Category: Analysis

Source: The Conversation – UK – By Adam Taylor, Professor of Anatomy, Lancaster University

Brazil’s jailed former president Jair Bolsonaro was recently reported to have undergone three medical treatments to stop a bout of persistent hiccups. While hiccups are usually harmless and short-lived, his case highlights a condition that can, in rare circumstances, become medically significant.

Hiccups are one of the few bodily functions named after the sound they make. The sound is caused by a sudden, involuntary spasm of the diaphragm – a large, dome-shaped muscle that separates the chest from the abdomen and plays an essential role in breathing.

When the diaphragm contracts unexpectedly, air is drawn rapidly into the lungs. At the same time, the vocal cords snap shut, producing the characteristic “hic” sound.

Most people hiccup between two and 60 times per minute. Episodes typically last a few minutes, sometimes a few hours, before resolving on their own. They are usually only a minor irritation.

Doctors become more concerned when hiccups persist. Those lasting longer than 48 hours are classified as “persistent”. If they continue for more than a month, they are described as “intractable hiccups” – a rare and often debilitating condition.

The causes of common, short-term hiccups are usually straightforward. They can be triggered by an overfull stomach, alcoholic or fizzy drinks, very hot or very cold drinks, or emotional states such as anxiety and excitement or stress. These factors irritate or stimulate the nerves involved in the hiccup reflex, briefly disrupting the normal control of breathing.

Given how common hiccups are, it is not surprising that there are countless suggested cures. Some are supported by scientific evidence, while others rely on anecdote and personal experience.

Many of the techniques that appear to work best have one thing in common: they affect how the diaphragm functions. By altering breathing patterns or briefly increasing carbon dioxide levels in the blood, they may help reset the nerves that control the muscle.

Several small studies have examined structured breathing techniques. One approach, called “hiccup-relief using prolonged active inspiration” – slowly breathing in very deeply and holding it to stop diaphragm spasms – showed success in 21 patients. Another technique, called supra-supramaximal inspiration (breathing in even more after you already feel completely full of air) relieved hiccups in six people in a separate study.

A device based on similar principles, using controlled sucking and swallowing to regulate diaphragm activity, demonstrated a nearly 92% success rate in over 200 people.

There are also many commonly cited home remedies, although these often have little or no evidence to support them. They include breathing into a bag, drinking or gargling iced water, pulling the tongue, biting a lemon, eating peanut butter, applying pressure to the eyeballs, rectal massage (yes, really), performing the Valsalva manoeuvre (trying to breathe out against a closed nose and mouth), or attempting to induce a sudden fright. However, for most people, a brief change in breathing or swallowing is enough to interrupt the hiccup reflex.

One reason hiccups are difficult to study is that they usually resolve quickly. Short episodes are hard to capture in controlled research settings, which limits large-scale studies. As a result, most published studies focus on persistent and intractable cases.

Intractable hiccups are rare, affecting about one in 100,000 people. They occur far more often in men, who account for more than 90% of cases, particularly those over the age of 50. In these people, hiccups can be exhausting and distressing, interfering with eating, sleeping and breathing.

In Bolsonaro’s case, the cause of his latest episode has not been made clear. In June 2021, however, he attributed a previous bout of persistent hiccups to medication prescribed after dental surgery. Although the specific drugs were not disclosed, several medications are known to trigger prolonged hiccups.

Corticosteroids, such as dexamethasone and methylprednisolone, particularly at high doses, are well-recognised triggers.

Unlike food or fizzy drinks, which irritate nerves directly, these drugs affect chemical messengers within the nerve pathways that control the diaphragm. Hiccups have even been reported following corticosteroid injections into the knee or shoulder, which are often given to relieve pain from arthritis.

Benzodiazepines (drugs to treat anxiety and insomnia) can also cause hiccups, sometimes even at low doses. Studies of procedures involving benzodiazepine sedation, such as endoscopy, show that around one in five patients given midazolam develop hiccups, compared with about one in 20 who are not given the drug. The effect is again more common in men.

Some antipsychotic medications, including aripiprazole, have also been linked to hiccups, which often resolve when the drug is stopped. These medications influence the same neurotransmitter systems involved in the hiccup reflex.

Not always benign

Treatment for persistent hiccups usually takes one of two forms: medication or physical procedures. The drugs doctors most often prescribe are baclofen and metoclopramide, which have been tested in small studies comparing them against placebos (dummy pills). If the medication doesn’t work or causes too many side-effects, doctors may consider more invasive treatments.

Bolsonaro underwent a phrenic nerve block, a procedure that temporarily reduces or paralyses the function of the phrenic nerve, which controls the diaphragm. The effect can last for hours, days or up to a few weeks.

Because the phrenic nerve plays a critical role in breathing, the nerves on both sides of the body are rarely blocked at the same time. When used appropriately, the procedure is highly effective.

In more severe cases, or when doctors find out what’s causing the problem, permanent treatments might be needed. These could include destroying the nerve that’s causing the hiccups using heat or freezing, or surgically cutting and sealing off the nerve to stop the signals.

Persistent hiccups after stomach surgery are common. Since Bolsonaro was previously stabbed in the abdomen, this could be playing a role in his hiccup problem.

Damage to the area of the brain responsible for regulating hiccups can also play a role. One well-known example is Charles Osborne who holds the record for the longest continuous bout of hiccups – lasting 68 years from 1922 to 1990.

Research shows they can sometimes be an early symptom of cancers of the oesophagus, colon, kidneys, or conditions affecting the brainstem. Studies have also found that men diagnosed with persistent hiccups have higher rates of certain cancers in the following 12 months.

Thankfully for most people, hiccups remain a harmless inconvenience. However, hiccups that persist for several days without an obvious trigger should be assessed by a doctor.

Adam Taylor 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. Jair Bolsonaro had surgery for his hiccups. How to know when hiccups need medical intervention – https://theconversation.com/jair-bolsonaro-had-surgery-for-his-hiccups-how-to-know-when-hiccups-need-medical-intervention-272749

Source: The Conversation – UK – By David Alexander, Affiliate Researcher, Political & International Studies, University of Glasgow

Diversity among students and researchers is a common goal across academia. This has been driven by a desire to increase opportunities for the historically marginalised in higher education – moving away from the straight, white and male personification of academia.

It also comes from a recognition that diversity brings innovation. It enhances the quality of research and teaching. It improves how higher education institutions engage with a diverse student body. Increased representation has affected how academia operates.

This is true in my discipline of political science. As we have worked to expand representation in the profession, we have broadened our understanding of the diversity of politics.

Growing representation in the field has increased our awareness of how different groups engage with politics. These are people often historically discounted in societies and ignored by political science: women, the LGBTQ+ community, people from ethnic minority backgrounds. Increased diversity gives academia invaluable general insight into the organisation of politics.

But disability in politics is in its infancy, as is the representation of the disabled scholar. Underrepresentation will affect any field. In political science, though, this is a particularly hazardous situation. Many of the issues disabled people encounter in society will result from political decision making.

In the UK, 25% of the population is considered to potentially have a disability. This not only includes physical or sensory impairment and neurodiversity, but long-term illness such as HIV, and mental health conditions such as depression.

Disabled students in higher education, from a position of underrepresentation, are also now an expanding group as the sector has made efforts to increase accessibility. Around 18% of UK students report having a disability. Yet only 7% of academics declare a disability in higher education.

Politics can deeply affect the lives of the disabled person. A change in policy may leave them unable to work or contribute to society, creating more barriers in life.

The unease in the disabled community about being represented in the assisted dying debate and the prospective fallout is one key example. Debate has also focused on what cars disabled people should be allowed to drive.

But because political science rarely recognises disability, politics and politicians are provided with little information on the impact of policy. We need more disabled political scientists to increase awareness, and this awareness will help better interrogate political issues around disability. More lived experiences of disability should provide insight, but also help create acknowledgement that the issues exist, from those who may never experience disability. But barriers exist.

Changing research

In my research, I argue that this lack of diversity has been entrenched by the marginalisation of disabled political scientists. We are not present or visible in research positions. At best, we are considered a novelty (as has been said to me on more than one occasion).

We – disabled scholars – are trying to highlight the disabling barriers that prevent career progress. These are usually hidden from non-disabled colleagues, who I believe are unaware of the issues, rather than looking to maintain exclusion.

One such barrier is hidden labour. A disabled scholar must make greater sacrifices to “make it” compared to non-disabled colleagues. This includes, for example, the energy required to access inaccessible teaching spaces, fieldwork travel and overcoming sensory overload or burnout. This effort must be put in to not have aspersions placed on a disabled scholar’s academic capacity. But there is often little or no acknowledgement from universities and other scholars of the barriers that mean this extra work is required.

We may be slowly approaching a turning point in the research of disability in politics. Several scholars are showing disability can provide understanding on how politics operates. Researchers are focusing on issues such as the political representation of the disabled person, and disability’s place within political theory. Others are exploring how disability affects support for political parties.

Research like this on disability is providing understanding of how far assumptions based on the non-disabled person are influential in politics. For instance, it is developing our knowledge about who gets to be represented in politics, and the barriers that exist for disabled people to actively engage in political participation.

There is a small but growing awareness that disability potentially offers a new perspective to frame our understanding of politics. Currently, this understanding is built on the image of the non-disabled person and what they believe politics should look like. The disabled person is an important part of society, but one that has often suffered from political decision making.

Once the disabled political scientist becomes a norm rather than exception, the importance of disability will be more undeniable. We will be better able to address and understand the impact politics has upon disabled people.

David Alexander 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. The academic study of politics is failing disabled people – with real-world consequences – https://theconversation.com/the-academic-study-of-politics-is-failing-disabled-people-with-real-world-consequences-259222

Source: The Conversation – UK – By Ievgeniia Kopytsia, Research Associate in the Law Faculty, University of Oxford

Russia’s war in my home country Ukraine has caused environmental damage on a vast scale. Roughly 2.4 million hectares of agricultural land – an area almost the size of Wales – are now littered with unexploded ordnance. Thousands of oil, chemical and ammunition facilities have also been damaged, releasing toxic substances into rivers, wetlands and the Black Sea.

The 2023 destruction of the Kakhovka dam on the Dnipro River alone flooded 600 sq km of land, destroying entire ecosystems. And total war-related emissions are now estimated to stand at the equivalent of around 230 million tonnes of CO₂. This is comparable to the annual emissions of Austria, Hungary, the Czech Republic and Slovakia combined.

Yet even under this pressure, Ukraine remains able to build a sustainable future. As outlined in a policy brief presented at Cop30 in Brazil by my colleagues from Oxford Net Zero and I, Ukraine has an opportunity to build a carbon market that can support its postwar recovery and strengthen its ability to withstand future conflict.

Wars and climate change are inextricably linked. Climate change can increase the likelihood of violent conflict by intensifying resource scarcity and displacement, while conflict itself accelerates environmental damage. This article is part of a series, War on climate, which explores the relationship between climate issues and global conflicts.

A carbon market allows companies to trade “carbon credits”, each of which represent one tonne of CO₂ reduced or removed from the atmosphere. These credits are generated by projects like reforestation or renewable energy and can be bought by companies to compensate for their own greenhouse gas emissions.

There are two main types of carbon market: a compliance market and a voluntary market. In a compliance market, a government controls the supply of carbon credits. They cap emissions at certain levels and issue tradable permits to companies, with a company that does not use all of its carbon credits able to sell them to one that expects to exceed its limits.

In a voluntary market, companies purchase carbon credits from project developers voluntarily to offset their own emissions. They often do so to enhance their own reputation or to meet demands from investors, with purchasing carbon credits usually a faster way to show climate action than cutting emissions directly.

The global compliance market is far larger than the voluntary market, valued at US$851 billion (£634 billion) in 2021. The voluntary market was valued at only US$2 billion that year. But a functioning voluntary carbon market could still be vital for Ukraine.

According to Morgan Stanley, a global financial services firm, the global voluntary carbon market is expected to grow to about US$100 billion in 2030 and US$250 billion by 2050. A well-designed national market could open access to private capital to support Ukraine’s recovery at a time when the public budget is stretched to breaking point.

Revenue from carbon credits could, for example, help finance more projects to reforest Ukraine’s war-damaged land and restore its degraded agricultural soil. It could also support the development of more decentralised renewable energy in the country.

Various assessments, including one by the World Bank, suggest these are all areas that will require billions of dollars in investment over the coming years. Carbon finance will not replace public funding, but it could complement it at a moment of acute fiscal pressure.

The technology and projects that are commonly financed through voluntary carbon markets, particularly renewable energy, could also make Ukraine better able to withstand the effects of conflict in the future.

Fossil fuel-based infrastructure is extremely vulnerable during war because it depends on centralised facilities, long supply chains and the continuous delivery of fuel. Refineries, pipelines and substations are immobile targets, while fuel convoys are exposed to attack.

Decentralised renewable energy systems reduce these risks. For example, localised solar power systems that operate independently from the national grid can keep hospitals, shelters and communication centres running even when the main electricity network is attacked.

Designing a market

The foundations for Ukraine to design its own national carbon market are already in place. Ukraine’s parliament adopted a law in 2024 that formally mandated the creation of an emissions trading system. The system is set to start in 2026 with a pilot phase, with the aim of establishing a framework for trading carbon credits.

There are also several voluntary nature restoration initiatives emerging in the country. A project called Rewilding Ukraine, for example, has begun restoring around 13,500 hectares of wetlands and grassland in southern Ukraine – an area comparable to the size of the Isle of Wight’s inland forests and farmland combined.

These projects are currently operated independently, while remaining fragmented and generally small in scale. But many are being developed with the expectation that they will eventually be integrated into a carbon market, which would allow them to generate verified carbon credits.

If Ukraine can begin building a credible carbon market under fire, then any country facing instability or crisis can do the same. But countries currently enjoying relative peace and stability should recognise the privilege they hold.

They can restore nature, strengthen resilience to climate change, and cut emissions without living under the constant threat of missiles and blackouts. I hope they choose to act now, before a crisis forces them to.

Ievgeniia Kopytsia 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. How Ukraine is fighting environmental damage and building its resilience amid war – https://theconversation.com/how-ukraine-is-fighting-environmental-damage-and-building-its-resilience-amid-war-271889

Source: The Conversation – UK – By Emre Tarim, Lecturer in Behavioural Sciences, Lancaster University

US president Donald Trump’s attacks on the chairman of the Federal Reserve, Jerome Powell, are yet another signal of a new era of economic policymaking and governance.

After repeatedly calling Powell “stupid” for not lowering interest rates quickly enough, Trump has now directed government prosecutors to launch a criminal investigation into Powell for allegedly misleading the Senate about the costs of renovations at the central bank’s buildings, allegations he denies.

While the immediate risk of forcing an interest rate cut too quickly would be higher inflation in the US, Trump’s unprecedented attacks on Powell cannot be seen merely as a domestic matter.

This is not just because of the US economy being the largest in the world, but also due to how businesses, consumers and governments use the US dollar in their economic affairs.

Since the 1980s when Trump was a celebrity businessman, he has been making his vision of economics clear. Now, as the most powerful man in the world, he is trying to put that vision into practice.

In this vision, there are clear winners and losers in any economic transaction. And instead of mutual benefits, the US must always be the winner.

While the fairness of trade relations is always open to academic and political scrutiny, the global economic order after the second world war has had a way of resolving disputes through bodies like the World Trade Organisation.

A rule-based international trade regime helped to generate spectacular economic growth in the second half of the 20th century. Yet, the start of the 21st century hasn’t been great for the world economy, with two major financial crises in the early 2000s (the dotcom bubble and global financial crisis).

Added to these are the rise of populist and authoritarian politics and the COVID pandemic. These have shifted the ground on which the rule-based global economy had been thriving since the 1950s. Threats to that world economic order also threaten the pre-eminent place of the dollar within it.

The US dollar was the official reserve currency of the world economy between 1944 and 1976 through international agreements backed by gold reserves. International trade imbalances, which initially favoured the US but then benefited the fast-recovering European and Asian economies, put an end to this gold standard.

Yet, because of what some scholars call path dependence (where society tends to stick to familiar processes), the dollar has continued to act like the world’s reserve currency.

Advances in finance theory and practice, such as new valuation models and increased computing power, have also helped businesses and governments manage their affairs in this deregulated yet highly integrated economic environment.

The autonomy question

Another important factor in the dollar’s dominance has been the strength of institutions, including the rule of law in the US. A pinnacle of this is the Fed, and its autonomy over monetary policy to ensure maximum employment and price stability in the US economy.

This autonomy is enshrined in the US constitution and many developed and developing countries followed suit and gave policy autonomy to their central banks. This was often after turmoil caused or exacerbated by politicians. Since the 1980s, the Fed has been the most important source of economic information for business, investors and governments around the world.

Read more:
The 1970s inflation crisis shaped modern central bank independence. Now it’s under populist threat – podcast

But now Trump is threatening to reverse this autonomy and replace it with his own vision of economics involving lower interest rates to boost economic activity and decrease government debt payments.

It’s possible that Trump may be following the lead of Turkish president Recep Tayyip Erdoğan, who put his country’s economy in negative interest rate territory in 2019. This was followed by soaring annual inflation, which some commentators calculated to be in triple digits.

Any politically driven cut in interest rates in the US, ushered in with a new Fed chairman (Powell’s term ends in May) will almost certainly lead to inflationary pressures. This is because it will trigger consumer borrowing and consumption, especially if people realise how the value of their dollars is deteriorating compared to goods, services and other currencies.

This can become a vicious cycle, where inflation gets out of control and US consumers avoid holding dollars. They may seek alternatives like gold and cryptocurrencies until a more orthodox monetary policy is adopted again. Of course, Trump is now a champion of cryptocurrencies, after once likening bitcoin to a “scam”.

None of this fits well with Trump’s election promise to bring down consumer prices.

Global trust and interest in US assets are already declining, as many investors are openly or anonymously (for fear of retaliation by the Trump administration) discussing their growing aversion to the US economy. This does not help the dollar. A depreciated and politically controlled dollar would likely herald the beginning of the end of dollar hegemony.

Over the years, commentators wrongly announced the beginning of this decline after events such as the introduction of the euro and moves by China to foster a new global monetary system. But these ignored how path dependence and inertia in economic affairs reduce uncertainty and can underpin a currency’s status as a reserve currency.

Yet, if Trump and his successors realise their economic vision, the world might finally see a real reversal in the dollar’s fortunes. This could come alongside increased economic regionalisation determined by the “us against them” mentality.

History teaches how such episodes led to open conflict – and how the world once managed to prevent them with a rule-based international order.

Emre Tarim 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. Trump’s attacks on the Federal Reserve risk fuelling US inflation and ending dollar dominance – https://theconversation.com/trumps-attacks-on-the-federal-reserve-risk-fuelling-us-inflation-and-ending-dollar-dominance-273396