Subtle visual cues nudge users to reveal more in online forum

Pictures may be worth a thousand words, but icons may be even more powerful in nudging people to disclose more information online, according to an interdisciplinary team of Penn State researchers.

In a study, researchers found that people using an online sexual health forum featuring computer graphics, called icons, that implied a sense of crowd size and connectivity, revealed more sensitive information than visitors to a site without those visual cues, said S. Shyam Sundar, James P. Jimirro Professor of Media Effects and co-director of the Media Effects Research Laboratory. Pictures meant to convey a sense of community on the web forum did not significantly affect the user’s disclosure, he added.

The subtle power of these cues could both help people build stronger online communities, as well as possibly lure them into revealing personal information, according to the researchers.

“This shows that little changes can mean a lot and it could help sites, such as online health forums, stay alive and help support their users,” said Sundar. “If people don’t reveal information in an online forum, the vitality of that forum decreases because not enough people are sharing details that make the forum worthwhile. On the other hand, if spam sites use these cues, they may be able to get more people to reveal sensitive information about their personal life, and that would be a bad thing.”

The researchers used a dynamic graphic representation of people standing in a crowd to convey crowd size. The size of the crowd suggested by the icon changed randomly for participants so that they were not merely jumping on the bandwagon of a

large crowd, according to the researchers. The connectivity icon showed a network map with one circle labeled “You” to suggest the participant’s place in the network. This icon also changed randomly.

The researchers, who report their findings today (November 6) at the Association for Computing Machinery’s annual Conference on Computer-Supported Cooperative Work and Social Computing in Jersey City, NJ, tested the icons on a sexual health forum because while people tend to be reluctant to share information about their sexual behavior, disclosure is important to help them access health information, as well as help them make better health decisions.

“In a marginalized — or stigmatized — group, it’s often hard to get people to talk or to reveal personal information. However, we found that once the users got the sense that they were in the same boat as others, or that they were connected to others in the same network, they were more willing to disclose their private information and revisit the forum.” said Andrew Gambino, doctoral student of mass communication, Penn State. “What we’ve found is a very basic design solution to increase participation in this group. This might be a way for small groups, particularly ones that deal with stigmatized or marginalized topics, to survive.”

The cues of both the crowd and connectivity icons may be stronger for people who have a desire to be part of an effort to build a community, according to the researchers. For instance, users of the site who indicated they were willing to share information to build a community were also more likely to disclose more highly sensitive information when they saw the crowd and connectivity icons.

A website with pictures that suggested a sense of community — for example, group pictures, or people holding hands — did not significantly affect the user’s sense of community or disclosure behavior.

“Sense of community may be a relatively stable attribute of forum participants, which would make it difficult to influence with a short-term intervention,” said Mary Beth Rosson, professor and associate dean of information sciences and technology, and a collaborator on the project.

The researchers recruited 218 participants from Amazon Mechanical Turk, an online task platform. The volunteers were randomly assigned to one of six different websites that were designed to reflect a site with a crowd cue or one without the crowd cue, a site with a connectivity cue or no connectivity cue, or a site that reflected the community framing or no framing.

Participants were asked to join a site described as “an online community open to anyone interested in exploring their sexuality and learning about sexual health and well-being.” The participants were then asked to share information about their sexual behaviors and health. They were also told that information would be used to connect them to similar people in the community.

Participants were given the option to not disclose information in every question, as well as the option to leave the website at any time.

“Offering many small opportunities to disclose or not disclose was intended to approximate the ubiquitous requests for sharing that users get from Web and smartphone apps in their everyday lives,” said Rosson.

In the future, the researchers may see if these cues influence disclosure on other types of online media, such as social media sites.

“We may see similar effects in social media, for example,” said Gambino. “If anything, we intentionally chose a very difficult subject, a difficult context, and found people sharing more information due to these simple cues and mindsets.”

Sundar, Rosson and Gambino worked with Jinyoung Kim, a doctoral student in mass communications at the time of the study, and Chulakorn Aritajati, Jun Ge and Christine Fanning, students of information sciences and technology.

The National Science Foundation supported this work.

Family tree of 400 million people shows genetics has limited influence on longevity

Although long life tends to run in families, genetics has far less influence on life span than previously thought, according to a new analysis of an aggregated set of family trees of more than 400 million people. The results suggest that the heritability of life span is well below past estimates, which failed to account for our tendency to select partners with similar traits to our own. The research, from Calico Life Sciences and Ancestry, was published in GENETICS, a journal of the Genetics Society of America.

“We can potentially learn many things about the biology of aging from human genetics, but if the heritability of life span is low, it tempers our expectations about what types of things we can learn and how easy it will be,” says lead author Graham Ruby. “It helps contextualize the questions that scientists studying aging can effectively ask.”

Ruby’s employer, Calico Life Sciences, is a research and development company whose mission is to understand the biology of aging. They teamed up with scientists from the online genealogy resource Ancestry, led by Chief Scientific Officer Catherine Ball, to use publicly available pedigree data from Ancestry.com to estimate the heritability of human life span.

Heritability is a measure of how much of the variation in a trait — in this case life span — can be explained by genetic differences, as opposed to non-genetic differences like lifestyle, sociocultural factors, and accidents. Previous estimates of human life span heritability have ranged from around 15 to 30 percent.

“Partnering with Ancestry allowed this new study to gain deeper insights by using a much larger data set than any previous studies of longevity,” said Ball.

Starting from 54 million subscriber-generated public family trees representing six billion ancestors, Ancestry removed redundant entries and those from people who were still living, stitching the remaining pedigrees together. Before sharing the data with the Calico research team, Ancestry stripped away all identifiable information from the pedigrees, leaving only the year of birth, year of death, place of birth (to the resolution of state within the US and country outside the US), and familial connections that make up the tree structure itself.

They ended up with a set of pedigrees that included over 400 million people — largely Americans of European descent — each connected to another by either a parent-child or a spouse-spouse relationship. The team was then able to estimate heritability from the tree by examining the similarity of life span between relatives.

Using an approach that combines mathematical and statistical modeling, the researchers focused on relatives who were born across the 19th and early 20th centuries, finding heritability estimates for siblings and first cousins to be roughly the same as previously reported. But, as was also observed in some of the previous studies, they noted that the life span of spouses tended to be correlated — they were more similar, in fact, than in siblings of opposite gender.

This correlation between spouses could be due to the many non-genetic factors that accompany living in the same household — their shared environment. But the story really started to take shape when the authors compared different types of in-laws, some with quite remote relationships.

The first hint that something more than either genetics or shared environment might be at work was the finding that siblings-in-law and first-cousins-in-law had correlated life spans — despite not being blood relatives and not generally sharing households.

The size of their dataset allowed the team to zoom in on longevity correlations for other more remote relationship types, including aunts and uncles-in-law, first cousins-once-removed-in-law, and different configurations of co-siblings-in-law. The finding that a person’s sibling’s spouse’s sibling or their spouse’s sibling’s spouse had a similar life span to their own made it clear that something else was at play.

If they don’t share genetic backgrounds and they don’t share households, what best accounts for the similarity in life span between individuals with these relationship types? Going back to their impressive dataset, the researchers were able to perform analyses that detected assortative mating.

“What assortative mating means here is that the factors that are important for life span tend to be very similar between mates,” says Ruby. In other words, people tend to select partners with traits like their own — in this case, how long they live.

Of course, you can’t easily guess the longevity of a potential mate. “Generally, people get married before either one of them has died,” jokes Ruby. Because you can’t tell someone’s life span in advance, assortative mating in humans must be based on other characteristics.

The basis of this mate choice could be genetic or sociocultural — or both. For a non-genetic example, if income influences life span, and wealthy people tend to marry other wealthy people, that would lead to correlated longevity. The same would occur for traits more controlled by genetics: if, for example, tall people prefer tall spouses, and height is correlated in some way with how long you live, this would also inflate estimates of life span heritability.

By correcting for these effects of assortative mating, the new analysis found life span heritability is likely no more than seven percent, perhaps even lower.

The upshot? How long you live has less to do with your genes than you might think.

Mothers prefer daughters and fathers prefer sons

Finnish and American researchers in evolutionary biology conducted an online experiment and survey which reveals that women prefer and are more likely to invest in their daughters and men in their sons. The study was designed to test the impact of parental resources on offspring sex preferences.

Specifically, the authors sought to test the Trivers-Willard hypothesis which predicts that parents in good conditions will bias investment towards sons, while parents in poor conditions will bias investment towards daughters.

“However, our study failed to show that the parents’ preferences for the offspring’s gender are affected by their status, wealth, education or childhood environment. Instead, parental preferences were best predicted by their sex. Women from all socioeconomic backgrounds expressed implicit and explicit preferences for daughters: they chose to donate more to charities supporting girls and preferred to adopt girls. In contrast, men expressed consistent, albeit weaker, preferences for sons,” explains lead author, Postdoctoral Researcher Robert Lynch from the University of Turku, Finland.

The researchers tested the Trivers-Willard effect with an online experiment by measuring implicit and explicit psychological preferences and behaviourally implied preferences for sons or daughters both as a function of their social and economic status and in the aftermath of a priming task designed to make participants feel wealthy or poor.

The results of the research help to make sense of the often contradictory findings on offspring sex preferences. The effects of parental condition and status, competing genetic interests between males and females, economic constraints on families, and the effects of cultural practices all conspire to complicate the evolutionary outcomes of parental investment strategies.

“Frequently, the impact of one factor, for example, the genetic sexual conflict between males and females, can mask the impact of another, such as the Trivers-Willard Hypothesis. This can make it difficult to parse their effects and make clear predictions about ‘optimal’ parental investment strategies from an evolutionary perspective. We hope that our study can shed new light on these strategies and provide a better understanding of evolutionary biology in humans,” states Lynch.

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Emotional vulnerabilities shape complex behavioral arrangement of toddlers with ASD

At the time when autism spectrum disorder (ASD) can be first reliably diagnosed, toddlers affected by ASD are already displaying emotional vulnerabilities potentially foreshadowing the emergence of co-morbid affective and behavioral conditions highly prevalent in older children, reports a study published in the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP).

The authors found that toddlers with ASD display enhanced anger and frustration and decreased fear in response to naturalistic situations. They also found that the capacity to experience joy appears intact in the early stages of the disorder.

“ASD onsets in most cases within the first two years of life and affects approximately 1 in 59 children,” said lead authors Suzanne Macari and Katarzyna Chawarska, PhD, at the Child Study Center at the Yale School of Medicine, New Haven, CT, USA. “This study documents, for the first time, that at the earliest age when the disorder can be reliably diagnosed, toddlers with ASD already display emotional vulnerabilities signaling risk for co-morbid affective and behavioral problems.”

The findings are based on a study of emotional development in toddlers referred for a differential diagnosis of ASD in the Northeastern United States and includes 43 toddlers with ASD and 56 non-ASD controls.

Toddlers aged 21 months were recruited between December 2013 and March 2017. Using a multi-modal approach, the researchers examined intensity of emotional responses across vocal and facial channels to naturalistic situations aimed to elicit anger, fear, and joy.

“The vulnerabilities are unrelated to autism symptoms and thus, contribute independently to the development of complex and highly heterogenous autism phenotypes,” added Drs. Macari and Chawarska. “In addition to targeting social and communication concerns, clinicians should also focus on assessing and treating affective symptoms in young children with ASD with the hope of ameliorating the severity of comorbid disorders so common in ASD.”

The researchers found that when a desired object is put out of reach of the toddler, toddlers with ASD displayed elevated levels of intensity of anger and frustration. However, when faced with novel and potentially threatening objects, their fear intensity is lower than in the comparison groups. While an elevated anger response may challenge the developing emotion regulation system, the attenuated fear response suggests atypical appraisal of threat and risk for safety concerns.

Although there is a prevailing notion that children with ASD do not experience joy as much as other children, the study found that levels of joy in response to playful situations was comparable in toddlers with ASD and the control groups. This suggests that in the early stages of the disorder, the capacity to experience joy may be intact. Harnessing this intact emotional competence for therapeutic purposes is essential as activation of positive emotions promotes learning and exploration and counters stress. Together, the study reveals a surprising and complex emotional landscape of toddlers with ASD and provides strong motivation for investigation of early emotional development in ASD and its role in emergence of autism.

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Alzheimer’s Disease: Can Exercise Prevent Memory Loss?

Can exercise prevent memory loss and improve cognitive function?

Answer From Jonathan Graff-Radford, M.D.

Possibly. Exercise has many known benefits, including reducing the risk of cardiovascular disease and diabetes, strengthening the bones and muscles, and reducing stress.

It also appears that regular physical activity benefits the brain. Studies show that people who are physically active are less likely to experience a decline in their mental function and have a lowered risk of developing Alzheimer’s disease.

Exercising several times a week for 30 to 60 minutes may:

  • Keep thinking, reasoning, and learning skills sharp for healthy individuals
  • Improve memory, reasoning, judgment, and thinking skills (cognitive function) for people with mild Alzheimer’s disease or mild cognitive impairment
  • Delay the start of Alzheimer’s for people at risk of developing the disease or slow the progress of the disease

Physical activity seems to help the brain not only by keeping your blood flowing but also by increasing chemicals that protect the brain. Physical activity also tends to counter some of the natural reduction in brain connections that occurs with aging.

More research is needed to know to what degree adding physical activity improves memory or slows the progression of cognitive decline. Nonetheless, regular exercise is important to stay physically and mentally fit.

Updated: 2014-10-22

Publication Date: 2014-10-22

Eat your vegetables (and fish): Another reason why they may promote heart health

Elevated levels of trimethylamine N-oxide (TMAO) — a compound linked with the consumption of fish, seafood and a primarily vegetarian diet — may reduce hypertension-related heart disease symptoms. New research in rats finds that low-dose treatment with TMAO reduced heart thickening (cardiac fibrosis) and markers of heart failure in an animal model of hypertension. The study is published ahead of print in the American Journal of Physiology — Heart and Circulatory Physiology and was chosen as an APSselect article for November.

TMAO levels in the blood significantly increase after eating TMAO-rich food such as fish and vegetables. In addition, the liver produces TMAO from trimethylamine (TMA), a substance made by gut bacteria. The cause of high TMAO levels in the blood and the compound’s effects on the heart and circulatory system are unclear, and earlier research has been contradictory. It was previously thought that TMAO blood plasma levels — and heart disease risk — rise after the consumption of red meat and eggs. However, “it seems that a fish-rich and vegetarian diet, which is beneficial or at least neutral for cardiovascular risk, is associated with a significantly higher plasma TMAO than red meat- and egg-rich diets, which are considered to increase the cardiovascular risk,” researchers from the Medical University of Warsaw in Poland and the Polish Academy of Sciences wrote.

The researchers studied the effect of TMAO on rats that have a genetic tendency to develop high blood pressure (spontaneously hypertensive rats). One group of hypertensive rats was given low-dose TMAO supplements in their drinking water, and another group received plain water. They were compared to a control group of rats that does not have the same genetic predisposition and received plain water. The dosage of TMAO was designed to increase blood TMAO levels approximately four times higher than what the body normally produces. The rats were given TMAO therapy for either 12 weeks or 56 weeks and were assessed for heart and kidney damage and high blood pressure.

TMAO treatment did not affect the development of high blood pressure in any of the spontaneously hypertensive rats. However, condition of the animals given the compound was better than expected, even after more than a year of low-dose TMAO treatment. “A new finding of our study is that [a] four- to five-fold increase in plasma TMAO does not exert negative effects on the circulatory system. In contrast, a low-dose TMAO treatment is associated with reduced cardiac fibrosis and [markers of] failing heart in spontaneously hypertensive rats,” the researchers wrote.

“Our study provides new evidence for a potential beneficial effect of a moderate increase in plasma TMAO on pressure-overloaded heart,” the research team wrote. The researchers acknowledge that further study is needed to assess the effect of TMAO and TMA on the circulatory system. However, an indirect conclusion from the study could underscore the heart-healthy benefits of following a Mediterranean-style diet rich in fish and vegetables.

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How to Persuade Someone You Love to See a Doctor

If you’ve ever had a close friend, family member, or partner avoid going to the doctor when they clearly need to see somebody, you’re probably familiar with the mix of concern and frustration this situation can create.

“Persuading another adult … to care for themselves can be trickier than you might expect,” psychologist Nancy Burgoyne, Ph.D., chief clinical officer and vice president of Clinical Services at The Family Institute at Northwestern University, tells SELF. You can’t exactly drag them to the doctor kicking and screaming the way you can with a kid who hates pediatrician visits.

Whether your loved one is neglecting a chronic illness, ignoring worrisome symptoms, or just hasn’t had their annual checkup in 10 years, here are some pointers for approaching the conversation.

1. Don’t try to guilt them into it.

Avoid saying anything like, “You’re being selfish and making your whole family suffer” or, “If you don’t go to the doctor, I swear you’ll give me an ulcer.”

“That’s probably the biggest mistake,” Andrew Roffman, L.C.S.W., clinical assistant professor in psychiatry and director of the Family Studies Program at the NYU Langone Child Study Center, tells SELF.

Guilt is not a good motivator, Burgoyne explains. It’s probably only going to make the person in question feel defensive. And, as Roffman points out, even if shaming someone does make them go to the doctor, your relationship may pay a price.

2. Don’t be controlling, either.

While it’s OK to be firm and persistent, attempting to control your loved one’s behavior with ultimatums or threats—“I’m taking you to the doctor tomorrow,” “I’m not hanging out with you this weekend if you don’t see someone this week”—will probably backfire, Roffman says.

This is another time they might dig in their heels out of pure opposition, Burgoyne explains: “What they are resisting in this case is not so much the help, but feeling controlled.”

3. Instead, start by reminding them how much they mean to you.

While it may seem obvious to you that you’re coming from a place of love, it’s really important to say that as a frame for the conversation. “What you’re really banking on here is the relationship you have with the person, so you want to start by affirming that,” Roffman says.

While the way you phrase that statement will obviously depend on the nature of your relationship, Roffman recommends something like, “You know how much I care about you and how much our relationship means to me. So, I wanted to say a few things that I’ve been thinking about.”

4. Use nonjudgmental “I” statements.

You may have heard that it’s better to use “I” statements during an emotional exchange rather than “you” statements. This definitely applies here. “I” statements can help you avoid coming across as critical and underscore that you’re not judging your loved one.

Roffman says the general message should be along the lines of, “I’m concerned about you and your wellbeing, and I believe going to the doctor would help you take care of your health.” Translation: Don’t say anything that could be construed as, “Here’s what’s wrong with you, and here’s a long list of how you’re failing by not going to the doctor.”

5. Tell them it’s OK to be nervous.

Sometimes people resist going to the doctor out of pure fear, Burgoyne says. Maybe they’re afraid of getting bad news or being told that they’ll have to make significant lifestyle changes.
At the same time, they might be embarrassed to admit they’re scared or nervous.

If you think this might be the case, let your loved one know their worries aren’t unusual. “Normalizing those kinds of anxieties and validating the person’s feelings can be helpful for some people,” Roffman says. Try something like, “I understand that the thought of going to the doctor might make you nervous. I think a lot of people feel that way.”

6. Talk about the good things that can happen if they do go to the doctor, not the bad ones that might happen if they don’t.

It may be tempting to catastrophize in an effort to scare your loved one straight. (“You’re going to have a stroke if you don’t get that high blood pressure checked out!”) But fear-mongering with dire predictions is cruel and ineffective. It will likely just raise the person’s anxiety and make them even less likely to seek help, Roffman says.

Focusing on the benefits of going to the doctor is a better strategy. Rather than, “If you don’t do this, you’re going to get that disease,” try, “If you do this, you’re going to feel better and enjoy life more,” Roffman says. Or say something like, “It’s highly likely that there’s a way [insert their symptoms or health conditions here] can be treated and that you’ll feel better.”

7. Offer to help with any logistical barriers that come with doctor’s appointments.

For someone who is already resistant to going to the doctor, logistical nuisances like finding a provider, working out the insurance, and obtaining old medical records can seem like daunting obstacles.

Ask if your loved one would like help with that sort of stuff by saying something like, “If you want, I can find somebody in-network for you.” But don’t go ahead and do anything without their OK, Roffman says. And if they reject your offer, don’t insist. At the end of the day, their health is their responsibility, no matter how much you love them.

8. If they’ve had a bad experience with doctors, help them find a good one.

In some cases, the person’s fear may be rooted in previous encounters with doctors. Most doctors are caring and want the best for their patients, but there are some bad apples in every profession.

While you can’t erase a bad medical memory for your loved one, you can validate their fear of having it repeated and try to help make sure it doesn’t happen again. Roffman recommends saying something like, “I know you had a bad experience, but no good doctor will treat you that way, and we’ll make sure to find a doctor who won’t do that.”

Then, help them find a capable and compassionate provider they’ll hopefully be comfortable with. Get referrals through friends and family, Roffman says. If you can’t do that (or honestly, even if you can), screen reviews online. You could also call a practice for your loved one and ask the administrative staff which of their doctors has an especially good bedside manner.

If your loved one has a particular concern, like being mistreated because of their sexual orientation or gender identity, connect them with resources that can help them find a provider who is an LGBTQ+ ally. Same goes if they’ve been fat-shamed at the doctor before (ask if their prospective doctors are trained in “health at every size” principles) or if they have any other specific hesitation.

Finally, if your loved one has an appointment with a great-seeming doctor but is still nervous, you can offer to accompany them to the appointment if you’re actually able to and you think it would help.

9. Know when to drop it.

Pushing too hard once you’ve reached an impasse will get you nowhere, Roffman says (except potentially into an argument). You also run the risk of making this a sore subject for the person, which will put you at a disadvantage in future conversations.

“It’s important to recognize that if it’s not going well in the moment, [you need to] back off and return to it another time when the person is in a more receptive state,” Roffman explains.

If this is an ongoing conversation for you two and you are hesitant to bring it up again, simply ask if it’s OK to do so, Burgoyne says. She suggests something like, “I know I have reminded you a bunch of times, but can I keep encouraging you?” or, “I realize it may be annoying, but I sense this is hard, and maybe reminders will help. What do you think?”

10. Lead by the example of looking after your own health.

If you want someone you love to take care of themselves, one of the best things you can do is follow your own advice. It might inspire them to take action, and they also can’t accuse you of hypocrisy by saying something like, “Why should I go to the doctor when you don’t?”

Plus, it ensures that you are well enough to be there for the other person going forward. You know how on airplanes you’re always supposed to put on your oxygen mask first before helping others? That’s a great life rule in general, and it absolutely fits this situation. “Take care of yourself so you are not both depleted,” Burgoyne says. “You have to establish a safe distance from unhealthy patterns that can trap you both.”

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How clear speech equates to clear memory

Some conversations are forgotten as soon as they are over, while other exchanges may leave lasting imprints. University of Texas at Austin researchers Sandie Keerstock and Rajka Smiljanic want to understand why and how listeners remember some spoken utterances more clearly than others. They’re specifically looking at ways in which clarity of speaking style can affect memory.

Keerstock, a UT Austin doctoral student, and Smiljanic, an associate professor and linguist who heads UTsoundLab, will describe their work at the Acoustical Society of America’s 176th Meeting, held in conjunction with the Canadian Acoustical Association’s 2018 Acoustics Week in Canada, Nov. 5-9 at the Victoria Conference Centre in Victoria, Canada.

In one experiment, 30 native and 30 nonnative English listeners were presented with 72 sentences, broken down into six blocks of 12 sentences each. These sentences — such as “The grandfather drank the dark coffee” or “The boy carried the heavy chair” — were alternately produced in two different styles: “clear” speech, in which the speaker talked slowly, articulating with great precision, and a more casual and speedily delivered “conversational” manner.

After hearing each block of a dozen sentences, listeners were asked to recall verbatim the sentences they had heard by writing them down on a sheet of paper, after being given a clue such as “grandfather” or “boy.”

Both groups of listeners, native and nonnative, did better when sentences were presented in the clear speaking style. This is in line with their previous study in which clearly spoken sentences were recognized better than casual sentences as previously heard by both groups of listeners. The UT Austin researchers offer a possible explanation for these results: When a speaker is talking faster or failing to enunciate as crisply, listeners have to work harder to decipher what’s being said. More mental resources, consequently, are drawn toward that task, leaving fewer resources available for memory consolidation.

Clearly produced speech could benefit students in the classroom and patients receiving instructions from their doctors, Smiljanic said. “That appears to be an efficient way of conveying information, not only because we can hear the words better but also because we can retain them better.”

In their next round of experiments, she and Keerstock will focus on the speakers rather than the listeners to see whether speaking clearly affects their own memory. “If you’re rehearsing for a lecture and read the material out loud in a hyperarticulated way,” Keerstock asked, “will that help you remember better?”

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Seven in 8 children’s tonsillectomies are unnecessary

A new study by the University of Birmingham has found that seven in every eight children who have their tonsils removed are unlikely to benefit from the operation.

Researchers analysed the electronic medical records of over 1.6 million children from more than 700 UK general practices dating between 2005 and 2016. They found that out of 18,271 children who had their tonsils removed during this time, only 2,144 (11.7 per cent) had enough sore throats to justify surgery.

The researchers at the University’s Institute of Applied Health Research concluded that their evidence, published today (Nov 6th) in British Journal of General Practice, showed that annually 32,500 children undergo needless tonsillectomies at a cost to the NHS of £36.9 million.

What’s more, they found that many children who might benefit from having their tonsils removed are not having the surgical procedure. They found that of 15,764 children who had records showing sufficient sore throats to undergo a tonsillectomy, just 2,144 (13.6 per cent) actually went on to have one.

Current UK health policy, based on the best scientific evidence, is that to meet the criteria to benefit from a tonsillectomy children must suffer from either more than seven documented sore throats in a year; more than five sore throats per year for two successive years; or three sore throats per year for three successive years.

The researchers found that, of those who had undergone a tonsillectomy, 12.4 per cent had reported five to six sore throats in a year; 44.7 per cent had suffered two to four sore throats in a year; and 9.9 per cent had just one sort throat in a year.

Tom Marshall, Professor or Public Health and Primary Care at the University of Birmingham, said: “Research shows that children with frequent sore throats usually suffer fewer sore throats over the next year or two. In those children with enough documented sore throats, the improvement is slightly quicker after tonsillectomy, which means surgery is justified.

“But research suggests children with fewer sore throats don’t benefit enough to justify surgery, because the sore throats tend to go away anyway.

“Our research showed that most children who had their tonsils removed weren’t severely enough affected to justify treatment, while on the other hand, most children who were severely enough affected with frequent sore throats did not have their tonsils removed. The pattern changed little over the 12 year period.

“Children may be more harmed than helped by a tonsillectomy. We found that even among severely affected children only a tiny minority of ever have their tonsils out. It makes you wonder if tonsillectomy ever really essential in any child.”

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How Bad Is It Really to Rock an Ariana Grande-Level High Ponytail All the Time?

Ariana Grande is known for her signature high ponytail, but she revealed in a Twitter exchange with Camila Cabello that it actually doesn’t feel so great.

Here’s what happened: Cabello shared with her fans on Sunday that she did a high ponytail “for the first time,” adding that it was “pulling on my BRAIN ITS SO PAINFUL” before asking Grande how she does it all the time. Grande responded by saying that she gets it—she’s “in constant pain always and [doesn’t] care at all.” Finally, Cabello revealed that she just couldn’t take it anymore and had to put her hair down.

The singers’ exchange left us wondering, how bad is it really to endure the discomfort of a super-tight pony regularly?

As you can probably guess, experts say you should probably avoid a hairstyle that causes you pain.

When you wear a tight, high pony like Cabello and Grande, it puts tension on your hair follicles, Samantha B. Conrad, M.D., clinical practice director at Northwestern Memorial Hospital Group’s department of dermatology, tells SELF. Your follicles are little pockets of your skin that surround the root of a hair. And the nerves and blood vessels in your scalp feed the roots of your hair, the American Academy of Dermatology (AAD) says.

But when you pull your hair back tightly and up high, it puts your hair at a sharp angle which “puts tension on that follicle unit and causes some strangulation of the unit,” Dr. Conrad says. And because there are nerve endings down there, this tension can cause pain—even more so if your hair is long or thick or if you’re wearing extensions because that adds extra weight on the ponytail. “That’s going to cause even more traction on the hair follicle,” Dr. Conrad says.

But it’s not just pain you have to worry about—this kind of tension on your hair follicles can cause permanent issues.

“Chronic traction on the hair follicles can cause permanent thinning of the hair,” Joshua Zeichner, M.D., a New York City–based board-certified dermatologist and director of cosmetic and clinical research in dermatology at Mount Sinai Medical Center, tells SELF. This type of hair loss is known as traction alopecia, the AAD says.

“When you begin to put tension on the hair shaft and hair follicle, that constant and chronic pressure leads to eventually destruction of that hair shaft and harm to the follicle itself,” Ken L. Williams Jr., D.O., FISHRS, a surgeon at St. Joseph Hospital and founder of Orange County Hair Restoration in Irvine, Calif., tells SELF. “And that can lead to traction alopecia.”

Luckily, it is possible to stop this kind of hair loss before it becomes permanent. So, if you start to notice some hair loss after wearing your hair a certain way, you’ll want to stop ASAP, Temitayo Ogunleye, M.D., assistant professor of dermatology at the Perelman School of Medicine at the University of Pennsylvania, tells SELF. “Initially this hair loss can be temporary, but with time [it] can become permanent,” she says.

Plus, you can develop headaches from wearing a tight, high ponytail regularly. “It’s due to the pressure, kind of like wearing a too-tight headband,” Dr. Conrad says. “Your body doesn’t like to have that kind of pressure on it, and your head can start to hurt to let you know it doesn’t like what you’re doing.”

If you love the look of a high ponytail, there are ways to continue wearing it without causing issues.

Wearing a hairstyle like this chronically isn’t great for the reasons mentioned above, Dr. Conrad says. But you certainly don’t have to give it up altogether.

The issue isn’t so much the ponytail itself—tension alopecia can occur with a high or low ponytail, or even pigtails or braids—but how tightly it’s pulled back, Dr. Zeichner says. “Try to keep the hair pulled back loosely to avoid any potential traction on the follicles,” he says. You can try pulling your hair into a high pony and then loosening up the area in front of the elastic to try to ease the tension you’re creating. However, keep in mind that this can be tricky if you have a lot of long, thick hair or heavy hair extensions.

It’s also a good idea to try to rotate in other styles that are a little more gentle on your follicles, Dr. Ogunleye says. So, maybe wear a high ponytail one day, followed by keeping your hair down the next, and consider taking out your ponytail as soon as you can when you get home to give your follicles a break.

But if you’re regularly having pain while wearing your go-to hairstyle, it’s really a sign that you need to change it up a bit.

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