Features

PARIS — With a wave of films, television series and art shows championing “gender fluidity” — and catwalks awash with “gender neutral” models and clothes — the old dividing line between the sexes is being increasingly called into question.

But as the blurring of boundaries has gone from the margins to being a progressive cause, the political temperature of the debate has risen sharply.

Gender fluidity has become a hot-button issue in the culture wars between liberals and conservatives, often reduced to newspaper stories over “which bathroom somebody chooses”, said Johanna Burton, curator of the exhibition “Trigger: gender as a tool and a weapon” which opened at New York’s New Museum.

“It is very much an exciting moment, but also a scary moment politically... Gender is in the forefront of people’s thoughts right now,” she added.

“I think people have considered the limits of the binary construction of gender for a very long time, but only recently has it made the newspapers every day.”

No one has put gender issues out there more than Bruce Jenner, the former decathlete and erstwhile member of the Kardashian clan, whose transition to becoming Caitlyn in 2015 pushed the subject into the mainstream.

Time and National Geographic magazines have both devoted their covers to the transgender debate.

Hollywood too has played a part. 

First the Wachowski brothers, creators of “The Matrix” movie franchise, became the Wachowski sisters and then they cast transgender actress Jamie Clayton as a hacker in their hit Netflix series “Sense8”. 

One of the first places trans issues stepped out of the shadows was on stage. And next year’s Avignon festival in France, the world’s biggest theatre gathering, will be on the theme of “gender, trans identity and transsexuality”.

“Gender doesn’t exist anymore,” according to Guram Gvasalia, the business brain behind fashion’s ultra-hip label of the moment, Vetements, whose collections are all mixed.

“Man or woman, we can choose what we want to be,” insisted Gvasalia, whose brother Demna Gvasalia designs for both the label and Balenciaga, where he has carried on the relaxed attitude to gender.

On the catwalks of Paris, New York and Milan, brands now regularly show “mixed” collections and many market their clothes as “gender fluid”. 

Philosopher Thierry Hoquet calls this the “Conchita Wurst phenomenon”, after the bearded Austrian drag queen who won the Eurovision Song Contest in 2014.

“Today some people mix masculine and feminine characteristics, and they do not need to be coherent,” he said. 

While the author of the book “Sexus Nullus” claimed these “gender pirates” are very rare, he believes they are also very influential. 

‘Anti-gender’ backlash

But this new emerging reality is not to everyone’s taste.

“There is a political battle being waged right now on the territory of gender,” said the American historian Joan W. Scott, a specialist in women’s history and gender studies. 

“The ‘forces of order’ and ‘anti-gender’ groups — the Vatican, religious fundamentalists, populists, nationalists, even some in the centre and on the left — have organised to stop the spread of the idea that gender is fluid or flexible and always mutable,” she said. 

US President Donald Trump was quick to realise it was a hot-button issue which could shore up his conservative base.

He banned transgender people from serving in the US Army in August and insisted on calling trans whistleblower Chelsea Manning a “he”.

An uncrossable divide?

In France, large protests against the legalisation of gay marriage in 2013 included slogans like “Hands off our stereotypes!”

They also spawned a movement to protect “traditional family values” and roles which later helped fuel a furore over false claims that a “theory of gender” was being taught in schools.

French sociologist Marie Duru-Bellat said that while trans issues have been embraced in the arts world, in society at large “there has been a hardening of attitudes”, and a reinforcing of the idea of an uncrossable divide between men and women.

She said some Catholic groups are holding “masculinity support” workshops and pointed to how gender stereotypes are still very strong among children. 

“There are a lot of people for whom equality is about men and women complementing each other,” said the academic, who wrote “La Tyrannie du Genre” (The Tyranny of Gender).

“So for them, you cannot touch traditional gender models.”

Bariatric surgery has become the medical profession’s go-to solution for meaningful weight loss, and new research shows why: It saves lives.

In a retrospective study of close to 34,000 patients with obesity, the 8,385 who got one of three surgical procedures were roughly two times less likely to die over the next four years than were obese patients whose doctors gave them only weight-loss advice and encouragement.

It did not matter whether patients opted for gastric bypass surgery, laparoscopic banding or laparoscopic sleeve gastrectomy. All three procedures were associated with a lower risk of death compared with nonsurgical treatment.

The results were published Tuesday in the Journal of the American Medical Association.

For every 1,000 “person-years” lived by the Israeli patients while they were part of the study, the ones who had surgery experienced 2.51 fewer deaths than the ones who didn’t.

After accounting for such factors as the patient’s age, sex and pre-surgical body mass index — along with whether they had diabetes, high blood pressure, cardiovascular disease or other medical issues — the study authors found that the risk of death during the four-year study period was twice as high for patients who avoided surgery than for those who got it.

When considering each type of surgery on its own, the researchers found that the risk of death for nonsurgical patients was twice higher than for patients who had laparoscopic banding, 2.65 times higher than for patients who had gastric bypass and 1.6 times higher than for patients who had laparoscopic sleeve gastrectomy. The differences among these three bariatric procedures were not large enough to be considered statistically significant.

Two related studies found that sleeve gastrectomy — a form of weight-loss surgery that has surged in recent years — is roughly as effective as gastric bypass, a forerunner that is more complex to perform.

In one of those studies, Swiss researchers found that five years after surgery, subjects who got sleeve gastrectomy and those who had the more complicated gastric bypass procedure lost essentially the same percentage of their excess weight — 25 per cent for the former group and 28.6 per cent for the latter.

The second study, conducted in Finland, found that gastric bypass resulted in slightly greater weight loss after five years. However, both procedures reduced patients’ need for diabetes, blood pressure and cholesterol medications at rates that were not significantly different from each other.

On the important subject of surgical complications, the studies found that sleeve gastrectomy and gastric bypass surgery each come with distinct risks. Sleeve gastrectomy patients were roughly 32 per cent more likely than those getting gastric bypass to suffer a worsening of gastric reflux symptoms. But patients who got gastric bypass surgery were somewhat more likely to need to return for corrective surgery (22.1 per cent vs 15.8 per cent) in the five years following their procedure.

In an editorial commenting on the findings, an obesity researcher and a bariatric surgeon acknowledged that, in embracing sleeve gastrectomy, the medical profession has not misplaced its bets.

“Collectively, these studies provide reassuring data to suggest that the rapid switch from Roux-en-Y gastric bypass to sleeve gastrectomy in the last decade has not been a therapeutic misadventure similar to the rise and fall of the adjustable gastric band,” wrote obesity specialists Dr David Arterburn and Dr Anirban Gupta, both of whom are based in the Seattle area. This surgery, better known as lap-band, “has been all but abandoned after being the most frequently performed bariatric procedure in 2008,” they wrote.

An ancient proverb states that “the enemy of my enemy is my friend”. According to this logic, the friend of my friend should be my enemy, right? So, why do not we take these pearls of wisdom seriously? If we did, we would avoid plenty of unnecessary heartache, I tell you, especially in this age of fake friendships.

On an average, I get roughly thirty new friend requests, via the social media, every month. This accounts to one a day, very much like the multivitamin that has been prescribed for me by my doctor. Most of them are accompanied by short messages where I am informed about the importance of accepting the friendly overtures that are sent my way. Why would anyone want to get to know a complete stranger beats me, but because I am naturally curious, I read all the missives, before deleting them. 

Some are grammatically incorrect, while others are in Spanish, Portuguese or French, the languages I need an interpreter for translation. My profile picture has me wearing a saree, which is essentially a traditional Indian dress that clearly marks my ethnicity, and avoids any confusion about my nationality. But still there are people who mistake me for a foreigner by writing to me in an alien dialect, and therefore, I derive great pleasure in marking such communication as spam. 

Recently, I heard a new term called “friend poacher”. What is that? Simply put, these are folks you introduce to your friends, who proceed to become more friendly with them, than they are towards you. So, basically, they poach your friends.

Now, for a gregarious person like me, I find no problem with that because one can just go out and make more friends. I mean, there is hardly any paucity of friendly people on planet Earth, and frankly, I quite like my one set of buddies to meet another group from elsewhere, and if they get along like a house on fire, why not? I love to, sort of, widen my circle of friends. Also, there is no copyright on friendship, is there?

Well, it seems that I am wrong, after all! My visitor from Dubai explains that being a “friend poacher” in his glitzy city, is a serious charge to be levelled against anyone who hobnobs with a certain section of the gentility. There are wheels within wheels apparently, and the culprits are made to face complete social ostracism, which, for many of them, is a fate worse than death. 

There are rules that have to be observed, and one cannot spontaneously decide to befriend somebody, simply because one hits it off with them. It is prohibited, unless it is with the knowledge and blessings of the introducer. And under no circumstance can the old friend be excluded from a gathering in which the new friend is invited. That is unthinkable and leads to instant accusations of “friend poaching”, an indictment nobody wants to live with.

I listen to all this with growing disbelief and wonder at their sheer level of immaturity. 

“One minute, who introduced us?” he asks me suddenly. 

“I can’t remember,” I shake my head.

“Try to recall,” he sounds panicky.

“I have to phone that person and tell him I’m here,” he says.

“It was your wife,” my husband chips in.

“Are you sure?” he is unsure.

“That’s right. Call her,” I tell him.

“Aha! I will give her the whole report later,” he exhales in relief.

Higher use of electronic media is tied to poorer sleep quality in children as young as three, a new study from Germany suggests. 

The study investigated the association between media consumption — including electronic media such as television, DVDs and computer gaming as well as books — with overall sleep quality in 530 three-year-olds born in southern Germany in 2012 and 2013. 

Based on parent responses to a questionnaire, higher electronic media consumption was strongly linked to poor overall sleep quality, including worsening bedtime resistance, sleep anxiety, and daytime sleepiness. 

“Previous studies have shown that media use, particularly electronic media use in the evening, is associated with poor sleep in adolescents and adults. This study shows that such relationships can be observed much earlier in life — even in the first 3-4 years,” said Dr Daniel Buysse, a sleep medicine researcher at the University of Pittsburgh in Pennsylvania, who was not involved in the study. 

Reading is a safer bet at bedtime, noted Lauren Hale, Professor of Family, Population, and Preventive Medicine at the Stony Brook University School of Medicine in New York. 

“Books at night may not be innately beneficial for sleep, but compared to using screen-based media, they present an alternative that is not disruptive to sleep health,” said Hale, who also was not involved in the new research. 

Nearly 40 per cent of parents reported never reading books to their children. Dr Yolanda Reid-Chassiakos, clinical assistant professor of paediatrics at the University of California, Los Angeles, who was not involved in the study, called that “surprising and disappointing”. 

All but one family had electronic media devices at home, nine 3-year-olds owned a device such as a mobile phone or tablet themselves and three children had a TV in their bedroom, researchers wrote in the journal Sleep Medicine. 

Nearly one in seven children watched more than one hour of TV per day. “This exceeds the recommended ‘up to 30 minutes’ after the age of 2 years,” said study coauthor Jon Genuneit of Ulm University in an e-mail. 

Dr. Nitun Verma, spokesperson for the American Academy of Sleep Medicine, was surprised that increased electronic media consumption was not linked with less reading or being read to. “But this doesn’t mean there is no connection. It is likely because they [study authors] didn’t study enough people,” he said in an e-mail. 

The researchers note that they lacked data on the content of media consumed, and on the children’s physical activity. The study is ongoing, however. Starting next year, the research team will collect data on physical activity, Genuneit said. 

The study was not a controlled experiment, so it cannot prove a causal link between higher electronic media consumption and lower sleep quality. 

It is also unclear whether children are consuming more electronic media at bedtime because they have trouble sleeping, or the other way around. 

“On a near-daily basis I talk with parents who tell me their child can’t fall asleep without the TV on, and yet, rather ironically, they are seeing me because their child can’t fall asleep,” said Dr Jonathan Hintze, a paediatric sleep medicine specialist with the Children’s Hospital of Greenville Health System in South Carolina, who was not involved in the study. 

Poor sleep quality can impair mood, performance and health, noted Kristen Knutson, an associate professor of neurology [sleep medicine] at Northwestern University. “We need to understand... how to mitigate these effects because people are not going to stop using [electronic devices],” said Knutson, who did not work on the German study.

Among the latest additions to Nissan’s extensive SUV and crossover line-up, the 2018 X-Trail is a face-lifted and revised model rather than all-new vehicle. With an emphasis on updating and improving its exterior and interior aesthetics, technology, driving and refinement, the refreshed X-Trail builds on a successful formula which has made it the world’s best-selling SUV, according to Nissan, with 835,000 units shifted worldwide, just in 2016.

A conservative update, the 2018 retains its predecessor’s versatility, practicality, accessibility and user-friendly cabin and driving experience.

Curvy and snouty

With swooping bonnet, heavily browed and squinting headlights, and a curvy waistline that rises towards high-set and bulging rear lights and a C-pillar with an upwards kink and boomerang-like forward-raked design, the X-Trail has a palpable sense of momentum and motion to the way it sits on the road. Refreshed subtly for 2018, the new X-Trail, however, has a snoutier and more aggressive “V-motion” grille that is wider, lower and shinier. Set to a black background, its grille and intake also now use slats and slots rather than a mesh design. New, more vibrant colours meanwhile include red, orange, brown, blue and gold beige. 

Featuring more sculpted and upright bumpers at the front and back, the updated X-Trail also gets a rugged-looking metallic front and rear skid plate-style elements, to go along with its good approach and departure angles. Also revised are its fog lights and side sills, while the headlights — and rear lights — receive a squintier and moodier treatment with a lower kink and boomerang motif LED signature outlines. Sportier and with a more up-market feet to it, the new X-Trail also drops the clear rear light cluster casing and gets a shark fin style rooftop antenna.

Seamless delivery

Powered by a transversely-mounted and unchanged 2.5-litre naturally-aspirated four-cylinder engine, the X-Trail develops 169BHP at 6,000rpm and 172 lb/ft of torque at 4,000rpm, which allows it to carry its 1,637kg mass at a decent pace from standstill to 100km/h and with versatility on the move. Smooth, refined and eager, the X-Trail’s engine is progressive in delivery and features good throttle control and response. Capable of keeping a good pace, the X-Trail’s chassis would have easily been able to handle more power, which in turn would have been particularly welcome during test drive on steeply inclined Lebanese mountain roads.

Fitted with a continuously variable transmission (CVT) that constantly adjusts ratios to exploit engine speed and torque for efficiency, the X-Trail is smooth and flexible. With a wide range of short and tall ratios, it delivers responsive performance and reserved 6.5l/100km combined fuel efficiency. It may not have the clarity, commitment or precision of a traditional gearbox when one needs a certain gear for a certain situation under hard driving, but the X-Trail’s CVT well mimics an automatic with pre-set ratios that one can also select to allow it to rev more eagerly and for engine braking on steep descents.

Unexpected agility

Gaining momentum with a slingshot effect as its engine revs and transmission ratios shift under hard acceleration, the X-Trail is not without a sporty and engaging side. Tidy on turn-in and in its handling in general, the X-Trail drives with more eagerness and cornering adjustability than expected in its segment, especially when entering a corner sharp and early and letting the weight shift to the outside and rear, before powering onto a straight. Keen and chuckable through corners, the X-Trail’s cornering agility is aided by its brake-based Active Trace Control torque vectoring system. Steering is meanwhile quick and light.

With suspension and steering unchanged, the X-Trail revised remains stable and refined on highway and manoeuvrable in the city, while slightly lower profile 225/55R19 tyres slightly improve handling without noticeably affecting rid comfort and fluency over imperfections. Sure-footed through corners, the X-Trail’s front-biased four-wheel-drive can reallocate more power rearwards when necessary and lock all four wheels at lower speeds, while ride quality is meanwhile settled over rebound.

Driving position is supportive and comfortable, and good road visibility — aided by blind spot sensors, 360° Around View Monitor, cross-path traffic detection and Intelligent Rear View Mirror — allowed one to easily negotiate narrow, crowded and chaotic Beirut streets.

Usability and equipment

Unique in its segment for being optionally available with seven-seats, the spacious X-Trail’s sliding and reclining 40/20/40 split middle bench can be adjusted to nine configurations, including easy rear seat access and versatile space allocation between cabin and cargo, with 455-litre minimum and 1,996-litres maximum luggage volume. Well accommodating even large and tall occupants in the middle row, the X-Trail’s client base is, however, mostly consists of those married with children using it as a daily drive, who go for seven- rather than five-seat versions. With that in mind, the X-Trail update focuses on improving usability and practicality, and includes a motion sensing automatic tailgate.

Refreshed with a more up-market approach inside the 2018 X-Trail features new interior trim, quality and textures with improved padding, and smaller sporty flat-bottom steering wheel, while the top spec SL model receives a warm and welcoming black and tan leather option.

Updated to keep up with evolving technology, the X-Train SL comes with standard adaptive front headlights and Intelligent Emergency Braking, while an optional Technology Package adds adaptive Intelligent Cruise Control. Additionally, the X-T-Trail’s navigation system is improved, while its infotainment system features a seven-inch screen, six speakers and Bluetooth and mobile connectivity. 

PARIS — Marriage may test one’s sanity, but living into old age with a partner also lowers the risk of dementia, researchers said recently.

In a study covering more than 800,000 people, they found that walking through life alone increased the chances of Alzheimer’s and other forms of dementia by 40 per cent.

Being widowed after extended co-habitation also took a toll, boosting the odds of mental slippage by about 20 per cent.

“There were fairly well established health benefits of marriage, so we did expect there to be a higher risk in unmarried people,” said lead author Andrew Sommerlad, a psychiatrist and research fellow at University College London.

“But we were surprised by the strength of our findings,” he told AFP. 

Couples living together without having formally tied the knot were still considered as being married for the purposes of the study, he added. 

Interestingly, elderly people who had divorced were no more likely to suffer from dementia that married couples.

Across the different categories, there was also no detectable difference between men and women in the rates of mental decline.

To explore the links between marriage and dementia, Sommerlad and colleagues reviewed data from 15 earlier studies covering 812,000 people from a dozen countries.

The vast majority were from Sweden, but there were enough from other nations — including France, Germany, China, Japan, the United States and Brazil — to confirm surprisingly little variation across cultures.

The finding were detailed in the Journal of Neurology, Neurosurgery & Psychiatry.

But even if the results were robust, the question remained: why? 

Because the study was observational rather than based on a controlled experiment — something scientists can do with rats or mice but not humans — no clear conclusions could be drawn as to cause and effect.

Still, the evidence suggests at least three mutually compatible explanations.

“We don’t think it is marriage itself which reduces the risk, but rather the lifestyle factors that accompany living together with a partner,” Sommerlad explained.

‘Dementia gap’

“These include a more healthy lifestyle — taking better care of physical health, diet, exercise — but also the social stimulation that comes with having a partner to talk to.”

Earlier research has shown that people who live alone die younger, succumb more quickly when they get cancer, and are generally in poorer health.

But the “dementia gap” between married folk and singletons is even wider than the gap in mortality, suggesting that living with someone has direct benefits for the brain too.

A second factor may be the extreme stress that comes with losing a life-long partner, which measurably impacts neurons in the hippocampus, the main locus of memory, learning and emotion.

“This theory could explain the increased dementia risk for widowed, but not divorced, people,” the study said.

Finally, there is the possibility that some people who have not married — especially in societies where that is the overwhelming norm — may have had cognitive challenges to begin with.

A marked difference in rates of dementia among loners of the same age but different generations bears this out.

“Single people born during the first quarter of the 20th century had a 40 per cent higher risk, whereas people of equivalent age who were born more recently have only a 24 per cent higher risk,” Sommerlad said.

This could be due to a diminishing difference in the lifestyles between married and unmarried people, he added. 

Researchers must focus on how to translate these findings into strategies for preventing dementia, commented Christopher Chen of National University Singapore and Vincent Mok from the Chinese University of Hong Kong.

Being reactive can constitute either a positive or a negative response. If you are accidentally touching the scorching hot burner on your stovetop, then reacting quickly by removing your hand is a positive response. Maintaining a three-metre radius from the stove to prevent yourself from getting burned is a negative response. Both will save your flesh from burning and scarring. Getting burned is just a fact of life if you are going to spend any considerable time cooking in the kitchen, but you can learn how to prevent and reduce harm.

We all have Danger Zones as dieters that need to be identified. That way, when were are near them, we can protect ourselves just like we do in our kitchens. Let us programme our brains to go into protection mode so that we stop ourselves from engaging in harmful behaviour.

Here is a list of protective behaviours I have identified for myself: Put away leftovers as soon as your dinner guests leave. No matter how tired you are, do not delay! Just do it!

Freeze desserts and any favourite foods that are calling your name. You are less likely to indulge if they are frozen. 

Give your restaurant server your order before they even get a chance to tell you about their fattening specials of the day. Unless you are ordering the catch of the day and eating the broiled fish, then order a salad with dressing on the side and forget about that juicy burger in the bun. If you must have a burger, ask your server to bring it without the bread. Tailor your order so it fits your waistline instead of the other way around!

Take that walk as soon as you get home from work. Don’t even pause to think about it. Just grab your ear buds, put your favourite music on and say to yourself, ‘Let’s roll!’

Say no to food pushers. As soon as Um Bassem offers me one of her cupcakes, I know that she’ll offer me a hundred other things afterwards so it’s easier to just say no. 

Make an immediate U-turn to avoid driving by your favourite ice-cream shop, especially during the hot summer days. There are other ways to cool off besides eating hundreds of calories in three minutes!

Give yourself a break! Now! Pronto! Not tomorrow or next week. Stop delaying and start giving yourself the much-needed rest you have been meaning to get. Sleep more and do not feel guilty about it! Research shows people who do not sleep enough eat more and are more susceptible to diabetes. 

If you are unhappy about something, deal with it right away. Do not let it fester inside you. This causes unnecessary stress that will increase your stress hormones and cause weight gain. Learn to deal with stress and process through life’s challenges as they come instead of letting them pile up and become unmanageable.

Stick to the things you enjoy doing. For me, it is walking at a very fast pace, so I walk twice a day and make sure I keep up my speed. The best exercise is always the one that you are going to stick with!

Change your attitude when you are around someone who is discouraging. The number one rule for me is to stay encouraged by remaining positive and never giving up. We cannot afford to give up hope on ourselves, for our sake and for the sake of our families, who desperately need us.

Following these simple tips and learning to react quickly can save us hundreds of calories and lots of headaches down the road. Here is to our health, one day at a time, one quick reaction at a time.

Reprinted with permission from Family Flavours magazine

Children and teens who spend a lot of time with their grandparents may be less likely than peers who do not to have negative and stereotypical ideas about the elderly, a recent study suggests. 

Researchers in Belgium asked 1,151 youth ranging in age from seven to 16 years about the time they spent with grandparents as well as their opinions about aging and the elderly. They found that kids who saw their grandparents at least weekly and described these interactions as happy were much less likely to express ageist views. 

“Previous research had suggested that frequency of contacts with the elderly [time spent together] had no effect on children’s attitudes towards older people, whereas a high quality of contact positively influenced these attitudes,” said lead study author Allison Flamion of the University of Liege. 

But most of this research was done in university students, not in children and teens, Flamion said by email. 

“The children in our study described their relationship with their grandparents very openly, as they perceived it,” Flamion said. “We were somewhat surprised to find such a strong correlation between the children’s perception of grandparents’ contacts and the ageist stereotypes turning up in the questionnaires.” 

In questionnaires, the researchers asked the youths about the health of their own grandparents, how often the two generations met and how the young people felt about their relationships with their grandparents. 

In general, views on the elderly expressed by the children and adolescents were neutral or positive. 

Girls had slightly more positive views than boys, and girls also tended to view their own aging more favourably, the researchers report in Child Development. 

Ageist stereotypes appeared to change at various points in childhood, the study also found. 

The youngest children, from seven to nine years old, expressed the most prejudice and kids from 10 to 12 years old had the most acceptance and tolerance. 

Teenagers had more prejudiced notions about aging than pre-teens, but not as much as the youngest children in the study. 

Grandparents’ health may also influence how children think about aging, the study suggests. 

Young people with grandparents in poor health were more likely to believe negative stereotypes about the elderly than children and teens with healthier grandparents. 

The study was not a controlled experiment designed to prove whether or how time with grandparents might impact children’s views on aging. 

Balcony on the Moon: Coming of Age in Palestine

Ibtisam Barakat

New York: Farrar Straus Giroux, 2016

Pp. 217

With a lyrical pen, Ibtisam Barakat tells of growing up in Ramallah when it was a small town, not the bustling city that often figures into today’s news. Starting with the 1967 war, which kept her family running from shelter to shelter, only able to return to their home four and a half months later, it is a story of life under occupation.

Yet, most of her memoir — in fact, the most compelling parts, centre on her family and her own unstoppable drive to get an education, to develop her passion for writing and to surmount the hurdles placed in the path of females.

The stone house from which the family fled during the war, and then returned to, has a special place in Barakat’s memories, partly because its semi-rural surroundings provided many opportunities for outdoor play and observing nature. But her parents decide to sell it after Israeli soldiers turn a nearby hill into a training ground and begin knocking on their door for no good reason.

“I think about that house every day, but it is no longer made of stone. Now it is made of memories — hours spent watching migrating birds in the sky, waiting for dinner, for Mother to come home from shopping trips, or for Father to come home from driving his truck.” (p. 6) 

Their new apartment has its advantages, however. For the first time the Barakats have hot and cold running water and electricity. This is the first of several subsequent moves dictated not by the occupation but by the family’s economic situation and convenience of location. 

Barakat’s experience of war at the age of three left her fearful, but her struggle to overcome her fear is what led to her love of books and reading: “Only when I enter the imaginative world of a story do I win against the fear of war beginning again and destroying everything… I also triumph over fear by listening to old people tell of memories that bring peaceful, faraway worlds to me. I like how their faces light up when they describe the happy times of hurreyyah, freedom.” (pp. 9-10)

It is not long before she aspires to write her own stories. Her sharp observation of the world around her and her fascination with words helps her to develop a fluid, original and expressive prose style that makes this book enjoyable reading.

Other challenges are not so easily overcome. She chafes at the restrictions imposed on girls. In a family of two girls and five boys, she questions why only she and her sister are expected to help with the housework, while her brothers are free to roam. As she grows older, she is distressed at seeing classmates taken out of school to be teenage brides, as happened to her mother.

It is interesting that she does not resent her brothers as such, nor her parents, who are quite open about preferring to have boys over girls, and impose restrictions on her like not riding a bicycle. In her early teens, she sees a copy of the Universal Declaration of Human Rights at an UNRWA office and copies it into her notebook. She begins to articulate her instinctive sense of justice and fairness more aggressively and in rights-based language when challenging her parents. Yet, one understands that she has inherited her sense of justice from her parents in the first place, and it coexists, however uneasily, with her love for her family. In her words: “thanks to Mother, I [and my siblings] know how to talk back, argue, and fight. Mother does not want us doing this with her, but because she does it, we have learned to do it”. (p. 81)

Barakat’s portrayal of her parents is both endearing and conflicted. Both are rooted in tradition but also seeking change. Both were deprived of more than a rudimentary education — her father due to his family’s poverty which led him to start working in a stone quarry at the age of eight, her mother due to having been married off at fifteen. They are loving but inconsistent.

Sometimes they support her ambitions; at other times, they think she is going too far as when at the age of twelve, she takes a summer job at a factory. Her mother constantly rails against having married early, yet, at one point brings a suitor for her daughter before she has completed high school. Only Ibtisam’s playful, inventive and determined spirit get her off the hook.

“Balcony on the Moon” is the sequel to Barakat’s earlier memoir “Tasting the Sky” (2007). It ends in 1981 with Barakat scoring so high on the tawjihi exam that she qualifies for a scholarship to study at Birzeit University. Today she lives in the United States, and seems to have written this book to spread understanding of the Palestinian cause.

In fact, it is a perfect book to introduce Palestine to those not inclined to read a dense history book, but Barakat’s courage and her battle with tradition make it good reading even for those who know the facts of Palestine’s history which she weaves into the narrative.

To his toolbox of Botox, fillers and plastic surgery, cosmetic dermatologist Dr Murad Alam has added a new, low-cost, non-invasive anti-aging treatment: facial yoga. 

Dermatologists measured improvements in the appearance of the faces of a small group of middle-age women after they did half an hour of daily face-toning exercises for eight weeks, followed by alternate-day exercises for another 12 weeks. 

The results surprised lead author Alam, vice chair and professor of dermatology at Northwestern Feinberg School of Medicine in Chicago. 

“In fact, the results were stronger than I expected,” he said in a phone interview. “It’s really a win-win for patients.” 

Participants included 27 women between ages 40 and 65, though only 16 completed the full course. It began with two 90-minute muscle resistant facial exercise-training sessions led by co-author Gary Sikorski of Happy Face Yoga in Providence, Rhode Island. 

Participants learned to perform cheek pushups and eye-bag removers, among other exercises. Then they practiced at home. 

Dermatologists looking at unmarked before-and-after photos saw improvements in upper cheek and lower cheek fullness, and they estimated the average age of women who stuck with the programme as significantly younger at the end than at the start. The average estimated age dropped almost three years, from nearly 51 years to 48 years. 

Participants also rated themselves as more satisfied with the appearance of their faces at the study’s end, Alam and colleagues reported in JAMA Dermatology. 

“Now there is some evidence that facial exercises may improve facial appearance and reduce some visible signs of aging,” Alam said. “Assuming the findings are confirmed in a larger study, individuals now have a low-cost, non-toxic way for looking younger or to augment other cosmetic or anti-aging treatments they may be seeking.” 

The exercises enlarge and strengthen facial muscles to firm and tone the face, giving it a younger appearance, he said. 

Happy Face sells instructional worksheets — promising smoother skin, firmed cheeks and raised eyelids — for $19.95. DVDs cost $24.95. But not all dermatologists are rushing to promote the videos or the exercises. 

Dr John Chi, a plastic surgeon and professor at the Washington University School of Medicine in St Louis, Missouri, said the study raises more questions than it answers. 

“The jury is still out on whether or not facial yoga is effective in reversing the signs of aging,” he said in an e-mail. 

Chi, who was not involved with the study, said he would recommend facial yoga to patients who found it relaxing and enjoyable but not for the purpose of facial rejuvenation. 

“While the premise of facial exercises to improve the facial appearance or reverse signs of aging is an appealing one, there is little evidence to suggest that there is any benefit in this regard,” he said. 

Chi said facial yoga had not been rigorously examined in peer-reviewed scientific studies. Asked if procedures such as facelifts, Botox and fillers had been rigorously examined in peer-reviewed studies, he replied: “Great question. Attempts to do so have been made in the scientific literature with variable levels of scientific rigor.” 

Alam agrees that his study raises additional research questions, such as whether the exercises would work for men and how much time people need to commit to doing the exercises for them to be optimally effective. He would like to see a larger study.