Category: The Conversation – UK

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 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

Source: The Conversation – UK – By Robert Dover, Professor of Intelligence and National Security & Dean of Faculty, University of Hull

For obvious reasons, the secretive world of intelligence agencies and the people who revolve in its orbit remains opaque. So much so, that some of those people may not even be aware of any involvement in the secret world.

The Epstein papers have thrown up speculation about whether the late financier and sex offender might have performed services for one or another of the big intelligence agencies. And in the wake of that speculation, it has been noted that the father of Epstein’s one-time girlfriend, Ghislaine Maxwell, was the late Robert Maxwell, well-known as a larger than life publisher and newspaper proprietor in the UK from the 1950s to the early 90s. He, too, was the subject of much speculation that he might have been involved in intelligence work.

Epstein is now better known for his sex trafficking network and Maxwell for stealing from his employees’ pension funds. But their examples point to how intelligence, high finance and influence work.

Generally speaking there are three main classes of people involved in state intelligence gathering. “Officers” are full-time employees of state intelligence agencies such as MI6. They run their groups of “agents”, who are not formally employed by the state but who deliberately and knowingly gather intelligence and perform tasks for intelligence officers. And there are what is known as “intelligencers” (or sometimes assets) who may not even know they are providing information to a spy agency.

The currency of human intelligence is access, knowledge and often the ability to compromise officials and influential people.

We often think that intelligence agencies and their agent runners seek to directly recruit people with the access and motivation to pass on state secrets. While this is undeniably the case – and the examples of the American Aldrich Ames and the Briton Melita Norwood provide good evidence of this – intelligence agencies are equally interested in recruiting what’s known as “access agents”.

Access agents

The value of an access agent is not the secrets they have access to, but the social and professional access they provide to people who do. People in high-end society, scientific research, banking, politics and culture make excellent targets for access agents. And from an agency’s point of view, the best thing is that these agents are deniable and under the radar.

Intelligence officers and their operatives require funding, mobility and a credible back story (known as a legend). Businessmen like Robert Maxwell and Jeffrey Epstein had plenty of all three, making them excellent candidates to theoretically serve the needs of intelligence agencies.

But rather than indulging in speculation about Epstein and Maxwell, which is unlikely ever to be conclusively confirmed or denied, it’s more instructive to look at what we know about access agents. They are often business people, sometimes academics or journalists with a reason to travel and the opportunity to meet people in influential circles in the course of their legitimate business.

It’s worth remembering that Kim Philby, the most notorious of the Cambridge spy ring, cut his teeth as a reporter in Spain during the civil war, before embarking on a career as an MI6 officer (and Soviet double agent). Australian journalist, Richard Hughes – who appeared lightly disguised in novels by Ian Fleming and John le Carre – was believed by many to be an agent for British intelligence, working in southeast Asia during the upheavals of the 1960s and 1970s.

Perhaps the most famous businessman-agent was Cyril Bertram Mills who combined being the director of the Bertram Mills Circus with a four-decade career spanning the years before and after the second world war with British intelligence. Travelling widely in Europe, ostensibly to seek out circus acts, he provided his spymasters with evidence of German rearmament in the 1930s. He also recruited Garbo, one of the most successful double agents, who was instrumental in convincing Germany that the D-Day landings would be in Calais, not Normandy.

An access agent is trained “to be the friend the informant doesn’t have”. They can provide what their contact needs and cannot get hold of: whether that’s useful inside information of some kind, an introduction to someone important, a sexual partner or finance for one of their ventures.

MI5 is quite open about this on its website: “Agents operate by exploiting trusted relationships and positions to obtain sensitive information. They may also look for vulnerabilities among those handling secrets.

Secrets and lies

Determining truth in intelligence is complicated. Very rarely do we see a single piece of incontrovertible evidence that proves someone’s intelligence status or the ethics or efficacy of their actions. But then as we know, all of this is shrouded in secrecy and supposition.

In Maxwell’s case, historical scholarship and TV documentaries have provided unverified hints. In Epstein’s we have indicators such as the claim by former US attorney, Alexander Acosta that he was told Epstein “belonged to intelligence”, when he negotiated his plea deal. But it’s unlikely we’ll ever know the truth about either.

Robert Dover 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. A whiff of espionage around the Epstein files points to how intelligence and influence interact – https://theconversation.com/a-whiff-of-espionage-around-the-epstein-files-points-to-how-intelligence-and-influence-interact-275344

Source: The Conversation – UK – By Amalendu Misra, Professor of International Politics, Lancaster University

Panama’s supreme court invalidated a contract in late January that had allowed Panama Ports Company, a subsidiary of Hong Kong-based firm CK Hutchison, to operate two ports on the Panama canal since 1997.

The decision, which ruled that the laws allowing the firm to operate the ports were “unconstitutional”, comes one year after the US president, Donald Trump, threatened to take control of the canal to limit Chinese influence over the waterway.

Beijing reacted to the ruling angrily, calling the judgment “absurd, shameful and pathetic”. It also said the Panamanian government will pay “a heavy political and economic price” for evicting the company from the ports. The ruling is the latest sign that China’s ambitions in the region are losing momentum.

Chinese influence in Latin America is a relatively recent phenomenon. Since 1823, when President James Monroe declared the western hemisphere closed to further European colonisation, the US has largely maintained strict control over the region’s affairs.

But that changed after the end of the cold war in 1991, with successive US administrations reducing their focus on Latin America. This allowed emerging superpowers such as China to assert their influence in the region.

China is now the top trading partner for South America and is becoming the largest for Latin America as a whole. It is also a major source of foreign direct investment and infrastructure lending for the region.

Chinese influence in what the US considers its own backyard has irked the Trump administration. Shortly after the operation to capture Venezuelan leader Nicolás Maduro in January, the US secretary of state, Marco Rubio, declared: “This is the western hemisphere. This is where we live – and we’re not going to allow the western hemisphere to be a base of operations for adversaries, competitors and rivals of the United States.”

The eviction of Panama Ports Company from the Panama canal will have been celebrated as a victory in Washington, which is looking to promote its own national interests in the region. But it is also possible that the incident could prompt countries throughout Latin America to address their reliance on China.

Over the past two decades, China has swamped countries in Latin America and the Caribbean with loans. However, unlike loans from the World Bank or International Monetary Fund that are contingent on structural and institutional reforms, Chinese loans come with few conditions attached. China generally requires governments to guarantee repayment through the future export of commodities such as oil.

At the same time, Chinese investments generally bring low environmental and labour standards. In a 2023 analysis of 14 Chinese mining, hydroelectric, fossil fuel, infrastructure and agriculture projects in Latin America, the UN Committee on Economic, Social and Cultural Rights identified patterns of serious rights abuses. These included abuses against the rights of Indigenous people, as well as the rights to health, a healthy environment, water, food and housing.

Chinese investments also tend to focus on areas that give Beijing control over a country’s critical infrastructure. For example, China controls a majority stake in the strategically important Chancay port in western Peru and Chinese firms now control approximately two-thirds of Chile’s energy distribution. Under these circumstances, reducing reliance on China is probably in the interests of many Latin American countries.

In February 2025, Panama became the first country in the region to withdraw from China’s global infrastructure and investment project, the Belt and Road Initiative. The announcement followed a visit by Rubio, drawing criticism from Chinese officials over what they saw as US attempts to “deliberately sow discord” between China and Panama.

At a press conference, the Panamanian president, José Raúl Mulino, said: “I do not know what was the intention of those who signed this agreement with China. What has it brought to Panama all these years? What are the great things that this Belt and Road Initiative has brought to the country?”

China’s choices

China itself already appears to be deprioritising Latin America as an investment destination, largely due to the region’s mediocre growth trajectory and frequent delays to loan repayments. It has scaled back on sovereign loans since 2020, while Chinese investment in large-scale Latin American infrastructure projects has reduced in recent years.

And it may be in China’s interests to accelerate this trend. The US capture of Maduro demonstrates the Trump administration’s willingness to induce dramatic changes in the Latin American political environment. These changes may undermine China’s ability to extract unpaid debts from governments in the region.

For example, analysts suggest there is a risk that the new Venezuelan government will attempt to challenge the legitimacy of the roughly US$10 billion (£7.3 billion) of debt it owes to China under a legal doctrine known as “odious debt”. This arises when a government argues that debt incurred by a previous regime did not benefit the nation and is therefore unenforceable.

The future ownership of the two ports previously operated by Panama Ports Company is unclear. The firm has announced it is launching international arbitration proceedings against Panama over the contract ruling, a process that is likely to last years. But it appears the high noon of Chinese economic domination in Latin America may well be over.

Amalendu Misra is a recipient of British Academy and Nuffield Foundation fellowships.

– ref. China is losing ground in Latin America – https://theconversation.com/china-is-losing-ground-in-latin-america-275346

Source: The Conversation – UK – By Dipa Kamdar, Senior Lecturer in Pharmacy Practice, Kingston University

When the days shorten and the sun sinks low in the sky, that familiar winter slump sets in. There’s a fundamental reason for this seasonal fatigue: low levels of vitamin D – the “sunshine vitamin”.

People in the UK simply can’t make enough of this vital nutrient from sunlight during winter, which is why many are advised to take a supplement.

So, what is vitamin D, why does it matter, and how much do you really need?

Why is vitamin D important?

Vitamin D is a fat-soluble vitamin. This means it’s absorbed with other fats in our diet, and stored in the body’s liver and fatty tissue.

Vitamin D helps the body absorb calcium from the gut and regulates calcium and phosphate levels. These minerals are crucial for healthy bones, teeth and muscles.

Vitamin D plays a key role in bone development and in the continuous renewal of bone tissue. Without enough vitamin D, adults can develop osteomalacia (soft bones) and children can develop rickets (a bone deformity, often characterised by bowed legs).

Vitamin D supplementation, in conjunction with calcium, helps maintain bone mineral density and has been shown in trials to reduce fracture risk in people with osteoporosis.

Many tissues in the body have receptors that respond to vitamin D, as well. This means vitamin D can also affect neuromuscular function by helping us maintain muscle strength.

Low vitamin D levels have also been associated with a higher risk of several health problems, including cardiovascular conditions such as high blood pressure and heart failure. However, it’s uncertain whether low vitamin D directly contributes to cardiovascular disease or is simply a reflection of overall poor health in people with chronic conditions.

Although the evidence is mixed, some studies suggest vitamin D may help boost the immune system, too. Some studies suggest that the severity of respiratory infections (such as flu or COVID) may be reduced if you regularly take a vitamin D supplement.

Low vitamin D levels have also been linked to multiple sclerosis. In addition, research suggests that vitamin D may help regulate mood – particularly among people with depression or those who are vitamin D deficient. The studies aren’t definitive, though.

Where do we get vitamin D from?

Unlike other vitamins, which we obtain through diet, vitamin D is made when the skin is exposed to sunlight.

In the UK, around 80-90% of the vitamin D we need comes from the sunlight we’re exposed to. Between late March and September, the sun is usually strong enough that most people produce the vitamin D they need naturally.

But from October to early March, the UK’s sun isn’t strong enough for the skin to synthesise vitamin D – even on bright days. This is why it’s recommended everyone should consider taking a daily supplement during the colder months to maintain optimum levels. This becomes even more important as people spend more time indoors during winter.

Some food sources do in fact contain vitamin D – including oily fish (such as salmon or sardines), red meat, egg yolks and fortified cereals. However, only a small proportion (roughly 10–20%) of our vitamin D levels are obtained through diet.

How much vitamin D should I take?

Adults and children over four years old should take 10 micrograms (400IU) of vitamin D per day during the autumn and winter.

Babies under one should be given 8.5-10 micrograms of vitamin D throughout the year if they are breastfed or partly breastfed. Infants are born with limited vitamin D stores, which are primarily transferred from the mother. While infants can produce vitamin D through sunlight exposure, this is often minimal due to sun protection measures. This is why a supplement is recommended.

Because formula is already fortified with vitamin D, only babies who drink less than 500ml of formula a day should be given a supplement.

Although 10 microgram supplements are sufficient, products up to 25 micrograms (1,000IU) are considered safe for general use.

Vitamin D comes in two main forms: D₂ (ergocalciferol) and D₃ (cholecalciferol). Although they differ slightly in chemical structure, both are well absorbed in the small intestine. However, some research shows vitamin D₃ is generally more effective at increasing and sustaining vitamin D levels in the body.

Some people may need to take a vitamin D supplement all year round. This includes people with darker skin tones, such as those of African, African-Caribbean or south Asian heritage, whose higher melanin levels act as a natural sunscreen, reducing how efficiently they synthesise vitamin D from sunlight. People who cover their skin for cultural or medical reasons, or who are housebound or indoors for long periods, will also have less exposure to sunlight and may require a supplement.

Adults over 65 should also consider year-round supplementation. This is because the way the body produces and processes vitamin D changes as we age.

Can you take too much?

It’s important you do not take more than the recommended standard dose. Taking more than recommended is unnecessary and potentially harmful. Higher doses should only be taken under medical supervision for a confirmed deficiency.

Very high intakes (more than 100 micrograms daily) taken over a long time can lead to excessive calcium levels in the body – causing weakened bones and potential kidney and heart problems. Because vitamin D stays in your body for a long time (about two months), symptoms of an overdose can last for several weeks.

You can’t get too much vitamin D from sunlight alone, but it’s still important to protect your skin to reduce the risk of sun damage and skin cancer.

During a British winter, vitamin D is one of the simplest tools we have to support our overall health. With limited sunlight, a small daily supplement offers a reliable way to keep bones and muscles in good working order through the darker months.

Dipa Kamdar 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. Vitamin D: everything you need to know about this supplement – from when to take it, to how much you really need – https://theconversation.com/vitamin-d-everything-you-need-to-know-about-this-supplement-from-when-to-take-it-to-how-much-you-really-need-274754

Source: The Conversation – UK – By Jordan Magnuson, Senior Lecturer in Games and Media Art, University of Southampton

Exchanging poems on Valentine’s Day is a long-standing tradition. But poetry doesn’t have to be bound to the page. This February 14, why not try sharing a game poem instead?

Game poems are tiny video games made as a form of poetic expression. They generally only take a few minutes to play and tend to challenge our expectations of what video games are for. Rather than entertaining players with points, competition, or spectacle, they aim to capture a feeling, a thought, or a fleeting moment.

It can seem strange, at first, to consider games as a form of poetry. We often associate video games with speed and large-scale entertainment, while we tend to associate poetry with slowness, intimacy and attention. But games are not bound to the conventions that dominate their mainstream forms.

Game poems show how video games can be used to explore interior life, relationships, and emotional nuance and offer a reminder that creative impact doesn’t always require length or complexity. Sometimes, five minutes is enough.

I’ve been making short video games as a form of poetic expression for over 15 years, and recently launched a playable online magazine dedicated to this sort of work.

If that all of that sounds abstract, the best way to understand what these games are about is simply to play one. Here are five short game poems, all playable in a web browser, that explore themes of love, intimacy, longing and separation – perfect for Valentine’s Day, whether you’re playing on your own, or with a special someone.

1. On Second Thought by Tereza Kotěšovcová

Estimated play time: less than five minutes | Gaming skills required: none

On Second Thought contains no text at all. Instead, it unfolds through simple images, rhythm and the repetition of a single button press. The game centres on a familiar emotional moment: the hesitation that comes with making the first move in a relationship.

As you interact, a seemingly quiet encounter is juxtaposed with the inner tumult that can often seize our imaginations at such moments. In the words of the artist: “You hesitate. You imagine the worst. Miss your moment, and the world will stutter: a coffee spills, a sun is eclipsed, a temple crumbles. You start again.”

Like a lyric poem, the game is less interested in explaining this experience than in letting you sit inside it.

2. Queers in Love at the End of the World by Anna Anthropy

Estimated play time: ten seconds (replays recommended) | Gaming skills required: none

Queers in Love at the End of the World lasts exactly ten seconds.

You and your lover are about to witness the end of the world. In that brief span of time, you can choose how to act: kiss, hold hands, try to say something meaningful – or hesitate and watch the moment pass.

The time limit is a merciless and potent constraint. There is no way to do everything, and no way to “win”. Each play-through becomes a small act of acceptance: whatever you chose, that was enough. Like a powerful short poem, the game lands with emotional force precisely because it ends so quickly.

3. Loneliness by Jordan Magnuson

Estimated play time: less than five minutes | Gaming skills required: none

Valentine’s Day can be a difficult time for people who are feeling isolated, and this game poem doesn’t shy away from that.

Loneliness is an abstract exploration game that I created where the only available input is movement. Explore a flat landscape populated by squares that engage in social interaction represented through patterns of their own simple movement. Do you avoid them or choose to approach? And what about the next group?

Is the way the others react to you real, imagined or remembered? The game leaves that question open, inviting reflection instead of offering answers. The familiar video game convention of exploring a landscape becomes a metaphor for navigating social and emotional distance.

4. The Love Letter by Alex Snyder

Estimated play time: five to ten minutes | Gaming skills required: some

Not all game poems are sombre. The Love Letter is playful, awkward and sweet.

You’re a student at school. A note with a heart appears in your locker. The problem is finding a quiet place to read it while navigating busy hallways and crowds of classmates.

This game poem borrows the language of classic arcade challenges – movement, timing, obstacles – but repurposes them to express something small and personal: the anxious thrill of teenage romance. It feels like a Valentine’s card rendered in playable form.

5. How to Walk Out the Door by Anton Patsi

Estimated play time: five to ten minutes | Gaming skills required: None. But fast typing skills will help.

And for the Valentine’s Day sceptics, something completely different. A game about breaking up. Ending a relationship can be harder than starting one. How to Walk Out the Door turns that difficulty into an intense 20-second loop.

Each round plays out under extreme time pressure and revolves around an unusual game mechanic: typing. With each attempt to leave, you can get a little further – or falter – before time resets and you’re forced to begin again.

The repetition is the point. The game uses rhythm and constraint to convey emotional exhaustion in a way that words alone might struggle to match.

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Jordan Magnuson 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. These five short video games work like poems – and they’re ideal for Valentine’s Day – https://theconversation.com/these-five-short-video-games-work-like-poems-and-theyre-ideal-for-valentines-day-275148