The Sleeping Beauties by Suzanne O'Sullivan

 The Sleeping Beauties - and other stories of mystery illness by Suzanne O'Sullivan (Picador, 2021)

[The author is a medical neurologist. Her other works on this topic are: It's all in your head: true stories of imaginary illness and Brainstorm: detective stories from the world of neurology.]

 The mind has a lot of power over the body. People can lose consciousness or have seizures through a psychological mechanism as well as part of a disease process. At least a quarter of neurology referrals believe they have epilepsy but instead have dis-associative or psychosomatic seizures. Up to one third of referrals attending a neurology clinic are likely to have a psychosomatic complaint - real physical symptoms from psychological or behavioural causes. The presenting symptoms can also be skin rashes, breathlessness, chest pain, bladder problems, diarrhoea, stomach cramps, and more. While these are symptoms of real problems, when scans and tests fail to reveal a physical cause, many still doubt psychological causes. With no single diagnosis or set criteria for conditions like autism and ADHD, there is a risk of interpretation by the user. Sometimes illness is a sign that the life we have chosen for ourselves is not the right one. Anglo-American cultures tend to consider depression as physiological and psychological, where other cultures regard it as situational.

For most of the 20th century psychosomatic disorders have been labelled 'hysteria' and 'conversion disorder' and viewed from Freud's theories, with hidden psychological trauma converted into physical symptoms. Many people, including doctors, still regard repressed trauma and denied abuse as the full explanation for all psychosomatic disease, even when the patient refuses this diagnosis.

Hysteria (and conversion disorder) are more aptly termed 'functional neurological disorders' (FND). In neurology the term 'functional' has replaced 'psychosomatic'; 'functional' indicates a problem with how the nervous system is working and implies a biological cause, not a mental one. The term 'mass psychogenic illness (MPI) has replaced 'mass hysteria'. A true MPI outbreak actually says more about the society in which it occurs, than it does about the individuals affected. 

• Mass anxiety disorder occurs out of the blue, without any preceding stresses needing to be present. It usually affects young people and happens in contained environments, such as schools. It spreads by direct contact and comes and goes quickly.
• Mass motor hysteria can affect people of any age, is more insidious in onset and lasts longer. Typically occurs where there is a background of chronic tensions within a close-knit community.  

The big problem with any MPI is how it is perceived and understood publicly. The way such illness is defined and discussed by the small number of experts who study it is often different to how it is understood outside those circles. In the medical field it is a disorder that arises from group interaction, and is sometimes referred to as a mass sociogenic illness - a social phenomenon rather than a truly psychiatric disorder. By others it is largely presented as a psychological problem, focusing on the individual and ignoring the role of the community. The cliches associated with it are very demeaning to young women, and can make the diagnosis unacceptable for social groups that do not easily fit that category, such as older people and males, or even to conflate it with 'faking' illness.

The media do not help with reports of 'mystery illness', even when a diagnosis of 'non-epileptic seizures' has been given. Reporters often state that 'medical tests have not been able to provide any answers, when they do not recognize the diagnosis is a legitimate medical condition. Publicity can even cause further cases in some circumstances.

Western doctors are trained to interpret symptoms in a literal way and treat as personal, but every medical problem is a combination of the biological, the psychological and the social. Positive blood tests or scan results provide evidence that allows others to believe in the suffering.

People find it hard to accept a psychosomatic disorder diagnosis. There is no correlation between severity or chronicity of disability and the disease process. 'Psychosomatic' and'functional' do not imply less severe or less disabling symptoms, nor are they imaginary; they are not self-limiting and can cause sustained disability. For many, they are a self-perpetuating phenomenon. Some get better, but for others the symptoms are intensified by the experience of being sick. Social and medical interventions affect the way a patient feels about the problem, and can even make things worse. More tests and less understanding of doctors' explanations leave people more confused and worried, leading to further searches for symptoms and possible external causes.

Functional neurological disorders are usually anatomically and biologically impossible. Symptoms come from the unconscious plus an inaccurate understanding of how the body works. Reading descriptions of psychosomatic disorders, people typically relate to some part of the illness described and hope to get a formal diagnosis. If a doctor is sure that a positive asylum decision is the only cure for resignation syndrome, people get to know this, and subconsciously further spread the outbreak. And sadly, many people still struggle to accept a diagnosis of of psychosomatic or functional illness and cannot let go of the idea that there is another explanation - a virus, a toxin or an unknown illness. Despite public perception, epileptic seizures are generally brief, while dis-associative seizures last a long time. FND disorders are not imaginary, but even medical practitioners have been know to dismiss them as malingering, while the public view is that it happens to damaged people.

It is not known why young women are more likely to be affected by these disorders, but theirs is typically a voiceless position in society, a strange and impossible position that women are supposed to occupy. Young women are told they are equal, but held back if they try to assert their equality. Also physical changes - cyclical hormones and tendencies to low blood pressure and fainting - can lead to dis-associative seizures. They can be expected to live traditional conservative lives while finding themselves sexualised by older men.

The book includes chapters on specific psychosomatic outbreaks in various countries.

Sweden: From 2005, some Yazidi refugee children, boys and girls, became anxious and depressed, withdrew into themselves, soon couldn't go to school, spoke less or not at all and eventually appeared to be in a coma, had to be fed by nasogastric tube and could not open their eyes. Between 2015 and 2016, 169 Yazidi refugee children in various towns were affected. Medical tests showed no disease so doctors diagnosed 'resignation syndrome', which exclusively affects children of asylum seeking families (who have usually suffered persecution in their homeland). The asylum process is slow, and might initially be refused. During this period children integrate in school and area, and since they speak and write Swedish, they often translate any letters sent to their parents. Medical assessment of age is fraught with error due to the effects of chronic deprivation, abuse and malnutrition that caused their flight. When granted residency, children usually 'woke up' though not overnight. Yazidi children arriving in other countries do not suffer from this  syndrome. Why? Until recently in Sweden, families with children with resignation syndrome were automatically granted automatic asylum, but with record numbers arriving in 2014, emerging hostility to immigrants led to this being dropped.

Texas USA: This state has a population of ethnic Miskito originally from Nicaragua. They have had outbreaks of 'grisi siknis', that were first reported in the 1970s but actually started earlier in Nicaragua. Symptoms include tremors, difficulty breathing, trance-like states and convulsions and begin with sufferers having a visual hallucination of being visited by a frightening stranger of the opposite sex who comes to lure the victim away. In Nicaragua, to escape they run into the jungle, the community find them and a local healer (shaman) will say ritual prayers. In Texas, typically the outbreaks occur in schools (mostly girls but sometimes boys) and when they attempt to run away they are restrained by family despite resisting strongly. In the Miskito community, young girls are subject to a lot of attention from (often older) men trying to pressure them into a relationship. Sometimes the interest is welcome and exciting for a girl but it conflicts with the moral standards of a conservative Christian church they follow. Being afflicted also means you are attractive. Grisi siknis is now part of Miskito culture.

Khazakhstan: The mining town of Krasnagorsk did well for many years with a population of c.6,500 in the 1960s, and was well resourced. When the mine shut in the 1990s, almost the whole of the town became unemployed overnight. As people left for jobs elsewhere, numbers dropped to c.300 in 2010 and just 30 in 2017. From 2010 people reported a wide range of symptoms, but generally older people tended to have long periods sleeping and children to be hyperactive. Cases often occurred in clusters following social gatherings at which happier times were recalled. People did not want to move, but sickness gave a reason why they had to go, and then environmental poison was suggested as a cause for the sickness. Fears about poisoning from the mine were not put to rest despite negative soil and water tests but the government resettlement offer of a move to Esil was not  popular. Unhappy that often smaller accommodation was offered, people felt there was official pressure to move. 

Asia: The Hmong are an ethnic minority in Vietnam. Originally from China, which they had fled at the end of the 19th century to escape persecution, they were then recruited by the US for the Vietnam war; when the US abandoned Vietnam, many Hmong fled to the US as refugees. Within a year there was a high incidence of men dying overnight with no known cause. As illiterate immigrants, used to mountain life and polygamous kinship structure, they found it difficult to live in confined spaces, or to use modern appliances. Their belief systems already included death caused by evil spirits, as do other non-western cultures; but even in the west it is common for people to know of someone who has died within hours or days of a beloved life partner.

Cuba: In 2017 at a time when relations between Cuba and the US were still starting to settle, a group of recently deployed US State Department employees developed serious but unexplained medical problems: headaches, earaches, hearing impairment, dizziness, tinnitis, unsteadyness, visual disturbances, memory problems, difficulty concentrating and fatigue. Despite intensive investigations, no cause was established. All brain scans were normal. Experts were clear that a sonic weapon that could such symptoms did not exist, medical experts were clear that sound did not cause brain damage, but media interest prolonged the investigations. At the  time, relations between the countries were still strained and there was concern over spying, though no physical evidence was ever found.

Columbia: In 2014 a group of schoolgirls had faintings and convulsions that were diagnosed as 'mass hysteria'. Such outbreaks are typically gone in a day but this was still ongoing five years later. Blood tests, brain scans and EEG tests were all negative, but parents felt that some results were held back. Initially media  publicity led to public labelling of the girls as 'crazy', but the community view now is that the HPV vaccine caused it, and referring to supposed incidents in Japan and Italy. This is despite the vaccination being a second dose, the first being given a month previously and having caused no symptoms.

Korea: There is an illness called hwa-byung, meaning fire illness. The condition is referred to as a culture-bound syndrome or folk illness. While the main symptom is a sense of heat or burning all over the body, it also has a cultural meaning. Associated with stress caused by infidelity, it is an acceptable way of asking for support.

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Reducing the Number of Premature Births

 At present there are few effective ways to prevent premature births. Such births increase the risk of death or disability in babies.

2022: The state of South Australia has now launched a screening programme that offers free blood tests to all pregnant women to identify and treat those who are low in omega-3. This is due to the findings of a recent research study led by Maria Makrides at the South Australian Health and Medical Research Institute, which investigated a possible link between low levels of the fatty acid omega-3 and premature birth. 

It is not clear why omega-3 fatty acids protect against preterm birth, but there is some evidence that it influences pre-labour changes to the cervix and contractions of the uterus.

• The results of a trial of supplementation of omega-3 show that it is effective in reducing the risk of birth happening before 34 weeks of gestation by 77 per cent for women who started the trial with low levels of omega-3. 
• However, the trial also showed that for those women who already had high levels of omega-3, the supplements actually increased the risk. 
• This suggests that supplementation should only be recommended to women with  low omega-3 levels. However, Makrides says that multivitamins that contain small amounts of omega-3 are fine for women who already have high levels. 

Source: 'Omega-3 supplements could cut the number of pre-term births' by Alice Klein in New Scientist, 5th March 2022.

Some facts about prematurity.

• In the UK, about eight in 100 babies will be born prematurely.
• Premature babies, especially those born very early, often have complicated medical problems. The earlier the birth, the higher the risk of complications.
• Most premature births occur in the late preterm (34 to 36 weeks of pregnancy).
• Moderately preterm (32 to 34 weeks of pregnancy)
• Very preterm (less than 32 weeks of pregnancy)
• Extremely preterm (at or before 25 weeks of pregnancy).

Depending on how early the birth is, the following mild and more severe complications may be present at birth.

• Small size with disproportionately large head and sharper looking, less rounded features due to lack of fat stores. Fine hair (lanugo) covering much of the body. 
• Low body temperature, especially immediately after birth (hence the need for incubators).
•  Difficulty breathing and lack of reflexes for sucking and swallowing, leading to feeding difficulties. 
• Other problems occur with breathing, heart complications, brain bleeds, low blood pressure, gut problems, anaemia and newborn jaundice, and gut problems.

In the longer term, after birth other complications may occur: cerebral palsy, impaired learning, vision problems, hearing problems, dental problems, behavioural and psychological problems, developmental delays and chronic health issues.

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Teenage Brains

 Blame my brain: the amazing teenage brain by Nicola Morgan. Walker Books, 2013.

The human brain contains about 100 billion nerve cells (neurons). Each neuron has a long tail-like part (axon) and many branches (dendrites). A neuron sends super-fast messages to other neurons by passing a tiny electrical current along its axon and across very tiny gaps (synapses) into the dendrites of other neurons. Every single thing you do - thought, action, sneeze, emotion - happens when the neurons send the right messages, very fast, through the complicated web of branches.

Every time you repeat an action, or thought, or recall the same memory, that same web is activated and the web of connections becomes stronger, and the better you are at that specific task. But if you don't use those connections again, they may die off and you forget a fact or a name, or how to do something. To relearn something, you need to rebuild the web of connections by practicing again. If someone has a brain injury (e.g. a stroke) they might need to relearn how to walk or speak.

At birth a human baby has almost all of its neurons but few dendrites and therefore few synapses connecting them - so can't do very much. But their brains develop fast with new dendrites and synapses, as they learn to recognise people, talk and walk. There are also critical periods in brain development. If you don't learn a foreign language before the age of about seven, you can still learn to speak it fluently but probably always speak with the wrong accent, having passed the age when the brain can pick up accents. But most skills can be picked up at any age.

One type of neuron is called a mirror neuron. These neurons fire up when we watch someone else do something. If we watch several times, it may be easier for us to do the same thing because we have watched someone else do it. And it might be these neurons that help us feel what other people are feeling (empathy).

It was thought that all important development takes place in the first three years of life, but now we know that: (1) We can grow more neurons after we are born. (2) The brain grows and develops even into later life. (3) While some neurons die, we sometimes grow new ones. Adolescence is a time of major change in the volume of grey matter in the brain, and some parts of the brain are affected more than others. Not all teenagers show this in their behaviour, but some do.

The part of the brain used for thinking, reasoning,  logic and decision making gets bigger mainly just before puberty (usually 11 to 12 years). But the pre-teen brain grows far too many connections and synapses, and during the teenage years these are cut back: dendrites that don't get used fall away and those that do get used get fewer and thicker.

Body clock: The adult human body clock is 'on' for for about 16 hours of the day when we are awake and it is difficult to sleep in this period. While babies need a lot of sleep, by the age of 9 or 10, we tend to have reached the adult pattern of eight hours of sleep. But research shows that teenagers need around nine hours, at the point they also stay up later - so they are not ready to wake at 7am. 

Sleep: If they are woken too early they risk losing REM (rapid eye movement) sleep which is particularly deep sleep, and seems to be important for memory and learning. Trying to catch up by sleeping more at weekends does not help the body clock and may even disrupt it further. And there is now evidence that the sleeping brain practises the things that you did when you were awake. And the brain is also changing physically by pruning some connections and strengthening others.

Risk taking: Surviving risks means the brain releases dopamine so activating the feelings of pleasure, otherwise we become lazy. But some people's brains are more geared to this than others and adolescents in general do take more risks. Also the pleasure reaction is often stronger than the rational (pre-frontal cortex) part of the brain that logically looks at the risks.  The need to impress friends is important for getting on in life, so teenagers often take different decisions when friends are present. And with puberty starting around 2 years earlier than 50 years ago, alcohol is more widely used, as are (increasingly stronger) drugs. 2013: Rates of sexually transmitted diseases have increased, almost a quarter of 15 year olds smoke regularly and a third have tried cannabis, and a fifth are classified as obese. And around 60% of teenage girls are on diets (often not healthy ones). But remember if a quarter of UK teens get drunk at least three time a month - three quarters don't. 

Female and male brains: [The following statements are averages and not everyone's brain behaves in the same way; the brains of some girls work more in a male way, and vice versa. and it's not about being homosexual or heterosexual.] Boys tend to be interested in technical details of (e.g. a mobile phone) and girls more in the appearance and how useful it is. Boys are more likely to be diagnosed with autism, lacking understanding of social skills and bonding mechanisms. However, this may be less so as if is now being recognised that girls can mask the symptoms of autism by copying behaviour to 'fit in'.

The male brain is typically 10% heavier than a female brain but female brains have a greater proportion of the information-processing grey matter. Women are less likely to have dyslexia, language difficulty, colour blindness, schizophrenia, ADHD, Tourette's and other brain disorders. In later life, men lose brain cells faster and are more likely to develop memory problems.

Sex Hormones: these are chemicals that affect many aspects of our lives. When a sperm fertilizes an egg, the resulting embryo always starts out female. During week 6 or 7 the sex hormones either turn  the embryo into a male (testosterone) or keeping it as female (oestrogen). Normal males will have a small amount of female hormones and females a small amount of male hormones. Hormone levels change during our lifetime and are especially active at puberty. They also change with the season and, for women, during the menstrual cycle.

Oestrogen: One effect of this hormone is to boost dopamine, which can make the world seem rosier, brighter but can also make it feel darker and sadder, and it can cause mood swings. But not all females have mood swings. And mood swings are not only causes by sex hormones. Boys have mood swings too.

Testosterone: Increased testosterone causes aggressive behaviour. Testosterone increases during and after intense sport, especially if you are on the winning side - and also if you are a spectator. Females with the condition 'congenital hyperplasia' have too much testosterone; they show more aggressive behaviour and better spatial skills - both of which are more common in males.

Learning: Different sexes may learn better with different teaching methods. For languages, some pupils (especially boys) may need the rules and grammar explained in a very structured way. In science subjects, some pupils (perhaps more often the girls) may need more rote learning, practical examples or a using comparisons or analogies.

Emotional behaviour: Girls start to use their pre-frontal cortex to control emotional behaviour sooner than boys, who may take longer to develop self-control.

Risk behaviour: Boys seem to take more risks and more dangerous ones - not wearing seat belts or helmets, driving while drunk, binge drink and drink heavily, use and deal drugs, smoke, fight and carry weapons, have sex before 13, overeat and so be overweight. Girls' risk taking is more often having sex when they hadn't intended to, fast or vomit to lose weight or avoid physical exercise.

Body changes: Girls start to look like women before boys start to look like men. This sometimes makes girls feel they are fat. Research using pictures shows that women think men like thinner women, while men didn't choose the same photos.

Developing early or late: Either is difficult for both sexes. Early development in girls creates an extra risk of early sex and alcohol addiction, depression, anxiety and eating disorders. For boys, while they may be more popular and given leadership roles, adults may expect them to be advanced in school work too which is unlikely as their frontal cortex is not mature.

Clumsiness: One the areas of the brain that grow the most in adolescence is the cerebellum, which is important in controlling large movements. However the brain may not have completely rewired itself as fast as the body growth. Stress can also cause clumsiness.

Social: Girls are likely to hit puberty just as they start secondary school, while boys have time to settle in before puberty starts. Both sexes may feel less comfortable with their other-sex parent and argue more with opposite sex siblings. It is thought that this is a biological way of preventing incest which can lead to deformities in offspring.

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Women and Science

Human society is diverse and we should celebrate and treasure the strength in this quality. When you don't have diversity in the creative process, you inevitably end up with a single, narrow, distorted perspective that hinders progress. 

While Aristotle answered the question 'What is the immediate source of the design that we see in living things?' correctly with 'It is the information that they inherit from their parents', there is much that he did not understand. For example, he thought that women were 'deficient' and a departure from the male, and believed that they had fewer teeth than men. But while attitudes to women have changed a great deal, in science as in other areas, women still struggle for the recognition they deserve. 

In the world of science, the achievements of women scientists are often not acknowledged, and are instead attributed to male colleagues. This has been named the 'Matilda effect' after the 19th century suffragist and abolitionist Matilda Joslyn Gage.

This is a problem with our culture, not with science. No major international exhibition of contemporary art has ever achieved gender parity, and it is telling how few women have been thought of as great artists throughout Western history.

Nettie Maria Stevens at Bryn Mawr College in Pennsylvania overturned the idea that the environment was important in determining the sex of a child, when she demonstrated that the X and Y chromosomes are responsible. Her colleague and mentor Edmund Wilson is more commonly cited as the discoverer. Though when she died of breast cancer in 1912, the journal Science referred to her worldwide reputation.

In late 1950's France, the credit for Marthe Gautier's work on the discovery of Down syndrome went instead to a male colleague, Jerome Lejeune.

Marie Sklodowska Curie, of Polish origin but who had to conduct her research in Paris, became the first women to win the 1903 Nobel Prize for Physics. In 1910 she lost the vote over her nomination as a member of the French Academie des Sciences. The following year she won the Nobel Prize for Chemistry, becoming the only person to win the award in two different sciences. The Academie only elected its first female full member in 1979, the mathematician Yvonne Choquet-Bruhat.

In the US, Esther Lederberg deserved more credit for her work in bacterial genetics, including the discovery of a virus that infects bacteria, but was given a shared Nobel prize in 1958 with her husband Joshua Lederberg. Esther was more adept at experimental work than Joshua. A major pioneer of bacterial genetics, Esther discovered the lamda phage, which is widely used to study gene regulation and genetic recombination. She also invented the replica plating technique, which is used to isolate and analyse bacterial mutants and track antibiotic resistance. This work was crucial to Joshua's research.

At the John Hopkins University, Baltimore, US, graduate student Candace Pert helped discover the opiate receptor (the cellular binding site for the body's own painkillers, endorphins, in the brain) and famously protested when only men went on the share the Nobel Prize for this work.

Who knows how different our world would be if pioneers such as Hilde Mangold and Rosalind Franklin had not died so tragically young? It is tempting to think that fertility science would have become more focused on making reproduction easier and more comfortable for women. But we all know that if Mangold and Franklin and other remarkable women like them had lived to an old age, it is doubtful if the dial would have turned much from male control to female empowerment.

Hilde Mangold (1898-1924) was a German embryologist best known for her 1923 dissertation which demonstrated embryonic induction, the capacity of cells to direct the developmental trajectory of other cells. This work was the foundation for her mentor, Hans Spemann's 1935 Nobel Prize for Medicine for the discovery of the embryonic organizer, and remains a fundamental concept and area of ongoing research in the field. Her dissertation is one of the very few doctoral theses in biology that have directly resulting in the awarding of a Nobel Prize. 

Rosalind Franklin (1920-1958) was an English chemist and X-ray crystallographer whose work was central to the understanding of DNA, RNA, viruses, coal and graphite. She is best known for her work on X-ray diffraction images of of DNA which led to the discovery of the DNA double helix - for which Francis Crick, James Watson and Maurice Wilkins shared the Nobel Prize in Phsiology or Medicine in 1962. Watson suggested she receive a Nobel Prize in Chemistry, but the Nobel Committee did not usually make posthumous awards, and are not currently permitted. (If a person is awarded a prize, but dies before receiving it, the prize is still presented.)

The fact is that the heroic narrative of the brilliant scientist who died tragically young has been told many times when it comes to men such as Alan Turing, Srinivasa Ramanujan and Blaise Pascal. But it is only in recent years that the many talented women who died before fulfilling their potential have started to rise out of the murk of history.

In 2020 the gap still remains. A 2018 study of more than 10 million research papers concluded that women were less often in authorship positions linked with seniority. Other studies show that grant reviewers award lower scores to proposals from women. And women often still feel it intimidating to speak in public, and are less likely to ask questions after a talk.

Source: The Dance of Life: symmetry, cells and how we become human. Magdalena Zernicka-Goertz & Roger Highfield. W.H. Allen, 2020.

Everybody Lies: What the Internet Can Tell Us About Who We Really Are

Everybody Lies: What the Internet Can Tell Us About Who We Really Are by Seth Stephens-Davidowitz
[Bloombsbury, 2017    978-1-4088-9471-2]

"This book is about a whole new way of studying the mind. Big data from internet searches and other online responses ... offer an unprecedented peek into people's psyches." Stephen Pinker.

The author is an internet data expert, tracking the digital trails people leave behind as they make their way across the web. He tries to understand what we really want, what we will really do, and who we really are. The book is a fascinating read, and I've just picked out some of his findings.

He accesses a variety of sources, including Google Trends, which tells users how frequently any word or phrase has been searched in different locations at different times. It allows you to compare the relative frequency of different searches, but does not report the absolute number of any search. It also will only provide data when lots of people make the same search. (2021: Google Trends requires a modern browser such as Chrome.) Other sources analysed were Wikipedia, Facebook profiles, Stormfront, PornHub and other Big Data sources. And it turns out that people lie to friends, lovers, doctors, surveys and themselves - but on Google they share embarrassing information.

Racial prejudice in the USA. Barack Obama won the 2008 US presidential race rather easily and the polls suggested that race was not a factor in how people voted. But Google Trends showed that on election night, searches and signups for Stormfront (a white nationalist site) were ten times higher than normal. And surprisingly, places with the highest search rates included upstate New York, western Pennsylvania, eastern Ohio, industrial Michigan and rural Illinois alongside West Virginia, southern Louisiana and Mississippi. This suggested that the true divide was not South versus North, but East versus West and that plenty of Democrats have racist attitudes.

The cause of racism is typically thought to be economic insecurity and vulnerability, but neither racist searches nor membership of Stormfront (a white nationalist site) rises when unemployment does.

Many people tell pollsters they intend to vote, but don't actually do so. Google searches for 'how to vote' or 'where to vote' more accurately reflected actual turnout. Seemingly neutral searches that include the names of both candidates can give a clue to voting intention, with the preferred candidate usually the first named. And the secret racism was a likely factor in Trump's election.

Surprisingly searches reflecting anxiety don't rise after terrorist attacks. Searches for jokes are lowest on Mondays, the day when most people report they are unhappy, they are lowest on cloudy or rainy days, and plummet after major tragedy.

While larger datasets can be useful in some situations, in others it is more important to have the right data. What symptoms best predict pancreatic cancer? Researchers found that searches for back pain and yellowing skin, or indigestion and abdominal pain were most likely to be made for those later diagnosed with the cancer.

There is a basic human fascination with the dramatic. In a survey people ranked death by tornado as more common than death from asthma, but asthma causes about seventy times more deaths than tornadoes. But tornado deaths get in the news,while asthma deaths don't.

What are the chances of becoming a basketball player? It is commonly held that most NBA players grow up in poverty, combining a range of data says not. In fact you are more likely to succeed if you live in a wealthy county of the US, with a comfortable family life and have a common given name - plus, of course, being tall. 

Buying wine? A big percentage of the quality of a wine is down to the weather during the growing season. Warm weather and early irrigation are needed for the best grapes. So if thinking of buying a 2016 bottle, you need to look at the weather that year where the grapes were grown.

Democrat politicians use terms such as estate tax, privatize social security, worker's rights and poor people while Republicans refer to death tax, reform social security, private property rights and government spending. Sometimes it is using different terms for the same concept. Republicans described the federal inheritance tax as a death tax, Democrats as an estate tax. if an area is generally liberal, the dominant newspaper will tend to be liberal and the market determines a newspaper's slant more often than its owner's views. And newspaper readership tilts a bit left on average.

And it turns out that people lie a lot, often the little white lie. A 1950 election survey in Denver found that far more people said they were registered to vote, voted last presidential election, voted last mayoral election, gave to a recent Community Chest charitable drive than actually happened taken from official counts. Giving the wrong information made people look good to others, even in a situation where they were not identified, while some people even lie to mess up surveys.

Surprisingly the internet news industry is dominated by a few massive sites. Therefore they tend to cover a wide range of subjects and views to appeal to the most people.

Data reveals that child abuse does not lessen in hard economic times, it just gets reported less. Women search more often for self-induced abortion in areas where it is hard to get a legal abortion.

On social media there is no incentive to tell the truth; on the contrary there is incentive to make yourself look good to friends, family members, colleagues and strangers. Family life seems perfect, and young adults are always at cool parties on Saturday nights.

In 2006 Facebook launched News Feed which gives users updates on activities of all their friends. While some saw this as stalker activity and tried to get it removed, Facebook saw that people were staying far longer on the platform. News Feed is still there.

Google searches show that you are not alone. The questions you don't raise in person as they sound too silly but they can alert us to people who are suffering. Analyzing these anonymous searches can assist agencies working in specific concerns. E.g. Child protection agencies could target resources to specific areas. And searching can lead us from problems to solutions. 'When we lecture angry people, search date implies that fury can grow. But subtly provoking people's curiosity, giving new information and giving new images of the group that is stoking their rage may turn their thoughts in different, more positive directions.'

What baseball team is doing well when a US boy is around 8 is likely to remain their lifetime team to support. For female baseball supporters, it is more likely to at age 22. Our political preferences are also linked to specific periods. Between the ages of 14 and 24, many Americans will form their views based on the popularity of the current president; the views will, on average, remain constant a lifetime.

There is a popular view that watching violent films encourages people to commit violent actions. It turns our that if watching such films at a cinema, where alcohol is not available, actually reduces crimes.

Doppelganger searches for someone who is as near as possible your exact match is used in some form by Amazon to suggest other books you might like, and Pandora to suggest songs you might want to listen too. But it can also help in medicine by finding others with similar symptoms; this can narrow down diagnoses, especially where the condition is rare.  

Many people play a lottery, but few win. But does winning make you happy? Not in the short term it seems, but longer term generally yes. But if someone wins and starts buying items such as an expensive car, neighbours are significantly more likely to go bankrupt attempting to buy likewise.

Money lenders want to assess the likelihood of borrowers repaying the loan. A research study showed that terms used by people researching lenders can indicate the most likely to repay (debt-free, after-tax, graduate, lower interest rate and minimum payment) or to default (God, promise, will pay, hospital, thank you). But this raise some ethical questions - is it acceptable? 

The ability to zoom in on gambling customers it potentially dangerous. Casinos know that every gambler has a 'pain point' when the level of losses frightens the player such that they stop for an extended period. So they try and make sure that the gambler gets close to the pain point but not quite there, for instance, by offering free meals. They use doppelganger methods to establish the likely pain points. 

Education research. Anonymized children's online behaviour can reveal how they are learning and developing. How is their spelling - does it indicate dyslexia? Do they have friends. Are they becoming more mature. Education software companies: with EDU STAR students log in to a computer and are randomly exposed to different lesson plans, then take a short test to see how well they learned the material. Schools can therefore learn what software works best. This can yield surprising results as students who were taught fractions via a game tested worse than those who learned in a more traditional way.

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