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Narrowing Market Breadth Raises Risk Of S&P 500 Pullback
The S&P 500 Has Set Record Afte...
Investopedia
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The S&P 500 has set record after record in the past month, but pop the hood and things aren’t looking quite so good.
The advance-decline (A/D) line, a measure of market breadth, has been on its way down since the end of May, even as the S&P 500 has soared to new heights, according to a note from LPL Financial Friday.
The A/D line is calculated by subtracting the number of declining stocks in the S&P 500 from the number of advancing stocks and adding the difference to the prior day’s value. An increasing A/D line indicates strong breadth, while a declining A/D line represents narrowing breadth.
Together, a soaring S&P 500 and declining A/D line, as shown in the chart from LPL Financial below, can be cause for concern on Wall Street. It indicates gains by a handful of large stocks are masking softness among smaller stocks, potentially signaling weakening investor sentiment.
The divergence also increases the market’s concentration risk because the biggest stocks are increasing their weight in the S&P 500 while laggards are losing weight. A sharp decline in the shares of the index’s largest companies will have an outsized impact on the index as a whole when breadth is minimal.
That dynamic was on full display on Thursday when the S&P 500 fell from a record intraday high as Nvidia (NVDA) slumped 3.5%—its largest one-day decline since late May. That's not a particularly long time, but in that period Nvidia shares rose 22%, boosting its market capitalization from $2.7 trillion to more than $3.3 trillion and increasing its influence over the S&P 500.
To be sure, Nvidia isn't the only stock that's contributed to the divergence. The other members of the $3 trillion club, Microsoft (MSFT) and Apple (AAPL), also have surged to all-time highs in recent weeks. They have been joined by a cadre of smaller mega caps, including Broadcom (AVGO), Oracle (ORCL), and Adobe (ADBE), which have been buoyed by earnings reports that demonstrated strong demand for their artificial intelligence (AI) offerings.
Meanwhile, the rest of the market has languished. As of Thursday’s close, Information Technology (+10.7%) was the only sector to have outperformed the S&P 500 (+3.7%) so far this month. The only sectors within 1 percentage point of the broader index were Consumer Discretionary (+3.3%) and Communication Services (+2.7%), sectors dominated by AI giants Amazon (AMZN), Alphabet (GOOGL), and Meta Platforms (META).
The A/D line divergence noted earlier does not, LPL Financial’s Chief Technical Strategist Adam Turnquist points out, mean the bull market is over, “but it does point to elevated risk the broader market could be due for a potential pause or pullback.”
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Healthwatch
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When cancer patients are treated with radiation, it's possible that the therapy itself may cause new tumors to form in the body later. Radiation kills cancer cells by damaging their DNA, but if the treatments cause genetic damage to normal cells near the radiation target, there's a small risk that these secondary malignancies may arise over time.
Just over 10 years ago, Canadian researchers set out to assess the risk of secondary malignancy among men with prostate cancer who were treated with a type of radiation called brachytherapy. Unlike radiation delivered from sources outside the body, brachytherapy is accomplished by implanting dozens of radioactive pellets, or "seeds," directly into the tumor site. Those seeds, which are never removed, emit radiation at a dose that declines toward zero over the course of a year.
Brachytherapy has the advantage of convenience. Instead of traveling for repeat sessions of radiation, men need only one treatment, usually given in an outpatient setting. But brachytherapy is also falling out of favor, in part because newer types of external beam radiation deliver high-precision doses with fewer side effects.
Study methodology and results
The Canadian study compared rates of secondary malignancies in the pelvis among men treated either with brachytherapy or with surgery to remove the prostate. All the treatments took place in British Columbia between 1998 and 2000. The brachytherapy group included 2,418 men with an average age of 66, while the surgically-treated group contained 4,015 men whose average age was 62. Within that group, 2,643 men had been treated with surgery alone, and 1,372 men with surgery plus external beam radiation given later.
After median follow-ups of between 5.8 years (brachytherapy) and 6.4 years (surgery), the study team reported in 2014 that there was no difference in rates of secondary malignancies between the groups, or with cancer incidence in the general population.
But that's no longer the case: In April 2024, the researchers published updated findings. This time, rates of new cancers in the pelvis — including the bladder and rectum — were higher in the brachytherapy group. Specifically, 6.4% of brachytherapy-treated men had secondary malignancies at 15 years of follow-up, increasing to 9.8% after 20 years. By contrast, 3.2% and 4.2% of surgically-treated men developed secondary pelvic malignancies over the same durations. There was no difference in deaths from secondary malignancies between the groups.
The strength of the association with bladder cancer in particular is "similar to that seen with smoking," wrote the author of an accompanying editorial. Results from the study "should be considered when treating men with localized prostate cancer who have a long life expectancy," the authors concluded.
Commentary from experts
"I do believe that this study reveals a dark truth about radiation for prostate cancer that has been long suspected," says Dr. Anthony Zietman, a professor of radiation oncology at Harvard Medical School and Massachusetts General Hospital, and a member of the advisory and editorial board for the Harvard Medical School Guide to Prostate Diseases. "As the decades pass after radiation therapy of any kind — brachytherapy or external beam — the risk for radiation-induced malignancies rises.
"These malignancies are usually in adjacent organs like the bladder and rectum, or within the prostate itself. They may be very curable, and thus the survival rates are the same for radiation or surgically treated patients, but there is little doubt that, for these patients, they represent a 'sting in the tail' long after the radiation has been given and forgotten. This data certainly gives us pause when offering radiation to very young men with several decades of life expectancy ahead of them, and it also reminds us of the value of follow-up visits."
"The fact that second cancers arise in the area where radiation was given is not surprising, but the magnitude of the long-term increases is concerning," added Dr. Marc Garnick, the Gorman Brothers Professor of Medicine at Harvard Medical School and Beth Israel Deaconess Medical Center, and editor in chief of the Harvard Medical School Guide to Prostate Diseases. "There are other common and troublesome urinary side effects of brachytherapy — independent of second cancers — that patients should fully consider before selecting it as a treatment option. This is especially true given the availability of other convenient and similarly effective prostate cancer therapies."
Source: Harvard Health Publishing
Healthwatch
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Parents like to think that they know what is going on with their children — and that they would know if their teen was suicidal. However, research shows that this is not always the case.
Teens may consider suicide more often than parents realize
In a study published a few years ago in the journal Pediatrics, researchers interviewed more than 5,000 adolescents ages 11 to 17. In those interviews, they asked them if they had ever thought about killing themselves — or if they had ever thought a lot about death or dying. The teens' parents were asked if they believed that their teens had ever thought about killing themselves, or had thought a lot about death or dying.
There wasn't a whole lot of match-up. Half of the parents of the adolescents who thought of killing themselves were unaware — as were three-quarters of the parents of adolescents who thought often about death.
This disconnect looms larger as research shows mental health problems are on the rise in youth. According to the 2021 Youth Risk Behavioral Survey, 42% of high school students reported persistent feelings of sadness and hopelessness; 22% seriously considered suicide, and 10% attempted it.
The numbers were higher for girls and youth who identify as LGBTQ+:
Many factors contribute to this. Stress and isolation caused by the pandemic clearly played a role. While teens are back in school, re-entry has been difficult for many. Social media clearly plays a role, inviting unrealistic comparisons, reinforcing negative thoughts and ideas, and encouraging doomscrolling. It is also a source of bullying: in the report, 16% of high school students reported being bullied electronically, including 20% of girls and 27% of those who identify as LGBTQ+.
Why the disconnect between teens and parents?
It's not that surprising that parents don't always know that their teens are considering suicide. Teens may not always realize how bad they are feeling, and may not want to tell their parents when they do — both for fear of worrying them, and also because of uncertainty about how their parents might react.
Parents may miss signs of depression in their teens, or quite genuinely misinterpret them or attribute them to something innocent; after all, it's natural to want to believe that your child is fine, rather than thinking that they might be suicidal. And given how much drama can be intrinsic to the life of a teen, it's understandable that parents could misinterpret statements about death or dying as, well, just teen drama.
What can parents do?
Sometimes it is just drama — or short-term blues after a breakup or another one of life's inevitable disappointments. And in the study, half of the teens whose parents thought they were suicidal, and two-thirds of those whose parents believed their teens thought about death, said they were fine. But when it comes to suicide, it's always better to be safe than sorry. So ask the questions — and ask for help.
Source: Harvard Health Publishing
Healthwatch
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On the Gulf Coast of Florida where I live, the telltale sign of summer is not an influx of beachcombers, afternoon storms that arrive exactly at 2 p.m., or the first hurricane warning, but the appearance of hundreds of paddleboarders dotting the inlet waters.
From afar, paddleboarding looks almost spiritual — people standing on nearly invisible boards and gliding across the surface as if walking on water.
But this popular water sport offers a serious workout, just as kayaking and canoeing do. While floating along and casually dipping a paddle in the water may look effortless, much goes on beneath the surface, so to speak.
As warm weather beckons and paddle season arrives, it pays to get key muscles in shape before heading out on the water.
Tuning up muscles: Focus on core, back, arms, and shoulders
"Paddling a kayak, canoe, or paddleboard relies on muscles that we likely haven't used much during winter," says Kathleen Salas, a physical therapist with Spaulding Adaptive Sports Centers at Harvard-affiliated Spaulding Rehabilitation Network. "Even if you regularly weight train, the continuous and repetitive motions involved in paddling require endurance and control of specific muscles that need to be properly stretched and strengthened."
While paddling can be a whole-body effort (even your legs contribute), three areas do the most work and thus need the most conditioning: the core, back, and arms and shoulders.
Many exercises specifically target these muscles, but here are three that can work multiple paddling muscles in one move. Add them to your workouts to help you get ready for paddling season. If you haven't done these exercises before, try the first two without weights until you can do the movement smoothly and with good form.
Three great exercises to prep for paddling
Wood chop
Muscles worked: Deltoids, obliques, rectus abdominis, erector spinae
Reps: 8–12 on each side
Sets: 1–3
Rest: 30–90 seconds between sets
Starting position: Stand with your feet about shoulder-width apart and hold a dumbbell with both hands. Hinge forward at your hips and bend your knees to sit back into a slight squat. Rotate your torso to the right and extend your arms to hold the dumbbell on the outside of your right knee.
Movement: Straighten your legs to stand up as you rotate your torso to the left and raise the weight diagonally across your body and up to the left, above your shoulder, while keeping your arms extended. In a chopping motion, slowly bring the dumbbell down and across your body toward the outside of your right knee. This is one rep. Finish all reps, then repeat on the other side. This completes one set.
Tips and techniques:
Make it easier: Do the exercise without a dumbbell.
Make it harder: Use a heavier dumbbell.
Bent-over row
Muscles worked: Latissimus dorsi, deltoids, biceps
Reps: 8–12
Sets: 1–3
Rest: 30–90 seconds between sets
Starting position: Stand with a weight in your left hand and a bench or sturdy chair on your right side. Place your right hand and knee on the bench or chair seat. Let your left arm hang directly under your left shoulder, fully extended toward the floor. Your spine should be neutral, and your shoulders and hips squared.
Movement: Squeeze your shoulder blades together, then bend your elbow to slowly lift the weight toward your ribs. Return to the starting position. Finish all reps, then repeat with the opposite arm. This completes one set.
Tips and techniques:
Make it easier: Use a lighter weight.
Make it harder: Use a heavier weight.
Superman
Muscles worked: Deltoids, latissimus dorsi, erector spinae
Reps: 8–12
Sets: 1–3
Rest: 30–90 seconds between sets
Starting position: Lie face down on the floor with your arms extended, palms down, and legs extended.
Movement: Simultaneously lift your arms, head, chest, and legs off the floor as high as is comfortable. Hold. Return to the starting position.
Tips and techniques:
Make it easier: Lift your right arm and left leg while keeping the opposite arm and leg on the floor. Switch sides with each rep.
Make it harder: Hold in the "up" position for three to five seconds before lowering.
Source: Harvard Health Publishing
Healthwatch
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When the trademark throbbing from a migraine finally lifts, the relief is profound. But for many people regularly stricken with these potentially debilitating headaches, their distress isn't over just because the pain ends. Instead, a distinct phase of migraine called the postdrome leaves them feeling achy, weary, dazed, and confused — symptoms eerily similar to another affliction altogether.
Dubbed the "migraine hangover," this constellation of post-headache symptoms is remarkably common, following up to 80% of migraine attacks, according to research published in Neurology. Scientists are increasingly turning their focus to this previously underrecognized component of migraine, according to Dr. Paul Rizzoli, clinical director of the Graham Headache Center at Brigham and Women's Faulkner Hospital.
"Not knowing it's an accepted part of migraine, patients come up with some creative ways to tell us about their postdrome symptoms — they feel washed out, their head feels hollow, or they feel like they have a hangover but weren't even drinking," Dr. Rizzoli explains. "Until recent years, science hadn't paid attention to this facet of the syndrome, but it's a natural progression from focusing on the problem as a whole."
The four phases of migraine
The typical migraine can be a wretched experience, with stabbing head pain joined by nausea, brain fog, and extreme sensitivity to light and sound, among other symptoms. Nearly 16% of Americans are affected by migraines, which strike women at nearly twice the rate as men. Severe headaches are also one of the top reasons for emergency room visits.
Spanning hours to days, migraine headaches can include four clear phases, each with its own set of symptoms. The pre-pain prodrome and aura phases may include various visual changes, extremes of irritability, difficulty speaking, or numbness and tingling, while the headache itself can feel like a drill is working its way through the skull.
Lingering migraine symptoms: The hangover
After that ordeal, one to two days of postdrome symptoms may sound tame by comparison, Dr. Rizzoli says. But the lingering fogginess, exhaustion, and stiff neck can feel just as disabling as the headache that came before. Since migraine is believed to act as a sort of electrical storm activating neurons in the brain, it's possible that migraine hangover results from "some circuits being electrically or neurochemically exhausted," Dr. Rizzoli says. "It just takes time for the brain to return to normal function, or even replace some chemicals that have been depleted in the process."
But much is still unknown about migraine postdrome, he adds, and research has found no consistent association between factors such as the type of migraine medication taken and duration of any subsequent hangover.
Tips to ease a migraine hangover
Following these steps regularly may help you ward off lingering symptoms after a migraine:
For migraine hangover sufferers so distracted by their inability to return to normal activities even after migraine pain lifts, physicians sometimes prescribe medications typically meant for conditions such as memory loss, depression, or seizures. While they may differ from the usual drugs used to treat migraine, some of these medicines have been observed to help postdrome syndrome or act as a preventive for headache.
"Think of the headache you just had like you've run a marathon or done some other stressing activity," Dr. Rizzoli says. "Your body needs to recover, which is not the same as staying in bed with the lights off. Ease up, but stay functional."
Source: Harvard Health Publishing
Healthwatch
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In this increasingly digital world, it's not surprising that children are spending more and more of their time on some sort of device. And while there is certainly much to be learned, explored, and created using devices, there are skills that devices can't always teach — and that children need to learn.
Play bolsters executive function and mood regulation skills
Executive function, emotional regulation, and general physical skills are important for children to learn — and practice — as they grow. The best way for children to learn these skills is through play; that's why we say that play is the work of a child. As devices become more pervasive, and as many children become more scheduled with lessons and organized activities, making time for device-free play can become forgotten.
I think that also, parents and children are literally forgetting how to play. Parents used to bring toys to entertain their children while they waited to see me; now they just hand their child their phone. Devices are so ubiquitous and easy, it can take real effort to put them aside and find something else to do.
Play is essential to healthy development
Harvard's Center on the Developing Child has developed excellent handouts for parents (note: automatic download) on different age-based games and activities to help support their child's development. I particularly like those that involve the parent too — because that not only helps your child, it helps your relationship.
Great games to play with younger children: Ages 4 to 7
In the first three years of life, play is about literally building brain connections and basic skills. As kids grow, play builds on those skills and gives them opportunities to think, be creative, cooperate with one another, and use their bodies.
Here are some ideas for 4-to 7-year-olds (note: automatic download):
Great games to play with older children: Ages 8 to 12
The 8-to 12-year-olds (note: automatic download) are capable of more complicated activities, like:
Opportunities to play help teens, as well
As kids grow into teens (automatic download), they naturally seek more independence and time with their peers. Opportunities for play take different forms depending on personal interests. Sports, cooking, music, theater, and even (within moderation) video games can encourage creativity, life skills, and fun.
For more information about how parents can build and encourage important life skills in their children, visit the Harvard Center on the Developing Child website.
Follow me on Twitter @drClaire
Source: Harvard Health Publishing
