by Iltifat Husain

via iMedicalApps

Source Article

There are plenty of apps in the Apple Store and the Android Marketplace that try to help patients quit smoking. Some of them even have integration with social media networks such as Facebook and Twitter. However, these same genre of apps are helping researchers study addition in a new way.

SmartPlanet has a great interview with Dr. David Wetter, who is leading a team of researchers using real-time smart phone data from those trying to quit smoking in order to better understand addiction.

These M.D. Anderson Cancer Center researchers are finding some interesting trends in the data they are collecting.

"We use smart phones to collect data during critical events that happen when people try to quit. For example, when they have a craving to smoke or when they actually smoke a cigarette, we’ll collect data. [We'll find out]: Who else is in the environment with them? What else is going on? Are cigarettes available? Are they drinking? Are they eating? Are they at work, at home, in the car?"

"The smart phone will also beep at random times throughout the day and evening to collect the same kinds of information. We can compare that information across different situations. For example, when someone is craving we may find that they’re in situation characterized by negative emotions, like anxiety and stress, much more so than when you beep them at random times."

From the data collected so far, Dr. Wetter’s group has found that volatility of emotions and intensity of cravings is predictive of relapse. People who have a roller coaster of emotions – volatility – are at a much higher risk of relapse. He credits these findings to the ability of collecting real time data via smart phones.

Source Article

by JEFFRY MCDOWELL on AUGUST 15, 2010

via GadgetsDNA.com

Source Article

Teachers and doctors are using iPads as a tool to reach out to children with Autism or Asperger Syndrome and the results are remarkably great. Autistic children are showing tremendous improvement after playing fun-filled exercises on iPad which is less stressful and more fun for both the teachers and the students. Below is the list of 10 best iPad applications to give Autism a voice.

Those who don’t know, Autism is a lifelong disability that affects the way a person communicates and relates to other people and the world around them. Those affected typically display major impairments in three areas: social interaction, communication and behavior (restricted interests and repetitive behaviors). 1 in 160 children have autism in some form, making it twice as common as cystic fibrosis, cerebral palsy, childhood deafness or blindness and ten times more common than childhood leukemia.

View list of apps at source article on GadgetsDNA.com

via Journal of Medical Internet Research

Source Article

ABSTRACT

(J Med Internet Res 2010;12(2):e23)
doi:10.2196/jmir.1286

KEYWORDS

Patient empowerment; Internet; eHealth

via Government HealthIT

By Mary Mosquera

Source Article


The Veterans Affairs Department is exploring a number of applications of wireless technologies to improve the health outcomes of veterans, especially those in rural areas that may be hundreds of miles from the closest VA clinic or hospital.

Wireless technologies can link veterans with their providers through personal cell phones and enable them to manage their health, said Gail Graham, deputy chief officer in health information management in the Veterans Health Administration.

For many veterans, “geographical distance from VA’s physical healthcare assets often presents a challenge to receiving care,” she said at a hearing of the House Veterans Affairs Committee health subcommittee June 24.

Among its projects, VA is building a prototype of a mobile version of MyHealtheVet, VA’s online personal health record, to deploy on mobile phones and test for usability and functionality. Through MyHealtheVet, veterans can receive patient education, wellness reminders and refill prescriptions.

VA sought the suggestions of veterans in five rural communities about the features they desired in a mobile version of MyHealtheVet, Graham said.

It’s already installed very small aperture terminals (VSATs) on its 50 mobile vet centers to provide satellite communications. The agency uses the centers to provide readjustment counseling services.  

VA’s wireless efforts are also part of changes it is making in the way it delivers care, by designing its systems around the needs of patients and to improve care coordination and online access through secure messaging, social networking tools and telehealth, Graham said.

VA will use these capabilities, among other things, to support a home-care model to help veterans manage their chronic diseases, and for a preventative care program for telephone-based health counseling to reduce risky behaviors, such as smoking and physical inactivity.

VA has demonstrated that it can realize cost savings and improve care with its deployment of promising technologies, said Dr. Joseph Smith, chief medical and science office at West Wireless Health Institute.

For example, through the use of its care coordination and home telehealth program VA reported a 25 percent reduction in bed days of care, and a 19 percent reduction in hospital admissions by linking chronically ill veterans with healthcare providers and care managers through videoconferencing, messaging and biometric devices and other tele-monitoring equipment, he said.

Through the program, which involved 43,000 veterans, one nurse could “touch” 150 patients remotely on a daily basis.

VA’s program “offers substantive proof that wireless health technology can dramatically increase the efficiency of already overstretched health professionals to help patients no matter where they are or when they need care,” Smith said.

The U.S. Army also is also using mobile phone technology for patients with mild traumatic brain injury, said Col. Ronald Poropatich, deputy director of the telemedicine and advanced technology research center, U.S. Army Medical Research and Materiel Command.

These patients, who are receiving outpatient care in their home communities, receive health tips, appointment reminders and general announcements from a secure central Web site where healthcare providers can enter and control message content and review delivery confirmations, he said.

The mobile messages provide additional communications between face-to-face office visits. Currently, the service is available to soldiers in five selected sites in Alabama, Florida, Illinois, Massachusetts and Virginia.

Similarly, VA will also test the use of videoconferencing with a mobile device for a small number of recently diagnosed patients with post traumatic stress disorder (PTSD) in San Diego, according to Smith, whose health institute is working with VA on the project.

via Virtual Worlds News

Source Article

via TheUnion.com
By Kyle Magin

Source Article

f North San Juan residents can't make it to Davis for medical care, technology can bring Davis to them.

The Sierra Family Medical Clinic is partnering with the University of California, Davis, to bring advanced care to its 120-plus diabetes patients through its telemedicine program.

“For some of our patients, it's hard to pay for enough gas in their car just to get here. Davis is a two-hour drive,” said Wendy Barnhart, the director of operations for the clinic. “Anything we can do to alleviate that is a big help to them.”

Starting later this month, Davis specialists will offer classes for diabetes patients through live videoconferencing at the clinic in North San Juan. Classes will focus on caring for diabetes patients, who often have highly specialized dietary and medical needs, Barnhart said.

Davis officials selected the clinic for the trial program, which they plan to expand to 18 other rural medical centers.

The program is a continuation of the clinic's telemedicine program, which has advanced over the past eight years, said clinic spokeswoman Krishna Dewey.

“It started when (executive director) Peter Van Houten realized this is the best way to assure patients can receive high-quality medical services from referrals right here on site,” Dewey said.

Primarily, the clinic uses telemedicine — videoconferencing for local patients and far-away doctors — for its behavioral health and psychiatric services, Dewey said. Patients are referred by their primary care doctor at the clinic to psychiatrists elsewhere and can meet with them by video in North San Juan.

“The psychiatrists actually prefer the visits because they can observe the innuendo from the patient's face more carefully,” Dewey said.

The primary care physician in North San Juan then can follow up immediately with the psychiatrist to receive any recommendations on treatments, such as prescription medication.

“Our doctors can follow up on the visit right away,” Dewey said.

To contact Staff Writer Kyle Main, e-mail kmagin@theunion.com or call (530) 477-4239.

by MICHELLE TRUDEAU

via NPR

Original Article

As the computing power of cell phones increases, more and more sophisticated mobile apps are being developed for the mental health field. They're seen as a way to bridge periodic therapy sessions — a sort of 24-7 mobile therapist that can help with everything from quitting smoking to treating anxiety to detecting relapses in psychotic disorders.

These mobile technologies let users track their moods and experiences, providing a supplemental tool for psychiatrists and psychologists.

"It gives me an additional source of rich information of what the patient's life is like between sessions," says University of Pennsylvania researcher Dimitri Perivoliotis, who treats patients with schizophrenia. "It's almost like an electronic therapist, in a way, or a therapist in your pocket."

Here's how one of the apps, called "Mobile Therapy," works: Throughout the day at random times, a "mood map" pops up on a user's cell phone screen. "People drag a little red dot around that screen with their finger to indicate their current mood," says Dr. Margaret Morris, a clinical psychologist working at Intel Corp. and the app's designer. Users also can chart their energy levels, sleep patterns, activities, foods eaten and more, she says.

Gaining New Insights And Reducing Stress

Morris designed the app, which can be downloaded onto most cell phones, to try to help people manage the stress of everyday life, to improve their mental health and reduce the risk of cardiovascular disease.

Based on the information entered by the user, the app offers "therapeutic exercises" ranging from "breathing visualizations to progressive muscle relaxation" to useful ways to disengage from a stressful situation, Morris says. And the information the app captures can later be charted, printed out and reviewed. The idea is that users can look at a whole week of mood data to see if there are any connections between their mood and other factors happening in their lives, and record it into the app.

Morris' Mobile Therapy app has been beta-tested in 60 people, and "everyone who used it described new insights about their emotional variability" and said it helped reduce their stress, she says.

Her research was recently published in the Journal of Medical Internet Research, where she writes that by using the app, participants were able to increase "self-awareness in moments of stress, develop insights about their emotional patterns and practice new strategies for modulating stress reactions."

Helping Teens With Behavioral 'Homework'

Another mobile app being developed targets a large group of cell phone users: teenagers.

Alan Delahunty, a psychotherapist from Galway, Ireland, treats teens suffering from clinical depression using cognitive behavioral therapy, or CBT. An essential component of CBT is "homework," which involves patients keeping a daily diary, charting their moods, energy levels, sleep, activities, etc.

Typically, patients will bring their paper charts into their therapist to discuss them during their weekly therapy session. But many patients — especially teens — balk at doing the CBT homework, and many stop doing it.

Previous research suggests that patients who do their CBT homework assignments and practice them between sessions are the ones who benefit the most and benefit the most quickly.

Knowing this, researchers Gavin Doherty and Mark Matthews at Trinity College in Dublin developed a cell phone app that's being tested by a couple of dozen therapists throughout Ireland.

Delahunty, one of the testers of the "mobile mood diary," says it's a very useful tool.

"From a clinical point of view, I've found it a huge improvement over the pen-and-paper technique," Delahunty says. He adds that his young patients love the app and rarely miss doing their daily homework. They're pleasantly surprised that they can use their cell phones to help themselves in therapy. And when they come into therapy, he says, "You get a complete printout of their mood, their energy level, their sleep patterns, and any comments they've made over the week or two. And then you can put that down on the table in front of you, and use it to discuss the therapy with the young person."

Because teens are so comfortable with texting, Delahunty adds, "I'm getting more comments. And in some cases, it's really like narrative therapy, where you'd be getting a paragraph of text for each day, which brings out a richness in the therapy situation that you can explore then."

Psychiatrists, too, find the mobile mood diary a benefit by looking at the graphs, monitoring the young person's moods. "That was helpful to them, in deciding whether the young person should be on medication or change their dosage or whatever because it [the mobile mood diary] was a very accurate measurement of how the young person's mood was moving," Delahunty says.

Apps For Severe Depression, Schizophrenia

Another mental health app under development, called CBT MobilWork, is tailored to adults with severe depression.

It's a collaboration between Judy Callan, a researcher at the University of Pittsburgh, and computer scientists at Carnegie Mellon University that Callan hopes to adapt for use in mental health programs for anxiety, phobias, eating disorders and more.

Callan describes how a typical patient might use this app, which tailors CBT homework to each user: "Say a patient just starts therapy and they're really depressed and they can hardly get out of bed. One of their homework assignments might be to, each day, just make your bed," Callan says.

Once the patient has successfully accomplished that task, the homework on the phone app will change, prompting and coaching the patient to take the next step.

There's also an app for one of the most intractable mental disorders: schizophrenia, which affects 1 percent of the U.S. population. It's for these patients that the University of Pennsylvania's Perivoliotis is developing innovative mobile technologies: palm-sized computers that chart a patient's moods and activities, for example; and a digital watch that has personalized scrolling messages. The messages on the watch can instruct a patient who hears voices, for example, to do exercises like deep breathing or muscle relaxation "to reduce the stress triggered by their voices," he says.

"One of our patients came in with chronic, constant auditory hallucinations that really controlled his life," Perivoliotis recalls. "The voices would threaten him that if he would go outside and do fun things, then terrible, catastrophic things would happen to him. He felt really enslaved by them. He felt no sense of control whatsoever."

So the therapist taught the patient a few simple behavioral exercises to reduce the severity of the voices. It's an exercise called the "look, point and name technique," Perivoliotis explains. "When a patient starts to hear voices, he applies the technique by looking at an object in the room, pointing to it and naming it aloud. He repeats this until he runs out of things to name."

Perivoliotis says "the technique usually results in reduced voice severity [i.e., the voices seem quieter or pause altogether], probably because the patient's attention is redirected away from them and because speaking competes with a brain mechanism involved in auditory hallucinations."

So the mobile therapy watch that this patient wore was programmed to remind him a few times a day to practice this technique to control the voices.

"It really did the trick," Perivoliotis says. The voices were dramatically reduced. "It kind of broke him out of the stream of voices and his internal preoccupation with them."

Exercises like these not only give the patient temporary relief from distressing symptoms but also, importantly, "they help to correct patients' inaccurate and dysfunctional beliefs about their symptoms — from, 'I have no control over the voices,' to, 'I do have some control over them,' " Perivoliotis says.

via better health

by Berci

Original Article

Internet addiction is becoming a major problem, and it’s less and less surprising when reports focusing on this issue are being published. Lately, the New York Times came up with the analysis of a recent study:

Researchers at the University of Maryland who asked 200 students to give up all media for one full day found that after 24 hours many showed signs of withdrawal, craving and anxiety along with an inability to function well without their media and social links.

Susan Moeller, the study’s project director and a journalism professor at the university, said many students wrote about how they hated losing their media connections, which some equated to going without friends and family.

I did some research and browsed the website of Microsoft’s Internet Addiction Recovery Program. 

Here you can find the symptoms, and if you think you should give it a try, keep in mind that: 1) the waiting list is long, and 2) it costs a lot to attend the 28-, 45- or 90-day program ($14 500!):

The mission of this innovative program is to help adults, addicted to video games and the internet, detach from their high-tech distractions, find balance, and reconnect to the real world. It is structured to include individual and group therapy, life-skills coaching, cooperative living, physical and nutritional education, mindfulness training, work and home-maintenance skill-building, 12-step meetings, and weekly, off-site, high-adventure expeditions. The facility is located on a beautiful, 5-acre parcel of land in western Washington.

*This blog post was originally published at ScienceRoll*

via Ahier.net

Original Article

People with diabetes have an increased risk of blindness, yet nearly half of the approximately 23 million Americans with diabetes do not get an annual eye exam to detect possible problems.

But it appears that cost-effective computerized systems to detect early eye problems related to diabetes can help meet the screening need, University of Iowa analysis shows.

The UI team compared the ability of two sets of computer programs to detect possible eye problems in 16,670 people with diabetes. Each of the two programs (known as EyeCheck and Challenge 2009) are based on technology developed at the UI and the programs performed equally well, achieving the maximum accuracy theoretically expected. The study was published online April 16 by the journal Ophthalmology.

The systems require a trained technician to use a digital camera to take pictures of the retina, located inside the eye. The images are then transferred electronically to computers, which can automatically detect the small hemorrhages (internal bleeding) and signs of fluid that are hallmarks of diabetes damage.

"It is an important question: whether a computer can substitute for a human to detect the initial signs of diabetic eye disease," said Michael Abràmoff, M.D., Ph.D., associate professor of ophthalmology and visual sciences at the UI Roy J. and Lucille A. Carver College of Medicine and an ophthalmologist with UI Hospitals and Clinics.

"Our analysis shows that the computerized programs appear to be as accurate and thorough as a highly trained expert in determining if these initial signs of an eye problem are developing in someone with diabetes. Once the initial problems are found, an eye specialist can treat the patient," added Abràmoff, who also is an associate professor of electrical and computer engineering in the UI College of Engineering.

To explain the system's efficiency, Abràmoff said that among a group of 100 patients with diabetes, 10 people would likely have diabetes-related eye problems. An ophthalmologist (eye doctor) would have to check the eyes of all 100 patients to find out who had problems. The computer programs, when given photos of the eyes of the same 100 patients, flag, on average, 20 people as possibly having diabetes-related eye problems. Thus, an ophthalmologist would need to see only the 20 people prescreened by the computer program instead of the original 100.

"The computerized programs are accurate and allow ophthalmologists to spend time on patients who actually need care and provide better care to those patients. Also, through this technology, people with diabetes can have an opportunity for screening that they might not otherwise have," Abràmoff said.

Abràmoff noted the study had some limitations. For one, the images were prescreened to ensure the computers could analyze them. However, his research group has already developed the tools to automatically ensure adequate image quality before proceeding.

In addition, the number of people in the study who actually had diabetes-related eye problems was lower than what might be seen in other populations, such as people whose diabetes is not under control. Thus, Abràmoff said, it will be important to test the systems in other, larger groups. Lastly, the computer-based assessments were compared to assessments done by only one human reader at a time, which may not reflect a comparison to assessments by multiple readers.

"A computer alone will never be a substitute for the care of a good doctor, but it's exciting to think that computers can be partners in finding the patients at risk of blindness who should see an ophthalmologist," said study author Vinit Mahajan, M.D., Ph.D., assistant professor of ophthalmology and visual sciences.

"In the United States alone, between 40 and 50 percent of people with diabetes are not getting the eye screening exams they need. We think these detection programs can meet this critical need very cost-effectively," Mahajan added.

The study was supported by grants from the National Eye Institute, Research to Prevent Blindness and the Netherlands Organization for Health-Related Research.

Abràmoff holds a patent, as well as patent applications, on the technology used in the study, and is one of the owners of the EyeCheck project. Study authors Meindert Niemeijer, Ph.D., UI research scientist, and Gwénolé Quellec, Ph.D., UI adjunct research scientist, hold patent applications on this technology, as well.

STORY SOURCE: University of Iowa Health Care Media Relations, 200 Hawkins Drive, W319 GH, Iowa City, Iowa 52242-1009

MEDIA CONTACT: Becky Soglin, 319-356-7127, becky-soglin@uiowa.edu

By RICHARD L. REECE, MD

via The Health Care Blog

Original Article

"- The real problem is not whether machines think, but whether men do."  -- B. F. Skinner

"If you are designing a machine, you had better think of everything, because a machine cannot think for itself."

 --  Edgeware: Insights from Complexity Science for Health Care Leaders, 1998

Obsession with medical technologies and machines characterizes American’s cultural expectations. We tend to think of our bodies as perpetual motion machines, to be preserved in perpetuity. If the face of our machines sag, we lift its faces up. If our pipes clog, we roto rooter them out or stent them. If impurities gum up our machinery, we filter them out. If our joints give out or lock up, we replace them. If we want to remove something in the machine’s interior, we take it out through a laparoscope. If the fuel or metabolic mix is wrong, we alter the mix or correct the metabolic defect with drugs If anything else goes wrong, we diagnose it and rearrange it electronically.

We are reluctant to let nature take its course. We rely on half-way technologies and machines to do the job of keeping us looking young, active, functioning , and alive. This fixation on machines and technologies is the big reason American health care is 50% more costly than that of other nations. With rapid access to machines and our reliance on them, we deliver a different product than other countries – more technologies and more machines, faster and more often. Our belief system is : Give a specialist a machine, and he or she will do the job, and we or the government will pay for it.

We love machines - heart lung bypass machines, dialysis machines, heart rhythm machines, imaging machines, Internet-run machines, ventilation support machines to keep us alive at the end of life. . Patients and lawyers expect us to use these machines, doctors constantly innovate to produce more machines, and we tend to use them – no matter what the cost.

Go to a cardiology convention, and you will witness display after display of heart rhythm pacemakers. Go to an orthopedic convention, and you will think you are in an industrial exhibit, with new devices as far as the eye can see and the mind can comprehend. Go to an orthopedic operating room, and you will hear the sounds of hammers and chisels and rods being inserted. Go to a hospital convention, and much of the chatter will be about new technologies and machines that attract more patients and more specialists, reverse the ravages of disease, and to enrich the bottom line.

The latest and most talked about machine in hospital marketing and in the hands of surgical specialists such as urologists, heart surgeons, and gynecologists is the da Vinci surgical robot, a $1.4 million machine named after Leonardo da Vinci. It is designed to be less invasive, to cut blood loss, to minimize complications, to increase hospital market share and revenues, and to attract both patients and specialists to hospitals.

The price is high, $1 million to $2.25 million per machine depending on the model, $140,000 a year for maintenance, and $1500 to $2000 per procedure for replacement parts. The manufacturer of da Vinci, Intuitive Surgical, Inc, must be doing something right. Last year it had a profit of $233 million on sales of $1.05 billion. It is deployed in 853 hospitals, large and small.

But, as with all medical machines, da Vinci is not infallible . It relies on the expertise and experience of its physician users (See Wall Street Journal, May 5, “Surgical Robot Examined in Injuries.”) The human body is not a machine, and not all of its problems and eccentricities , given the individualities and variabilities of the human condition, lend themselves to automatic or flawless operation and correction. Complications happen. Human judgment is still required.