Newsworthy Science
- Thread starter Birdjaguar
- Start date
The solution is an exaggeration. Phages will likely help, but that is only one of the components (and an exciting one, that for sure). We also need new antibiotics, in some areas better hygiene, less senselessly prescribed antibiotics, and probably a bunch of more things too.
Bestbank Tiger
Deity
One of the biggest problems is people who don't follow the instructions on antibiotics. Stopping when they feel better instead of completing the course, for example.
One guy who worked in Central America developed urine strips that revealed codes for free cellular minutes. Idea was to give people an incentive to finish taking their meds.
The World Hasn’t Seen Cicadas Like This Since 1803
Brood XIX and Brood XIII will both emerge this spring. The last time these bugs showed up at the same time in the United States, Thomas Jefferson was president.
Two cicada groups, known as broods, are set to appear this spring in a dual emergence that will span across the Midwest and Southeastern United States.Credit...Suzanne DeChillo/The New York Times
By Aimee Ortiz
Jan. 19, 2024
The cicadas are coming — and if you’re in the Midwest or the Southeast, they will be more plentiful than ever. Or at least since the Louisiana Purchase. This spring, for the first time since 1803, two cicada groups known as Brood XIX, or the Great Southern Brood, and Brood XIII, or the Northern Illinois Brood, are set to appear at the same time, in what is known as a dual emergence. The last time the Northern Illinois Brood’s 17-year cycle aligned with the Great Southern Brood’s 13-year period, Thomas Jefferson was president. After this spring, it’ll be another 221 years before the broods, which are geographically adjacent, appear together again. “Nobody alive today will see it happen again,” said Floyd W. Shockley, an entomologist and collections manager at the Smithsonian National Museum of Natural History. “That’s really rather humbling.”
These insects will begin to appear in late April. They’ll use their forelegs to tunnel out from the earth, their beady red eyes looking for a spot where they can peacefully finish maturing. A few days after they emerge and molt, the males will start buzzing in an effort to find a mate, a slow-building crescendo of noise that in a chorus can be louder than a plane.
A cicada from Brood X in 2021 next to the shed exoskeleton from which it emerged. Credit...Jim Wood, Smithsonian Institution Dr. Shockley said the dual emergence would most likely result in more than one trillion cicadas appearing in the roughly 16-state area where the two broods are generally seen. Forested areas, including urban green spaces, will have higher numbers than will agricultural regions. To put that into perspective, one trillion cicadas, each of which are just over an inch long, would cover 15,782,828 miles if they were laid end-to-end. “That cicada train would reach to the moon and back 33 times,” he said.
One of the more exciting aspects of this dual emergence, Dr. Shockley said, lies in the possibility of interbreeding along the narrow band in northern Illinois where the two broods will overlap. “Under just the right circumstances and with just the right number of individuals cross breeding,” he said, “you have the possibility of the creation of a new brood set to a new cycle. This is an extremely rare event.”
In most cases, Dr. Shockley said, the cicadas, which live about a month, will die not far from where they had emerged. But since they’re “not great flyers and even worse landers,” cicadas often end up on sidewalks and city streets, where they can be squished by people or cars and “could conceivably make things slick.” “In urban areas, there will be sufficient numbers to necessitate removal of their bodies,” he said. “But rather than throwing in the trash or cleaning up with street sweepers, people should consider them basically free fertilizer for the plants in their gardens and natural areas.” According to the University of Illinois Urbana-Champaign, during a 1990 cicada emergence, “there were reports from people in Chicago having to use snow shovels to clear their sidewalks of the dead cicadas.”
Brood XIII is shown by blue dots, and Brood XIX is shown with red dots. Credit...Gene Kritsky, Mount St. Joseph University The first wave of periodical cicadas, which differ from those that appear annually in smaller numbers, will show up in northern Louisiana, southern Arkansas, Alabama, Mississippi, northern Georgia, and up into western South Carolina, said Gene Kritsky, a retired professor of biology at Mount St. Joseph University in Cincinnati, and the author of several books on cicadas, including “A Tale of Two Broods,” which was published this month.
Then it’ll be central North Carolina, eastern Tennessee and northern Arkansas, followed by southern Missouri, southern Illinois and western Kentucky. Finally, he said, the cicadas will appear throughout central and northern Missouri and Illinois, northwestern Indiana, southern Wisconsin and eastern Iowa. All told, these areas will be buzzing for about six weeks as the insects fly around looking to mate and deposit their eggs into slits they cut into tree branches. Then they’ll die, bringing with them an unforgettable smell, described by Dr. Shockley as similar to rotting nuts, as their bodies decay. The insects are clumsy fliers, making them easy prey for predators like birds. They don’t bite, sting or carry any diseases, and they serve as natural tree gardeners. The holes they leave behind help aerate the soil and allow for rainwater to get underground and nourish tree roots in hot summer months. The slits they make in trees can cause some branches to break, and the leaves then turn brown in a process known as “flagging.” But it’s like a natural pruning, and when the tree grows the branch again, the fruit will be larger. The cicadas’ rotting bodies provide nutrients that trees need.
“They’re very important to the ecosystem in the eastern deciduous forest,” Professor Kritsky said, referring to the forest ecosystem in the eastern half of the country.
John R. Cooley, a biology professor at the University of Connecticut, said his best advice for people living in the regions of the dual emergence is to let the bugs be.
Cicadas are clumsy fliers, making them easy prey for predators like birds. Credit...Gene Kritsky, Mount St. Joseph University “The forest is where they live,” he said. “They are a part of the forest. Don’t try to kill them. Don’t try to spray insecticide, all that kind of thing. That’s just going to end badly because there are more than you could possibly kill with insecticide, you’d end up killing everything.” If you have delicate plants you want to protect, Professor Cooley said, use special netting created for that purpose. While the prospect of the trillion cicadas that the dual emergence is expected to bring might sound horrifying to some, Dr. Shockley emphasized the awe of this rare natural event.
“Don’t be scared of it, embrace it for the wondrous event that it is and embrace the fact that it’s very temporary,” he said. “It will be intense, but short-lived.”
Broken_Erika
Play with me.
Hermit crabs are 'wearing' our plastic rubbish
Hermit crabs all over the world, which scavenge shells as armour for their bodies, are turning increasingly to plastic waste instead.
The conclusion is based on analysis of photos, taken by wildlife enthusiasts, and published online.
Scientists said they were "heartbroken" to see the extent to which the animals were living in our rubbish.
They said two-thirds of hermit crabs species were pictured in "artificial shells" - items that humans discarded.
The discovery is published in the journal Science of the Total Environment.
The study used social media and photo-sharing websites, as one of the researchers Marta Szulkin, an urban ecologist from the University of Warsaw, explained: "We started to notice something completely out of the ordinary.
"Instead of being adorned with a beautiful snail shell, which is what we're used to seeing - they would have a red plastic bottle cap on their back or piece of light bulb."
She and her colleagues, Zuzanna Jagiello from the University of Warsaw and Łukasz Dylewski, from Poznan University of Life Sciences, found a total of 386 individuals using artificial shells - mainly plastic caps.
"According to our calculations, 10 out of the 16 species of land hermit crabs in the world use this type of shelter and it's been observed in all tropical regions of the Earth," Prof Szulkin explained.
It isn't yet clear whether these materials are harmful - or perhaps even helpful - for the small, vulnerable crustaceans.
"When I first saw these pictures, I felt it was heart-breaking," Prof Szulkin told BBC Radio 4's Inside Science. "At the same time, I think we really need to understand the fact that we are living in a different era and animals are making use of what is available to them."
Fighting over plastic
This internet-based ecological study, revealed that this use of artificial shells is a "global phenomenon"."We saw it in two-thirds of all terrestrial hermit crab species," said Prof Szulkin. "That's what we could identify just by using pictures taken by tourists."
The researchers say the findings open up new questions about how these coastal crustaceans interact with and use plastic. As well as understanding whether it causes them any harm, the scientists want to work out how it might affect their evolution.
This whole group of crabs have adapted to scavenge and use discarded snail shells to protect their fragile bodies. And when those shells are in short supply, the crabs will fight over them.
What we don't know is how much the element of novelty might affect them - and whether the crabs will fight over artificial plastic shells," explained Prof Szulkin.
The researcher said that the natural snail shells were in decline, so she suspected it might be becoming easier for the animals to find an artificial alternative. And lighter, plastic 'shells' might even help smaller, weaker crabs to survive because they are easier to carry.
There is certainly a great deal of plastic in the marine environment for the animals to choose from. A recent study that attempted to quantify the scale of plastic pollution estimated that at least 171 trillion pieces of plastic are now floating in our oceans.
That could nearly triple by 2040 if no action is taken, experts have warned.
But there is hope that 2024 could see nations finally sign up to a long-awaited global treaty to end the scourge of plastic.
Mark Miodownik, who is professor of materials and society at University College London told the BBC that there was a lesson for humans in these images. "Just like the hermit crabs," he said, "we should be reusing plastics much more, instead of discarding it."
https://www.bbc.com/news/science-environment-68071695
Bestbank Tiger
Deity
Plastic is a serious issue, but why would it be heartbreaking if nature finds a way to repurpose it? That's actually a good thing - we dodged a bullet and can learn our lesson going forward.
Farm Boy
I hope you dance
- Joined
- Sep 8, 2010
- Messages
- 28,269
I was newlywed the last time these suckers came out. I loved it, totally surreal. She got mostly used to them so long as they weren't currently crashing into her face. I think my favorite moment was right when they were trailing off and things were winding down, I was about 2 1/2 hours inland from Lake Michigan, and there were a couple very fat, very hungover-looking seagulls starting to shift around with a very much "where the hell am I?" look to them.The World Hasn’t Seen Cicadas Like This Since 1803
Brood XIX and Brood XIII will both emerge this spring. The last time these bugs showed up at the same time in the United States, Thomas Jefferson was president.
[/URL]
Two cicada groups, known as broods, are set to appear this spring in a dual emergence that will span across the Midwest and Southeastern United States.Credit...Suzanne DeChillo/The New York Times
By Aimee Ortiz
Jan. 19, 2024
The cicadas are coming — and if you’re in the Midwest or the Southeast, they will be more plentiful than ever. Or at least since the Louisiana Purchase. This spring, for the first time since 1803, two cicada groups known as Brood XIX, or the Great Southern Brood, and Brood XIII, or the Northern Illinois Brood, are set to appear at the same time, in what is known as a dual emergence. The last time the Northern Illinois Brood’s 17-year cycle aligned with the Great Southern Brood’s 13-year period, Thomas Jefferson was president. After this spring, it’ll be another 221 years before the broods, which are geographically adjacent, appear together again. “Nobody alive today will see it happen again,” said Floyd W. Shockley, an entomologist and collections manager at the Smithsonian National Museum of Natural History. “That’s really rather humbling.”
These insects will begin to appear in late April. They’ll use their forelegs to tunnel out from the earth, their beady red eyes looking for a spot where they can peacefully finish maturing. A few days after they emerge and molt, the males will start buzzing in an effort to find a mate, a slow-building crescendo of noise that in a chorus can be louder than a plane.
A cicada from Brood X in 2021 next to the shed exoskeleton from which it emerged. Credit...Jim Wood, Smithsonian Institution Dr. Shockley said the dual emergence would most likely result in more than one trillion cicadas appearing in the roughly 16-state area where the two broods are generally seen. Forested areas, including urban green spaces, will have higher numbers than will agricultural regions. To put that into perspective, one trillion cicadas, each of which are just over an inch long, would cover 15,782,828 miles if they were laid end-to-end. “That cicada train would reach to the moon and back 33 times,” he said.
One of the more exciting aspects of this dual emergence, Dr. Shockley said, lies in the possibility of interbreeding along the narrow band in northern Illinois where the two broods will overlap. “Under just the right circumstances and with just the right number of individuals cross breeding,” he said, “you have the possibility of the creation of a new brood set to a new cycle. This is an extremely rare event.”
In most cases, Dr. Shockley said, the cicadas, which live about a month, will die not far from where they had emerged. But since they’re “not great flyers and even worse landers,” cicadas often end up on sidewalks and city streets, where they can be squished by people or cars and “could conceivably make things slick.” “In urban areas, there will be sufficient numbers to necessitate removal of their bodies,” he said. “But rather than throwing in the trash or cleaning up with street sweepers, people should consider them basically free fertilizer for the plants in their gardens and natural areas.” According to the University of Illinois Urbana-Champaign, during a 1990 cicada emergence, “there were reports from people in Chicago having to use snow shovels to clear their sidewalks of the dead cicadas.”
View attachment 683101
Brood XIII is shown by blue dots, and Brood XIX is shown with red dots. Credit...Gene Kritsky, Mount St. Joseph University The first wave of periodical cicadas, which differ from those that appear annually in smaller numbers, will show up in northern Louisiana, southern Arkansas, Alabama, Mississippi, northern Georgia, and up into western South Carolina, said Gene Kritsky, a retired professor of biology at Mount St. Joseph University in Cincinnati, and the author of several books on cicadas, including “A Tale of Two Broods,” which was published this month.
Then it’ll be central North Carolina, eastern Tennessee and northern Arkansas, followed by southern Missouri, southern Illinois and western Kentucky. Finally, he said, the cicadas will appear throughout central and northern Missouri and Illinois, northwestern Indiana, southern Wisconsin and eastern Iowa. All told, these areas will be buzzing for about six weeks as the insects fly around looking to mate and deposit their eggs into slits they cut into tree branches. Then they’ll die, bringing with them an unforgettable smell, described by Dr. Shockley as similar to rotting nuts, as their bodies decay. The insects are clumsy fliers, making them easy prey for predators like birds. They don’t bite, sting or carry any diseases, and they serve as natural tree gardeners. The holes they leave behind help aerate the soil and allow for rainwater to get underground and nourish tree roots in hot summer months. The slits they make in trees can cause some branches to break, and the leaves then turn brown in a process known as “flagging.” But it’s like a natural pruning, and when the tree grows the branch again, the fruit will be larger. The cicadas’ rotting bodies provide nutrients that trees need.
“They’re very important to the ecosystem in the eastern deciduous forest,” Professor Kritsky said, referring to the forest ecosystem in the eastern half of the country.
John R. Cooley, a biology professor at the University of Connecticut, said his best advice for people living in the regions of the dual emergence is to let the bugs be.
Cicadas are clumsy fliers, making them easy prey for predators like birds. Credit...Gene Kritsky, Mount St. Joseph University “The forest is where they live,” he said. “They are a part of the forest. Don’t try to kill them. Don’t try to spray insecticide, all that kind of thing. That’s just going to end badly because there are more than you could possibly kill with insecticide, you’d end up killing everything.” If you have delicate plants you want to protect, Professor Cooley said, use special netting created for that purpose. While the prospect of the trillion cicadas that the dual emergence is expected to bring might sound horrifying to some, Dr. Shockley emphasized the awe of this rare natural event.
“Don’t be scared of it, embrace it for the wondrous event that it is and embrace the fact that it’s very temporary,” he said. “It will be intense, but short-lived.”
What draws the moth to the flame
Nocturnal insects appear drawn to artificial lights because they instinctively twist their backs towards bright objects. The instinct to tilt their backs towards the brightest thing available at night — the sky — allows insects to quickly figure out which way is up. Researchers who tracked insects’ flight patterns with motion-capture cameras found that this even leads the animals to flip upside down and crash into the ground when the light source is underneath them. The researchers suggest reducing upward-facing lights and ground reflections to avoid confusing flying insects at night.
Paper
Nocturnal insects appear drawn to artificial lights because they instinctively twist their backs towards bright objects. The instinct to tilt their backs towards the brightest thing available at night — the sky — allows insects to quickly figure out which way is up. Researchers who tracked insects’ flight patterns with motion-capture cameras found that this even leads the animals to flip upside down and crash into the ground when the light source is underneath them. The researchers suggest reducing upward-facing lights and ground reflections to avoid confusing flying insects at night.
Paper
Spoiler In video format :
You thought the volcano that destroyed the Minoans was big? You should have seen the one half a million years ago.
One of the world’s most-studied volcanoes turns out to be hiding plenty of secrets. Geologists have unearthed major clues about past eruptions of the Greek island of Santorini by drilling into the sea floor around the partially submerged volcano.
Santorini is famous among volcanologists for its Bronze Age eruption in approximately 1600 BC, which might have contributed to the decline of the Minoan civilization on the island of Crete. Santorini is also home to more than 15,000 residents and attracts around 2 million tourists each year, who instagram their way around the white- and blue-washed buildings set against the glittering sea.
During an expedition between late 2022 and early 2023, researchers discovered evidence of a previously unknown cataclysm. Half a million years ago, the volcano erupted violently enough to blanket three nearby islands in debris, and it sent underwater currents racing for 70 kilometres. The eruption was much larger than the one in 1600 BC and was one of the biggest ever in this part of the Mediterranean.
The expedition also pulled up evidence that Santorini erupted in the year AD 726 in a blast approximately the size of Mount St Helens’ in Washington in 1980.
One of the world’s most-studied volcanoes turns out to be hiding plenty of secrets. Geologists have unearthed major clues about past eruptions of the Greek island of Santorini by drilling into the sea floor around the partially submerged volcano.
Santorini is famous among volcanologists for its Bronze Age eruption in approximately 1600 BC, which might have contributed to the decline of the Minoan civilization on the island of Crete. Santorini is also home to more than 15,000 residents and attracts around 2 million tourists each year, who instagram their way around the white- and blue-washed buildings set against the glittering sea.
During an expedition between late 2022 and early 2023, researchers discovered evidence of a previously unknown cataclysm. Half a million years ago, the volcano erupted violently enough to blanket three nearby islands in debris, and it sent underwater currents racing for 70 kilometres. The eruption was much larger than the one in 1600 BC and was one of the biggest ever in this part of the Mediterranean.
The expedition also pulled up evidence that Santorini erupted in the year AD 726 in a blast approximately the size of Mount St Helens’ in Washington in 1980.
Spoiler Pictures :
Last edited:
The dawn chorus is lonely male birds singing because their mates have not got up yet
The spring dawn and dusk chorus of birds is a widespread phenomenon, yet its origin remains puzzling. We propose that a dawn and dusk chorus will inevitably arise if two criteria are met: (1) females leave their roost later in the morning and go to roost earlier in the evening than their mate, and (2) males sing more when separated from their mate. Previous studies on blue tits (Cyanistes caeruleus) support the first criterion. We here report that males sing at a higher rate whenever they are separated from their mate and that song rate increases with the duration of female absence. These findings can explain the existence of the dawn and dusk chorus in blue tits, and they can explain why the dawn chorus is more pronounced than the dusk chorus, as is typically observed. An exhaustive literature search provides support for both criteria of the ‘absent mate’ hypothesis in several passerine birds. We found no evidence contradicting the hypothesis. The new hypothesis is not inconsistent with many of the existing hypotheses about dawn singing, but may be a more general explanation for the occurrence of a dawn and dusk chorus. We describe how the ‘absent mate’ hypothesis leads to testable predictions about daily and seasonal variation in song output.
The spring dawn and dusk chorus of birds is a widespread phenomenon, yet its origin remains puzzling. We propose that a dawn and dusk chorus will inevitably arise if two criteria are met: (1) females leave their roost later in the morning and go to roost earlier in the evening than their mate, and (2) males sing more when separated from their mate. Previous studies on blue tits (Cyanistes caeruleus) support the first criterion. We here report that males sing at a higher rate whenever they are separated from their mate and that song rate increases with the duration of female absence. These findings can explain the existence of the dawn and dusk chorus in blue tits, and they can explain why the dawn chorus is more pronounced than the dusk chorus, as is typically observed. An exhaustive literature search provides support for both criteria of the ‘absent mate’ hypothesis in several passerine birds. We found no evidence contradicting the hypothesis. The new hypothesis is not inconsistent with many of the existing hypotheses about dawn singing, but may be a more general explanation for the occurrence of a dawn and dusk chorus. We describe how the ‘absent mate’ hypothesis leads to testable predictions about daily and seasonal variation in song output.
Men often lament life when their mates are not around!
That makes it sound quite romantic, but perhaps they are on the pull while she is not there to complain.
Yes!!
Farm Boy
I hope you dance
- Joined
- Sep 8, 2010
- Messages
- 28,269
Does it?
Genetically Modified house plants glow!
Consumers in the United States can now pre-order a genetically engineered plant for their home or garden that glows continuously. At a base cost of US$29.00, residents of the 48 contiguous states can get a petunia (Petunia hybrida) with flowers that look white during the day; but, in the dark, the plant glows a faint green. Biotechnology firm Light Bio in Sun Valley, Idaho, will begin shipping a batch of 50,000 firefly petunias in April.
Keith Wood, chief executive and co-founder of Light Bio, has been working on bioluminescent plants — which emit light through chemical reactions inside their cells — since the 1980s. In 1986, he and his colleagues reported making the first such plant, a type of tobacco (Nicotiana tabacum) into which they inserted the luciferase gene from fireflies (Photinus pyralis). At the time, the goal was to learn about the basics of gene expression, and the tool is still used by plant biologists today. Researchers can engineer plants so that when a particular gene of interest is activated, the luciferase gene is too, and the plant will light up.
Because this was “a cool thing”, Wood says, start-up companies then tried to make the plants for decorative purposes. But the plants glowed only faintly and needed special food to fuel their light-emitting chemical reaction.
The firefly petunia glows brightly and doesn’t need special food thanks to a group of genes from the bioluminescent mushroom Neonothopanus nambi. The fungus feeds its light-emitting reaction with the molecule caffeic acid, which terrestrial plants also happen to make. By inserting the mushroom genes into the petunia, researchers made it possible for the plant to produce enzymes that can convert caffeic acid into the light-emitting molecule luciferin and then recycle it back into caffeic acid — enabling sustained bioluminescence. Wood co-founded Light Bio with two of the researchers behind this work, Karen Sarkisyan, a synthetic biologist at the MRC Laboratory of Medical Sciences in London, and Ilia Yampolsky, a biomolecular chemist at the Pirogov Russian National Research Medical University in Moscow.
Consumers in the United States can now pre-order a genetically engineered plant for their home or garden that glows continuously. At a base cost of US$29.00, residents of the 48 contiguous states can get a petunia (Petunia hybrida) with flowers that look white during the day; but, in the dark, the plant glows a faint green. Biotechnology firm Light Bio in Sun Valley, Idaho, will begin shipping a batch of 50,000 firefly petunias in April.
Keith Wood, chief executive and co-founder of Light Bio, has been working on bioluminescent plants — which emit light through chemical reactions inside their cells — since the 1980s. In 1986, he and his colleagues reported making the first such plant, a type of tobacco (Nicotiana tabacum) into which they inserted the luciferase gene from fireflies (Photinus pyralis). At the time, the goal was to learn about the basics of gene expression, and the tool is still used by plant biologists today. Researchers can engineer plants so that when a particular gene of interest is activated, the luciferase gene is too, and the plant will light up.
Because this was “a cool thing”, Wood says, start-up companies then tried to make the plants for decorative purposes. But the plants glowed only faintly and needed special food to fuel their light-emitting chemical reaction.
The firefly petunia glows brightly and doesn’t need special food thanks to a group of genes from the bioluminescent mushroom Neonothopanus nambi. The fungus feeds its light-emitting reaction with the molecule caffeic acid, which terrestrial plants also happen to make. By inserting the mushroom genes into the petunia, researchers made it possible for the plant to produce enzymes that can convert caffeic acid into the light-emitting molecule luciferin and then recycle it back into caffeic acid — enabling sustained bioluminescence. Wood co-founded Light Bio with two of the researchers behind this work, Karen Sarkisyan, a synthetic biologist at the MRC Laboratory of Medical Sciences in London, and Ilia Yampolsky, a biomolecular chemist at the Pirogov Russian National Research Medical University in Moscow.
^^^ I ordered a plant today. It should be shipped in April.
I hope you do not get eaten by triffids.
This is a really interesting study at the interface between medicine and economics
Why a cheap, effective treatment for diarrhoea is underused
Actors posing as dads of sick children reveal the hidden motives behind doctors’ and pharmacists’ prescription decisions.
“The gap between knowing the right thing and doing the right thing is a persistent problem,” says David Levine, a health economist at the University of California, Berkeley. That gap is highlighted by a study published today in Science.
Every year, half a million children under five die of diarrhoea globally — but doctors and pharmacists often don’t prescribe a cheap lifesaving treatment for the condition. A large Indian study suggests that this happens because prescribers don’t think that their patients want the therapy.
Most private doctors and pharmacists in the study understand the benefits of an oral rehydration solution (ORS). The treatment, a pre-mixed sachet of salts and sugars that is mixed with water, has been around for more than half a century. It prevents dehydration and drastically reduces the risk of children dying from diarrhoea.
To better understand why more children aren’t given ORS, Zachary Wagner, a health economist at the RAND Corporation, a non-profit research and policy organization in Santa Monica, California, and his colleagues launched a large experimental intervention in two Indian states, Karnataka and Bihar.
They sent actors pretending to be the fathers of a sick two-year-old child to more than 2,000 randomly selected private doctors and pharmacists in mid-sized towns. Three-quarters of carers in India seek help for their sick children from private clinics and pharmacies.
The interactions were designed to assess whether low levels of ORS prescription were due to supply shortages, incentives to sell more expensive drugs, such as antibiotics, or sensitivity to patient desires.
Each actor arrived at a facility unannounced and explained that their child had been experiencing diarrhoea for two days. Some told the provider that they had previously used ORS to treat their child and asked whether they should use it again. Some instead mentioned antibiotics, and others brought up no earlier treatments. Some actors noted that they would not be purchasing any medications at the facility and just wanted advice. The researchers also sent a six-week supply of ORS to half of the facilities.
The researchers found that a patient’s treatment preference was much more important than the clinic’s or pharmacy’s financial incentives or available stock in explaining why ORS is under-prescribed.
Actors who expressed a preference for ORS were twice as likely to get it as those who mentioned no treatment. A survey of more than 1,000 carers across the two states and representatives from the clinics and pharmacies revealed that 48% of carers feel that ORS is the best treatment for diarrhoea, but only 16% express that preference when visiting clinics. In turn, only 18% of doctors and pharmacists think that their patients want ORS.
Happy clients
The results “somewhat go against the belief among economists that financial incentives matter an awful lot”, says Karen Grépin, a health economist at the University of Hong Kong. Instead, informational barriers were more important.
But Ramanan Laxminarayan, an epidemiologist at Princeton University in New Jersey, says that financial incentives can be hard to disentangle from other motives. “We think of doctors as neutral decision-makers based on what is best for the patient, and that is often not the case,” says Laxminarayan. “Doctors make decisions based on what makes a patient happy,” he says, which has an underlying financial motive. “If a patient is not happy with you, they are not going to keep coming back.”
Overall, Grépin says the study is impressive, but there is still a lot more to unpack. For example, it is not clear why some patients don’t communicate their preference for ORS to their providers. The study also doesn’t offer a clear path forward on how to improve ORS uptake, she says. “It doesn’t really tell me what to do next.”
Wagner plans to design studies to test interventions for changing the perception of doctors and pharmacists, and how patients express their preferences. “Just telling people that ORS is a lifesaving medicine — we’ve hit the ceiling on what that can do.”
Why a cheap, effective treatment for diarrhoea is underused
Actors posing as dads of sick children reveal the hidden motives behind doctors’ and pharmacists’ prescription decisions.
“The gap between knowing the right thing and doing the right thing is a persistent problem,” says David Levine, a health economist at the University of California, Berkeley. That gap is highlighted by a study published today in Science.
Every year, half a million children under five die of diarrhoea globally — but doctors and pharmacists often don’t prescribe a cheap lifesaving treatment for the condition. A large Indian study suggests that this happens because prescribers don’t think that their patients want the therapy.
Most private doctors and pharmacists in the study understand the benefits of an oral rehydration solution (ORS). The treatment, a pre-mixed sachet of salts and sugars that is mixed with water, has been around for more than half a century. It prevents dehydration and drastically reduces the risk of children dying from diarrhoea.
To better understand why more children aren’t given ORS, Zachary Wagner, a health economist at the RAND Corporation, a non-profit research and policy organization in Santa Monica, California, and his colleagues launched a large experimental intervention in two Indian states, Karnataka and Bihar.
They sent actors pretending to be the fathers of a sick two-year-old child to more than 2,000 randomly selected private doctors and pharmacists in mid-sized towns. Three-quarters of carers in India seek help for their sick children from private clinics and pharmacies.
The interactions were designed to assess whether low levels of ORS prescription were due to supply shortages, incentives to sell more expensive drugs, such as antibiotics, or sensitivity to patient desires.
Each actor arrived at a facility unannounced and explained that their child had been experiencing diarrhoea for two days. Some told the provider that they had previously used ORS to treat their child and asked whether they should use it again. Some instead mentioned antibiotics, and others brought up no earlier treatments. Some actors noted that they would not be purchasing any medications at the facility and just wanted advice. The researchers also sent a six-week supply of ORS to half of the facilities.
The researchers found that a patient’s treatment preference was much more important than the clinic’s or pharmacy’s financial incentives or available stock in explaining why ORS is under-prescribed.
Actors who expressed a preference for ORS were twice as likely to get it as those who mentioned no treatment. A survey of more than 1,000 carers across the two states and representatives from the clinics and pharmacies revealed that 48% of carers feel that ORS is the best treatment for diarrhoea, but only 16% express that preference when visiting clinics. In turn, only 18% of doctors and pharmacists think that their patients want ORS.
Happy clients
The results “somewhat go against the belief among economists that financial incentives matter an awful lot”, says Karen Grépin, a health economist at the University of Hong Kong. Instead, informational barriers were more important.
But Ramanan Laxminarayan, an epidemiologist at Princeton University in New Jersey, says that financial incentives can be hard to disentangle from other motives. “We think of doctors as neutral decision-makers based on what is best for the patient, and that is often not the case,” says Laxminarayan. “Doctors make decisions based on what makes a patient happy,” he says, which has an underlying financial motive. “If a patient is not happy with you, they are not going to keep coming back.”
Overall, Grépin says the study is impressive, but there is still a lot more to unpack. For example, it is not clear why some patients don’t communicate their preference for ORS to their providers. The study also doesn’t offer a clear path forward on how to improve ORS uptake, she says. “It doesn’t really tell me what to do next.”
Wagner plans to design studies to test interventions for changing the perception of doctors and pharmacists, and how patients express their preferences. “Just telling people that ORS is a lifesaving medicine — we’ve hit the ceiling on what that can do.”
Bestbank Tiger
Deity
If the parent says "this worked last time" and there's no contraindication it makes sense to prescribe what's requested.
Otherwise the providers should be encouraged to recommend ORS, if that's what works the most often and has the lowest risk.
Otherwise the providers should be encouraged to recommend ORS, if that's what works the most often and has the lowest risk.
