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Weight loss is a complicated process. There are so many factors involved including your diet, how much sleep you get each night and the kind of exercise you do. Our recent study shows that your specific genetic profile may also have a dominant effect on how well you lose weight through exercise. This might explain why two people who do an identical workout will see very different results.

We identified 14 genes that appeared to significantly contribute to how much weight a person lost through running. This suggests that some of us have a natural talent when it comes to burning fat and losing weight through exercise.

To conduct our study, we recruited 38 men and women born in the UK aged between 20 and 40. None of the participants regularly exercised at the start of the study. The group was randomly divided, with one half following a strict eight-week endurance programme that consisted of three weekly runs of 20-30 minutes.

The other group acted as a control. They were instructed to refrain from exercise and continue their daily routines as normal over this study period, including diet and lifestyle habits.

All participants conducted a running test to see how far they could run in 12 minutes, and were weighed before and after the study period. This was to gauge their initial fitness level and see how much they changed over the duration of the study. Body mass index (BMI) was also calculated.

Additionally, a saliva sample was collected from each person with a DNA test kit at the end of the study to assess their unique genetic profile.

It’s important to note that everyone who participated in the study had a similar body weight, BMI and aerobic fitness level at the start of the study. This is beneficial for multiple reasons. It meant everyone was at the same starting point, and some confounding variables were already controlled for such as fitness level. This ultimately improves accuracy in interpreting the results.

Exercise genes

Everyone in the exercise group managed to lose weight – around 2kg on average. The control group, on the other hand, put on a little bit of weight.

While a 2kg weight loss may not sound like a lot, it’s significant considering the exercise regime only lasted eight weeks and participants made no changes to their diet.

More significant, however, was the large variation in results among those that exercised – with an up to 10kg difference in weight loss between some of the participants. In fact, everyone within the exercise group improved at different rates.

Since we controlled for factors such as the intensity, duration and frequency of the exercises and used participants who’d had a similar body weight and fitness level at the start of the study, this suggests that some people naturally benefited more than others from endurance training.

When we looked at the genetic profiles of our participants, we found that differences in each person’s response to the exercise was strongly associated with their specific genetics.

We showed there was a strong linear correlation between the amount of weight participants lost and 14 genes that have previously been shown to be associated with body weight, metabolism or psychological conditions that affect BMI. The greater number of these genes a participant had, the more weight they lost. Our results also revealed that around 63% of the variance in weight lost among participants were explained by the genes identified.

For example, research has shown the PPARGC1A gene plays a role in metabolism and the use of fats for energy while exercising. Our study found that all participants who lost more than 1.5kg from exercise had this gene. Those who lost less than this did not have this gene.

Genes are only one part of the equation, however.
EvMedvedeva/ Shutterstock

Our findings align with what previous studies have shown. But while previous papers have only looked at the link between individual genes and weight loss, ours is the first to show that 14 different genes appear to work in combination to affect whether a person loses weight from endurance exercise.

Piece of the puzzle

Our study also suggests that while some people possess genes that make it easier for them to get fit and lose weight, people with these favourable genetics can only flourish if they actually exercise. In fact, our control group also had a number of these listed genes, but without exercise these genes could not activate, and so the participants did not lose any weight.

While our study provides compelling findings, it’s not without limitations. Since we only looked at endurance-based exercise, it will be important for future studies to investigate whether there are similar links between weight loss, genetics and combinations of different types of training (such as a mixture of endurance and strength sessions into a training plan).

It’s also worth mentioning that exercise is only one piece of the puzzle when it comes to weight loss. So even if you have all 14 of these genes, you won’t lose any weight or get fit if you don’t exercise and maintain a healthy diet and sleep pattern.

On the flip side, someone that only has a few of these favourable genes can still benefit if they exercise and are mindful of other aspects of their lifestyle. Läs mer…

Moldova is emerging as a major strategic battleground in a fierce competition between Russia and the west. A Kremlin-backed disinformation campaign has intensified over the last few months, in the run-up to Moldova’s presidential elections.

One of the key reasons for this is that a referendum on EU membership has been scheduled for the same day, October 20.

The challenges for this small country, wedged between Ukraine and Romania, are complex. Russia continues to foment instability through its persistent disinformation initiatives, instigation of anti-government protests, and acts of sabotage and vandalism.

Add to this credible allegations of vote buying, and efforts to call into question the legitimacy of a pro-European election and referendum result, and the situation in Moldova appears highly combustible.

Moldova gained its independence in 1991 after the fall of the Soviet Union. A brief civil war between the government and separatists in the eastern Transnistria region, supported by remnants of the Soviet army stationed there, ended with the de-facto division of the country.

Read more:
Moldova: Russia continues its mischief-making in breakaway Transnistria

Attempts to settle this conflict have made little progress over the past three decades. And living with an unresolved conflict within its borders has held Moldova back in its development, and contributed to economic problems.

Voting on EU membership

Moldova’s incumbent, staunchly pro-western president, Maia Sandu, has tied the EU referendum to her re-election campaign. The referendum could be the country’s best chance to finally break free from its Soviet past.

If recent polls are accurate, a clear majority of the electorate is likely to vote “yes” on whether they support joining the EU, which would be the first step in a lengthy process.

Moldova’s president speaks to the European parliament in 2022.

For many Moldovans, EU membership is associated with better economic development in one of Europe’s poorest countries. The October 10 visit of Ursula von der Leyen, president of the European Commission, suggested that the EU could help.

Von der Leyen did not merely offer political support for Sandu, she also brought with her a financial support package worth €1.8 billion (£1.5 billion) over the next three years to boost economic growth.

But this vision that the EU can help Moldova’s economy is fiercely contested by Russia and its proxies in Moldova. They exploit the anxiety among a significant number of Moldovans that a vote to join the EU is one that will force the country towards higher inflation, more immigration, politicised anti-corruption measures, mandatory English-language proficiency, and the sale of Moldovan land to foreigners.

Shutterstock

Persistent domestic issues such as the economy have been skilfully targeted in a vast Kremlin-backed influencing campaign.

For a long time, Moldova has suffered from a lack of social, political, institutional and territorial cohesion. The country has significant social divisions between different ethnic and linguistic groups, as well as urban-rural and rich-poor divides.

Politically, the party system remains highly fractured and increasingly polarised, and lacking common ground over what Moldovan national identity stands for.

Moldova’s challenges

Moldova’s territorial disputes also remain challenging. This is most obvious in the pro-Russian Transnistria region and in Gagauzia, but also in ethnically and culturally distinct regions such as Balti and Taraclia.

These regions will require careful management to prevent a major political and economic crisis in the aftermath of October 20 and beyond. Some of the reforms in the country as part of the integration process, such as EU regulations on competition, subsidies and market access, will have a short-term cost for Moldova. Moldovans who oppose the country’s westward orientation are likely to exploit this in anti-EU narratives.

So far, Russian destabilisation operations don’t seem to have eroded most Moldovans’ European aspirations. But the mix of blunt disinformation and skilfully capitalising on the cost of living crisis, which has hit Moldova hard as a result of the war against Ukraine, has given Russia and its allies tools to entrench, and in some cases deepen, divisions here.

iliya Mitskovets / Alamy

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Much of the pro-European campaigning has been framed as anti-Russian. But one of the cleverer moves by the pro-Russian movement is to suggest that Moldovans can be both a friend to Moscow and Brussels, and don’t have to choose.

If a Sandu government is building a pro-European alliance, she will want to grow support from the Russian-speaking part of the population. This will be essential to both counter Russian destabilisation efforts and to build a broader coalition.

As countries that have joined the EU – from the Baltic to the Balkans – have demonstrated over the past two decades, the EU accession process can help reshape political and economic institutions, and can ultimately help create a more optimistic vision of the future.

Crucially, this is not something that Russia’s narrative of fear can credibly offer to the majority of Moldovans. Läs mer…

Like most of the UK, universities were surprised by the timing of July’s general election. They had no time to influence the incoming Labour government’s policy commitments.

Labour’s manifesto acknowledged the financial problems suffered by England’s universities, which are caused by a real-terms decline in the maximum fee they are allowed to charge UK undergraduates. But it did not explain how they would be resolved.

However, universities have used the summer to sharpen their case. This is detailed in a new report, which is timed to influence the new government’s first budget at the end of October. It calls for a rise in tuition fees, increased research funding and grants for students from poorer backgrounds.

Many of the report’s authors have served as senior ministers and public officials. They have direct experience of the difficult choices made in government.

But the report has been put together by Universities UK, which represents all types of universities. So it seeks more funding for all university activities, and does not help the government make choices between potential investments. The government could, for example, increase student numbers and research funding throughout higher education or concentrate on particular subjects and places.

This is quite different to the new government’s approach. It wants to provide confidence in university finances. Then set priorities for investment and identify how to address them.

The higher education regulator, the Office for Students, has a new chair – senior public servant Sir David Behan – and a new remit. The regulator will switch resources previously devoted to culture wars issues, such as campus debate, towards closer engagement with universities on their financial health.

In parallel, the government is establishing a new agency called Skills England to set priorities throughout tertiary education. This embraces learning in universities, further education colleges and private training providers, both in the classroom and the workplace. These priorities will be part of a broader industrial strategy, which will be finalised early next year.

In its green paper on the industrial strategy, the government highlights the importance of place. By supporting the clustering of industries in specific locations, it wants not only to stimulate economic growth but also to create education and job opportunities in those places. Different regions have strengths in life sciences, advanced manufacturing, digital industries and clean energy, and different types of cultural industries.

This strategy will require alignment of the diverse influences shaping tertiary education. That includes the choices made by students about what and where to study, employers about the use of a growth and skills levy, and local mayors who already fund adult learning and have been promised more powers. The strategy will also include visas for graduate and other migrant workers, which will become increasingly tied to the government’s priorities.

Suggestions and requests

Some aspects of Universities UK’s report are consistent with this approach. It advocates closer collaboration between universities, colleges and employers in local areas, and joined up funding and regulation to encourage this.

It sets an ambition for 70% of all young people to take part in tertiary education. This contrasts with the last Labour government’s target for 50% in higher education alone.

The report also shows how universities and government could share evidence to set joint objectives. That could enable a more common understanding of the costs and benefits of international students, and the impact of universities in their local areas.

Crucially, the Universities UK report asks the government for more money. The most substantial changes involve raising UK undergraduate fees alongside inflation, reintroducing government maintenance grants for the poorest students, and increasing funding for research.

This injection of funds would be accompanied by a transformation scheme to improve efficiency. But the report does not identify whether that should lead universities and subjects in some places to grow, while others reconfigure and consolidate.

Universities have successfully argued for higher fees on three occasions during the 21st century to date. In 2004, 2010 and 2016, Labour, the coalition and then Conservative governments agreed to raise the maximum fee for UK undergraduates to £3,000, £9,000 and £9,250 respectively.

These changes were backed by income-contingent student loans and supplemented by increasing research funding. On each occasion, governments were persuaded about the benefits of a financially sustainable, globally competitive and expanding university sector. These changes allowed all universities to increase their income and grow.

However, there is now sharper recognition that increasing the supply of graduates and research can yield unequal opportunities and growth.

Analysis of student migration patterns shows the inequalities arising from unfocused growth, including an increasing concentration of highly skilled jobs in particular areas, such as London.

Labour’s manifesto stated that “the country remains too centralised, with the economic potential of too many regions and communities ignored”. So the government may prefer not to invest more in higher education unless it is focused on specific activities and places.

Since July, universities have enjoyed a more engaged and supportive government. The minister responsible for research has announced that the war on universities is over. And his counterpart in education is welcoming international students to the UK. Any increase to fees and funding will, though, incur political and financial costs. That will require ministers to set priorities and make choices. Läs mer…

Hurricane Milton slammed into the west coast of Florida on October 9, becoming the second powerful hurricane to hit the state in just two weeks.

While most people turned to meteorologists for explanations, a vocal minority remained sceptical, proposing that the hurricanes were engineered, that Florida’s weather was being manipulated, or even that it was targeted at Republican voters.

These ideas aren’t new. As psychologists, we research the roots of conspiracy theories, and have found they often emerge in the wake of natural disasters. Investigating these theories is especially crucial as extreme weather events are projected to become more severe and frequent.

Conspiracy theories explain important events by attributing them to the secret actions of a small, powerful group. Yet, if we take a step back from this psychological definition, something striking becomes apparent.

If conspiracy theories explain events as the actions of a small group, then conspiracy theories should only apply to events where such a group’s influence is plausible.

For example, faking the moon landing would have required Nasa to create an elaborate set, costumes, actors, and maintain secrecy. While unlikely, it is conceivable because humans can design sets, make costumes, and act. However, climate-based conspiracy theories don’t fit this mould as easily.

Unlike movie sets or staged events, humans don’t control the climate in the same direct way. While we can seed individual clouds to encourage rain, for instance, a whole hurricane is simply far too big and too powerful for human technology to have any impact. This makes climate conspiracy theories seem less plausible, as the climate is beyond the direct manipulation that other conspiracy theories depend on.

In the aftermath of Hurricane Helene, Donald Trump made a series of false claims including that the government was ‘going out of their way to not help people in Republican areas’.
Erik S Lesser / EPA

Why people turn to weather conspiracies

People have a fundamental need to feel safe and secure in their environment. If climate change is real, it poses an existential threat, leading some to reject it in favour of conspiracy theories that preserve their sense of safety.

Additionally, individuals desire a sense of control and agency over their environment. When faced with the uncontrollable nature of climate change, people often embrace conspiracy theories to regain that sense of control. Notably, recent psychological research has shifted focus from macro-level conspiracy beliefs, like climate change, to micro-level beliefs concerning local natural disasters.

The first psychological study of this kind looked at a major tornado outbreak in the US midwest in 2019. Researchers found that people more affected by the outbreak were more likely to believe the tornadoes were controlled by the government. Importantly, this belief was explained by the fact that those affected by the tornadoes felt like they had no control over their own life.

Tornado aftermath in Dayton, Ohio, May 2019. Tornadoes killed 42 in the US that year.
CiEll / shutterstock

Building on these initial findings, another study asked participants to imagine living in a fictional country called Nebuloria. Half were told that natural disasters might occur soon, prompting them to take precautions for their safety, while the others were told that such disasters were rare and that there was no need to worry.

Participants were then asked about various conspiracy beliefs, such as whether the contrails left by planes Nebuloria were “evidence of weather manipulation”. Results showed those in the high-risk scenario were more likely to endorse conspiracy beliefs.

Notably, what explained this increase in conspiracy beliefs was the fact that high-risk participants felt a sense of existential threat. This suggests that when people feel vulnerable due to environmental risks, they turn to conspiracies to regain control, even if the threats are beyond their reach.

A self-perpetuating cycle

It might seem intuitive that if you don’t believe in something, you won’t act as though it were true. Thus, if you don’t believe that climate change is true you are not going to act as if it is. Indeed, a large and growing amount of psychological research bares this out.

The more that people ascribe to climate-related conspiracy beliefs the less likely they are to believe in the scientific consensus of human-made climate change, the less likely they are to have any pro-environmental concern, and the less likely they are to trust in the scientists that produce the evidence.

These beliefs do not remain abstract. The more that people believe in climate conspiracy theories, the less likely they are to take action to mitigate climate change. Research has shown that merely exposing people to climate change conspiracies is sufficient to decrease their desire to sign a petition to support pro-environmental policies.

This has serious implications. First, if people don’t believe in climate change, they won’t take action, accelerating its progression. Second, the more that climate change accelerates, the more frequent natural disasters become. As we’ve seen, an increase in natural disasters leads to a rise in conspiracy beliefs, creating a harmful and self-perpetuating cycle.

Research shows that natural disasters can fuel conspiratorial thinking about unrelated events, which harms democratic engagement, public health and social cohesion. In short, climate-based conspiracy theories can have wide-ranging negative effects beyond climate-related matters.

What can be done?

There are reasons to be hopeful that certain interventions that foster analytical thinking or a critical mindset can reduce conspiracy beliefs. For example, exposing people to scientific reasoning that challenged the assumptions behind COVID-19 conspiracies significantly reduced their belief in those conspiracy theories. Also, a better use of resources and skills to cope with natural disasters can reduce conspiracy theories.

If we don’t act on climate change, the rise in natural disasters will likely lead to more conspiracy theories. The stakes are high, but with thoughtful interventions, we can break this harmful cycle.

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Get our award-winning weekly roundup in your inbox instead. Every Wednesday, The Conversation’s environment editor writes Imagine, a short email that goes a little deeper into just one climate issue. Join the 35,000+ readers who’ve subscribed so far. Läs mer…

It’s now almost two years since Elon Musk concluded his takeover of Twitter (now called X) on 27 October 2022. Since then, the platform has become an increasingly polarised and divisive space.

Musk promised to deal with some of the issues which had already frustrated users, particularly bots, abuse and misinformation. In 2023, he said there was less misinformation on the platform because of his efforts to tackle the bots. But others disagree, claiming that misinformation is still rife there.

A potential reaction to this may be apparent in recent data highlighted by the Financial Times, which showed the number of UK users of the platform had fallen by one-third, while US users had dropped by one-fifth. The the data used to reach these conclusions may be open to question, as it is hard to find out user numbers directly from X.

The figures also come out against the background of a disagreement over whether X’s traffic is waning or not. But there has been a notable trend in academia for individuals and some organisations to leave for alternative platforms such as Bluesky and Threads, or to quit social media altogether.

Elon Musk has claimed that X is hitting record highs in user-seconds, a measure of how long users are spending on the site. But advertising revenue is reported to have dropped sharply amid Musk’s controversial changes, such as his “free speech” approach on the platform. If so, it will be reflected in the platform’s financial performance which has been dire. The platform currently has no clear pathway to profitability.

X’s loss has naturally been a gain for its competitors. Despite a rather slow start due to its “invite only” model, Bluesky recently announced that it had topped 10 million users. This is still quite small compared to X’s 550 million users and Threads’ 200 million users.

But there are questions with all platforms over how active users are and the proportion of bots versus human users. Threads also benefits by being connected to Instagram.

The world’s richest man can afford to let X devalue from his purchase price of US$44 billion (£33.7 billion). Likewise, Meta can probably afford to prop up Threads. But Bluesky will have to find inventive ways to remain viable as a platform. So is it the right time for users to try something completely different on social media?

Alternatives to X have to be mindful of striking the right balance between being a viable social media platform and not developing the same issues that have turned X toxic for many users.

Elon Musk bought Twitter in 2022.
Frederic Legrand – Comeo / Shutterstock

The approach taken by Bluesky and Mastodon is to engage with their community more to deal with issues such as abuse and fake information. Moderating content is tricky, as it requires a lot of resources and support for those using the platform.

But the contrast with Elon Musk’s approach to ownership is stark.

The problem for Bluesky, and to a lesser extent Mastodon, is that once a platform gains traction it also attracts those with bad intent. Think of it as the one nice, cool bar in town that suddenly becomes popular. Once everyone hears about the bar, the troublemakers start to arrive.

When that happens, the good people have to find a bar elsewhere. Once an alternative platform becomes a means to reach many millions, the people that drove users away from X may head there like moths to a light.

Alternative approaches

One possible solution is a subscription model for social media alongside paid advertisements. For growing platforms, such as Bluesky, sponsored posts and adverts will come as the user base grows in numbers.

But as was evident with X, that is unlikely to be enough. X’s annual revenue peaked at US$5 billion (£3.8 billion) in 2021 and has been in decline ever since. This also takes into account how the platform has culled thousands of jobs in the past two years.

The subscription model is not new to social media. X has its own paid-for blue checkmark and LinkedIn has a premium subscription. This alone still does not guarantee a profitable or functioning social media platform.

Having a subscription-based social media platform is not exactly equitable either, as not everyone can afford to pay. The question is how much people would be willing to pay for a social media subscription that guarantees no adverts and bots, as well as proper moderation to remove abusive and fake information accounts.

The trade off is that free users would have to deal with the inconvenience of adverts on their timelines. There could be other models floated where non-profit and student accounts are cheaper, but this again excludes other users. It also may not sit well with shareholders focused on profitability.

As it stands, if all 10 million Bluesky users paid £5 a month to the platform, it would generate £60 million a year. That is not even close to X’s revenue of US$300 million (£230 million) back in 2012.

Real change

People moving to a new social media platform will want assurances that it won’t turn into another X. Organisations and individuals with large followings may also be reluctant to invest time in new platforms when they still get something out of the old. There are big, mainstream alternatives of course: Instagram, Facebook and TikTok, but Twitter offered something different.

Real change could happen when the organisations leaving X due to how it has been run reaches a critical mass, though what that threshold represents is open to question. Those in the world of academia are cautious and at best hedging their bets, as I have found with my own search.

Just as X increasingly fails to deal with misinformation, it is leaning further into the same headwind as right-wing platforms such as Truth Social. The newer platforms might find themselves a safer haven for now, but that is likely to change if lessons around ownership, funding and moderation are not learned. Läs mer…

In an era of increasing financial complexity, who really calls the shots when it comes to investing your household’s savings? This question has significant implications for financial health and overall wellbeing.

As economists, we specifically wanted to understand how “bargaining power” is distributed between men and women in a mixed-sex household when it comes to finances. This bargaining power refers to the ability of one partner to influence decisions that affect the household – the partner with more bargaining power has a greater say.

To investigate this, my research partners and I analysed household investment decisions in Australia, Germany and the US. Our recent research reveals a persistent gender gap in household investment decisions, with men often wielding greater influence, even when their female partners may be more risk-averse.

This isn’t just a matter of who manages the online brokerage account – it has real consequences for families. In many households, partners have different levels of risk tolerance.

In Australia, this was the case for 43% of households, increasing to 57% in Germany and 65% in the US. This suggests that disagreements over investment decisions are common.

For example, a man might prefer high-risk, high-reward stocks, while his female partner prioritises safer, long-term investments. If the man dominates the decision-making, the family portfolio might be exposed to a level of risk the woman finds uncomfortable, potentially jeopardising their financial security.

But how do we measure this “bargaining power” within households? We developed an approach that goes beyond simply asking couples who makes the decisions. Instead, we looked at actual investment choices and combined this with data on individual risk tolerances. This allowed us to estimate how much each partner’s preferences influenced the final investment decisions.

Across all three countries, men tend to have more control over investment decisions than their female partners. In an average Australian household, the man’s bargaining power is 60%, compared to 40% for the woman.

In the US and Germany, men hold even greater sway, with their bargaining power rising to 61% and 69% respectively. While men’s greater bargaining power could be justified if they were better traders, evidence suggests they tend to trade more frequently and underperform compared to women.

This power imbalance stems from two main sources.

The first of these is individual characteristics. In our study, male partners are often older, more likely to be employed, and have higher incomes – factors that tend to increase their influence in financial decision-making. These characteristics can give male partners a sense of authority and control over financial matters, leading to an unequal balance of power in investment decisions.

Our study found that personality traits also play a part, with individuals who are less agreeable and less extroverted – typically more likely to be men – tending to have more bargaining power.

And the second is traditional gender norms. Typically, men tend to have extra bargaining power – this can be due to deeply rooted societal expectations about them being the primary breadwinners and financial decision-makers. This effect is amplified when women also adhere to these norms.

Of the two, we found that gender norms are a far more powerful force than individual characteristics in explaining the gender gap in bargaining power.

Why this matters

This gender gap in investment decision-making is closely linked to other household money matters, such as day-to-day spending and large purchases. Household investment and consumption decisions are highly correlated and usually made by the same person, with male partners often appearing to have the upper hand.

This imbalance can have significant implications for women’s financial wellbeing. Being exposed to higher investment risk than they are comfortable with can leave female partners feeling vulnerable and undermine their sense of financial security.

The gender patterns spill over into other financial decisions too.
fizkes/Shutterstock

Our research provides evidence that supports the idea that gender inequality is not just a public issue but one that exists in private spaces as well. By showing that men often hold more bargaining power in discussions around investments, it underscores the need for policies that address gender disparities at home, not just in the workplace.

So, what can be done? Promoting gender equality in financial decision-making starts with open communication and recognising that both partners’ perspectives are valuable. Couples should discuss their financial goals, risk tolerance and investment strategies together, ensuring that both partners feel heard and understood.

Beyond individual households, challenging traditional gender norms is a crucial step towards creating a more equitable financial future for everyone. This isn’t just about fairness; it’s about ensuring that families make sound financial decisions that reflect the needs and preferences of all members. By empowering women to take an active role in investment decisions, we can help to create a more secure and equitable financial future for families everywhere. Läs mer…

The assassination of Hezbollah’s leader, Hassan Nasrallah, in September sent shock waves through the Middle East and beyond. Nasrallah had evolved into the very embodiment of Hezbollah over his 32 years in charge, and had established himself as a key figure in Iran’s so-called axis of resistance.

At the height of his influence, Nasrallah was so widely admired from North Africa to Iran that shops sold DVDs of his speeches, cars were embellished with his image, and many Lebanese even used his quotes as ringtones.

He is not the first sectarian leader to have been assassinated in Lebanon. And on each occasion the killings have intensified sectarian tensions in the country and have jeopardised social stability. The impact of Nasrallah’s death will, in my opinion, probably be no different.

His killing could destabilise the fragile balance of power in the country. And it could also trigger a reshuffling of political alliances within Lebanon’s complex sectarian power-sharing framework that was established in 1990 after the end of the civil war.

A man in Baghdad, Iraq, carries an image of the late Hezbollah leader, Hassan Nasrallah.
Ahmed Jalil / EPA

In 1977, the leftist leader of the Druze community, Kamal Jumblatt, was assassinated by two unidentified gunmen in his stronghold in the Shouf mountains of central Lebanon. Many of his followers believed they knew who was responsible, and channelled their anger toward Lebanon’s Christian community.

Security officials reported that more than 250 Christians were killed in revenge, many brutally, with their throats cut by Druze assailants. At least 7,000 Christians fled their villages after the killings, with around 700 of them travelling to the presidential palace in Baabda, a suburb of Beirut, to request government protection.

This spell of fighting marked a significant escalation of sectarian violence during the civil war, and resulted in a persistent cycle of retaliation, deepening division and entrenched sectarian identities.

iliya Mitskovets / Alamy

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Then, in June 1982, a powerful bomb explosion killed Lebanon’s Maronite Christian president, Bashir Gemayel. The assassination was carried out by two members of the Syrian Social Nationalist party, reportedly under orders from Syria’s then president, Hafez al-Assad.

The next day, Israeli troops entered west Beirut in support of the Phalange, a Lebanese Christian militia that blamed the Palestinian Liberation Organisation (PLO) for Gemayel’s death. Israel had earlier that month launched a massive invasion of Lebanon to destroy the PLO, which had been carrying out attacks on Israel from southern Lebanon.

Knowing that the Phalangists sought revenge for Gemayel’s death, Israeli forces allowed them to enter the Shatila refugee camp and the adjacent Sabra neighbourhood in Beirut and carry out a massacre a few months later. Lebanese Christian militiamen, in coordination with the Israeli army, killed between 2,000 and 3,500 Palestinian refugees and Muslim Lebanese civilians in just two days.

Scores of witness and survivor accounts say women were routinely raped, and some victims were buried alive or shot in front of their families. Women and children were crammed into trucks and taken to unknown destinations. These people were never seen again.

UN relief workers at the Shatila refugee camp in the aftermath of the massacre.
Keystone Press / Alamy Stock Photo

Following the end of Lebanon’s civil war, there was a period of relative stability as a delicate balance of power was established between Lebanese sects. But a car bomb in downtown Beirut in 2005 killed the country’s former prime minister, Rafic Hariri, and again altered the dynamics of sectarian rivalry in Lebanon.

Lebanon lost one of its central figures, while fury over Syria’s alleged involvement in Hariri’s murder raised international pressure on Syria to end its 29-year occupation. The withdrawal diminished Syria’s influence as the primary mediator in the country, and the underlying tension between the two main sectarian groups vying for power, the Sunnis and Shia, surfaced abruptly.

Lebanon experienced 18 months of political deadlock and protests, with Hezbollah and its allies pushing for a veto power in the government. Hostilities intensified and violence became a constant threat.

Then, in May 2008, the Lebanese government attempted to remove a Hezbollah-aligned security officer and investigate the organisation’s private communications network. This ignited fierce clashes between supporters of the government and the Hezbollah-led opposition.

Hezbollah and its allies occupied west Beirut and at least 71 people, including 14 civilians, were killed over the following fortnight.

Hezbollah steadily expanded and enhanced its military capabilities over the next ten years. And it also emerged as a powerful regional player by joining Iran and Russia in supporting Bashar al-Assad’s regime in the Syrian civil war.

The organisation assumed an increasingly central role in Lebanese politics, and secured a majority of seats in the 2018 parliamentary elections.

What happens now?

Lebanon’s modern history is rife with conflict. The assassination of Nasrallah marks the latest in a series of bloody milestones that have served as sharp turning points – and even transformational moments – in Lebanon’s sectarian politics.

Christian and Sunni factions in Lebanon have for years viewed Hezbollah as effectively commandeering the state, leveraging its powerful military wing and Iranian backing. With Hezbollah now visibly weakened in the absence of its powerful and charismatic leader, this longstanding power dynamic may be set for a shift.

There are signs that divisions are already deepening. Videos from Tripoli, a predominantly Sunni city in northern Lebanon, show residents dancing in the streets in celebration of Nasrallah’s death. Other videos show people removing Hezbollah stickers from the vehicles of displaced Shias.

Meanwhile, Hezbollah supporters have pledged retaliation for Nasrallah’s elimination. Lebanon once again finds itself on the verge of fierce sectarian tension and instability. Läs mer…

In general, death is a taboo subject. Nobody teaches us how to look after a dying person, and we also ignore or overlook the fact that caring for someone at the end of their life gives us a chance to reflect on the limits of our own existence.

When a patient is facing a serious illness, fear and a sense of abandonment can often make them feel profoundly cut off from the rest of the world. For this reason, it is crucial that they have people around them who are willing and able to look after them. We all know that one day it could be us, or a loved one, who needs to be eased through their suffering.

This is where palliative care comes in, a field that supplements curative medicine with care and support.

12 October marked World Hospice and Palliative Care Day, which invited us to reflect on the on this field’s significance, and on the advances made since the World Health Assembly passed resolution 67.19 in 2014, which urged countries to include it in their health services.

A holistic and multidisciplinary approach

Palliative care improves quality of life for patients and families dealing with chronic or terminal illnesses by relieving pain and other physical symptoms, as well as providing psychological, social and even spiritual support. It can be provided at any stage of illness and in conjunction with curative treatments, helping patients to live actively until the end.

Collaboration between the family and the palliative care team ensures that all the needs of the sick person – be they physical, social, emotional and spiritual – are met. It also addresses the needs of those close to the patient – bereavement support begins even before the loss, helping family members to cope with grief.

This holistic and interdisciplinary approach is essential to alleviating suffering, and providing a feeling of safety and trust.

10 years of progress, but still a long way to go

In 2014, the World Health Organisation highlighted the need to include palliative care in health policies and to improve access to essential medicines such as morphine. It also stressed the importance of training health professionals in palliative care and promoting research to improve the quality of services.

In the ten years since, major progress has been made, although significant challenges remain. In many countries, awareness of pain care has increased and training programmes have been developed, improving the quality of care. Access to basic pain relief drugs has also been made easier.

However, globally, only 14% of people in need of palliative care receive it, with very pronounced inequalities in low and middle income countries.

Restrictive regulation of morphine and other medicines remains an obstacle, and lack of both financial and human resources limits many countries’ ability to provide quality services.

How can palliative care be improved around the world?

Governments need to develop national policies and strategies that integrate palliative care into their health systems, creating legal frameworks that facilitate access at all levels. Training of health professionals, both through ongoing education and in medical and nursing degrees, is also essential.

Ensuring access to medicines such as morphine is crucial, and restrictive regulations need to be reviewed and modified. In addition to physical symptom management, palliative care needs to include psychosocial and spiritual support for both patients and families.

Lastly, it is also vital to raise public awareness through advocacy and education campaigns. Implementing all these steps will ensure accessible and quality palliative care.

How can you and I help?

As much of the world’s population ages and the burden of non-communicable diseases increases, the need for palliative care will continue to grow.

To meet this need, we have to build community networks that are aware of the value of care, and that collaborate with local organisations and train volunteers to provide accompaniment for those in need of palliative care. This will help to create caring and compassionate communities that improve the quality of life for patients and their families.

In addition to laws and government decisions, numerous initiatives have emerged to address this need. For instance, Pallium Latin America promotes training in palliative care and supports health professionals in their work throughout the region. Initiatives such as Pallium Canada and the Pallium Project in Spain train non-specialists to integrate palliative care into health systems, enabling quicker and more comprehensive access.

Other organisations, such as Pallium India and the New Health Foundation in Spain, mobilise communities to provide care and support for people with advanced or chronic diseases.

While considerable progress has been made, many challenges still remain. Three out of four people will require access to palliative care during their lifetime, meaning palliative care is, quite literally, everyone’s business. Läs mer…