Category: Academic Analysis

Source: The Conversation – UK – By Cassie Brummitt, Assistant Professor in Film and Television Studies, University of Nottingham

Have you heard of the writer Brandon Sanderson? If you’ve not, you’re sure to soon as a major deal with AppleTV signals that his writing could be a big new fantasy franchise that everyone will be talking about.

Sanderson is best known for his expansive literary universe, the Cosmere, with books set on various planets that manifest different but interconnected forms of magic. What’s so significant about this AppleTV deal is that Sanderson will possess remarkable control over the production of adaptations of his entire back catalogue. Crucially, it has been reported that he will have approval over any decisions, enabling him to oversee projects as writer, consultant and producer.

It’s a level of creative control over the adaptation process from page to screen which has been described as unprecedented for an author.

Writers are often wheeled out when promoting an adaptation to reassure audiences of how “faithful” it is or to show support for any changes to the source material. But it’s not particularly common for an author to wield significant creative authority over the production process itself, especially for big-budget franchises.

In my book on the Harry Potter franchise I explore, for example, how JK Rowling’s approval (and supposed influence) was frequently invoked in promotion for Harry Potter films to build prestige for the franchise. But, it wasn’t until the Fantastic Beasts series (2016-22) that she actually received a production credit as screenwriter.

There are some exceptions. George RR Martin contributed to script-writing, casting and production in the first few seasons of the Game of Thrones TV show, an adaptation of his novel series A Song of Ice and Fire. Martin has since acknowledged, however, that he had “less and less influence” over the TV show as it progressed, with similar breakdowns in communication during the adaptation of prequel series House of the Dragon.

Authors also sometimes write their own adapted screenplays. Gillian Flynn, for example, wrote both the novel Gone Girl and the screenplay for its film adaptation. Emma Donoghue won a best adapted screenplay Oscar for her work adapting her novel Room.

This process, called “self-adaptation”, has a long history in media and entertainment, even going back to Charles Dickens who adapted his works into stage plays. But authors may, of course, have strong opinions about how their work is adapted or have differing priorities to studio executives. Right now, when big-budget franchise instalments are expected to make hundreds of millions and hopefully attain long-term popularity, it’s a risky strategy to give creative control of a budding franchise to an author.

But that is exactly what’s happened with Sanderson. His literary properties are no doubt attractive to studio heads, having sold more than 50 million copies worldwide and slotting into the science fiction and fantasy niche carved out by mega-franchises like the MCU (Marvel Comic Universe), Game of Thrones and Harry Potter.

He’s also famously productive – publishing more than 50 novels in the last 20 years – which reduces the risk of acquiring a literary property whose overall narrative will never been concluded, something HBO had to navigate with the Game of Thrones TV show. The appeal for AppleTV is also clear, given its strategy to adapt genre fiction such as Foundation, Silo and Murderbot.

But how and why has Sanderson managed to retain so much creative control? I think the key lies in his commercial approach.

Sanderson established his own publishing and entertainment company, Dragonsteel Books, in 2012. As an online storefront it sells merchandise from special-edition books to board games to t-shirts. In 2020, it was reported he raised a record-breaking £30 million through Dragonsteel Books, using Kickstarter to self-publish four “secret projects” he had written during the COVID pandemic.

Since 2021, Dragonsteel Books organises a yearly Brandon Sanderson fan convention. And, in 2024, Sanderson announced that his company had purchased land to build “Dragonsteel Plaza”, which is expected to contain a bookstore, creative hub and company headquarters.

Sanderson challenges our cultural idea of the author as a creative genius who shuns commercial activity: he actively embraces it. He demonstrates the kind of attitude that aligns with the priorities of a global megacorporation such as AppleTV that is looking for ambitious large-scale franchises to launch.

With his Mistborn series touted for film and Stormlight Archive for television, it remains to be seen what Sanderson’s creative direction will look like. But what’s clear is the benefit of Sanderson’s collaboration for AppleTV: a creative figurehead and a commercially strategic ally for a fledgling franchise that has incredible potential for longevity.

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Cassie Brummitt does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

– ref. Fantasy writer Brandon Sanderson has retained rare control over screen adaptations of his Cosmere universe – https://theconversation.com/fantasy-writer-brandon-sanderson-has-retained-rare-control-over-screen-adaptations-of-his-cosmere-universe-275251

Source: The Conversation – UK – By Paul Jones, Associate Dean for Education and Student Experience at Aston Business School, Aston University

It is tempting to treat the fallout between Brooklyn Beckham and his A-list parents as mere celebrity gossip. But this story has struck a chord with many families because it disrupts a comforting assumption: that strong bonds, shared history and success protect families from fracture.

The breakdown of even highly visible, seemingly close families raises an uncomfortable question. Why do family relationships, often our longest lasting and most emotionally charged connections, sometimes become so strained that contact is reduced or cut off entirely?

Answering that requires a look at the relational dynamics that shape many families. Family rupture is not an anomaly confined to extreme circumstances or public families under scrutiny. It is part of everyday life for many people.

Large population surveys suggest that around one in four adults are estranged from at least one family member at any given point in time. This may involve a parent, sibling, child or other close relative.

When research focuses specifically on parent–child relationships, roughly one in ten adults report estrangement from a parent or child, with some differences between mothers and fathers. Across studies, estrangement from parents tends to begin in early adulthood, often during the early to mid-20s.

Conflict with family members can often feel more painful and enduring than other relationship breakdowns. The reason why has to do with identity and belonging. From early childhood, family relationships shape how we understand ourselves. In Brooklyn Beckham’s case, his public statements hint at this tension.

Growing up in a highly visible family meant that, for him, roles, expectations and identities were formed under constant public scrutiny. As adulthood brings new partnerships and a desire for autonomy, those early roles can become harder to inhabit, particularly when private family dynamics are played out in public.

Roles, expectations and emotional patterns become deeply embedded over time. When conflict emerges, it rarely challenges behaviour alone. It threatens how we see ourselves in relation to people who have known us longest.

When conflict becomes estrangement

Conflict escalation often follows predictable psychological patterns. Minor disagreements take on symbolic meaning. Old grievances resurface. People move from addressing an issue to defending their identity, values or sense of worth. Once this shift occurs, emotional responses intensify, positions harden and resolution becomes much harder to achieve.

Estrangement, then, is rarely about a single argument. It reflects accumulated disconnection, unmet expectations and unresolved emotional histories that have built up over years.

Research in psychology and family studies consistently highlights a few recurring and interacting dynamics. Over time, people can find themselves locked into family roles that no longer fit, particularly if they feel persistently misunderstood or undervalued. What once felt like shared history can begin to feel restrictive rather than supportive.

At the same time, criticism or dismissal within families is often experienced as an attack on core self-beliefs, not simply a disagreement. When repeated attempts to explain or resolve these tensions fail, many people turn to avoidance or emotional distance as a form of self-protection. Silence, while painful, can feel safer than continued conflict.

None of these dynamics are unique to celebrity families. Seeing them play out publicly simply makes visible what many families manage quietly behind closed doors.

How to cope

Popular advice about family conflict tends to emphasise openness and communication. While well-intentioned, suggestions to “just talk it out” often fail because they ignore emotional safety, timing and boundaries. Conversations entered without shared readiness or clear intent can easily reopen old wounds.

Psychological research points to more realistic approaches.

1. Separate repair from reconciliation

Repair may involve greater understanding or boundary setting rather than restoring closeness. Reconciliation is not always possible or healthy.

2. Manage expectations

Accepting that some conflicts reflect fundamental value differences rather than misunderstandings can reduce guilt and self-blame.

3. Protect wellbeing

Prolonged family conflict is associated with stress, anxiety and poorer mental health. Seeking external support is not a sign of disloyalty but of self-care.

Estrangement is also rarely static. Many relationships fluctuate over time. Some reconnect after years or decades, while others remain distant but emotionally resolved.

Family rifts feel particularly unsettling because they collide with powerful cultural myths. In many western cultures, family life is still framed through powerful ideals of unconditional love, permanence and harmony. These narratives are reinforced through media, popular psychology and social expectations, leaving little room to acknowledge conflict, distance or estrangement as ordinary parts of relational life. When reality fails to match that ideal, people often carry shame alongside grief.

Recognising how common family estrangement is, and understanding the psychological dynamics behind it, helps shift the conversation away from blame. It allows space for compassion, boundaries and healthier coping.

The Beckhams’ situation serves as a reminder of something deeply ordinary. Families are complex systems shaped by history, identity and meaning. Sometimes that complexity holds. Sometimes it fractures. And when it does, the experience is painful, but far from unique.

Paul Jones does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

– ref. Beckham v Peltz: why families fall out, and how to deal with estrangement – https://theconversation.com/beckham-v-peltz-why-families-fall-out-and-how-to-deal-with-estrangement-274887

Source: The Conversation – UK – By Stephen Barber, Professor of Global Affairs, University of East London

Suggestions that Peter Mandelson may have shared government information with Jeffrey Epstein amid the fallout of the global financial crisis are being investigated by police.

Emails between Mandelson and the disgraced financier, released by the US Department of Justice, are said to include market-sensitive details. This was at a time when Mandelson was in government and ministers around him were scrambling to keep the UK economy afloat.

Now, the 2008 global financial crisis belongs to a different political generation, with almost all of the leading players having left the world stage. But the ripple effect of the credit crunch can still be felt in our politics and in our pockets.

This surely makes the allegations against Mandelson, some of which date to his time as UK business secretary, even more awful. The anaemic UK economy, its weakened public finances and the divisive nature of UK politics can all trace their ways back to the crisis.

This catastrophic event, where developed economies were brought to the brink of collapse, came at the end of a long period of prosperity. It put paid to a belief, embraced by Gordon Brown when he was chancellor, that the UK had achieved a “Goldilocks economy” – not too hot and not too cold. This was supposedly a triumphant end to the boom and bust of the past.

For a time it worked. Britain experienced 16 years of quarter-on-quarter economic growth, emerging from the aftermath of “Black Wednesday” in 1992 when sterling fell out of the European Exchange Rate Mechanism.

The cracks first started to appear in 2007 as US lenders specialising in sub-prime mortgages (typically sold to high-risk borrowers) started to collapse. This was at the heart of what would become a global catastrophe. To meet market demand, lenders bundled together thousands of everyday home loans into “mortgage-backed securities”. These were then sold as low-risk debt to investors.

You can see the attraction: safe and steady repayments over the long term, underpinned by bricks and mortar. Only it was a deception, because that debt was not all safe. As house prices kept rising, banks increasingly agreed loans with customers who did not have the capacity to repay them. And the loans were made against property that had been overvalued.

Then the housing market weakened. Credit markets seized up, since holders of securitised debt found they couldn’t unwind their positions (put simply, they were unable to sell them on) – it was impossible to tell which parts of their holdings were sound and which were toxic. The result was that institutions stopped lending, interest rates on corporate borrowing jumped, investment ground to a near halt and stock markets plummeted.

Banks, big as well as small, started to fail. While the collapse of US giant Lehman Brothers in September 2008 marked the start of the global crisis, in the UK it was the liquidity emergency of Northern Rock that brought things into focus. Savers, having lost confidence, queued up outside branches in September 2007 to withdraw their money, marking the first run on a UK bank since the 19th century. But worse still, banks had lost trust in each other.

Banks are not just any business; they are the arteries of a functioning economy. Policymakers around the world judged that these banks were simply too big to fail. Governments responded with unprecedented interventions, including bank rescues, capital injections, fiscal stimulus and major regulatory reforms.

In Britain, this included nationalising Northern Rock in February 2008, recapitalising Royal Bank of Scotland and Lloyds, and launching wide-ranging guarantee and liquidity schemes. It meant containing the crisis, recapitalising the system, and restructuring the sector – all paid for by government borrowing.

In December 2008, Brown – by now prime minister – claimed he had “saved the world”. But what followed was the longest and deepest recession since the Great Depression of the 1930s. And that sharp downturn, in contrast to the previous decade, hit the young and the unskilled hardest as unemployment rose. For those in work, pay growth stalled.

It was during this period that Mandelson is suspected of sharing sensitive government information with Epstein. In June 2009, an email appears to show the then-business secretary forwarding details of proposals to sell off UK government assets to raise money for the public purse.

The crisis had blown a hole in the UK’s public finances as the Treasury grappled with falling tax receipts and increased demands on spending on public services and welfare. Added to this, bank rescues had of course piled up public debt.

Meanwhile, other emails in late 2009 appear to show Mandelson and Epstein discussing ways to push back against UK government plans for a “supertax” on bankers’ bonuses. These proposals were a bid to recoup some of the public money pumped into the sector.

For all the successes, perhaps the “Goldilocks economy” wasn’t entirely built on responsible policymaking. While inflation targets were hit, Bank of England experts had all but failed to notice the massive asset bubble. And then there were the “light-touch” banking controls, which even the regulator blamed for its failure to spot the storm brewing.

The long tail of the crisis

While economies eventually stabilised, not least because of Brown’s leadership and that of the subsequent coalition government, the consequences of the crisis play out to this day. In contrast to the optimism of the previous period, the years since the financial crisis have seen weak economic output, derisory productivity growth as well as slow improvements in pay.

Those were the years of austerity policies, with increasing distrust of institutions and a backlash against “elites”. All of this fuelled populism on the left and right.

Many felt left behind by the globalisation that had driven the economy from the mid-1990s, or were hit hard as low-skilled work became more precarious and public services squeezed, or felt taken for granted by the political class. When it came to their vote, Brexit was an opportunity to express their frustration and disrupt a system that they no longer believed worked for them.

And so it is impossible to understand the fractious nature of politics today, or the relatively feeble state of the UK economy, without understanding the huge challenge that the financial crisis posed to a generation of politicians. Although Mandelson is understood to deny any criminality, his alleged betrayal came at the peak of this jeopardy. We are all still paying the cost of bringing the global economy back from the brink.

Stephen Barber does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

– ref. Mandelson and the financial crash: why the Epstein allegations are so shocking – https://theconversation.com/mandelson-and-the-financial-crash-why-the-epstein-allegations-are-so-shocking-275272

Source: The Conversation – UK – By Manal Mohammed, Senior Lecturer, Medical Microbiology, University of Westminster

Police Scotland has launched an investigation into the deaths of six patients, including adults and children, believed to have contracted fatal infections at the Queen Elizabeth University Hospital in Glasgow.

The inquiry follows a long-running controversy over hospital-acquired infections at the site, with concerns raised by families and clinicians about water contamination, ventilation systems and wider environmental safety within the hospital.

The hospital has been under scrutiny for several years after campaigners raised questions about possible links between infections and environmental factors within the building. The investigation will examine whether any such factors contributed to the deaths.

Modern hospitals are generally safe places to receive care. But infections remain a risk wherever large numbers of vulnerable patients receive complex treatment.

Hospital-acquired infections (HAIs), also known as nosocomial (meaning originating in hospital) or healthcare-associated infections, are infections patients contract during or after receiving treatment in healthcare settings that were not present when they were admitted.

These infections can occur not only in hospitals, but also in nursing homes, rehabilitation centres, outpatient clinics and dialysis units. They represent a persistent and serious threat to patient safety worldwide. Patients may develop bloodstream infections from contaminated intravenous lines or severe diarrhoeal illness after exposure to resistant bacteria on hospital wards.

Hospital-acquired infections are among the most common adverse events in healthcare globally. They can lead to longer hospital stays, higher costs, disability and death. Across the European Union and European Economic Area combined, surveillance data suggest more than four million patients are affected each year. In the UK, healthcare-associated infections affect hundreds of thousands of people annually and remain a major patient safety concern.

Most hospital-acquired infections are treatable. However, they can become life-threatening when they lead to bloodstream infection or sepsis or occur in already vulnerable patients. Many involve microbes that no longer respond to standard antibiotics.

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Read more:
Sepsis: why this deadly condition is so hard to diagnose

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These infections are especially dangerous for people with weakened immune systems, including older adults, newborn babies and patients undergoing surgery or intensive treatments. Healthcare workers are also at risk because of repeated exposure to infectious patients and contaminated environments.

Causes of HAIs

Hospital-acquired infections can be caused by many microbes, including bacteria, fungi and viruses.

One well-known bacterium is Staphylococcus aureus, which often lives harmlessly on the skin or in the nose but can cause serious infection if it enters the body. A particularly problematic strain is methicillin-resistant S. aureus (MRSA), which has evolved resistance to several commonly used antibiotics.

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Read more:
Golden staph: the deadly bug that wreaks havoc in hospitals

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Another major cause is Clostridioides difficile, which can trigger severe diarrhoea and inflammation of the colon, particularly after antibiotic use disrupts normal gut bacteria. These pathogens have been major concerns for decades because they resist treatment and spread easily in healthcare settings.

Other emerging threats include carbapenem-resistant Enterobacteriaceae, gut bacteria resistant to carbapenems, a class of last-resort antibiotics. These gram-negative bacteria have a cell wall structure that makes them naturally more resistant to many antibiotics and harder to treat. They frequently cause bloodstream infections and urinary tract infections in hospitals.

A growing fungal threat is Candidozyma auris, a drug-resistant yeast that has caused outbreaks worldwide and can survive for long periods on surfaces.

Viruses also play a role. Respiratory viruses such as coronavirus, influenza, respiratory syncytial virus and human metapneumovirus can spread rapidly in wards. Norovirus frequently causes outbreaks of vomiting and diarrhoea because it spreads easily and survives well on surfaces.

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Read more:
Norovirus: what to know about this bug as northern hemisphere countries face outbreaks

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Bloodborne viruses such as hepatitis B, hepatitis C and HIV can spread through contaminated needles, blood products or failures in infection control. Other viruses, including varicella-zoster and measles, have also caused hospital outbreaks.

Hospital-acquired infections spread through multiple routes. Direct contact between patients and healthcare workers is common, as is transmission via contaminated equipment or surfaces when cleaning is inadequate.

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Environmental sources can contribute. Hospital water systems have been linked to outbreaks in some investigations. Surfaces and medical devices such as catheters and ventilators can harbour microbes if not properly sterilised. Research also highlights less obvious routes, including insects carrying resistant bacteria.

Antimicrobial resistance

One of the biggest challenges in tackling hospital-acquired infections is antimicrobial resistance. This occurs when microbes evolve so that medicines designed to kill them become less effective.

Hospitals use large quantities of antibiotics, creating pressure for microbes to develop resistance. Over time this can lead to superbugs that spread quickly, including among frontline healthcare workers. Clear communication about risk and prevention is essential.

Global surveillance indicates that antibiotic-resistant infections in healthcare settings are rising sharply.

Hospital-acquired infections can be fatal, particularly when they lead to bloodstream infection or sepsis. In 2019, antimicrobial resistance was directly responsible for an estimated 1.27 million deaths worldwide.

Outbreaks occur when infection rates rise above expected levels and may begin with a single infected patient, contaminated equipment or environmental sources. Once established, infections can spread quickly between wards.

Preventing hospital-acquired infections requires strict hygiene, sterilisation, environmental cleaning and responsible antibiotic use. Surveillance systems and rapid responses help contain outbreaks early. Improved ventilation, antimicrobial materials and better hospital design may also reduce transmission.

Hospital-acquired infections remain a major global public health challenge because they occur in places meant to heal. No one should enter hospital for treatment and leave with a preventable infection.

Manal Mohammed does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

– ref. Why ‘superbugs’ thrive in hospitals – https://theconversation.com/why-superbugs-thrive-in-hospitals-274414

Source: The Conversation – UK – By Robert MacKinnon, Clinical Scientist and Deputy Head of School for Psychology, Sports and Sensory Sciences, Anglia Ruskin University

Are you one of those people who can’t drop off to sleep if it’s “too quiet”? If so, you’re not alone. According to a 2023 survey of UK participants, 50% of people listen to some kind of noise to help fall asleep.

Many people have turned to pink, white or brown noise to help them drift off. But a new study has found listening to pink noise, an alternative to white noise, even to drown out irritating background sounds, can disrupt the quality of sleep you get.

What is pink noise?

Not all noises are equal though when it comes to sleep. Noises range from structured sound like music and speech, with patterns and meaning, through to others that have some arrangement and perhaps calming effect, like birdsong, ocean waves or wind chimes to noise with no order at all.

We can describe sounds by how much energy each frequency of the sound has. White noise is a totally random sound. Each different frequency in white noise has the same energy, so it sounds like a hissy continuous sound. A 2017 study found white noise seems to help some people concentrate.

Pink noise is different. Instead of equal energy at each frequency, the energy halves with every doubling of frequency (so 500Hz has twice the energy of 1000Hz). This mimics a lot of sounds in nature (like running water) and gives a deeper, more rumbly sound. It sounds less harsh than white noise.

You can also get brown noise – stop laughing – which is named after 18th-century scientist Robert Brown rather than anything bowel related. It is sometimes referred to as red noise instead. Higher frequencies have less energy
(500Hz has four times the energy of 1000Hz). It is even more bass-heavy than pink noise, sounding like heavy rain or a roaring waterfall.

What did the study find?

The new study by the University of Pennsylvania, sponsored by the US Federal Aviation Authority, compared the affect of pink noise and earplugs upon participants’ sleep when intermittent noise of planes flying overhead was played over a loudspeaker.

The control condition here was a noise-free night where the participants were monitored, but were not having their sleep interrupted. The researchers then tested the same participants under different conditions on different nights of their stay during the experiment. They measured brain activity, heart rate and muscle activity while participants slept, which allowed them to analyse the different stages of sleep.

The researchers first looked at how pink noise affected participants’ sleep when there was no other background noise and compared the effect to the control night. They found that pink noise led to a reduction of the amount of participants’ rapid eye movement (REM) sleep, which should make up about a quarter of our sleep. REM sleep isn’t considered a restful type of sleep but it is the sleep state in which we dream. REM is important for memory formation, brain plasticity and emotion regulation, particularly for children.

In the next phase of the experiment, they found that the environmental noise, by contrast, reduced the amount of so-called N3 sleep compared to the control night. This is the deepest non-REM type of sleep. It is where the body grows and repairs itself, and about a quarter of sleep should normally be of this type too.

The researchers then tried to block the environmental noise. When they used earplugs to see if they would help participants’ sleep, they worked well, restoring about three quarters of the lost N3 sleep. When they tried pink noise to see if it could help, they found that it actually made the sleep structure worse, reducing both N3 and REM sleep.

So is silence best?

Perhaps, and especially for babies and toddlers whose brains are still undergoing the most change and development. For adults though, there does seem to be some suggestion playing nighttime sounds helps. A 2022 review found that there was widespread, but low-quality, evidence that sounds at night time (especially pink noise) helps with the amount of sleep people get and also that people felt that it was better quality sleep. This was self-reported, rather than measured using equipment like in the new study from Pennsylvania, which might help to explain the different findings.

Other things may stop you getting to sleep. Many people experience tinnitus, a ringing or buzzing sound in the head or ears, which can be worst before bed and affect sleep quality. A silent room can make it seem even louder. Some people find a background sound, whether a “colour” of noise, nature sound, music or a podcast, helpful here to get to sleep. Being able to pick which “colour” of random sound you prefer has been shown to help people with tinnitus.

However, there are reports of potential harm from using any of these “random” sounds to help with tinnitus instead of more patterned noise like music or speech. This is because the random sounds can show the same kind of effect as ageing does on the brain. How this works, whether potential noise-induced hearing loss acts as an step in the chain, and how broadly it happens, remain areas of investigation.

So it’s not quite time to put the story of sleep quality and noise to bed just yet. In the meantime, trying some earplugs if there is unwanted sound, or keeping any noises calm, not too loud and relaxing for you may be the best bet for a good night’s sleep.

Robert MacKinnon does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

– ref. Pink noise: what is it and can listening to it make your sleep worse? – https://theconversation.com/pink-noise-what-is-it-and-can-listening-to-it-make-your-sleep-worse-275179

Source: The Conversation – UK – By Katie Green, Senior Lecturer in Leadership and Leadership Development, Manchester Metropolitan University

Everyone recognises the trope of the stressed-out senior manager who’s always close to breaking point. But, in fact, mid-career is one of the most vulnerable periods for burnout and stress in a worker’s life. At this stage, many people have extra responsibilities outside work at the same time as their employer increases expectations around performance, availability and leadership.

Mid-career is often where this double load increases the risk of burnout. Research has found that these professionals experienced particularly high levels of burnout, worked longer hours and reported lower job satisfaction compared to other age groups. A key driver was the ongoing tension between meeting the demands of their job and maintaining a work–life balance.

Importantly, burnout is now widely recognised not as an individual failing, but as a workplace problem. The condition is characterised by emotional exhaustion, cynicism and lower productivity, with research showing that it is shaped primarily by organisational structures, cultures and leadership practices rather than a worker’s weakness or a lack of coping skills.

Burnout does not affect all groups equally. Women, for example, report higher levels of both personal and work-related burnout than men, particularly in mid-career. This could reflect women taking on more of a family’s caring responsibilities as well as expectations about availability and emotional labour.

The COVID pandemic intensified these dynamics. Many mid-career professionals had to juggle work and family responsibilities at the same time as their social interactions were curtailed and their workloads and working hours stretched. Since the height of the pandemic, all sectors and roles have seen increases in burnout rates, with health and social care organisations being hit particularly hard.

Absorbing the pressure

Stress and burnout come at a cost to employers through lost working days, absenteeism and “leavism” (people working while on leave). Mid-career professionals are especially exposed because they are often expected to absorb pressure without showing strain. This could be, for instance, leading a team through organisational change at the same time as meeting their own performance targets and supporting junior colleagues.

In many organisations, chronic overload and constant busyness are normalised and even rewarded. Permanent availability becomes a marker of competence rather than a warning sign.

Despite this, there remains an assumption that mid-career professionals are inherently resilient. However, prolonged exposure to high levels of stress can make them less resilient. Experience does not necessarily protect against burnout; in many cases it just conceals it.

Symptoms such as fatigue, insomnia and anxiety are frequently minimised or ignored until stress reaches a breaking point. Those known for their ability to “power through” often suppress warning signs to maintain a professional identity. These workers often delay asking for help, in part because things commonly associated with burnout (long hours, constant responsiveness and chronic overwork, for example) are often normalised.

While short-term stress can sometimes enhance performance, so-called “good stress” sits close to a tipping point. When pressure becomes chronic and recovery time is limited or absent, stress becomes a direct pathway to burnout.

My research looking at line managers’ development highlights these risks. Middle leaders and mid-career professionals were consistently described as overloaded and under-trained for their management responsibilities. Many had entered leadership roles with little or no formal preparation, and had to learn how to manage people on the job.

Promotions often brought significant increases in responsibility without corresponding investment in training. And where there were opportunities for development, they were frequently ad hoc and inconsistent. This combination fuelled anxiety and self-doubt – well-established precursors to burnout.

As part of the project, we interviewed more than 150 line managers from both the public and private sectors. Our findings strongly suggest that burnout is shaped by workplace systems, norms and expectations. Organisational practices and processes, along with culture and leadership patterns, play an important role. Unrealistic targets, excessive monitoring and a culture of long hours amplify stress. And leadership practices that prioritise constant performance pressure actively increase burnout risk.

Work climate matters more than hours alone – risk factors include bullying, sexual harassment and toxic leadership styles. Notably, burnout is closely linked to engagement from leaders, or the absence of it. For example, one study found that mid-career professionals, particularly women, suffer burnout when their effort goes unrecognised by managers.

Leaders who listen, acknowledge effort and offer recognition can significantly reduce the risk of burnout. Essentially, feeling that your work matters and is valued makes a measurable difference.

Leaders can design work for sustainability rather than endurance. This includes making sure workloads and targets are realistic, as well as stamping out cultures where constant availability is prized.

Mid-career leadership roles must be properly supported, and workers should be given protected time for training and development rather than being expected to learn through trial and error. Their managers should try to create a safe environment – listening seriously, responding early to concerns and intervening before stress escalates into burnout.

Finally, strong team working and a sense of community at work provide meaning that buffers against burnout. In mid-career, when pressures converge from multiple directions, connection is not a luxury but a necessity. The importance of joy at work is often overlooked. Opportunities to create meaning, connection and enjoyment are not indulgent extras; they protect against chronic stress and burnout.

Katie Green does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

– ref. Why mid-career is such a dangerous time for burnout and workplace stress – https://theconversation.com/why-mid-career-is-such-a-dangerous-time-for-burnout-and-workplace-stress-275358

Source: The Conversation – UK – By Barbara Jacquelyn Sahakian, Professor of Clinical Neuropsychology, University of Cambridge

Menopause is a key period in a woman’s life. This transition is often accompanied by wide-ranging physical and psychological symptoms — some of which can be debilitating and affect daily life. Menopause has also been linked to cognitive problems — such as memory, attention and language deficits.

To mitigate the effects of menopause — including hot flashes, depressive symptoms and sleep problems — many women turn to hormone replacement therapy (HRT). In England, an estimated 15% of women are prescribed HRT for menopause symptoms. In Europe, this number is even higher – varying between 18% in Spain to 55% in France.

But there’s limited understanding of the effects of menopause and subsequent HRT use on the brain, cognition and mental health. To address this, we analysed data from nearly 125,000 women from the UK Biobank (a large database containing genetic and health data from about 500,000 people).

We placed participants into three groups: pre-menopausal, post-menopausal and post-menopausal with HRT. The average age of menopause was around 49 years old. Women who used HRT typically began treatment around the same age.

In short, we found that menopause was associated with poorer sleep, increased mental health problems and even changes within the brain itself.

Post-menopausal women were more likely than pre-menopausal women to report symptoms of anxiety and depression. They were also more likely to seek help from a GP or psychiatrist and to be prescribed antidepressants.

Sleep disturbances were more common after menopause, as well. Post-menopausal women reported higher rates of insomnia, shorter sleep duration and increased fatigue.

Brain imaging analyses also revealed significant reductions in grey matter volume following menopause. Grey matter is an important component of the central nervous system which is composed mainly of brain cells. These reductions were most pronounced in regions critical for learning and memory (namely the hippocampus and entorhinal cortex) and areas key in emotional regulation and attention (termed the anterior cingulate cortex).

Notably, the hippocampus and entorhinal cortex are among the earliest affected in Alzheimer’s disease, the most common form of dementia.

The changes we observed in our study could suggest that menopause-related brain changes may contribute to increased vulnerability to Alzheimer’s disease later in life. This could help explain why there’s a higher prevalence of dementia observed in women.

We also investigated whether taking HRT post-menopause had any effect on health outcomes. Notably, HRT did not improve the reduction in brain grey matter.

In addition, we found that women using HRT showed higher levels of anxiety and depression compared to post-menopausal women who had never used HRT. However, further analyses indicated that these differences were already present. This suggested that pre-existing mental health problems may have influenced the decision to begin using HRT rather than these symptoms being caused by the medication itself.

One potential benefit of HRT use was noted in cognitive performance – particularly for psychomotor speed. Psychomotor slowing is a hallmark feature of ageing.

Post-menopausal women who had never used HRT showed slower reaction times compared with both pre-menopausal women and post-menopausal women who had used HRT. This indicates that HRT helps to slow the menopause-related declines in psychomotor speed.

HRT and menopause

There’s still much we don’t know about HRT – and more evidence on its benefits and risks are still needed.

Some studies report that those taking HRT have an increased dementia risk, while others suggest a decreased risk of dementia.

More research is also needed to understand the effects of HRT and how the different routes and dosages affect menopause symptoms. But according to one UK Biobank study of 538 women, the effects don’t appear to differ – regardless of factors such as the formulation, route of administration and duration of use.

Importantly, however, it’s difficult to establish whether women are actually receiving an effective dose. One in four women using the highest licensed dose of HRT still had low levels of estradiol (oestrogen) – around 200 picomoles per litre. Older women and HRT patch users were more likely to have lower levels.

Optimal plasma levels to relieve menopause symptoms are between 220-550 picomoles per litre. This means that for 25% of the women in the study, HRT would not have had optimal benefit for menopause symptoms.

Considering that most women go through the menopause, it’s important to resolve the question of whether HRT is beneficial – including preventing brain grey matter volume reductions and reducing the risk of dementia. It will also be important to know what the best dose and route of administration are.

There is evidence to suggest healthy lifestyle habits may mitigate these menopause-related changes in brain health.

Our work and that of other research groups shows that a number of lifestyle habits can improve brain health, cognition and wellbeing, thereby reducing the risk of cognitive decline associated with ageing and dementia. This includes regular exercise, engaging in cognitively challenging activities (such as learning a new language or playing chess), having a nutritious and balanced diet, getting the right amount of good-quality sleep and having strong social connections.

Research also shows regular physical activity can increase the size of the hippocampus, which may help mitigate some of the menopause-related reductions observed in this region.

Sleep is also critically important as it supports the consolidation of memories and helps clear toxic waste byproducts from the brain – processes that are essential for memory, brain health and immune function.

Having a healthy lifestyle may offer an accessible and effective strategy to promote brain health, cognitive reserve and resilience to stress during and after the menopause transition.

Barbara Jacquelyn Sahakian receives funding from the Wellcome Trust and the Lundbeck Foundation. Her research work is conducted within the NIHR Cambridge Biomedical Research Centre (BRC) Mental Health and Neurodegeneration Themes. She receives Royalties from Cambridge University Press for Brain Boost: Healthy Habits for a Happier Life.

Christelle Langley receives funding from the Wellcome Trust. Her research work is conducted within the NIHR Cambridge Biomedical Research Centre (BRC) Mental Health and Neurodegeneration Themes. She receives royalties from Cambridge University Press for Brain Boost: Healthy Habits for a Happier Life.

– ref. Menopause: our study revealed how it affects the brain, cognition and mental health – https://theconversation.com/menopause-our-study-revealed-how-it-affects-the-brain-cognition-and-mental-health-275329