affect those at the very bottom of the AI supply chain who are often highly vulnerable: data labellers.

Low wages, dangerous working conditions

One way companies involved in the AI supply chain try to reduce costs is by employing large numbers of data labellers in countries in the Global South such as the Philippines, Venezuela, Kenya and India. Workers in these countries face stagnating or shrinking wages.

For example, an hourly rate for AI data labellers in Venezuela ranges from between 90 cents and US$2. In comparison, in the United States, this rate is between US$10 to US$25 per hour.

In the Philippines, workers labelling data for multi-billion dollar companies such as Scale AI often earn far below the minimum wage.

Some labelling providers even resort to child labour for labelling purposes.

But there are many other labour issues within the AI supply chain.

Many data labellers work in overcrowded and dusty environments which pose a serious risk to their health. They also often work as independent contractors, lacking access to protections such as health care or compensation.

The mental toll of data labelling work is also significant, with repetitive tasks, strict deadlines and rigid quality controls. Data labellers are also sometimes asked to read and label hate speech or other abusive language or material, which has been proven to have negative psychological effects.

Errors can lead to pay cuts or job losses. But labellers often experience lack of transparency on how their work is evaluated. They are often denied access to performance data, hindering their ability to improve or contest decisions.

Making AI supply chains ethical

As AI development becomes more complex and companies strive to maximise profits, the need for ethical AI supply chains is urgent.

One way companies can help ensure this is by applying a human right-centreed design, deliberation and oversight approach to the entire AI supply chain. They must adopt fair wage policies, ensuring data labellers receive living wages that reflect the value of their contributions.

By embedding human rights into the supply chain, AI companies can foster a more ethical, sustainable industry, ensuring that both workers’ rights and corporate responsibility align with long-term success.

Governments should also create new regulation which mandates these practices, encouraging fairness and transparency. This includes transparency in performance evaluation and personal data processing, allowing workers to understand how they are assessed and to contest any inaccuracies.

Clear payment systems and recourse mechanisms will ensure workers are treated fairly. Instead of busting unions, as Scale AI did in Kenya in 2024, companies should also support the formation of digital labour unions or cooperatives. This will give workers a voice to advocate for better working conditions.

As users of AI products, we all can advocate for ethical practices by supporting companies that are transparent about their AI supply chains and commit to fair treatment of workers. Just as we reward green and fair trade producers of physical goods, we can push for change by choosing digital services or apps on our smartphones that adhere to human rights standards, promoting ethical brands through social media, and voting with our dollars for accountability from tech giants on a daily basis.

By making informed choices, we all can contribute to more ethical practices across the AI industry. Läs mer…

Less than a month after Amazon announced employees would need to give up their flexible work arrangements and return to the office full-time, new research has reinforced the value of a flexible work culture.

The 2024 Employee Benefits Review, by consultancy firm Mercer, found 89% of Australian organisations still offer the option of working from home, with the average number of mandated office days stable at about three a week, the same as last year.

In this era of limited pay growth, businesses are also increasingly leveraging flexible work arrangements to attract and retain top talent, enhance employee engagement and foster a positive workplace culture.

The research shows some Australian workers are even prepared to take a pay cut for the sake of a more flexible work life. This and other findings conflict with a renewed push by some big businesses to get employees back to the office.

Businesses at odds with the research

Three weeks ago, Amazon CEO Andy Jassy issued a memo calling all employees back to the office five days a week.

Up to this point, the return to office (RTO) conversation had largely fallen silent for most of this year. Hybrid work arrangements were generally being accepted as the norm for office workers.

Amazon’s move has reignited the topic. Shortly after the Amazon announcement, Tabcorp CEO Gillon McLachlan ordered workers back to the office to improve performance and create “a winning culture”.

However, not everybody supports the idea, here or overseas. Senior executives at Google and Microsoft were quick to distance themselves. They reassured workers hybrid arrangements would stay as long as productivity levels didn’t fall.

What a new national survey found

Mercer’s report, released on October 2, is based on data from 502 Australian organisations across all major industry groups and sectors. It found flexible work – when managed well – can contribute to a positive workplace culture. It can also improve diversity and inclusion, while broadening the potential talent pool.

As well as letting people work from home, the report found 77% of participating firms allow staff to adjust their start and finish times. And 5% let their employees work four days instead of five at the same pay. This is commonly referred to as the 100:80:100 model of a four day work week.

Many businesses gave employees the flexibility to change their start and finish times.
Monkey Business Images/Shutterstock

Four per cent of businesses offered a “compressed working year” – the ability to work the equivalent of 48 weeks in just 40 weeks. Another business was experimenting with letting staff work four years at 80% of salary, and take the fifth year as leave.

Mercer’s client engagement manager Don Barrera said

employers need to find the balance between the needs of their employees and the overall business objectives in order to create a benefits strategy that delivers value to all.

Changing culture

With flexible work now firmly embedded in many Australian companies, work culture is changing too.

Just under 60% now define their culture around “work-life balance.” This places greater emphasis on people, but not at the expense of performance.

This fits with 2021 research identifying positive links between flexibility, employee engagement, productivity and overall performance.

Workplace Gender Equality Agency research released earlier this year describes flexible work as “the key to workplace gender equality”.

Other studies have found flexible work increased potential employment opportunities for people with disabilities.

Flexibility also now extends beyond simply work arrangements. According to the Mercer research, it can include career development, training opportunities, parental leave, part-time work, annual leave, and support for financial wellbeing.

In recognition of cost-of-living pressures, 65% of organisations now offer health and wellbeing classes and 29% offer financial wellness programs. By broadening the scope of flexibility, businesses can better respond to their workforce’s evolving needs.

Everyone benefits

Both employers and employees can benefit from flexibility. For employees, it’s about improving work-life balance, with one-third now willing to forgo a 10% pay rise in favour of flexible, reduced hours, or a compressed work schedule.

For employers, the benefits are attracting and retaining top talent, fostering a positive workplace culture, and being able to adapt to changing market conditions with a skilled and engaged workforce.

By understanding the interconnection between these needs, firms can create a work culture that recognises employees have commitments and interests outside work. This can help employees achieve better work-life balance. Läs mer…

Political operatives on the far right have long spoken about their ambition to shift the “Overton window”. The aim is to “mainstream” ideas long considered unthinkable, through gradual, step-by-step radicalisation and repetition – especially on hot-button issues such as immigration, sexuality, race and identity.

If challenged, commentators respond by appealing to “free speech”, accusing their critics of denying this basic liberal right.

The career of former Fox News celebrity Tucker Carlson represents a case study in the success of this political strategy in the United States. As his recent interview with Holocaust revisionist Darryl Cooper highlights, the Overton window seems to have shifted so far that it now includes the extreme right in ways that were unthinkable as recently as a decade ago.

The interview on Carlson’s YouTube channel raises unsettling questions about the visions of history and politics all of this “free speech” is opening us towards, and how democratic debate could possibly be benefited by this process.

Careering free speech

Carlson has a history of promoting baseless claims. In late 2021, he exercised his freedom of speech by producing a three-part documentary alleging that the riot of Trump followers at the US Capitol on January 6 2021 was a “false flag” FBI operation, the true aim of which was to vilify the MAGA movement.

He has pushed COVID vaccine conspiracy theories and promoted the “great replacement” conspiracy theory on more than 400 shows. Long restricted to the extreme right fringe in Europe, this “theory” suggests that progressive elites in Western nations promote non-European immigration for their own political advantage, with the sinister ambition to “replace” the “white race”.

Carlson was ousted from Fox News in 2023, shortly after the cable network’s $787.5 million settlement with Dominion Voting Systems for spreading disinformation about the 2020 election. His own emails admitting Fox’s dishonesty were used as evidence in the case.

Then came 2024. In February, Carlson visited Russia, becoming the first Western journalist to interview President Vladimir Putin since the start of the Ukraine war. Carlson allowed Putin to air his rationalisations for Russia’s invasion of Ukraine, without any real challenge.

Aleksandr Dugin.
Duma.gov.ru via Wikimedia Commons, CC BY

Carlson then sat down for his YouTube channel with Russian neofascist Aleksandr Dugin. Dugin is a pro-Putin intellectual who was once fired from his academic position for urging his countrymen to “kill, kill, kill” their Ukrainian neighbours. He has expressed admiration for the Waffen SS – the most radical military arm of the Nazi SS – and decried the “Jewish elite”, which he proposes runs the US. In 1996, Dugin called for “an authentic, real, radically revolutionary and consistent fascism” in Russia, “borderless as our lands, and red as our blood”.

Shortly after his interview with Dugin, Carlson hosted Cooper, who proposed that British prime minister Winston Churchill, not Adolf Hitler, was the “chief villain” of World War II.

As for the Holocaust? Cooper challenged almost everything “mainstream” historians agree about Nazi atrocities. He claimed the Nazis’ hands were tied due to food shortages after Hitler invaded Soviet Russia. Since Churchill had refused to admit defeat after the fall of France in 1940, the Nazis were effectively blockaded. This left them with a choice between slowly starving the millions of “prisoners” their invasions bequeathed them and the more “humane” measure of “finishing them off quickly”.

These views, which have long circulated in neo-Nazi circles, are demonstrably false. They transparently serve to sanitise Hitler’s atrocities.

Bipartisan concerns

With his interview with Cooper, Carlson’s journey to the farthest reaches of the political right finally seems to have sparked bipartisan concern. Alongside condemnation from the White House, criticism came from some conservative lawmakers, including New York Republican Mike Lawler, who commented:

Platforming known Holocaust revisionists is deeply disturbing. During my time in the State Assembly, I worked with Democrats and Republicans to ensure all students in New York received proper education on the Holocaust, something Mr Cooper clearly never had.

Conservative political theorist Leo Strauss once opined that Weimar Germany collapsed because its liberal freedoms allowed Nazism, with its craven appeals to base hatreds, to proliferate. The shift of the Overton window in the US to include the far-right makes his warning newly unsettling.

Conservative theorist Leo Strauss in 1939.
Monozigote, via Wikimedia Commons, CC BY-SA

We have slowly arrived at a place where a commentator of enormous influence, who is close to a presidential candidate, is platforming a fan of Heinrich Himmler’s SS and neo-Nazi talking points.

The problem here is arguably not only that Carlson is hosting extremists such as Dugin and Cooper, but that he presents them to his many followers as courageous truth-tellers, whose views have been “forbidden” by censorious elites. He extolled Cooper as “the best and most honest popular historian in the United States”. Elon Musk posted on X in praise of Carlson’s interview, before quietly removing the post.

The same wide-eyed sympathy characterised Carlson’s exchanges with Putin and Dugin. Little wonder the latter celebrated his interview as a great tactical victory. Carlson had, in effect, given Dugin’s ideas an entrée into the US, from which Dugin himself remains banned.

To what end?

The pressing question all this raises is just what good can possibly come from opening the Overton window to ideas which generations of people since World War II have known to be toxic and incompatible with the political values of nations such as the US and Australia, which Carlson visited earlier this year.

In response to this question, formulaic outrage about the right to freely express any and all ideas, including the most hateful and patently false, really doesn’t cut it. In political scientist Robert O. Paxton’s definition, fascism is characterised by:

obsessive preoccupation with community decline, humiliation, or victimhood and by
compensatory cults of unity, energy and purity, in which a mass-based party of committed nationalist militants, working in uneasy but effective collaboration with traditional elites, abandons democratic liberties and pursues with redemptive violence and without ethical or legal restraints goals of internal cleansing and external expansion.

There is nothing in such a militant perspective consistent with the basic principles of democratic countries: social pluralism, the rule of law, multiparty politics with the peaceful transition of power, and the protected liberties of citizens – including freedom of speech.

Freedom of speech and its enemies

John Stuart Mill argued for freedom of speech on the grounds that the contest of opinions is needed to discover and share the truth. This classic liberal defence of free expression faces inescapable challenges, however, when it comes to the opinions of avowed enemies of “liberalism” such as Dugin and Cooper.

They are people who deride concerns about individual rights and protections. They assert the demands of the mythologised “ethnic community”. They conceive of politics as a war or struggle for domination.

Proponents of far-right views have, at best, a conditional interest in seeking the truth. Mill’s conception of a pluralistic public sphere of competing voices is anathema to them, if they attain power. They have no interest in fostering an independent-minded population capable of holding leaders to informed account.

The far right accepts the need to lie, suppress information and “strategically” present its position to different audiences. Such dishonesty is an instrument in the existential struggle. Its shameless deployment is a sign of strength and fidelity to the higher “truth” of the cause.

German philosopher Rainer Forst has studied the issues of free speech and toleration.
www.stephan-roehl.de, via Wikimedia Commons, CC BY-SA

All of this suggests deep “free speech” reasons for scepticism about the formulaic appeal to this liberal value being used to mainstream the ideas of Dugin and Cooper. Liberal democracies champion toleration. Yet as philosopher Rainer Forst has shown in a classic study, this toleration necessarily requires the clear-sightedness to identify, and the forthrightness to oppose, principled intolerance and the promotion of group hatred.

The time is surely past for the postwar complacency that far-right politics “could never happen again” in new forms. This is a time when a US vice-presidential candidate has happily shared a stage with Carlson after his Cooper interview.

The same candidate now owns his willingness to “create” stories about immigrants to spread fear and division before a national election whose results his party has again committed to challenging should they lose.

It is time to outspokenly defend democratic values and institutions against their foes, rather than let the disingenuous appeal to “free speech” be used to undermine them. Läs mer…

It might seem surprising today in the era of Donald Trump, but Republicans in the United States once championed immigration and supported pathways to citizenship for undocumented Americans.

In January 1989, Ronald Reagan’s final speech as president was an impassioned ode to the immigrants who made America “a nation forever young, forever bursting with energy and new ideas”.

Contrast this with Trump, who has normalised dehumanising rhetoric and policies against immigrants. In this year’s presidential campaign, for instance, he has referred to undocumented immigrants as “animals” who are “poisoning the blood of our country”.

Both Trump and his vice presidential running mate, JD Vance, also repeated a false story about Haitian “illegal aliens” eating pets in Springfield, Ohio.

Perhaps most troubling, Trump has pledged to launch “the largest deportation operation in the history of our country”, if he’s elected.

Immigration policies throughout history

Nativism, or anti-immigrant sentiment, has a long history in American politics.

In 1924, a highly restrictive immigration quota system based on racial and national origins was introduced. This law envisaged America as a white, Anglo-Saxon, Protestant nation.

However, there was no restriction on immigrants from the Western Hemisphere. The agricultural and railroad sectors relied heavily on workers from Mexico.

In 1965, the quota system was replaced by visa preference categories for family and employment-based migrants, along with refugee and asylum slots.

Then, as violence and economic instability spread across Central America in the 1970s, there was a surge in undocumented immigration to the US.

Scholar Leo Chavez argues that in the late 1980s and early 1990s, an alarmist “Latino threat narrative” became the dominant motif in media discussions of immigration.

This narrative was frequently driven by Republican politicians in states on the US-Mexico border, who derived electoral advantage from amplifying voter anxieties.

The growing popularity of this negative discourse coincided with a significant increase in income inequality – a byproduct of neo-liberal policies championed by Reagan and other Republicans.

Read more:
Before Trump, there was a long history of race-baiting, fear-mongering and building walls on the US-Mexico border

A dramatic shift in Republican rhetoric

In the early-to-mid 20th century, Democrats were often the party that supported restrictive immigration and border policies.

However, most Republicans at the national level – strongly supported by business – tended to endorse policies that encouraged the easy flow of workers across the border and increased levels of legal immigration.

Prominent conservative Republicans also rejected vilifying rhetoric towards undocumented Americans. They presented all immigrants as pursuing opportunities for their families, a framing that emphasised a shared vision of the American dream. In this telling, their labour contributed to the economy and America’s growth and prosperity.

George H. W. Bush And Ronald Reagan debate immigration in a Republican primary debate in 1980.

Reagan, the most influential conservative of the late 20th century, opposed erecting a border wall and supported amnesty over deportation.

Reagan also strongly supported bipartisan immigration reform. In 1986, Congress passed an immigration act that increased border security funding, but also ensured 2.7 million undocumented immigrants, primarily of Latino background, were able to gain legal status.

Twenty years later, President George W. Bush and Republican Senator John McCain lobbied for a bipartisan bill that would have tightened border enforcement while simultaneously “legalising” an estimated 12 million undocumented immigrants. It was narrowly defeated.

This vocal support for immigrants by leading Republicans was striking because for much of the period between the late 1980s and the early 2000s, a majority of Americans actually wanted immigration levels reduced.

Then, around 2009, a dramatic shift in political rhetoric took place. The Tea Party movement brought border security and “racial resentment” towards immigrants centre stage, challenging conservative Republicans from the populist right.

Supporters of a controversial new law in Arizona in 2010 that made it a crime under state law to be in the country illegally.
Ross D. Franklin/AP

As a result, more and more Republicans began to voice restrictionist and xenophobic rhetoric and support legislation aimed at cracking down on illegal immigration.

What’s surprising, though, is the number of undocumented immigrants in the US was actually declining at this time, from 12.2 million in 2007 to 10.7 million in 2016.

Donald Trump and the new nativism

In this worsening anti-immigrant climate, Trump descended a golden escalator in mid-2015 to launch his presidential campaign.

In his speech that day, immigration was front and centre. Trump vowed to “build a great wall” and accused Mexico of sending “rapists” and “criminals” to America.

His speeches during the presidential campaign were marked by frequent anti-Mexican assertions and calls for Islamophobic visa policies. This hostile stance on immigration was central to his victory in both the Republican primaries and the general election against Hillary Clinton.

Once in office, Trump then adopted a “zero tolerance” stance towards undocumented immigration. His administration pursued a heartrending family separation policy that split children and their undocumented parents at the border. This approach was celebrated on conservative media outlets such as Fox News.

During his presidency, he also reduced legal immigration by almost half, drastically cut America’s refugee intake, and introduced bans on people from Muslim-majority countries.

Policy expert David Bier concluded the goal of Republican lawmakers had shifted:

It really looks like the entire debate about illegality is not the main issue anymore for Republicans in both chambers of Congress. The main goal seems to be to reduce the number of foreigners in the United States to the greatest extent possible.

Indeed, Trump’s vision of the nation had overtly racial overtones.

In one 2018 meeting, he asked why America should accept immigrants from “shithole countries” like Haiti, El Salvador or the African continent. His preference was for Norwegian migrants.

Immigration as a major election theme

From 2021–2023, undocumented US-Mexico border crossings surged due to natural disasters, economic downturns and violence in many Latin American and Caribbean nations. Many of the recent arrivals are asylum seekers.

Though the numbers have fallen sharply in 2024, immigration and the border are still one of the top issues for voters across the political spectrum. The issue is particularly important in the key swing state of Arizona.

In 2024, Trump’s central immigration promise was encapsulated by the beaming delegates waving signs calling for “Mass Deportations Now” at the Republican National Convention.

The Trump-Vance ticket has blamed undocumented immigrants for almost every economic and social problem imaginable. The two candidates present them as a dangerous and subversive “other” that cannot be assimilated into mainstream American culture.

Yet Trump, as both president and candidate, has worked to prevent the passage of border security legislation. Turmoil on the border benefits him.

And his nativism now encompasses all forms of immigration – he has pledged to curb legal channels for people to enter the country, as well.

All of this rhetoric has had a dramatic impact on public opinion. Between 2016 and 2024, the number of people supporting the deportation of undocumented immigrants jumped from 32% to 47%.

In July 2024, 55% of Americans also said they wanted to see immigration levels decrease, a 14-point increase in one year.

Many Americans do not perceive immigration as a source of vitality and renewal as they had in the past. Instead, reflecting Trump’s language, they are viewing immigrants as an existential threat to the country’s future. Läs mer…