Organ donation: Opt-out defaults do not increase donation rates

Longitudinal study examines organ donation rates in five countries that have changed their organ donation default policy from opt-in to opt-out

Max Planck Institute for Human Development

With the demand for donor organs far outstripping the supply, calls for changes in public policy are growing. An opt-out (‘presumed consent’) default policy is often seen as a promising approach. This policy stipulates that all adults are automatically considered potential organ donors after their death, unless they explicitly withdraw their consent during their lifetime. In contrast, the opt-in (‘explicit consent’) system requires potential donors to actively consent to donate their organs after they die. The discussion around implementing an opt-out policy has recently gained traction again in Germany, raising the question of whether such a change in policy would actually lead to an increase in the number of deceased organ donors.

A recent analysis of all member countries of the Organisation for Economic Co-operation and Development (OECD) found no significant difference in deceased donor rates between opt-in and opt-out countries, but significantly fewer living donors—individuals who voluntarily donate organs, like a kidney, while alive—in opt-out countries. However, such cross-sectional analyses cannot control for all country-specific factors like health infrastructure, culture, and religious issues—all of which can influence donation rates. 

To address the limitations of prior research, the current study used a longitudinal approach, analyzing changes in deceased donor rates over time in five countries—Argentina, Chile, Sweden, Uruguay, and Wales—that had switched from an opt-in to an opt-out default policy. This method provided a more reliable assessment of the  impact of opt-out policies by controlling for long-term trends and country-specific factors. 

Data was collected from international databases, including the International Registry in Organ Donation and Transplantation (IRODaT) and the Global Observatory on Donation and Transplantation (GODT). Of the 39 countries that had changed from explicit to presumed consent by December 2019, only five could be included in the analysis due to a lack of historical data for changes made before the IRODaT database was launched in 1996 and because presumed consent practices often existed informally prior to formal legislation. 

Consistent with previous cross-sectional analyses, the study found that switching the default from opt-in to opt-out did not lead to any increase in organ donation rates in the five countries considered. Moreover, the results indicated that the opt-out default did not cause even a slight upward curve in organ donations: the long-term trend remained the same, showing no change in the rate following the switch. As expected, the results did show a reduction in deceased donations with the onset of the COVID-19 pandemic, with only a slow recovery observed by 2022. 

“Simply switching to an opt-out system does not automatically lead to more organ donations,” states author Mattea Dallacker, who led the project at the Center for Adaptive Rationality at the Max Planck Institute for Human Development. “Without accompanying measures, such as investments in the healthcare system and public awareness campaigns, a shift to an opt-out default is unlikely to increase organ donations. There is no easy solution to the complex challenge of boosting organ donation rates,” she continues. 

The study also underscores the crucial role of relatives in organ donation decisions. Even in presumed consent systems, where individuals are considered donors unless they opt out, families are often consulted and can override the presumed consent. Since many people do not talk about their donation wishes with loved ones, presumed consent can lead to uncertainty and hesitation among families, potentially resulting in refusals.

“A possible alternative to the opt-out system is a mandatory choice system,” says Ralph Hertwig, Director at the Center for Adaptive Rationality at the Max Planck Institute for Human Development. “This would allow citizens to explicitly register their consent or objection to organ donation, when applying for a driver’s license or ID card, for example. This active choice system could prompt people to make an informed decision, which would eliminate the perceived ambiguity about their preference that appears to lead to higher family refusal rates. Good and accessible information about organ donation is essential for informed choice,” Hertwig continues.

 Key points: 

• Longitudinal study examines organ donation rates of deceased individuals in five countries with an opt-out system (Argentina, Chile, Sweden, Uruguay, and Wales).
• The switch from an opt-in to an opt-out default policy did not increase organ donation rates in the five countries studied. 
• To reduce uncertainty and improve donation rates, countries need to invest in transplant coordination services and infrastructure, encourage individuals to talk about their donation wishes with relatives, and train medical teams to navigate difficult conversations with families.

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Journal

Public Health

DOI

10.1016/j.puhe.2024.08.009 

Method of Research

Data/statistical analysis

Subject of Research

People

Article Title

Opt-out defaults do not increase organ donation rates.

Article Publication Date

20-Sep-2024

COI Statement

Ethical approval The project did not require ethical approval as the authors analysed publicly available, non-identifiable data from different countries. Funding This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Competing interests The authors report no conflicts of interest.

 

On the origin of life: How the first cell membranes came to exist

New research provides a possible explanation on the development of early Earth protocells

University of California - San Diego

 

video: 

Time-lapse fluorescence microscopy video showing vesicle formation (images were taken every 2 minutes for 4 hours).

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Credit: (cr: Neal Devaraj lab / UC San Diego)

Few questions have captivated humankind more than the origin of life on Earth. How did the first living cells come to exist? How did these early protocells develop the structural membranes necessary for cells to thrive and assemble into complex organisms?

New research from the lab of University of California San Diego Professor of Chemistry and Biochemistry Neal Devaraj has uncovered a plausible explanation involving the reaction between two simple molecules. This work appears in Nature Chemistry.

Life on Earth requires lipid membranes – the structure of a cell that houses its interior mechanics and acts as a scaffold for many biological reactions. Lipids are made from long chains of fatty acids, but before the existence of complex life, how did these first cell membranes form from the simple molecules present on Earth billions of years ago?

Scientists believe that simple molecules of short fatty chains of fewer than 10 carbon-carbon bonds (complex fatty chains can have nearly twice that many bonds) were abundant on early Earth. However, molecules with longer chain lengths are necessary to form vesicles, the compartments that house a cell’s complicated machinery.

While it may have been possible for some simple fatty molecules to form lipid compartments on their own, the molecules would be needed in very high concentrations that likely did not exist on a prebiotic Earth – a time when conditions on Earth may have been hospitable to life but none yet existed.

“On the surface, it may not seem novel because lipid production happens in the presence of enzymes all the time,” stated Devaraj, who is also the Murray Goodman Endowed Chair in Chemistry and Biochemistry. “But over four billion years ago, there were no enzymes. Yet somehow these first protocell structures were formed. How? That’s the question we were trying to answer.”

To uncover an explanation for these first lipid membranes, Devaraj’s team started with two simple molecules: an amino acid named cysteine and a short-chain choline thioester, similar to molecules involved in the biochemical formation and degradation of fatty acids.

The researchers used silica glass as a mineral catalyst because the negatively charged silica was attracted to the positively charged thioester. On the silica surface, the cysteine and thioesters spontaneously reacted to form lipids, generating protocell-like membrane vesicles stable enough to sustain biochemical reactions. This happened at lower concentrations than what would be needed in the absence of a catalyst.

“Part of the work we’re doing is trying to understand how life can emerge in the absence of life. How did that matter-to-life transition initially occur?” said Devaraj. “Here we have provided one possible explanation of what could have happened.”

Full list of authors: Christy J. Cho, Taeyang An, Alessandro Fracassi, Roberto J. Brea and Neal K. Devaraj (all UC San Diego); Yei-Chen Lai, Alberto Vázquez-Salazar and Irene A. Chen (all UCLA).

This research was supported, in part, by National Science Foundation (EF-1935372) and the National Institutes of Health (R35-GM141939).

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Journal

Nature Chemistry

DOI

10.1038/s41557-024-01666-y 

Method of Research

Experimental study

Article Title

Protocells by spontaneous reaction of cysteine with short-chain thioesters

NO GOD!

 

Anti-fatberg invention could help unclog city sewers

RMIT University

 

image: 

Dr Biplob Pramanik shows the difference between a concrete block coated with his team’s anti-fatberg invention compared to a block without any coating after undergoing an experiment that mimicked a sewer environment under extreme conditions to speed up the fatberg formation process. The white coloured blobs on the uncoated block are a mixture of fat, oil and grease (FOG).

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Credit: Will Wright, RMIT University

Engineers from RMIT University have invented a protective coating for concrete pipes that could help drastically reduce the formation of fatbergs in sewers.

Fat, oil and grease (known as FOG) – infamous for solidifying inside pipes and concrete sewers – causes half of all sewer blockages in the United States and 40% in Australia. The cost of these blockages in terms of maintenance and rehabilitation is estimated at US$25 billion in the US and A$100 million in Australia per year.

It is the mixture of fat, oil and grease with calcium and water in sewers that often leads to the formation of fatbergs. But the team’s zinc-enhanced polyurethane coating offers a promising sustainable solution by reducing the release of calcium from concrete blocks by up to 80% compared with uncoated concrete.

The study led by Dr Biplob Pramanik mimicked a sewer environment under extreme conditions that rapidly sped up the fatberg formation process over 30 days.

It showed the coating reduced build-up of FOG on concrete by 30% compared to non-coated concrete.

“The reduction of fat, oil and grease build-up can be attributed to the significantly reduced release of calcium from coated concrete, as well as less sticking of FOG on the coating surface compared to the rough, uncoated concrete surface,” said Pramanik, Director of Water: Effective Technologies and Tools (WETT) Research Centre at RMIT.

“Traditional coatings like magnesium hydroxide, widely used for over two decades, are effective in controlling sewer corrosion but can inadvertently contribute to FOG build-up by interacting with fatty acids.”

The team’s invention is stable in water and withstands temperatures of up to 850 degrees Celsius. It is also self-healing at room temperature, meaning it can repair any damage to itself and extend its lifespan.

“We drew inspiration from the regenerative capabilities observed in nature, including human skin’s ability to heal itself,” Pramanik said.

Co-researcher Dr Sachin Yadav said the team examined the healing performance of the coatings by inflicting surface scratches with a blade.

“The creation of surface scratches on the self-healing polyurethane coating sample triggered the healing process,” Yadav said.

“After the healing period, we observed a noticeable improvement in the surface scratches.”

Next steps

The team is developing an improved coating to achieve a greater reduction of FOG deposition in sewers by enhancing its self-healing capabilities and mechanical strength.

Pramanik is also the Chief Investigator for a recently announced ARC Linkage Project that will develop an advanced grease interceptor for restaurants and other food service establishments to remove small FOG particles more effectively than current technologies.

His team at RMIT is partnering with South East Water, VicWater, Water Research Australia, Barwon Region Water Corporation, Queensland Urban Utilities and water technology company ACO on the ARC Linkage Project.   

‘Novel hybrid coating material with triple distinct healing bond for fat oil and grease deposition control in the sewer system’ is published in the Chemical Engineering Journal (DOI: 10.1016/j.cej.2024.156226).

 

MULTIMEDIA AVAILABLE FOR MEDIA USE

Images and video clips of Dr Biplob Pramanik showing the difference between a concrete block coated with his team’s anti-fatberg coating compared to a block without any coating after undergoing an experiment that mimicked a sewer environment under extreme conditions to rapidly speed up the fatberg formation process over 30 days.

These images and video clips are available here: https://spaces.hightail.com/space/WPabFy7l1H

IMG_0642 shows Dr Pramanik holding the two concrete blocks side by side (the coated block is on the left). The white coloured blobs on the uncoated block are a mixture of fat, oil and grease (FOG) that have been deposited on the block.

Credit for all photos and video: Will Wright, RMIT University

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Journal

Chemical Engineering Journal

DOI

10.1016/j.cej.2024.156226 

Method of Research

Experimental study

Subject of Research

Not applicable

Article Title

Novel hybrid coating material with triple distinct healing bond for fat oil and grease deposition control in the sewer system

Article Publication Date

1-Nov-2024

 

Journal of Dental Research publishes study analyzing the worldwide economic effects of oral health conditions

International Association for Dental, Oral, and Craniofacial Research

Alexandria, VA – The International Association for Dental, Oral, and Craniofacial Research (IADR) and the American Association for Dental, Oral, and Craniofacial Research (AADOCR) have announced the publication of a study in Journal of Dental Research that examines the overall effects of oral health on global, regional, and national economies.

The recent WHO Oral Health Resolution and the subsequent WHO Global Oral Health Action Plan highlight the key relevance of providing information on the economic impacts of oral conditions. The purpose of this study was to provide updated estimates for the global, regional and country-level economic impacts of oral conditions in 2019. Extending previously established methods, dental expenditures (costs for treatments) and productivity losses for five oral conditions (caries in deciduous & permanent teeth, periodontitis, edentulism, other oral diseases) were estimated for the year 2019.

“These findings demonstrate the enormous global economic burden that arises from oral diseases due to the costs of treatment and losses in productivity,” said JDR Editor-in-Chief Nick Jakubovics. “Oral diseases must be included in the upcoming United Nations High-Level Meetings on Non-Communicable Diseases and Universal Health Coverage.”

The estimated total worldwide economic impacts of dental diseases in 2019 were $710B, whereof $387B ($327B-$404B) due to direct costs and $323B ($186B-$460B) due to productivity losses for the five main oral conditions. Low Income countries spent an average of $0.52 ($0.22-$0.96) per capita on dental care, while High Income countries spent an average of $260 ($257-$268) per capita – a 500-fold difference. These findings suggest that the prevention and treatment of oral diseases continue to substantiate an enormous economic burden to individuals and society.

The comprehensiveness of estimates supersedes that of previous work as the primary information on direct costs was identified for a higher number of countries. The need for more and better routine reporting and monitoring of the economic impact of oral conditions is emphasized, particularly for the WHO Eastern Mediterranean and African regions. The relevance of such information is also highlighted by its inclusion in the first-ever WHO Global Oral Health Status Report and Global Strategy on Oral health 2023-2030. Given the persistently high economic burden of oral conditions, there is a key role for better prioritization of cost-efficient oral health programs as well as needs-responsive capacity planning.

About the Journal of Dental Research

The IADR/AADOCR Journal of Dental Research (JDR) is a multidisciplinary journal dedicated to the dissemination of new knowledge in all sciences relevant to dentistry and the oral cavity and associated structures in health and disease. The JDR Editor-in-Chief is Nicholas Jakubovics, Newcastle University, England. Follow the JDR on Twitter at @JDentRes.

About IADR
The International Association for Dental, Oral, and Craniofacial Research (IADR) is a nonprofit organization with a mission to drive dental, oral, and craniofacial research for health and well-being worldwide. IADR represents the individual scientists, clinician-scientists, dental professionals, and students based in academic, government, non-profit, and private-sector institutions who share our mission. Learn more at www.iadr.org.

About AADOCR

The American Association for Dental, Oral, and Craniofacial Research (AADOCR) is a nonprofit organization with a mission to drive dental, oral, and craniofacial research to advance health and well-being. AADOCR represents the individual scientists, clinician-scientists, dental professionals, and students based in academic, government, non-profit, and private-sector institutions who share our mission. AADOCR is the largest division of IADR. Learn more at www.aadocr.org.

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Journal

Journal of Dental Research

 

The blue-green sustainable proteins of seaweed may soon be on your plate

Chalmers University of Technology

 

image: 

 Proteins from seaweed, such as sea lettuce, have the potential to become an important food component. However, the proteins are often tightly bound, but now researchers at Chalmers University of Technology, in Sweden, have found a new way to extract these proteins three times more efficiently than before. Here, sea lettuce is grown in tanks containing water that was previously used in the seafood industry. Through this cultivation, they take up nutrients that would otherwise have been discarded.

 

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Credit: Credit: Sophie Steinhagen

The protein in sea lettuce, a type of seaweed, is a promising complement to both meat and other current alternative protein sources. Seaweed also contains many other important nutrients, and is grown without needing to be watered, fertilised or sprayed with insecticides. However, the proteins are often tightly bound, and their full potential has not yet been realised on our plates.  But now researchers at Chalmers University of Technology, in Sweden, have found a new way to extract these proteins three times more efficiently than before – and this progress paves the way for seaweed burgers and protein smoothies from the sea.

"It tastes like umami with a certain salty flavour, despite not containing such high levels of salt. I would say it's a great flavour enhancer for seafood dishes and products, but the possibilities to explore are endless. Why not protein smoothies or ‘blue burgers’ from the sea?" says João Trigo, PhD in Food Science at Chalmers, about the dark green powder, which is a concentrate of proteins from sea lettuce, scientifically known as Ulva fenestrata. Sea lettuce is a type of macroalgae, commonly called seaweed, which grows on rocks in calm waters, or free-floating on the surface, and resembles ordinary lettuce leaves in appearance.

The so-called protein shift – switching from red meat to more sustainable and healthy protein sources – is a way to reduce the climate impact of food production while providing everyone with a nutritious diet. Many alternative protein sources, mainly based on pea, soy and mushroom, are common in our grocery stores. But all the vegetarian protein that is found under the sea is still an untapped source.

The CirkAlg-project, led by Chalmers University of Technology, has explored the possibilities of developing processes that can create a new, “blue-green” food industry in Sweden, and make use of seaweed as a promising source of protein. Within the framework of the project, a newly published scientific study shows a unique way of extracting proteins from sea lettuce, so that it is now possible to extract three times more protein from the seaweed than was possible with previous methods.

"Our method is an important breakthrough, as it brings us closer to making it more affordable to extract these proteins, something that is done with pea and soy proteins today,” says João Trigo.

Contains several essential nutrients

In addition to essential proteins, sea lettuce contains several other substances of great nutritional value for humans, such as vitamin B12 and the same kind of omega-3 fatty acids found in oily fish, like salmon. People who do not eat animal products are at risk of developing a deficiency of vitamin B12, which is necessary for the body to form red blood cells, among other things. And the cultivation of sea lettuce has several advantages compared to land-growing proteins – such as the fact that the seaweed does not need to be watered, fertilised or sprayed with insecticides. Sea lettuce is also hardy and grows well under many different conditions, such as different salinity and access to nitrogen.

"Humanity will need to find and combine the intake of many more diversified protein sources than we have available in our diet today, to meet sustainability and nutritional requirements. Algae is a good addition to many of the products already on the market. We need all these solutions and so far, the sea-based possibilities, the so-called blue proteins, have been overlooked," says Ingrid Undeland, Professor of Food Science at Chalmers and coordinator of CirkAlg.

In addition to the newly published extraction method, the Chalmers researchers are working together with the University of Gothenburg to increase the actual protein content in the seaweed. By cultivating sea lettuce in process water from the seafood industry, the protein content can be increased significantly, while nutrients that would otherwise be lost are circulated back into the food chain. At Tjärnö Marine Laboratory (part of the University of Gothenburg) in northern Bohuslän in Sweden, a large number of successful cultivation experiments have been carried out within the CirkAlg-project, based on industrial water side currents.

"In the future, we also want to be able to make use of the parts of the algae that are not proteins, and that could be used in food, materials or for medical applications. The goal is that no molecules should go to waste, to achieve both sustainability and commercial opportunities," says Ingrid Undeland.

More about the extraction method

In addition to proteins that are water-soluble, sea lettuce also contains plenty of fat-soluble so-called membrane proteins. This means that the seaweed proteins are more complex to extract than, for example, soy and pea protein. In a first-step of the new process, the cell membranes of the sea lettuce are opened up in order to access the fat-soluble proteins. The different types of proteins are then extracted with water adjusted to a high pH, and in the next step, by making the solution acidic, the proteins are precipitated into aggregates that could then be separated from the water and utilised as a protein-rich ingredient. It was also seen that the marine omega-3 fatty acids were enriched in the protein ingredient, and a follow-up study confirmed that the same was true for vitamin B12. The new algae protein ingredient can thus help meet a wider range of nutritional needs compared to soy protein.

 

The study) A new method for protein extraction from sea lettuce (Ulva fenestrata) via surfactants and alkaline aqueous solutions was published in Food Chemistry. The study's authors are João Trigo, Sophie Steinhagen, Kristoffer Stedt, Annika Krona, Simone Verhagen, Henrik Pavia, Mehdi Abdollahi and Ingrid Undeland. At the time of the study, the researchers were active at Chalmers University of Technology, the University of Gothenburg and RISE - Research Institutes of Sweden.

 

For more information, please contact:

Ingrid Undeland, Professor, Division of Food and Nutrition Science, Department of Life Sciences, Chalmers University of Technology, +46 737 08 08 64, undeland@chalmers.se

João Trigo, PhD, Division of Food and Nutrition Science, Department of Life Sciences, Chalmers University of Technology, +46 739 78 74 16  trigo@chalmers.se

Ingrid Undeland speaks English and Swedish, João Trigo speaks English and Portuguese. They can be available for live and pre-recorded interviews. At Chalmers, we have podcast studios and film equipment on site and can assist with requests for TV, radio or podcast interviews.

Footage from seaweed being cultivated and harvested at Tjärnö Marine Laboratory in northern Bohuslän in Sweden can be downloaded here. 
Credit all footage: Chalmers | Lars Lanhed

Caption: Proteins from seaweed, such as sea lettuce, have the potential to become an important food component. However, the proteins are often tightly bound, but now researchers at Chalmers University of Technology, in Sweden, have found a new way to extract these proteins three times more efficiently than before. Here, sea lettuce is grown in tanks containing water that was previously used in the seafood industry. Through this cultivation, they take up nutrients that would otherwise have been discarded.
Credit: Sophie Steinhagen

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Journal

Food Chemistry

DOI

10.1016/j.foodchem.2024.141839 

Method of Research

Experimental study

Subject of Research

Not applicable

Article Title

A new method for protein extraction from sea lettuce (Ulva fenestrata) via surfactants and alkaline aqueous solutions

Article Publication Date

13-Nov-2024

COI Statement

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: João P. Trigo, Ingrid Undeland, and Mehdi Abdollahi have a patent pending to Chalmers Ventures AB as a result of the work described in this article. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Contexts of sexualities in France

INSERM (Institut national de la santé et de la recherche médicale)

13-Nov-2024

The latest research conducted by Inserm-ANRS on sexualities and sexual health in 2023 reveals trends that reflect developments observed over the past several decades. However, significant changes have emerged since the early 21st century, especially among women, within a context of increased social and economic autonomy, the advancement of gender and sexual equality, and the ongoing transformation of family structures. These changes also take place against a legislative backdrop that has evolved considerably in recent years. The 2013 law on same-sex marriages and the 2021 law on assisted reproductive technologies for female couples and single women have played a crucial role in reducing institutional discrimination against individuals with same-sex partners in their pursuit of marriage and parenthood.

The initial results illuminate what could be termed the “contemporary paradox of sexuality.” This paradox is characterized by greater diversity alongside a decreased intensity of sexual activity with a partner. The diversification of sexual activity is evident through the increase in the number of opposite-sex and same-sex partners, the extension of sexual activity into older ages, and the broadening of sexual repertoires, including masturbation. This trend is not new, but has intensified in recent years, particularly among women. At the same time, individuals report having engaged in sexual intercourse in the past twelve months less frequently than in 2006, especially those who are not in a relationship, and the frequency of sexual intercourse over the past four weeks has decreased regardless of relationship status. These trends are also observed in other countries, including Germany, the United States, Finland, the United Kingdom, and Japan.

The factors driving these trends are multifaceted. Firstly, women and men under 69 in France are less likely to be in a relationship today compared to previous decades (Rault and Réigner-Loilier 2015). As a result, periods without a stable partner have become more common in 2023 than in the past. The rise of digital spaces for sexual expression also contributes to this shift, particularly among younger individuals, as sexual experiences not only involve physical settings but also occur online. Additionally, research indicates that the COVID-19 pandemic, especially during lockdowns, has adversely affected the mental health of young people in the long term (Hazo and Costemalle 2021), potentially altering their expectations regarding sexuality.

Furthermore, these changes occur within a broader context that challenges traditional perceptions of women’s sexual availability. The results indicate a decline since 2006 in the frequency of sexual encounters women accept to please their partner, even when they themselves are not interested. Today, younger generations seem to view a lack of sexual activity as less problematic than in the past. Similarly, the belief that men have "naturally" greater sexual needs than women, which prevailed in 2006, no longer holds true in 2023. Notably, these shifts do not appear to diminish the sexual satisfaction of either women or men, as both groups continue to report similar levels of satisfaction with their sex lives as they did in 2006.

The CSF-2023 survey also highlights an increasing challenge to the heterosexual norm in attitudes and practices. Social acceptance of non-heterosexual sexualities has grown significantly over time, although notable resistance still exists, and discrimination against individuals with same-sex partners, particularly against transgender people, remains frequent, negatively impacting their mental health. Among individuals who have had same-sex partners, only half (56.1% of women and 50.6% of men) report having used a condom during their first sexual encounter with a new partner. Furthermore, these individuals exhibit a higher prevalence of STIs compared to the general population, reaching 1.4% for women and 2.4% for men aged 18-59.

The CSF-2023 findings suggest that it is ultimately the contours of sexuality that are evolving, as heterosexual penetrative sexuality gradually gives way to a more diverse practices, less focused on vaginal penetration and increasingly occurring in digital spaces, and is notably less frequent but more often desired.

This shift can be viewed in relation to the ongoing increase in reports of sexual violence, a trend that began well before the #MeToo movement. The growing social mobilization against all forms of sexual violence has transformed the normative frameworks of sexual consent. The rise in reported incidents reflects both an acknowledgment by respondents of events that were previously not considered violent and a greater capacity to denounce such occurrences. However, the results of this new survey paint a concerning picture of the extent of these violences, and statistics regarding younger generations illustrate the continued prevalence of the issue.

The survey also shows that transidentity and questioning gender binary norms remain stigmatized, significantly more so than homosexuality, and individuals who have considered changing their gender report considerably poorer mental health outcomes than others. Nevertheless, social acceptance of transgender and non-binary individuals is evolving, as evidenced by more favorable attitudes from younger generations. It is also among the youngest age groups that a greater number of individuals have thought about changing their gender at some point in their lives. These results indicate a growing reflexivity among individuals regarding their own gender, which is no longer simply experienced as a biological given.

Even though gender inequalities remain pronounced from the onset of sexual activity through to older ages, and discrimination against individuals with same-sex partners and transgender individuals remains common, the developments highlighted by the 2023 survey overall reflect a growing trend toward gender and sexual equality in French society. The results also shed light on the issues related to the prevention of risks associated with sexuality. The use of condoms during first sexual encounters has declined in recent years, and the protection observed during initial sexual encounters with new partners falls significantly short of the recommendations set forth by the national sexual health strategy. Additionally, vaccination coverage for hepatitis B and the papillomavirus (HPV) remains low, particularly among men. While contraceptive coverage is generally very high, the types of methods used have evolved considerably. The results confirm a decreasing reliance on the pill, a trend observed since 2005 that intensified following the media crisis of 2012, particularly among young people, who are increasingly turning to the intrauterine device (IUD) and condoms, although the pill remains the most commonly used method in this age group. Among women aged 18-49, the IUD has become the most widely used method in 2023. Meanwhile, non-medical methods are on the rise, with one in ten women remaining without contraceptive protection. The survey also notes an increase in unintended pregnancies among young women, reflecting the rise in the incidence of voluntary terminations of pregnancy observed since 2016. These findings call for a reconsideration of prevention programs for STIs and unintended pregnancies, while integrating digital tools that can help expand access to care, provided they adhere to the same quality standards as other health care sources. The digitalization of sexual health represents a broader challenge of de-medicalizing sexual health in France, which is still in its early stages compared to policies implemented in other countries, such as England and the United States.

* * *

Numerous analyses are currently underway, which will provide a deeper understanding of the results presented here, taking into account the detailed social characteristics of individuals. The ongoing analyses also focus on emotional and sexual trajectories, the use of pornography, paid sexual exchanges, norms and representations of sexuality, feminism and sexuality, sexuality in older age, consent, the links between sexuality and diseases, prevention practices, and medical violence, among other topics. These analyses will cover both metropolitan France and the overseas territories (Martinique, Guadeloupe, Guyana, Réunion). They will also allow for international comparisons with countries that have conducted similar types of surveys based on WHO protocols, such as Canada and England.

Results will be published in 2025 in a special issue of the journal Perspectives on Sexual and Reproductive Health, and in-depth analyses will be presented in a forthcoming book to be published in 2026 by La Découverte.

 

Researchers use high-resolution images to create model that predicts landslide risk in coastal areas

The inventory identified some 1,000 landslide points in São Sebastião (São Paulo state, Brazil). The research group is now using airborne laser scanning and other data inputs to create a methodology capable of more precise results

Fundação de Amparo à Pesquisa do Estado de São Paulo

 

image: 

Camburizinho Beach at the foot of Morro da Baleia in São Sebastião; field photographs taken in 2023 (left) and 2024 

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Credit: Carlos Henrique Grohmann

São Sebastião, a municipality on the coast of São Paulo state in Brazil that was partially cut off from the rest of the country in February 2023 after a period of torrential rain, had more than 1,000 landslide points, according to an inventory produced by researchers at the University of São Paulo’s Institute of Astronomy, Geophysics and Atmospheric Sciences (IAG-USP) and Institute of Geosciences (IGc-USP) using aerial images collected shortly after the disaster.

The scientists are now analyzing higher-resolution LIDAR images to find out how the inventory correlates with other variables and to develop a method for mapping the risk of landslides more precisely. LIDAR (Light Detection and Ranging) is an airborne remote sensing method that uses light in the form of a pulsed laser to generate precise 3D images of the Earth’s surface.

“In this type of analysis, known as a landslide susceptibility assessment, knowledge of the areas in which landslides occurred, including topographical, geological and other data, is extrapolated for other areas. We currently have digital elevation models with a spatial resolution [pixel size] of 30 m. The LIDAR data lets us go a step farther and apply elevation models with higher resolution [as high as 1 m] and more precision,” Carlos Henrique Grohmann, full professor at IAG-USP, told Agência FAPESP.

Grohmann is the leader of the project, which is supported by FAPESP, and involves a partnership with the São Paulo State Institute of Geography and Cartography (IGC-SP, an arm of the Department of Budget and Administration). The institute is creating a repository of LIDAR images for the entire state. This is the first time the scientific community has had access to LIDAR data for the Serra do Mar region.

The expectation is that the new methodology will be ready by the end of 2025, so that policymakers and planners can use it to map landslide-prone areas in the municipality more comprehensively.

In February 2023, São Sebastião declared a state of emergency due to the damage caused by a record amount of rain totaling 683 millimeters (mm) in less than 15 hours – the monthly average is 300 mm. At least 60 people died and hundreds were made homeless, not to mention the destroyed infrastructure and other material damage. Roads were swept away or blocked, hindering travel and transportation.

“What happened in São Sebastião last year was an anomaly, but heavy rainfall is usual in summer, and landslides are frequent. The point is that areas once covered with vegetation have lost this protection and are now highly vulnerable,” Grohmann said. 

Scientific studies have shown that extreme weather events such as severe drought, torrential rain and tropical cyclones will be increasingly frequent and intense from now on because of global warming. According to the Climate Change 2023 Synthesis Report produced by the Intergovernmental Panel on Climate Change (IPCC), the global surface temperature is already 1.1 °C higher than in the preindustrial period (1850-1900) and is set to reach 1.5 °C above that level by 2035. Last year was the warmest in the planet’s history, according to the World Meteorological Organization (WMO). This new reality calls for prevention and planning actions based on up-to-date information.

São Sebastião, which has an area of 402 square kilometers and some 81,000 inhabitants, had around 2,200 houses in 21 landslide-prone areas in 2018, according to a survey published by the Technological Research Institute (IPT, an arm of the São Paulo State Department of Economic Development). The city entered into an agreement with IPT in February 2024 to update this map of high-risk areas following the 2023 disaster.

IPT’s 2024 report lists neighborhoods such as Barra do Una, Juquehy, Barra do Sahy, Baleia, Camburi, Boiçucanga and Itatinga as high-risk. All were badly damaged by heavy rain in February 2023.

New tools

Landslides are common geological processes in mountainous areas, especially those with a tropical climate like Serra do Mar, where São Sebastião is located. They may occur on various spatial and temporal scales and are among the main agents of erosion that cause geomorphic change on cliffs, escarpments and hillsides.

In light of their destructive effects, especially in irregularly occupied areas such as squatter settlements, landslides are a focus for scientific studies aiming at identification, characterization, monitoring and prevention. “Other government bodies are analyzing high-risk areas. We also plan to compare the data collected in our survey with the findings of these official studies,” Grohmann said.

His group uses drone images and 3D modeling, as well as LIDAR, which determines the height of objects by measuring the time taken by pulses to return to the airborne device. The 3D results display the shape of the terrain and specific surface features, characterizing the structure of the vegetation and the topography of the bare ground without the influence of forests or buildings.

In addition to predicting landslides in São Sebastião, the group expects to obtain a morphometric characterization and assessment of surface changes in the Toque-Toque Grande neighborhood, which has been monitored since 2010, as well as points on Morro da Baleia and Sahy.

The inventory that mapped landslide risks in the municipality is published in the Brazilian Journal of Geology. The data is available from Zenodo, a repository of open-access publications and information created to facilitate data and software sharing. The development of these facilities was supported by FAPESP via two projects (22/04233-9 and 19/26568-0).

About São Paulo Research Foundation (FAPESP)

The São Paulo Research Foundation (FAPESP) is a public institution with the mission of supporting scientific research in all fields of knowledge by awarding scholarships, fellowships and grants to investigators linked with higher education and research institutions in the State of São Paulo, Brazil. FAPESP is aware that the very best research can only be done by working with the best researchers internationally. Therefore, it has established partnerships with funding agencies, higher education, private companies, and research organizations in other countries known for the quality of their research and has been encouraging scientists funded by its grants to further develop their international collaboration. You can learn more about FAPESP at www.fapesp.br/en and visit FAPESP news agency at www.agencia.fapesp.br/en to keep updated with the latest scientific breakthroughs FAPESP helps achieve through its many programs, awards and research centers. You may also subscribe to FAPESP news agency at http://agencia.fapesp.br/subscribe.

 

 

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Journal

Brazilian Journal of Geology

DOI

10.1590/2317-4889202420240006 

Article Title

Landslides of the 2023 summer event of São Sebastião, southeastern Brazil: spatial dataset