Scientists use AI to develop better predictions of why children struggle at school

Scientists using machine learning — a type of artificial intelligence — with data from hundreds of children who struggle at school, identified clusters of learning difficulties which did not match the previous diagnosis the children had been given.

The researchers from the Medical Research Council (MRC) Cognition and Brain Sciences Unit at the University of Cambridge say this reinforces the need for children to receive detailed assessments of their cognitive skills to identify the best type of support.

The study, published in Developmental Science, recruited 550 children who were referred to a clinic — the Centre for Attention Learning and Memory — because they were struggling at school.

The scientists say that much of the previous research into learning difficulties has focussed on children who had already been given a particular diagnosis, such as attention deficit hyperactivity disorder (ADHD), an autism spectrum disorder, or dyslexia. By including children with all difficulties regardless of diagnosis, this study better captured the range of difficulties within, and overlap between, the diagnostic categories.

Dr Duncan Astle from the MRC Cognition and Brain Sciences Unit at the University of Cambridge, who led the study said: “Receiving a diagnosis is an important landmark for parents and children with learning difficulties, which recognises the child’s difficulties and helps them to access support. But parents and professionals working with these children every day see that neat labels don’t capture their individual difficulties — for example one child’s ADHD is often not like another child’s ADHD.

“Our study is the first of its kind to apply machine learning to a broad spectrum of hundreds of struggling learners.”

The team did this by supplying the computer algorithm with lots of cognitive testing data from each child, including measures of listening skills, spatial reasoning, problem solving, vocabulary, and memory. Based on these data, the algorithm suggested that the children best fit into four clusters of difficulties.

These clusters aligned closely with other data on the children, such as the parents’ reports of their communication difficulties, and educational data on reading and maths. But there was no correspondence with their previous diagnoses. To check if these groupings corresponded to biological differences, the groups were checked against MRI brain scans from 184 of the children. The groupings mirrored patterns in connectivity within parts of the children’s brains, suggesting that that the machine learning was identifying differences that partly reflect underlying biology.

Two of the four groupings identified were: difficulties with working memory skills, and difficulties with processing sounds in words.

Difficulties with working memory — the short-term retention and manipulation of information — have been linked with struggling with maths and with tasks such as following lists. Difficulties in processing the sounds in words, called phonological skills, has been linked with struggling with reading.

Dr Astle said: “Past research that’s selected children with poor reading skills has shown a tight link between struggling with reading and problems with processing sounds in words. But by looking at children with a broad range of difficulties we found unexpectedly that many children with difficulties with processing sounds in words don’t just have problems with reading — they also have problems with maths.

“As researchers studying learning difficulties, we need to move beyond the diagnostic label and we hope this study will assist with developing better interventions that more specifically target children’s individual cognitive difficulties.”

Dr Joni Holmes, from the MRC Cognition and Brain Sciences Unit at the University of Cambridge, who was senior author on the study said: “Our work suggests that children who are finding the same subjects difficult could be struggling for very different reasons, which has important implications for selecting appropriate interventions.”

The other two clusters identified were: children with broad cognitive difficulties in many areas, and children with typical cognitive test results for their age. The researchers noted that the children in the grouping that had cognitive test results that were typical for their age may still have had other difficulties that were affecting their schooling, such as behavioural difficulties, which had not been included in the machine learning.

Dr Joanna Latimer, Head of Neurosciences and Mental Health at the MRC, said: “These are interesting, early-stage findings which begin to investigate how we can apply new technologies, such as machine learning, to better understand brain function. The MRC funds research into the role of complex networks in the brain to help develop better ways to support children with learning difficulties.”

I Tried the Manduka GRP Yoga Mat That Promises to Stay Dry When You’re Dripping Sweat

I’m not shy about the fact that I’m a very sweaty human. I spent hours testing different headbands to find one that would keep sweat from dripping in my eyes midworkout. I wear special studio skin shoes to yoga so I won’t slip and slide and fall on my face. So when I heard about Manduka’s new GRP yoga mat ($98, manduka.com) that’s supposed to stay grippy even when you’re dripping buckets of sweat, I had to see what it was all about—and if it was worth the price tag.

Normally when I go to hot yoga, I bring at least two towels—a long grippy one to lay atop my mat to catch aforementioned perspiration (Manduka actually makes the best hot yoga towels, in my opinion) along with a smaller one to wipe my face and body throughout the class. But the Manduka GRP mat is supposed to be so good at absorbing sweat that it’ll stay dry all on its own. Honestly, the whole idea of abandoning one of my sweat rags was a little terrifying, but since using the Manduka GRP meant that I’d have less laundry to do, I figured it was worth facing my fears.

So, with my GRP mat in hand and just my small face towel, I headed to a hot yoga class to see if it held up to the claims.

When I unrolled the Manduka GRP mat, I immediately noticed how different the top layer felt—almost like a luxe leather.

According to the company, the mat was designed to get grippier with sweat—the opposite of pretty much every other yoga mat in existence. I could tell right off the bat that the top material was different. It felt sort of leathery, as opposed to the smoother, more rubbery feel of other mats.

I will say that the leatherlike coating wasn’t the most gentle on my feet and toes. When my postures were less than perfect, especially during transitions, I’d often feel my big toe nail scrape along the surface, which was a little painful, yet it did remind me to realign my positioning, whatever that’s worth.

The biggest downside? The mat smelled pretty bad at first.

I just have to to mention how the mat smelled when I first unrolled it—and which actually worsened throughout my 75-minute practice. You can, however, wash the mat, which helps get rid of the stench—more on that later.

But I was happy to find that my hands and feet remained in place throughout my practice, both when holding poses and transitioning from one to the next.

Not only that, but the mat itself stayed put, too. I’m used to having my mat slide a bit against the studio floor during at least a few Downward Facing Dogs and Vinyasa flows. But the extremely sticky bottom of the Manduka GRP was unfazed. Once I laid the mat down, it didn’t move for the entire class, which is pretty remarkable, especially considering the pools of sweat I left behind.

My mat after a 75-minute yoga class

Speaking of sweat, it took about an hour into the 75-minute class for a little puddle of sweat to even show up.

I know this looks like a lot of sweat, but this is nothing compared to what usually is on my mat after 75 minutes of hot Vinyasa. The mat just absorbed it all. I’ve never seen anything like it before.

I reached out to Manduka to ask them how this worked, and they put me in touch with Craig Stiff, the company’s director of hardgoods. He explained that the mat is made from an open-celled polyurethane, which means that there are tiny little openings in the surface that let sweat and moisture sink in. That’s what keeps the surface so dry. “Most yoga mats have closed-cell construction, which require a towel as soon as things get sweaty,” Stiff told me. He added that every layer of the GRP mat is designed with this open-cell construction, which not only lets moisture absorb, but also helps it evaporate later.

The middle layer of the mat is made of charcoal-infused rubber. “We infused charcoal in the core of the mat to absorb sweat and eliminate odor,” explains Stiff.

You can (and should) deep clean the mat regularly to get rid of all that sweat lurking inside.

When my hot Vinyasa class ends, I usually spend an extra minute or two (sweating) in Savasana before I pull it together and get up to leave. Thankfully, my studio provides mat wipes so not only do I sop up all the remaining sweat with a towel, but I am able to give my mat a quick wipe-down. This time, though, I skipped over the wipes and decided to go home and follow Manduka’s deep-cleaning instructions instead. And also because I wanted to try to get rid of that intense scent.

Unlike other yoga mats, you actually can submerge the Manduka GRP in a bathtub to thoroughly clean it. The brand recommends mixing in their Deep Cleanser and letting it float in the tub for five to 10 minutes before squeezing out excess water and hanging it to dry. They recommend giving the mat a deep clean every two to four months.

I didn’t have the cleanser, so I used a little bit of gentle body wash. While I can’t speak to how that impacts the materials over time, I can say that after baby’s first bath, it smelled so much better. Problem solved, thank goodness.

Overall, the GRP definitely lives up to the hype, and is a great product for intense sweaters and dedicated hot yoga students.

It’s remarkable how much sweat this beast of a yoga mat can absorb. If that’s something that’s very important to you, then it might be worth investing in the GRP mat. If you’re not the sweatiest person, and a regular mat plus a towel is sufficient for you, then you may want to pass on the $98 purchase. Also, please tell me your secrets. Until then, I’ll be toting the GRP mat back and forth to my studio and diligently treating it to a spa day every few months.

Buy it: Manduka GRP yoga mat ($98, manduka.com)

First-born children more likely to learn about sex from parents

Birth order may play a significant role in how children learn about sex, especially for boys, according to a new study published in the journal Sex Education.

Researchers found that first-born children were more likely to report parental involvement in sex education than later-born children, a pattern which was especially pronounced in men.

Led by the London School of Hygiene & Tropical Medicine (LSHTM), the study is the first to look at the relationship between birth order and two key sexual health outcomes: parental involvement in sex education and early sexual experience.

The study’s authors say that a better understanding of the relationship between birth order and parental involvement in learning about sex could help to improve the design and delivery of sex education programmes.

Researchers used data from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3), the largest scientific studies of sexual health and lifestyles in Britain. Conducted by LSHTM, UCL and NatCen Social Research, the studies have been carried out every 10 years since 1990, and have involved interviews with more than 45,000 people to date.

Taking a sub-sample of Natsal-3 participants — 5,000 individuals aged 17 to 29 who were either first-born, middle-born or last-born — the team analysed responses to questions about the involvement of parents or siblings in sex education and early sexual experiences .

First-born children were more likely to report parental involvement in sex education compared with later-born children. From the study sample, 48% of first-born women and 37% of first-born men reported discussing sex with a parent aged 14, as opposed to 40% of middle-born women and 29% of middle-born men.

Middle-born and last-born men were less likely than first-born to report having found it easy to discuss sex with their parents growing up. Later-born men were also less likely to report learning about sex from their mothers, while last-born women were less likely than first-born women to report a parent as a main source of sex education.

Although there were differences by birth order in parental involvement in sex education, there did not appear to be an association between birth order and early sexual experiences, although middle-born men were at increased odds of being under 16 when they first had sex.

Dr Lotte Elton, who led the research as part of her MSc project at LSHTM, said: “Although there has been much research into how the order in which children are born into a family may impact psychological or social outcomes, studies on the relationship between birth order and sexual health outcomes are limited.

“In addition to seeing differences in sex education according to birth order, we also found clear differences between the sexes; across all birth order categories, men consistently reported lower parental involvement in sex education than women. Our findings suggest that the previously-reported difficulties men face in talking about sex with parents may be exacerbated if they are middle- or last-born.”

When researchers looked at sibling involvement in learning about sex, they found that all later-born children were more likely to report learning about sex from siblings compared with first-born children.

Although there is little research on how sex education from siblings might affect sexual health, associations between sibling behavior and sexual health outcomes have been documented — for example, having a sexually active brother or sister has been linked with more liberal sexual attitudes, and sisters of pregnant and childbearing adolescents have been found to be younger at first sexual intercourse.

With later-born children reporting that siblings played a greater role in their learning about sex, the authors say that brothers and sisters could be utilized in sex education programmes.

Given that later-born children are learning from their siblings about sex, dedicated sex education programmes could better equip adolescents to teach their younger siblings about sex, particularly where parental involvement in sex education is low.

Wendy Macdowall, senior investigator from LSHTM, said: “Our findings support previous work demonstrating gender disparities in family involvement in sex education, highlighting the need for further work in this area — particularly around how birth order might affect the involvement of parents in children’s sex education.

“The results are particularly significant given plans to make sex education compulsory in schools in England and Wales, since relying on parents to provide sex education for children may disadvantage later-borns.”

The authors acknowledge the limitations of the study. Of particular importance is that middle-born children had different socio-demographic characteristics, including social class and ethnicity, compared to first- and last-born children, which means that even with statistical adjustment, the results for middle-born children may reflect socio-demographic differences rather than birth order.

Furthermore, although adjustment was made for sibling number, other sibling factors which were not adjusted for, such as gender and age difference, which may have been relevant.

Natsal-3 is one of the largest and most comprehensive studies of sexual behaviour and lifestyles in the world, and is a major source of data informing sexual and reproductive health policy in Britain. Natsal was funded by the Medical Research Council and the Wellcome Trust, with additional funding from the UK Research and Innovation and Department of Health and Social Care.

36 of the Best Skin-Care Products for Acne-Prone Skin

I honestly can’t remember not having pimples. Not to say that my skin hasn’t come a long way in the years since I walked the halls of my local middle school. I’ve gone from daily breakouts to the random zit, but either way, pimples have been a mainstay on my face my whole life. They come in different shapes, sizes, and textures depending on the day—usually under the skin—and the majority of the time, the pimples leave love notes—in the form of dark marks—behind on my face after they’re gone.

I have my go-to brands that have made vast improvements in my skin’s texture and number of surprise zits. But finding them hasn’t always been easy. There have been countless times where I thought a cleanser or exfoliator would clear up my stubborn acne for good, then find that a few days later I had a new zit coming in. Let’s just say that in the process of trial and error, there’s been a lot of error.

To help the rest of you hone in on creams, cleansers, and exfoliators that won’t break you out, we’ve rounded up 36 of the best products for acne-prone skin, according to dermatologists and women who’ve put them to the test IRL. Bonus: You can get many of these at the drugstore for under $20.

Acne stigma linked to lower overall quality of life, Irish study finds

Many people with acne are negatively impacted by perceived social stigma around the skin condition, a new study from University of Limerick (UL), Ireland, has found.

A survey of 271 acne sufferers has revealed that their own negative perceptions of how society views their appearance is associated with higher psychological distress levels and further physical symptoms such as sleep disturbance, headaches and gastrointestinal problems.

Females in the study reported greater impairment of life quality and more symptoms than males. Acne severity was significantly correlated with health-related quality of life and psychological distress.

UL researchers Dr Aisling O’Donnell and Jamie Davern conducted the study to investigate whether acne sufferers’ perceptions of stigmatisation significantly predicts psychological and physical health outcomes; specifically health-related quality of life, psychological distress, and somatic symptoms.

“We know from previous research that many acne sufferers experience negative feelings about their condition, but we have never before been able to draw such a direct link between quality of life and perception of social stigma around acne,” said Dr O’Donnell of the Department of Psychology and Centre for Social Issues Research at UL.

Survey respondents who perceived high levels of acne stigma also reported higher levels of psychological distress, anxiety and depression as well as somatic conditions such as respiratory illness.

“The findings of this study echo previous research showing that individuals with visible physical distinctions, which are viewed negatively by society, can experience impaired psychological and physical well-being as a result,” Dr O’Donnell continued.

According to the article’s lead author, PhD student Jamie Davern, a lack of representation of people with acne in popular culture can increase the perceived stigma around the condition.

“Like many physical attributes that are stigmatised, acne is not well represented in popular culture, advertising or social media. This can lead people with acne to feel that they are ‘not normal’ and therefore negatively viewed by others. Online campaigns like #freethepimple and the recent ‘acne-positive’ movement emerging on social media is an encouraging development for people of all ages that are affected by acne,” he explained.

Although adolescents are most commonly afflicted by acne, the condition has been reported to affect 10.8% of children between the ages of 5-13 years and 12.7% of adults aged over 59.

“Importantly, the findings provide further support for the comparatively limited amount of studies investigating physical health problems experienced by acne sufferers. This is important information for clinicians dealing with acne conditions. It’s also useful for those who are close to acne sufferers. The wider negative impacts some acne sufferers experience are very challenging and require sensitivity and support,” Mr Davern concluded.

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Materials provided by University of Limerick. Note: Content may be edited for style and length.

The First Subtle Signs That Chrissy Teigen Knew Something Was Off Before Her Postpartum Depression Diagnosis

Most of us have an idea of what depression or postpartum depression (PPD) is “supposed” to look like. But, in reality, it looks different for everyone. For Chrissy Teigen, as she explained in a new interview, PPD affected her life in the kitchen—and when her relationship with food began to change, she started to suspect that something wasn’t quite right.

“I started looking at food and was like, ‘I’m just not in the mood,'” Teigen told People in the new interview.

“It’s like going to the grocery store when you’re full. You just don’t want the same things. Food wasn’t that thrilling for me,” she said. “That was one of the first times I knew something was wrong.”

For the cookbook author, who frequently shares recipes and photos of the food she’s made on social media, this set off a few alarms. “When I wasn’t feeling great, being in the kitchen was like torture. It felt like such a job, and you want to be excited when you’re in the kitchen,” she added. “I cook because I love food and I love to eat. It makes me happy to serve people. And when you aren’t feeling that way, it was like torture.”

As SELF wrote previously, postpartum depression symptoms aren’t always obvious.

In general, the symptoms of postpartum depression are similar to those associated with other types of clinical depression, including feelings of profound sadness, loneliness, or hopelessness. But depression can also come with a loss of interest in the things you once found pleasurable, like cooking, for example.

And, as Teigen previously spoke about, it can come with physical symptoms as well. “Getting out of bed to get to set on time was painful,” she wrote in an essay for Glamour last March.

“My lower back throbbed; my shoulders—even my wrists—hurt. I didn’t have an appetite. I would go two days without a bite of food, and you know how big of a deal food is for me. One thing that really got me was just how short I was with people…. I wondered: Am I making this all up? Is this pain even real anymore?” she said in her essay. “Before, when I entered a room, I had a presence: head high, shoulders back, big smile. Suddenly I had become this person whose shoulders would cower underneath her chin. I would keep my hands on my belly and try to make myself as small as possible.”

She was also worried that she would get PPD again following the birth of her son, Miles. But that didn’t happen this time around, thankfully.

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‘Desperate Housewives’ Star Marcia Cross Reveals That She’s in Recovery After Anal Cancer Treatment

Desperate Housewives star Marcia Cross is known for her long, flowing red hair, but she revealed in a series of recent Instagram posts that she lost it after undergoing treatment for anal cancer.

“So grateful and happy to be alive but sad that my hair fell out and is about 1 inch long now and looks cra cra. Anyone else have #hairloss due to #cancer? Talk to me. I feel you,” she captioned a photo on Instagram of herself with short hair, pouting for the camera.

Cross, 56, followed up with another Instagram post clarifying that she is “post cancer” now. “All good now,” she said. “I am healthy, happy, and more present and grateful than ever.” In a later post, Cross finally revealed that she had anal cancer, adding, “I know, right?!”

Anal cancer is rare, but it is more common among people over 35.

This type of cancer, which affects the anal canal (the short tube at the end of your rectum through which poop leaves your body), is less common than cancers that affect the colon or rectum, according to the American Cancer Society (ACS). About 8,500 new cases of anal cancer are estimated to be diagnosed in 2018, and about 1,160 people are expected to die of the disease this year, according to statistics from the National Cancer Institute. The cancer is rare in people under 35, the ACS says, and most people are diagnosed in their early 60s.

There are many factors that can increase your risk for anal cancer (including your age, smoking, as well as a previous diagnosis of cervical, vulvar, or vaginal cancer). But the Mayo Clinic says that it’s the human papilloma virus (HPV), the most common STI, that’s at the root of most cases of anal cancer. In fact, as SELF wrote previously, the rate of anal cancers associated with HPV increased an average of 2.9 percent in women every year since 1999, while the rates other forms of HPV-related cancer have been declining.

Anal cancer can cause symptoms that can easily be confused with those of less severe conditions.

There aren’t currently anal cancer screening guidelines for the general public. It can be caught during rectal exams in people who might receive these examinations regularly for other health reasons (e.g. they have HIV). And while it might also be caught during a routine colonoscopy, anal cancer is usually diagnosed when someone notices symptoms—but those symptoms may not be obvious.

“It can be difficult to differentiate anal cancers from other perianal type-diseases because the symptoms are quite broad,” Anton Bilchik, M.D., Ph.D., professor of surgery and chief of gastrointestinal research at John Wayne Cancer Institute at Providence Saint John’s Health Center in Santa Monica, Calif., tells SELF.

Symptoms include bleeding from the anus or rectum, pain in the anal area, a mass or growth in the anal canal, and anal itching, the Mayo Clinic says. Unfortunately, hemorrhoids (which are swollen veins in your rectum and anus) and anal fissures (which are tears in the anal mucosa) can cause similar symptoms, Dr. Bilchik points out.

“People will often present with these non-specific findings and say, ‘For months, I’ve had this hemorrhoid that wouldn’t go away,’” Van Morris, M.D., an assistant professor of gastrointestinal medical oncology at the MD Anderson Cancer Center, tells SELF.

But, in general, anal cancer is more likely to cause bleeding that increases with time, while hemorrhoids or anal fissures will have bleeding that comes and goes with harder stools, Dr. Morris notes. People with anal cancer also may feel like they have some sort of mass in their rectal area, he says. Those who have more advanced anal cancer might notice swollen lymph nodes in their groin.

Treatment for anal cancer usually involves a combination of radiation and chemotherapy, which can indeed result in hair loss.

Anal cancer is generally treated with a combination of chemotherapy, which has shown to be most effective for treating this form of cancer, the Mayo Clinic says. Patients usually undergo radiation therapy for five to six weeks and chemotherapy during the first and fifth week, according to the Mayo Clinic. Surgery may also be recommended in some cases.

Most people do well with treatment, especially if their cancer is caught early and hasn’t spread to other organs, Dr. Bilchik says. “There are high rates of cure with this disease, and surgery is only done if there is a local recurrence,” Sarah Hoffe, M.D., section head of GI Radiation Oncology at Moffitt Cancer Center, tells SELF.

Although this cancer is rare, it’s important to be aware of the symptoms, especially if you’ve ever had an abnormal Pap result.

“Women who have had prior abnormal Pap smears, even without diagnosis of cervical cancer, need to be more [tuned in] to these symptoms,” Dr. Morris says. And, if you start having anal bleeding, itching, and pain, make sure your doctor knows about your history of having an abnormal Pap—even if it was years ago, he says.

Above all, remember that you know best when something feels off with your body. If you’re not sure what’s going on, check in with your doctor to find out.

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9 Expert Tips for Removing Food Stains From Your Clothes

We’ve all been there: You’re at a friend’s barbecue and drop a plateful of strawberry cheesecake on your new silk top (guilty). Or you knock over a cup of iced coffee on your all-white outfit (guilty, again). Maybe it’s not your fault, maybe you’re just the casualty of someone spilling their red wine on you (also me). Whatever the reason, the result often plays out the same way: instant freakout, futile search for club soda, too much rubbing, mourning for a garment you’ll never wear again because you don’t know how to remove the food stain from your clothes.

Determined never to let another piece of clothing get bested by a barbecue, I reached out to three cleaning experts for advice on dealing with common food stains. Ahead, nine experts’ tips that’ll help you remove even the toughest of stains.

1. First things first: Scrape, then blot.

If you spill food on yourself, remove as much as possible as quickly as you can without rubbing it into the fabric, which will only make things worse. Experts advise scraping it off with a dull object, like a credit card or a butter knife, and then using a clean paper towel to blot.

2. Don’t panic—and put down the club soda.

“If you dirty yourself while you’re out, avoid the temptation of using paper napkins and club soda,” warn Gwen Whiting and Lindsey Boyd, who co-founded The Laundress, an eco-friendly line of detergent and home-cleaning products. It’s better to wait and treat the stain at home where you have the proper products, tools, and time to treat the affected area. “Any frantic attempts can end up making more messes, leaving you with traces of paper lint on the item and an even larger stain.”

3. Determine what kind of stain you’re dealing with before trying to get it out.

Food stains belong to one of three categories: protein, tannin, and grease. Understanding which category your food stain belongs to will help you determine the most effective treatment, Melissa Maker founder of Clean My Space tells SELF. “It makes stains far less intimidating to treat, and you avoid the mistake of just throwing it in the washing machine, hoping it’ll go away.”

Tannin stains include teas, coffee, juice, berries, chocolate, red wine, popsicles and condiments like ketchup and mustard, anything that is rich in color. Protein includes anything meat-based or dairy, like yogurt or milk. John Mahdessian, owner of NYC high-end dry cleaner Madame Paulette, tells SELF that if you scratch a stain and it’s white, then it’s usually a protein stain. Grease stains are from oils, including salad dressings, and butter.

4. Choose a cleaning agent that “goes with” the stain to pretreat it.

Tannin stains have an acidic value, and can be treated with a mix of water and vinegar. (You can also buy a product that’s specifically made for stain removal, like this scented vinegar, $10, from The Laundress.) For protein and grease stains, Maker recommends using a degreaser, like dishwashing detergent, since they have similar properties. She likes Biokleen All Purpose Cleaner, $12, to get the job done. Additionally, to help lift oil marks from garments, try cornstarch or baby powder: “Sprinkle it on and let sit for about 15 minutes so the powder absorbs the oil, then scrape off,” and pretreat with a degreaser, Maker says.

Puracy Natural Laundry Stain Remover, $20 for a 2-pack, and Method Stain Remover, $3, are good products to keep around the house for emergencies and can be used on any type of stain.

5. Test your cleanser of choice in an inconspicuous area before using it on the stain.

Sometimes, soaking a stain with water and a cleanser can leave water marks or ring marks. This often happens when you use too much product. To avoid this, first use a dull edge to scrape off the stain or blot the problem area with a clean paper towel or cloth to remove most of it, then apply a little amount of product—a soft-bristle cleaning toothbrush gives you good control over the amount. If a ghost ring still appears, flush the area really well with cool water to get all of the suds out. Otherwise, you’re good to pretreat the stain, The Laundress co-founders explain.

6. Depending on the severity and type of stain, pretreat for at least 15 minutes before putting your clothes in the washing machine.

These things need time to work, so leave pretreating solutions on for 15 minutes if it’s a fresh stain. For larger stains, Maker says you can let them soak up to 24 hours.

7. Wash grease and protein stains in cold water.

Generally speaking, you want to follow the fabric care label once you throw your dirty clothes in the washing machine. But no matter what the label says, don’t wash grease or protein stains in hot or warm water because because the heat will set the stain.

8. You can still treat old stains.

While its true that the sooner your deal with a stain, the higher your success rate, that doesn’t mean it’s impossible to get rid of old food stains. “After pretreating, use water pressure to help work the stain,” say Whiting and Boyd. “Follow by soaking the garment in a basin or sink for up to 30 minutes and repeat as necessary until you see the desired results, then launder according to the label.”

9. If you’re unsure what to do, don’t do anything.

When in doubt, don’t DIY it. The experts say it’s better to blot as much as possible with a clean paper towel and then take the item to a professional service rather than go at it yourself and risk damaging it, especially if the item is made of a delicate material like silk, satin, or merino wool. If you can get it to the cleaners within a few hours, you’ll have a good chance of salvaging it.

Anal Sex and GI Issues: Can You Enjoy Anal Sex With GI Problems?

A few years ago, I found the perfect butt plug. Called Cupid’s Itty Bitty Beginner’s Plug, it was small, a pretty pastel pink, made with soft silicone, and complete with an external ring to make sure it didn’t get lost inside me. (Yup, that can happen.) After covering the plug in water-based lube (very necessary, as the anus isn’t self-lubricating), my partner inserted it into my butt to warm me up for anal sex.

We fooled around for 30 minutes or so, but when my partner took out the butt plug, it…wasn’t perfectly baby pink anymore. A few, er, brown spots dappled the smooth silicone. This incident happened some years ago, before I was more comfortable in my body. I got so embarrassed I called the whole thing off despite genuinely enjoying anal sex.

I have irritable bowel syndrome, or IBS. I also happen to really like anal sex. As you can imagine, the two don’t always go together.

The cause of IBS isn’t entirely known, although potential factors include overly active or underactive intestinal muscles, inflammation in the GI tract, an off-kilter gut microbiome, and more.

Not knowing the exact cause doesn’t change IBS’s effect on my body. I often experience symptoms like diarrhea that comes on suddenly, stomach cramping, and nausea. I also need colonoscopies every five years as I have a family history of colon cancer and am prone to polyps, or small growths along the colon that carry a risk of becoming cancerous if not caught early. My IBS can really throw a wrench into my life, including the whole anal sex thing.

I’m not the only person to crave receptive anal sex just to have the mood ruined by a gastrointestinal condition. “I bottom significantly less then I would like. I love anal, but I’m afraid I’ll shit on a casual encounter, which would be awkward as all hell,” LGBTQ writer, speaker, and activist Zachary Zane, who also has IBS, tells SELF. “[It] makes it more difficult for me to relax… It’s tough to enjoy sex if you’re worried you’re gonna explode.”

Many GI conditions besides IBS can cause symptoms that might interfere with anal sex.

Up to 70 million people in the United States are affected by digestive diseases, according to the National Institutes of Health.

One is IBD, or inflammatory bowel disease. This umbrella term describes disorders involving chronic inflammation of the digestive tract, such as ulcerative colitis and Crohn’s disease, the Mayo Clinic explains. These conditions can cause debilitating symptoms like severe diarrhea, intense abdominal cramping, and fatigue that makes it difficult to get out of bed—never mind have sex.

Another possible issue is chronic constipation, which is when you have consistent trouble pooping for at least three months, according to the Mayo Clinic. This is a symptom I sometimes experience with IBS. I can confirm that when you are totally backed up, there’s no way you’re backing up into anything.

There’s a whole host of other GI troubles that might interrupt your experimentation with anal sex, like peptic ulcers (which can cause nausea, heartburn, and stomach pain), anal fissures (painful little cuts in the delicate tissue down there), and hemorrhoids (piles of swollen veins that can prompt anal bleeding, pain, irritation, and itching, among other symptoms). Not quite a recipe for great butt sex!

“[With GI issues], it is the unpredictability of both frequency and severity of symptoms that disrupts one’s life,” Elena Ivanina, D.O., M.P.H., a gastroenterologist and assistant professor at Lenox Hill Hospital of Northwell Health, tells SELF. “[You] may not be able to guess when the stomach pain will hit and have you doubled over, or the strong urge to poop makes you run to the nearest bathroom.” Which brings us to our next point…

Real talk: If you have a GI condition, do you need to worry about pooping during anal sex?

Let’s chat about pooping during anal, because that’s probably why you clicked this story. It is a fact that sometimes, as they say, shit happens. “Sex can be messy … and it’s definitely true with anal sex, IBS or not,” licensed psychologist and certified sexologist Denise Renye, Psy.D., tells SELF.

There are two main possibilities when it comes to GI conditions specifically: that you will actively poop during anal because of, say, diarrhea, or that you might have extra stool in your rectum (the part of your large intestine closest to your anus) due to something like constipation.

The thing is that some residual fecal matter can hang out in your rectum even if you don’t have a GI condition, so, yeah, anyone with a functioning butthole might see some poop during anal, Dr. Ivanina says. Having persistent, somewhat unpredictable poop problems simply makes you a little more vulnerable to this.

That doesn’t, however, mean poop absolutely will crash your anal party. If it does, wash your hands and the affected body parts and reassess how much you feel like getting back to anal after that. If you’re going to continue with penetration and you were using a condom, you should grab a fresh one. If you were using a barrier method such as a dental dam for analingus, you’ll need a new one of those instead.

Should you use an enema before anal sex to decrease the chances of pooping?

Enemas are injections of fluid into the rectum to flush out any stool that’s in there. In general, it’s OK to use enemas “carefully and appropriately, but not on a frequent basis,” Dr. Ivanina says.

The muscles in the rectum typically know what they’re doing when it comes to keeping poop in or pushing it out. You don’t want to use enemas so often that you mess with your body’s natural defecation process, especially if you have a GI condition that’s already screwing with the way you poop. If you’ve never discussed enemas with your doctor, it can be smart to check with them before adding an enema into your routine.

Next up: Are you more likely to experience pain during anal sex if you have a GI issue?

“If someone has a GI disease involving the anus/rectum—for example, a flare of ulcerative colitis, a rectal ulcer, or an anal fissure—it may not be safe to have receptive anal sex,” Dr. Ivanina says. First of all, it might really hurt. But also, anything that increases your chances of exchanging fluids, like anal fissures that can leave bloody cracks in your skin, may put you or your partner at increased risk of sexually transmitted infections.

This is why you should always use condoms for penetration (including on toys) and barrier methods like dental dams for analingus. (The exception is if you and your partner are in a committed monogamous sexual relationship and have been tested recently.) If you are using a condom, you should always get a new one when switching between anal and vaginal penetration, otherwise you can deposit bacteria from your GI tract right into your vagina where it may cause an infection.

If you have a GI-related medical condition, are interested in anal sex, but are concerned about the poop factor, Dr. Ivanina suggests talking to your doctor about your treatment plan.

The goal is to get on as regular a pooping schedule as possible and decrease flares of any symptoms. That might include tweaking your diet by cutting down on triggers such as spicy foods and beverages like coffee and alcohol, exercising more to increase movement in your colon, and possibly getting on (or changing) medications for your specific situation.

This might be tough to do, but in an ideal world you’d also let your doctor know that you’re interested in trying anal sex. This can help them tailor their recommendations, plus it may be important for them to know for sexual health reasons.

With the right preparation, teamwork, and tons of lube, anal sex can be awesome—even for those with GI conditions.

Unless a medical professional has specifically told you that it’s unsafe or you’re having a flare of symptoms like pain, diarrhea, or constipation, it’s likely OK to try anal sex, Dr. Ivanina says. But protection is essential, especially since your condition might increase the risk that your partner will encounter substances like poop. And no matter how much lube you’ve slathered on, stop if you experience pain. Always listen to your body.

Also, it would be great to give your partner a heads up about your GI condition before trying anal sex. Having anal often involves some kind of conversation anyway, so it shouldn’t be that weird. Anyone who is worth having sex with shouldn’t freak out about this.

If a possible partner is an asshole about discussing how your condition may impact anal sex, they’re probably not worthy of entrance into your, well, asshole.

“At this point, I only bottom for guys I’m dating or more serious about, so if [there is poop], it’s not the end of the world,” Zane says. “We laugh, and then hop into the shower together. It comes with the territory, you know? If you’re playing around in the mud, you’re bound to get dirty sometimes.”

As someone who has pooped on dicks and farted during oral sex, I couldn’t agree more. “Many times, people are self-conscious, yet we are all humans, and any caring partner will understand any mess that may be present,” Renye says.

That partner I mentioned who saw poop on my butt plug? They’ve also escorted me home from two colonoscopies, witnessed me high on sedatives after said colonoscopies, and enjoyed crazy hot anal sex with me. Such is the only type of person who deserves the potential delight of venturing past your butthole.

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Alzheimer’s Disease: 10 Facts You Should Know

We’re just going to go ahead and state the obvious: Alzheimer’s disease is terrible, and no one should ever have to deal with it. Whether you fear a loved one is showing signs of Alzheimer’s or they’ve received a diagnosis, you may be confused, scared, and not sure what to expect. Here, we’ve rounded up 10 essential facts about Alzheimer’s disease to offer some understanding of what the condition entails.

1. Alzheimer’s disease is an irreversible, progressive condition that destroys a person’s memory and other important mental (and eventually physical) functions.

This disease is the most common cause of dementia, which describes a group of brain disorders that erode a person’s cognitive abilities and communication skills, according to the Mayo Clinic.

If someone has Alzheimer’s, they typically experience mild confusion and difficulty remembering things to start, but eventually they may forget important people in their lives, undergo dramatic personality changes, have trouble planning, communicating, and making safe decisions, and need full-time care.

2. Alzheimer’s progresses through five stages, and the first one doesn’t cause any symptoms at all.

This first stage is called preclinical Alzheimer’s disease, according to the Mayo Clinic. People in this stage don’t exhibit any outward symptoms of the condition, but they are undergoing brain changes that will induce signs of Alzheimer’s down the line. Although symptoms aren’t apparent at this point, experts are working on developing innovative brain imaging technology that might be able to pick up on signs of the condition at this stage.

After preclinical Alzheimer’s, which can last for years, a person develops what’s called mild cognitive impairment due to Alzheimer’s disease. This involves confusion, trouble making decisions, and issues remembering things such as recent conversations or upcoming appointments, but not at a severe enough level for it to really affect a person’s job or relationships, the Mayo Clinic explains. (Of course, these symptoms aren’t always a sign of Alzheimer’s—we’ll discuss that a bit more down below.)

The following phase is mild dementia due to Alzheimer’s disease. This is when symptoms become apparent enough that they often lead to an Alzheimer’s diagnosis, the Mayo Clinic notes. At this point, Alzheimer’s is affecting a person’s day-to-day life with symptoms such as noticeable short-term memory loss, trouble with problem-solving, poor decision-making, mood changes, losing items, getting lost themselves (even in familiar locations), and having a hard time expressing themselves. This can translate into the person asking the same question repeatedly because they forget the answer, a difficult time handling what used to be manageable responsibilities (like tracking their budget), and irritability or anger as their world begins to shift in confounding ways.

This eventually progresses into moderate dementia due to Alzheimer’s disease, which is essentially an intensifying of symptoms. A person with this stage of Alzheimer’s tends to need more care making it through the day and avoiding dangerous situations, such as becoming lost (wandering around to find a familiar setting is common in this stage). This is also when long-term memory becomes more compromised, so a person with this level of Alzheimer’s may begin to forget who their loved ones are or get them confused with each other.

Lastly, during severe dementia due to Alzheimer’s disease, a person may be unable to communicate coherently, even if they are physically able to speak. As they lose control over physical functions such as walking, holding their head up, and bladder and bowel activity, they may depend on others to care for them. People with this final stage of Alzheimer’s may also have difficulty swallowing. Sadly, this is often how death from Alzheimer’s can come about. Food or drinks can wind up in the lungs due to impaired swallowing, leading to pneumonia, or a person may become dehydrated or malnourished.

There’s no set amount of time it takes for every person with Alzheimer’s to advance through each of these stages, but the Mayo Clinic notes that people with the condition live eight to 10 years after diagnosis on average.

3. Normal forgetfulness is a thing, and it’s very different from Alzheimer’s-related memory loss.

It’s completely fine to occasionally forget where you put things, the names of people you don’t see that often, why you entered a room, and other minor details. Memory lapses can happen for all sorts of reasons, from a lack of sleep to normal cognitive changes as you grow older.

“Mild forgetfulness is a common complaint in people as they age,” Verna R. Porter, M.D., a neurologist and director of the Alzheimer’s Disease Program at Providence Saint John’s Health Center in Santa Monica, California, tells SELF. “The main difference between age-related memory loss and dementia (such as Alzheimer’s disease) is that in normal aging, the forgetfulness does not interfere with your ability to carry on with daily activities,” Dr. Porter says. “The memory lapses have little impact on your daily life.”

If you or a loved one is dealing with persistent memory loss and accompanying symptoms such as difficulty staying organized, confusion, and mood changes, that’s more of a cause for concern.

4. Alzheimer’s affects millions of people in the United States, causing over 110,000 deaths each year.

Estimates range, but the National Institute on Aging (NIA) says that more than 5.5 million people in the United States have the disease. According to the Centers for Disease Control and Prevention, it was the sixth leading cause of death in the United States in 2017, killing 116,103 people.

5. Doctors aren’t totally sure what causes Alzheimer’s disease, but brain changes are definitely involved.

Alzheimer’s disease damages and kills brain cells. This destruction is what affects a person’s cognitive, social, and physical abilities.

Researchers have also discovered two specific abnormalities in the brains of people with Alzheimer’s disease, the Mayo Clinic says. One is that they have plaques, or buildup of a protein called beta-amyloid that may harm brain cells, including by impeding cell-to-cell communication. Another is tangles in the transportation system that brain cells rely on to move nutrients and other substances that are necessary for your brain to function properly.

6. There’s also a genetic component for some people, especially those with early-onset Alzheimer’s disease.

Early-onset Alzheimer’s disease happens when a person develops the condition anywhere from their 30s to mid-60s, according to the NIA. People with this early-onset form comprise less than 10 percent of the Alzheimer’s population. These cases are sometimes due to three specific gene mutations or other genetic factors. However, this kind of genetic influence is only involved in less than 5 percent of Alzheimer’s disease cases overall, according to the Mayo Clinic.

Late-onset Alzheimer’s (which is much more common and typically shows up in someone’s mid-60s) mainly arises due to age and brain changes. Genetics are sometimes involved, but much more rarely than in a person who starts exhibiting symptoms when they’re younger.

7. Experts have pinpointed certain risk factors that increase your odds of developing Alzheimer’s disease.

Getting older is the biggest one, the Mayo Clinic says. To be clear, Alzheimer’s isn’t just a regular part of aging that everyone should expect, but it’s much more common in people over 65. This is part of why women seem to be at a greater risk of developing Alzheimer’s disease—they simply tend to live longer.

Having a first-degree relative (like a dad or sister) with the disease also seems to raise your risk. This is due to that genetic component, which doctors are still investigating.

Another potential factor: past head trauma, like a concussion. “In general, head injuries can result in less brain [matter] because an accompanying brain injury can occur,” Amit Sachdev, M.D., an assistant professor and director of the Division of Neuromuscular Medicine at Michigan State University, tells SELF. “Less brain means less ability for the brain to age gracefully.”

There’s also a surprising potential link between heart disease risk factors and those that contribute to your chances of getting Alzheimer’s. For example, high blood pressure, high blood cholesterol, obesity, and poorly controlled type 2 diabetes can increase your risk of developing both conditions, according to the Mayo Clinic. This may be because of a health issue called vascular dementia, which is when impaired blood vessels in the brain cause memory and cognitive difficulties.

In addition, Down syndrome is one of the strongest risk factors for one day developing Alzheimer’s, and symptoms tend to present 10 to 20 years earlier than they do in the general population, according to the Mayo Clinic. The Down/Alzheimer’s link may center around having an extra copy of chromosome 21, which is what brings about characteristics of Down syndrome. This extra chromosome material contains the gene that produces those beta-amyloid plaques that can harm brain cells, the NIA explains.

8. Doctors can’t definitively diagnose Alzheimer’s without looking at a person’s brain, but they know enough about the symptoms to tell when someone has it.

The only current test to absolutely confirm Alzheimer’s involves a microscopic exam of a deceased person’s brain to look for those plaques and tangles, according to the Mayo Clinic. Although tests to confirm whether or not a living person has Alzheimer’s seem to be forthcoming, they’re not yet ready for widespread use.

Instead, doctors basically make an extremely educated guess. They do this with strategies like ordering blood tests to rule out other causes of memory loss, administering mental status tests to evaluate a person’s thinking and memory, ordering brain imaging such as an MRI or CT scan, and testing a person’s cerebrospinal fluid for biological markers that can point toward the possibility of Alzheimer’s.

9. There’s no proven way to prevent Alzheimer’s disease, but certain lifestyle factors could reduce your risk.

Research has found a link between engaging in socially and mentally stimulating activities and a reduced risk of Alzheimer’s disease, the Mayo Clinic points out. It seems as though these types of activities strengthen your “cognitive reserve,” making it easier for your brain to compensate for age-related changes, according to the NIA.

Reducing your risk of heart disease may also help lower your risk of Alzheimer’s the Mayo Clinic says. “Things that promote a healthy body will promote a healthy brain,” Dr. Sachdev says. “In this case, healthier blood vessels are less likely to become damaged and more likely to support the brain.”

Lowering your risk of heart disease and Alzheimer’s means staying active and eating well, among other things. “Exercise may slow existing cognitive deterioration by stabilizing older brain connections and [helping to] make new connections,” Dr. Porter says. Experts are also investigating if exercise can bolster the size of brain structures that are key for memory and learning. In any case, the American Heart Association recommends getting 150 minutes of moderate exercise every week or 75 minutes of vigorous movement (or a mix of moderate and vigorous workouts) each week.

The Mediterranean Diet, which focuses on eating produce, healthy oils, and foods low in saturated fat, has also been linked with a lowered risk of developing heart disease and Alzheimer’s, the Mayo Clinic says.

Does this mean you have to overhaul the way you currently eat in order to avoid Alzheimer’s? No. It only means that scientists have studied one specific way of eating enough to land on this result. Healthy eating looks different for different people, and a lot of this can depend on your culture, too. The point is really to eat in a way that helps to reinforce your body and mind, not that you need to follow any one type of way for optimal health.

10. There is no cure for Alzheimer’s disease, but there are treatment options to help with symptoms.

The U.S. Food and Drug Administration (FDA) has approved two types of medications to help manage the memory loss, confusion, and problems with thinking and reasoning of Alzheimer’s disease, according to the NIA.

Cholinesterase inhibitors are reserved for mild to moderate Alzheimer’s. It seems as though they impede the breakdown of acetylcholine, a brain chemical implicated in memory and thinking, but these drugs may start to work less effectively as Alzheimer’s progresses and a person produces less acetylcholine.

When it comes to moderate to severe Alzheimer’s, doctors may use a drug called memantine, which appears to regulate glutamate, a neurotransmitter that can cause brain cell death in large amounts. Sometimes doctors prescribe both cholinesterase inhibitors and memantine drugs, since they work in different ways.

Unfortunately, these drugs won’t fully stop the progression of the disease. But they may help slow the symptoms so that a person with Alzheimer’s can have a better quality of life for a longer period of time.

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