November 2019

How to Overcome the Fear of Making Friends as an Adult

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Making friends is straightforward, when you’re a kid. Why isn’t it as easy to make friends as an adult? As a kid if you wanted to make friends you could just ask another kid if they want to play. There were usually toys or a playground involved and before you knew it you were laughing and playing with your new friend.

Yes, that’s a bit of a simplification and it isn’t always that easy for all kids. Nonetheless, making friends as children and even teens seems a bit more natural than it does for adults. As adults we’re busy, we put up walls, or focus on family, and then one day we look around and realize we don’t have as many friends as we would like — maybe we don’t have any at all.

Creating Adult Friendships

Once you’ve realized that your friendship deficit and would like to change that, what’s next? Chat someone up at a bar? Go back to school? Swipe right? Although some of those may work, they probably aren’t the best options.

The truth is that, as we age, it’s not really the opportunities for friendships that change, it’s us. As children we are far less preoccupied with the busyness of life, and we typically are also less concerned about rejection. As adults we not only become busy, but we also become very aware and afraid of rejection. This is part of what makes seeing potential for new friendships so difficult. 

So what should you do if you want to increase the size of your friend circle? Well, there are a few simple things that can drastically help.

To begin with you need to change your thinking and stop worrying about being rejected. Most people are similar in that they would like to create additional friendships. Think about it — generally if you smile at someone they will smile back, if you say hello and ask about their day they will do the same. No, this doesn’t mean that you will start planning vacations together, but it does show that most people are receptive. Apply this same logic to those in your life that you may want to get to know better. Initiating conversations and showing interest in someone’s thoughts, opinions, and well-being will be met with in-kind behavior more often than not. And this can become the beginning of a friendship.

These opportunities present themselves throughout your day, even if you don’t realize it — work, coffee shop, gym, or your child’s school. It just takes some initiative and effort to begin the process. 

The second thing to remember is not to make it complicated. You don’t need to rehearse, plan, or over-think things — just allow yourself to relax and naturally begin a conversation. 

You’ll also need to understand that these things don’t happen overnight. One good conversation does not create a life-long friendship. It will take time to determine if you’re actually compatible and to develop the kind of connection that is sustainable.

Not all of these attempts will be successful, but that shouldn’t discourage you. It takes having certain traits, interests, and experiences in common to bring two people together and create a friendship. There are times when those things exist and times when they don’t. 

Why Friendships as Adults Are Important

Research shows that new friendships start to decline in our 20s. Studies have also shown that friendships are a big factor in mental and physical health, as well as longevity. In other words, loneliness  kills — even in a relationship. 

Friendships help keep us balanced and give us an outlet for expressing our feelings. They also provide substance and meaning to our lives. Caring about others and feeling cared about plays a big part of feeling important, like you matter, and that you have purpose. 

One of the biggest problems we have as adults, however, is knowing what a friend really is. Many people will say they have plenty of friends. They have work friends, friends at the gym, or friends that they grab a drink with, but are these really meaningful friendships? They may be, or have the potential to be, but without effort they also may just be acquaintances rather than friendships. 

Social contact is important, even if it is just superficial conversation. But those conversations are not a substitute for a meaningful friendship. No matter your age 25, 45, or 85, you are not too old to make a new friend. So next time you have the opportunity, take the risk and begin the process of making a new friend.

Structure-function Relationship in Advanced Glaucoma After Reaching the RNFL Floor

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imagePrécis: Although the circumpapillary retinal nerve fiber layer (cpRNFL) reached the measurement floor, the nasal macular region is important for assessing central visual function in advanced glaucoma. Purpose: To investigate the relationship between the central visual field (VF) and macular parameters obtained from spectral-domain optical coherence tomography (SD-OCT) in patients with advanced glaucoma that reached the cpRNFL thickness measurement floor and to determine whether the structural changes measured by SD-OCT are useful for estimating the functional status in these patients. Methods: A total of 68 eyes from 68 patients with advanced glaucoma were included. Only eyes having an average cpRNFL thickness of ≤57 μm that reached the measurement floor were included. Macular imaging using Cirrus SD-OCT and 10-2 Humphrey VF was performed. The VF mean deviation was converted to a linear scale using unlogged 1/Lambert values. The relationships between the central VF and various macular parameters were determined. Results: Patients had a mean VF mean deviation of −20.69 dB and an average cpRNFL thickness of 51.76±3.61 μm. Correlations between the VF and all cpRNFL thickness parameters were not significant. However, significant correlations were found between the central VF and superonasal macular ganglion cell-inner plexiform layer thickness (r=0.334; P=0.003), inner nasal macular thickness (r=0.301; P=0.013), and outer nasal macular thickness (r=0.331; P=0.007). Conclusions: Even after the cpRNFL had reached the measurement floor, several macular parameters showed a statistically significant relationship with functional status in VF. In particular, the assessment of structural changes in the nasal macular region may be important in determining the central VF in advanced glaucoma.

258 Can clinical experts settle on a diagnosis of TIA?

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Transient ischaemic attacks (TIAs) are sudden onset focal neurological deficits of vascular pathogenesis that resolve within 24 hours. TIAs remain a diagnostic challenge due to its clinical heterogeneity and lack of biomarkers. Previous studies on the diagnostic accuracy of TIAs by non-specialists have used TIA experts (neurologists or stroke physicians) as the gold standard. However, the inter-rater variability in TIA diagnoses among these experts is not firmly established. Here we conduct a meta-analysis of the inter-rater variability of TIA diagnosis between experts.


We performed a systematic review of studies from 1988 to present day using MEDLINE, EMBASE, and PubMed. Two reviewers independently screened for eligible studies and extracted inter-rater variability measurements using Cohen’s Kappa scores between expert clinicians.


14 original studies reporting on variability in TIA diagnosis for 15,907 patients were found. Meta-analysis revealed an overall agreement between experts of =0.73 (95%CI 0.63–0.84)


Overall agreement between experts is good for TIA diagnosis, but variation still exists for a sizable proportion of cases. Further research into reliability of the accepted gold standard as well as alternative clinical, imaging or blood biomarkers are required given the important clinical implications for making a TIA diagnosis.

One in four children ' have problematic smartphone usage '

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Research suggests behaviour could be linked to poorer mental health but further studies needed

One in four children and young people could have problematic smartphone use, according to research that also suggests such behaviour is associated with poorer mental health.

The amount of time children and teens spend using their devices has become an issue of growing concern, but experts say there is still little evidence as to whether spending time on screens is harmful in itself.

Related: The majority of 11-year-olds own smartphones. And experts are worried | Nancy Jo Sales

Related: 'Do you wind it up?': today’s teens tackle rotary phones, FM radio and map reading

Related: We’re told that too much screen time hurts our kids. Where’s the evidence? | Andrew Przybylski and Amy Orben

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