Smartphone Apps to Manage Schizophrenia and Bipolar Disorder

cogito

Smartphone apps are being developed to address mental health issues such as support, reminders, monitoring of mood changes and even stress levels. Tools under development from startups, academic institutions, and research clinics aim to help people manage everything from severe depression to bipolar disorder and schizophrenia. A recent article in Wired magazine points out that “through the discreet and continuous recording of social and physical behavior, these apps can detect changes in mental well-being, deliver micro-interventions when and where needed, and give patients a new awareness of their own illnesses. In the long run, they may even diminish the stigma attached to mental health disorders.”

A Boston-based company Cogito was conducting a clinical trial of an app at the time of the Boston Marathon bombing. Their smartphone application continuously and passively monitors psychological health and well-being using built-in mobile sensors and survey questions. “The bombing offers a unique pre-and post-disaster dataset for understanding the longitudinal trajectories and risk factors for PTSD following trauma. Initial analyses of the data show that survey participation dropped by ~50% during the two weeks immediately after the Boston bombing, perhaps an early indication of the PTSD symptom of withdrawal. Of those that did respond, participants reported an average of ~14% increase in severity of attitudes and behaviors linked with depression and PTSD in the two weeks following the bombing than they did in the two weeks prior.”

A number of apps are being researched to monitor the symptoms of bipolar disorder and schizophrenia. The University of Michigan is working with a company to monitor individuals with rapid-cycling bipolar disorder. Although the possibilities are interesting, many of these ‘medical apps’ are untested and unregulated. Last year the FDA released a document for guidance on medical apps, however it focused mostly on apps that diagnose or turn a smartphone into an EEG. There are no guidelines for mental health apps as yet.

Source:

Wired
November 20, 2014

 

 

Nearly Half of Consumers Desperately Need Their Smartphones

smartphonesA survey by Bank of America states that 47 percent of U.S. consumers admit they wouldn’t last a day without their smartphone. Additionally, of those surveyed who use their phone for mobile banking, 31 percent said they log on at least once a day, while 82 percent access their accounts at least once a week or more. These findings are part of the inaugural Bank of America Trends in Consumer Mobility Report, “a study that explores broad mobile trends and banking behaviors among adult consumers across the country who own a smartphone and have an existing banking relationship. The survey found that mobile connectivity is so critical, the smartphone falls below only the Internet and personal hygiene when ranked by importance to people’s daily lives. Ninety-one percent say their mobile phone is very important, just as important as their car (91 percent) and deodorant (91 percent); and significantly more important than television (76 percent) and coffee (60 percent). The report also found that the youngest millennials ages 18-24 are most likely to view their mobile phones as very important (96 percent) — more so than deodorant (90 percent) and even their toothbrush (93 percent).”

So who own smartphones? The Pew Research Internet Project states that “As of January 2014, 90% of American adults have a cell phone. 58% have a smartphone.”

Here is the breakdown of their study.

cell-owners-in-2014

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Sources: Bank of America Newsroom

Pew Research Internet project

Is it time to update physician’s social media guidelines?

s_cover_jcv082113According to an article in this month’s JAMA, organized medicine should change the medical profession guidelines on social media use that calls on doctors to separate their personal and professional online personas. The article suggests that “instead of focusing on professional and personal boundaries, physicians should zero in on the boundary between what is appropriate and what is not. When a physician asks, ‘Should I post this on social media?’ the answer does not depend on whether the content is professional or personal but instead depends on whether it is appropriate for a physician in a public space,” the authors said.

The separation of personal and professional personae was a recommendation first made by the American Medical Association in 2010. Other physician organizations followed suit with their own guidelines, each promoting the same personal-professional separation advice. In April, the American College of Physicians and the Federation of State Medical Boards released similar guidelines. According to the JAMA authors, “Separation of identities online is operationally impossible.” They argue that an online search for a social media page would connect both personal and professional pages. “Despite the increasing availability of paid services to monitor and control a person’s Web presence, no current technology exists to overcome fully this particular barrier.”

In addition, the argument highlights that “Professional identity constitutes and is constituted by personal identity, perhaps as one of the many ‘subidentities’ or roles individuals might have, such as a spouse, parent and so on. Separation therefore verges on nonsensical. The argument is also made that separation may be harmful and that depersonalized online interactions could lead patients to believe the doctor is hiding something. They also could lead to a physician’s inability to normalize a difficult situation or express empathy.

JAMA: Social Media and Physicians’ Online Identity Crisis

Study: Mobile Phones to Measure Happiness

smartphone1Researchers at Princeton University are developing ways to use mobile phones to evaluate the impact of the environment or location on a how a person feels.

Volunteers were recruited to provide information about their feelings and locations. The team created an application for the Android operating system that documented each person’s location and periodically sent the question, “How happy are you?”

Cell phones can efficiently capture information that is generally difficult to record and be “in the moment.” This is important because these notes are likely to be more accurate than feelings jotted down after the fact. Since our society is so mobile and ‘on-the-go,’ this study hopes to capture a range of emotions associated with a geolocation. Over a three-week period, researchers collected information from 270 volunteers in 13 countries who were asked to rate their happiness on a scale of 0 to 5. From the information collected, the researchers created and fine-tuned methods that could lead to a better understanding of how our environments influence emotional well-being. The study was published in the June issue of Demography.

According to the authors, “The mobile phone method could help overcome some of the limitations that come with surveys conducted at people’s homes. Census measurements tie people to specific areas — the census tracts in which they live — that are usually not the only areas that people actually frequent. People spend a significant amount of time outside their census tracks., If we want to get more precise findings of contextual measurements we need to use techniques like this.”

Though many of the volunteers lived in the United States, some were in Australia, Canada, China, France, Germany, Israel, Japan, Norway, South Korea, Spain, Sweden and the United Kingdom. The researchers noted that the team’s focus at this stage was not on generalizable conclusions about the link between environment and happiness, but rather on learning more about the mobile phone’s capabilities for data collection. “I’d be hesitant to try to extend our substantive findings beyond those people who volunteered.” said the lead author Palmer.

For more info and some preliminary results

Abstract

Princeton press release

HIPPA Issues When Recommending Apps to Patients

healthapp2A study by the Privacy Rights Clearinghouse, a nonprofit advocacy organization in San Francisco, evaluated 43 popular free and paid apps that were made for consumer use. Apps used by health professionals were not part of the study.

Researchers reviewed the mobile application privacy policies and  installed and used the apps to see what data were stored on the apps. They also looked at the communication between the apps and the Internet.

The study found that many of the apps sent unencrypted data to advertisers, probably without users’ knowledge. Seventy-two percent of the apps exposed personal information that could include dates of birth, personal location, ZIP codes, medical information, email addresses, first names, friends, interests and weights. Some apps sent information to as many as 10 third parties.

Paid apps, which ranged from less than $1.50 to more than $10, posed less risk to users’ privacy. That’s probably because they don’t rely only on advertisers to make money, according to the study. According to AMA News, “Physicians might think twice about advising patients to use some mobile health and fitness apps. A July report indicates that many of those apps compromise patients’ privacy. Just recommending apps may put doctors at risk for violations of the Health Insurance Portability and Accountability Act.”

Source: http://amamednews.com

Studies of Alcohol Use on Facebook

 

cyberpsych

A study published in Cyberpsychology, Behavior, and Social Networking evaluated 160 Facebook profiles to examine how drinking alcohol is portrayed in both text and images. A second component of the study sought to determine how friends react to these alcohol-related postings.

The analysis generated 2,575 pictures and 92 status updates referring to alcohol use, which represented about 6.50% of the pictures in the total sample and 2.90% of the text updates. These visual and textual references, as well as the peer reactions to these posts, mostly referred to alcohol use in a positive context (72.23% of the pictures and 72.83% of the messages).

The results of this study demonstrate that alcohol-related references are quite common, while negative reactions to these posts are seldom. The authors suggest that further research into the effects of these visual and textual messages is warranted.

jamapeds

A similar study last year in JAMA Pediatrics examined the associations between displayed alcohol use and intoxication/problem drinking (I/PD) references on Facebook and self-reported problem drinking using a clinical scale. The study included undergraduate college students (age range, 18-20 years) at 2 state universities with public Facebook profiles. The profiles were categorized into 1 of 3 categories: Nondisplayers, Alcohol Displayers, and I/PD Displayers.

Results showed that among 307 profiles identified, 224 participants completed an online survey that measured problem drinking using the Alcohol Use Disorders Identification Test (AUDIT) scale. (73% response rate). The average age was 18.8 years; 122 (54%) were female; 152 (68%) were white; and approximately 50% were from each university. Profile owners who displayed I/PD were more likely (odds ratio, 4.4; 95% CI, 2.0-9.4) to score in the problem drinking category of the AUDIT scale, had 64.0% (incidence rate ratio, 1.64; 95% CI, 1.27-11.0) higher AUDIT scores overall, and were more likely to report an alcohol-related injury in the past year (P = .002).

The authors concluded that Facebook displayed references to I/PD were positively associated with AUDIT scores suggesting problem drinking as well as alcohol-related injury. Results suggest that clinical criteria for problem drinking can be applied to Facebook alcohol references.

Sources

Cyberpsychology, Behavior, and Social Networking

JAMA Pediatrics

Camp for Technology Detox

JPCAMP3Welcome to Camp Grounded, an adults-only summer camp about two and half hours north of San Francisco. Approximately 300 people gathered there for three days of color wars, talent shows, flag-raisings and other regressive activities organized by Digital Detox, an Oakland-based group dedicated to helping technology-addicted people to “disconnect to reconnect.”

So many of us feel compelled to stop what we are doing and read and respond to text messages, tweets, check out a friend’s Facebook post, comment on a blog entry, etc. By removing these things that “supposedly ‘connect’ us in this wireless, oversharing, humble-bragging age, the founders of Digital Detox hoped to build real connections that run deeper than following one another on Twitter or “liking” someone’s photo on Instagram.”

Without the distractions of the Web, social media, television and breaking news, campers, ranging in age from 19 to 67, were invited to share with one another and learn about ourselves. For many, this was the first time in a decade or more that they have not had their smartphone as a 24/7 companion.

The rules of Camp Grounded were simple: no phones, computers, tablets or watches; work talk, discussion of people’s ages and use of real names were prohibited.

The goal of the Camp is “to connect people. There’s always going to be more media, more to do outside of where you are. The only moment that matters is right now.” Not having technology for a weekend and facing who you really are or are not, can offer powerful insights and reboot nature’s operating system.

Read more
Source: NY Times

 

Bio-tech Teaching With Access to Multimillion Dollar Lab Equipment

labsterImagine having access to the technology that we see on CSI or NCIS? Or being really able to sequence DNA or have a knowledgeable virtual assistant to show you how to use all their the cool new toys that can make you a Bio-Engineer?

Labster is a bio-tech education startup founded back in 2011. It has gone further than most by creating an entire virtualized laboratory for teaching bio-tech students without the need to purchase expensive lab equipment or conduct potentially hazardous experiments for real. Labster began selling licenses for its software to universities and schools, and also to corporations for training. Current customers include Stanford, Hong Kong and Copenhagen Universities. The software has been tested by more than 10,000 students over the past year.

Students and bio-curious folk could never get access to the hundred-thousand dollar “next-generation” sequencing (NGS) machines, Electron-Microscopes or even High-Performance Liquid Chromatography (HPLC) simulation, they now have 24/7 access to a virtual 3D laboratory full of all these awesome machines, with real-life mathematical simulations of anything from basic PH base/acidity simulations to DNA manipulations and enzyme simulations (all made in Unity3D for web and iPad).

It is basically a science video game but because access to the highly expensive lab instruments and equipment its software is simulating can be dangerous, the access to some aspects is necessarily limited. It’s offering free user accounts for people signing up in the first three months. After which it will be charging for use — with a fee for each new virtual cases (going the downloadable content route), selling via the iPad App Store.

Labster website

Video

Smart Pill: Ingestible Computing

As society struggles with wearable technology and privacy, along comes the “computer in a pill” that can monitor our internal systems. Inside the pills are sensors and transmitters. After ingestion, they make their way through the stomach and intestines and relay information.

One company, Proteus Digital Health, makes one of these swallowable health monitors which needs no battery, the body is the power source much like the science project of a potato what can power a light bulb – the Proteus pill has added magnesium and copper on each side of its sensor, which can generate electricity from stomach acids.

The smart pill sends information to a cellphone app through a patch worn on the body. The tiny computer can track medication-taking behaviors and monitor adherence to a prescribed regimen or it can detect a patient’s response to a medicine. It can also monitor movement and rest patterns.
Another company called HQ, Inc, makes the CorTemp Ingestible Core Body Temperature Sensor which has a built-in battery and wirelessly transmits real-time body temperature as it travels through a patient. It has been studied with firefighters, football players, soldiers and astronauts to evaluate the body’s response to extreme temperatures. The HQ and Proteus pills pass naturally through the body in approximately 24 hours.
The Proteus pill is FDA approved.
Sources:

Use of Virtual Community of Practice in Residency Training

A study in the Journal of Medical Internet Research evaluated the usefulness of implementing a virtual community of practice in a Family Practice residency training program in Australia. According to the authors, training for Australian general practice, or family medicine, can be isolating, with residents or trainees moving between rural and urban environments, and between hospital and community clinic facilities. Virtual communities of practice (VCoPs), groups of people sharing knowledge about their domain of practice online and face-to-face, may have a role in overcoming the isolation associated with general practice training.
A survey was developed assessing computer, Internet, and social media access and usage, confidence, perceived usefulness, and barriers, facilitators, and intentions to use a private online network for training purposes. The survey was sent by email link to all 139 residents and 224 supervisors in one of Australia’s 17 general practice training regions. Complete and usable responses were received from 131 participants.
Most respondents had access to broadband at home and at work. Residents were more likely to spend more than 2 hours on the Internet, and to use social media sites for non-work purposes On a 5-point Likert scale, confidence was high and was negatively associated with higher age, but not associated with training stage. Social media confidence was lower, with residents more confident than supervisors for almost all social media activities. Overall usefulness was scored positively, and was not significantly associated with age or training level.
The authors concluded that general practice registrars and supervisors are interested in using a private online network, or VCoP, for work and training purposes. Important considerations were concerns about privacy and usefulness that may be overcome by training and support to offset some other concerns, such as time barriers. Participants at an early stage in their training are more receptive to using an online network. More senior residents and supervisors may benefit from more training and promotion of the online network to improve their receptiveness.