Category Archives: Health

health-related posts

Weather Apps Can Be Lifesavers When Tornadoes Approach

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This blog is dedicated to exploring the side effects of new communication technologies. Often those unintended side effects are negative. In the last 24 hours, as killer tornadoes swarmed across Oklahoma, several positive side effects of the new technologies became apparent.

Extra Warning Time

Perhaps the most striking examples are weather apps for smartphones. ABC News last night interviewed a survivor of the devastating tornado packing 200 mile per hour winds that devastated Moore, Oklahoma. The survivor talked about how a weather app on his iPhone warned him of the approaching storm 15 to 20 minutes before it struck his location, giving him time to get out of its path.

It appeared that he used my favorite weather app, one called RadarScope. This powerful app enables users to see storms coming at them in real time from more than 100 miles away. Many other apps can do that too. What makes this one so powerful is its stunning accuracy and range of measurement tools.

I’ve found that RadarScope’s accuracy can be measured in city blocks and minutes. In addition to reporting storms’ reflectivity, it also reports velocity, rainfall amounts, storm height, movement at different levels within storms, and much more. It’s a tool designed for professional meteorologists that amateurs can also appreciate.

As I write this 12 hours after the storm struck Moore, the death toll there has already reached 91 and is expected to climb even higher. One can only wonder how much worse the tragedy would have been were it not for weather apps that gave people time to evacuate or reach storm shelters.

Lost-and-Found Role for Social Media

Social media are also already playing a role in the recovery from this storm. As people find mementos, they are posting images of them online, turning the Internet into the world’s largest lost-and-found system.

Will news consumption preferences change media crisis coverage?

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In 2004, Stuart Fischoff, Ph.D., Professor Emeritus of Psychology, California State University, Los Angeles, published a poignant essay entitled Media Crisis Coverage: To Serve and to Scare. It was published in the Journal of Media Psychology.

Professor Fishoff examines what he calls the “dysfunctional partnership between the media and the public in our increasingly media-centric lives.”  He describes the intimate, adrenaline-fueled dance between viewers and producers of television crisis coverage and observes:

“The thin line between gut-wrenching, vital information and a news-sponsored horror show begins its fade to oblivion.”

In 2001, days after 9/11, a survey by the Pew Internet & American Life Project titled How Americans Used the Internet After the Terror Attack found that 81% of all Americans said they got most of their information from TV; only 3% of Internet users got most of their information about the attacks from the Internet.”

In his essay Media Crisis Coverage, Fischoff observed:

“During a crisis, many viewers, particularly those with 24-hour cable news shows, seek out the constant drumbeat of news coverage to stay informed and reduce the stress that accompanies uncertainty.  But watching hours of crisis coverage footage can often have the opposite effect.  Visual images go directly to the most primitive parts of our psyche, pushing all the fear buttons.  Anxiety is elevated.  People watch in order to calm themselves.  The more they watch, the more they want to watch because the more anxious they feel.  And the cycle continues.”

To reduce the psychological trauma and anxiety of being drawn into news/horror shows, Fischoff made a number of recommendations. One had to do with the size of the screen that viewers used to watch crisis coverage.

“Shrink the size of the image,” said Fischoff.  “Here is another example of when size matters: According to Detenber (1996), size is important to emotional response. It is important to babies in perceiving others, and to adults when watching a movie in a theater. Image size positively affects the arousal and dominance dimensions of emotional responses. Size is a primitive heuristic (in animals, for example, who is prey and who is predator, or who is too powerful to safely take on) that influences a range of judgments. Films seen as large images on a screen elicit stronger feelings of arousal than the same films when viewed on small screens disbursing small images.”

After reading this essay, I began to wonder about two things:

  • Will the trend toward getting news from the Internet, especially via smartphones and tablets, reduce the traumatic stress that people feel when viewing crisis coverage? Their screens are much smaller than televisions’ (70″ LED screens seem to be the current norm for new TVs).
  • In times of real crises, such as 9/11, will people revert back to getting news from TV because of the “quality” of coverage it presents?

Fast forward ten years. By 2011, Pew found that “The internet now trails only television among American adults as a destination for news, and the trend line shows the gap closing.” The report also found that in December 2010, 41% of Americans cited the internet as the place where they got “most of their news about national and international issues,” up 17% from a year earlier.

Source: Pew Internet and American Life Project

 My Take

Current Internet news coverage fundamentally differs from television news coverage. It tends to be more text than video focused, although this is beginning to change with increases in bandwidth. The comparative lack of video and sound remove much of the visceral “you-are-there” impact of crisis coverage. And if digital coverage becomes too repetitive, i.e., with endless reruns of the Twin Towers falling, viewers can easily switch “channels” or topics. The Internet offers millions of URL’s to choose from.

I suspect that the shift to digital news consumption will have a psychologically mitigating effect on consumers. I also suspect, for television producers, the real horror show will be their bottom line.

Adapting to the Side Effects of New Technologies

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Rehak’s Law: Like medicine, every new technology has side effects that are unintended. Rehak’s Corollary: The more popular the technology, the greater the side effects. For instance:

  • Cell phones and texting distract drivers and contribute to traffic accidents.
  • The Internet makes porn readily available to kids.
  • Electronic commerce opens a door to identity theft.
  • Email invites spam
  • Video games make violence feel commonplace

Diffusion Theory Describes How Innovations Spread Through Society

“Diffusion” is term used by marketers to describe the process by which the market accepts new technologies, products and ideas. Everett Rogers popularized the theory in his 1962 book Diffusion of Innovations. The book explains how, why, and at what rate new technologies, products and ideas spread through cultures. Rogers describes five categories of adopters.

  • Innovators – venturesome
  • Early adopters – leaders
  • Early majority – deliberate
  • Late majority – skeptical
  • Laggards – fearful

The ability of most marketers to find and appeal to innovators and early adopters determines their success. The distribution of these groups within any population looks something like this.

 Diffusion curve

How Society Adapts to Side Effects of New Technologies

Roger’s theory focuses on the adoption of new technologies, products and ideas. One could draw a similar curve, however, that describes adaptation to new technologies, products and ideas as people deal with their inevitable side effects. Here, too, I have observed five stages.

  • Recognition
  • Communication
  • Insulation
  • Regulation
  • Obsolescence

Superimposed over the adoption curve, the adaptation curve looks something like this.

Adaptation curve

Innovators and early adopters are among the first to recognize side effects.

They communicate with each other to raise awareness of side effects as they become apparent. At this early stage, self-defense is the only defense against dangers.

As more people adopt new technologies, aftermarkets develop for products and services that insulate people from negative side effects. For instance, computer networking spawned products that:

  • Inoculated computers against viruses
  • Blocked hackers with firewalls
  • Encrypted data to protect against identity theft

At this stage, the spread of side effects plateaus but continues. If the problems are severe enough and affect enough people, government steps in to pass regulations that impose fines or jail time on abusers.

However, abuse – or the side effect – never really stops until a technology becomes obsolete and people migrate to newer technologies (the dotted line in the graph above). At that point, criminals lose interest and follow the market. By the time you reach the end of one technology’s life cycle, something new is coming out. The cycle, like life, repeats itself.

The Dark Side of Cell Phones: Traffic Accidents

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shutterstock_54292804What discussion of media impacts of life would be complete without looking at the relationship between cell phones and traffic accidents.  Cell phones were originally seen as on-the-road safety devices. Ironically, today The National Safety Council, CDC, U.S. Department of Transportation and World Health Organization  recognize them as one of the leading causes of traffic accidents.

The National Safety Council estimates that at least 23 percent of all traffic crashes – or at least 1.3 million crashes – involve cell phone use per year. An estimated 1.2 million crashes each year involve drivers using cell phones for conversations and at least 100,000 additional crashes can be related to drivers who are texting. Cell phone conversations are involved in 12 times as many crashes as texting.

Researchers observing more than 1,700 drivers found that three out of every four drivers using a cell phone committed a traffic violation according to the National Safety Council. At any given daylight moment, they say that 9 percent of drivers are talking on phones (handheld and hands-free).

The National Safety Council report also indicates that talking on a cell phone while driving makes you four times more likely to crash, and texting while driving increases your chances of a crash by up to 8 to 23 times.

The Centers for Disease Control and Prevention (CDC) claims that an average of 15 people are killed each day and more than 1,200 people are injured in crashes that were reported to involve a distracted drive. The CDC recognizes three main types of distraction:

  • Visual—taking your eyes off the road;
  • Manual—taking your hands off the wheel; and
  • Cognitive—taking your mind off what you are doing.

Distracted driving activities include (but are not limited to) things like using a cell phone and texting. The CDC says texting while driving is especially dangerous because it combines all three types of distraction. Younger, inexperienced drivers under the age of 20 may be at highest risk because they have the highest proportion of distraction-related fatal crashes.

The World Health Organization (WHO) recognizes distracted driving as a serious and growing problem. With more and more people owning mobile phones, and the rapid introduction of new “in-vehicle” communication systems, they claim this problem is likely to escalate globally in the coming years.

WHO says drivers using mobile phones increase their accident risk by increasing their reaction times, inadvertently following too closely and swerving into adjacent traffic. They also claim that there is no conclusive evidence to show that hands-free phoning is any safer than hand-held phoning, because of the cognitive distraction involved with both types of phones.

The problem of distracted driving has become so serious that the U.S. Department of Transportation has set up a program to end it. See D!straction.gov to get the facts, get involved and see what the government recommends.

Impact of Media on Child Health

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I have long felt that in the Information Age, media are like the air we breath and the water we drink – necessary for life, but sometimes toxic and often unhealthy. Browsing this morning, I found this group: The Center for Media and Child Health (CMCH).

videogameAt Children’s Hospital Boston, the Harvard Medical School, and the Harvard School of Public Health, this group is dedicated to understanding and responding to the effects of media on the physical, mental, and social health of children through research, translation, and education.

They have found that young people spend more time using media—TV, movies, music, computers, Internet, cell phones, magazines, and video games—than engaging in any other single activity except sleep. Their site is a treasure trove of scientific research related to these topics.

According to the Center for Media and Child Health:

The media that children use and create are integral to their growing sense of themselves, of the world, and of how they should interact with it. These pervasive, persuasive influences have been linked to both negative health outcomes, such as smoking, obesity, sexual risk behaviors, eating disorders and poor body image, anxiety, and violence, and to positive outcomes, such as civil participation, positive social behavior, tolerance, school readiness, knowledge acquisition, and positive self-image. For any given child, which effects occur depends largely on the media’s content, the child’s age, the context in which the child uses media, the amount of media the child uses, and whether that use is active and critical.”

 

To create positive rather than negative outcomes, they propose five Five Cs, which I summarize below:

  • Control time
    Limit media use to an amount appropriate for your child’s age.
  • Filter Content
    All media educate. Some teach healthy lessons, others harmful.
  • Influence Context.
    Where, when, how, why, and with whom kids use media can enrich or harm them.
  • Teach Critical thinking
    It’s essential for healthy development.
  • Create media mastery
    Show kids how to think about media they use, instead of passively consuming it.

My Take

To kids, media represent a way to explore the world, stay connected, share experiences, identify with groups, and show off. They’re a badge of belonging. They’re a gateway to information, entertainment and temptation.

Research shows that kids consume up to seven hours per day of media (ten and a half hours if you factor in multitasking). Nothing will influence the type of adults that kids become more than you and the media they consume. The wise parent will teach kids to use media time wisely. I read that in a fortune cookie, so I know it must be true.

Impact of Television Screens on Nervous Tics

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According to the Encyclopedia of Mental Disorders, tics are sudden, painless, nonrhythmic behaviors that appear out of context. Simple motor tics are brief, meaningless movements like eye blinking, facial grimacing, head jerks or shoulder shrugs. They usually last less than one second, but can last longer, occur frequently and be more serious..

For those who have never witnessed this affliction, YouTube posted a video of a tic-stricken person watching TV. Tics are often related to a more severe related disorder called Tourette’s Syndrome.

Tics Related to TV Viewing and Video Games

A UK group called Tourette’s Action says that tics usually increase with stress, tiredness and boredom and are often prominent when watching television.

Many others note an association between tics and television watching. However, the cause is not fully understood. Some psychologists believe that tics can be suppressed through concentration; they attribute tic outbursts to relaxation while watching TV. Others see the flickering lights of TV and video games as the culprits. Still others see tics as a genetic disorder and believe that environmental factors may trigger them.

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CRT flicker is imperceptible to most people but may be related to tics in others.

An article posted by The American Nutrition Association in Nutrition Digest notes several types of hypersensitivities associated with tics and says “Television and video games both have a high frequency flicker that doesn’t bother most of us, but often triggers tics. TV and computer video games watched by toddlers are linked to ADHD as well as tics.”

The Association for Comprehensive NeuroTherapy (ACN) which explores treatments for tics and other neurological disorders sponsors a forum for parents of children with tics. A review of the postings on the forum found that 20 of 27 (74 percent) of parents who eliminated screen viewing for at least a week saw a significant reduction in their children’s tics. Most children with screen sensitivity also had food sensitivities. Several parents noted that correcting food issues, such as hypersensitivity to yeast, eliminated the screen sensitivity.

A comprehensive book on the subject, Natural Treatments for Tics and Tourette’s: A Patient and Family Guide, by Sheila J. Rogers contains numerous stories from parents who found that eliminating or restricting television viewing for children with tics lessened the symptoms.

The book also refers to reports from Japan about eye twitching, muscle twitching and in rare cases, even seizures associated with playing video games. Rogers cites warnings printed in Nintendo manuals starting in 2004.

The good news: Rogers reports that tics were most frequently observed while subjects were viewing cathode ray tubes (CRTs) which have much more pronounced flicker than the LCD, plasma and LED screens being sold today.

A neurotransmitter inside the brain called dopamine may trigger tics in people with hypersensitivity to light. Light strongly affects the body’s production of dopamine. Victoria L. Dunckley, M.D., wrote in Psychology Today:
“Since video games and computer use increase dopamine, and tics are dopamine-related, it’s understandable that electronic media worsen tics.  For bothersome tics, I recommend a three week “electronic fast” to normalize brain chemistry and improve sleep (restful sleep improves tics in and of itself).”

We have all become dependent on electronic media; it’s hard to fathom life without screens. This is one more example of how media can impact life in surprising ways.

Television Affective Disorders

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Yesterday, I discussed screen fixation and its relationship both to attention deficit disorder and attention deficit hyperactivity disorder. Today, I’d like to focus on several affective disorders. Psychologists have described seasonal affective disorder (S.A.D.) – depression related to shorter winter days. I have personally noted several other widespread affective disorders related to television viewing. Together, they fall under the general heading of T.A.D. (television affective disorders).

couplewatchingtvinbedAny woman who has ever tried to tear her boyfriend or husband away from Sports Center at 2 a.m. has experienced a malady called Male Affective Disorder (M.A.D.). Male symptoms include restlessness, decreased libido, excessive consumption of Doritos, general irritability when distracted, high blood pressure during fourth quarters, and loud, uncontrolled outbursts of verbal epithets when referees make idiotic calls.

These, in turn, create F.A.D. (Female Affective Disorder). F.A.D. symptoms in the female include cold shoulders, a hyperactive grumble gland, pouting, elevated temper, door slamming, excessive re-reading of Jane Eyre, sleeping at the opposite end of the house, tightly crossed legs, excessive consumption of chocolate, and expensive trips to Tiffany & Co.

In extreme cases, both M.A.D. and F.A.D. have been known to enrich divorce lawyers. Physicians urge intervention before this happens. The only known cure is for the female to confiscate the remote before the male becomes fixated on the screen and distract the male by hiding the remote in her bra.

This can sometimes lead to B.A.D. (Bedtime Affective Delight). As the male attempts to recover the remote, he playfully tears clothes off the female. This focuses his attention fully on her. Symptoms include heavy breathing; flushed cheeks; racing hearts; heightened arousal; spontaneous clutching; sudden, uncontrolled release of tension; prolonged snuggling; and deeper-than-normal sleep followed by Sports Center at 4 a.m.

M.A.D., F.A.D. and B.A.D. represent proof positive that television can affect relationships in both negative and positive ways. As these phenomena are so widely observed and well documented in households across America, I see little need for further study.

Screen Fixation and Attention Deficit Disorder

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While searching for information about the relationship between ADD and different types of monitors, I came across a touching story in the New York Times. Published in 2011 by Perri Klass, M.D., the article titled “Fixated by Screens, but Seemingly Nothing Else” began with the story of boy whose teacher thought he had attention deficit disorder. The teacher urged the boy’s mother to have him tested: “He can’t sit still … He’s always getting into trouble.”

The mother felt her son could not have attention deficit disorder because he could sit for hours concentrating on video games. The physician had heard it all before. He said, “Sometimes parents make the same point about television: My child can sit and watch for hours — he can’t have A.D.H.D.”

“In fact, a child’s ability to stay focused on a screen, though not anywhere else, is actually characteristic of attention deficit hyperactivity disorder. There are complex behavioral and neurological connections linking screens and attention, and many experts believe that these children do spend more time playing video games and watching television than their peers.”

But researchers, the article continues, are still trying to determine whether the screen fixation is a cause or an effect of attention disorders.

Some researchers, according to Klass, feel that flickering screens may reward the brain by releasing the neurotransmitter dopamine and therefore attract children with deficit disorders. The brains of these children may be deficient in dopamine and they are, in effect, self-medicating with video.

Other researchers fear video may cause deficit disorders. Klass says, “Some studies have found that children who spend more time in front of the screen are more likely to develop attention problems later on.”

He cited a 2010 study in the journal Pediatrics. It found that viewing more television and playing more video games were associated with subsequent attention problems in both schoolchildren and college undergraduates. The theory goes something like this. In video games, the need to keep responding rapidly in order to win creates hyper-alertness that makes the real world seem under-stimulating by comparison.

My Take

Regardless of the cause/effect question posed above, these studies show that exposure to television and video games can affect brain chemistry over the long term. These visual mediums have the power to affect how we feel, how we think, and how we interact with those around us. Tomorrow, I will write about several affective disorders related to television usage that I have personally observed and documented.

Using Social Media to Detect Poor Quality Health Care

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In an era when a growing number of patients are using social media to describe their patient experiences, some health care professionals are suggesting that mining the “cloud of patient experience” could be an interesting way to help professionals improve that experience.

The idea is proposed in a “viewpoint” article entitled “Harnessing the cloud of patient experience: using social media to detect poor quality healthcare” published online by BMJ Quality and Safety in January 2013. The authors, F. Greaves, D Ramirez-Cano, C Millett, A Darzi and L Donaldson, of the Department of Primary Care and Public Health, Imperial College London, say that:

“We believe the increasing availability of patients’ accounts of their care on blogs, social networks, Twitter and hospital review sites presents an intriguing opportunity to advance the patient-centred care agenda and provide novel  quality of care data.”

DataCenterHand

They outline how collecting and aggregating patients’ descriptions of their experiences on the internet could be used to detect both poor and high quality clinical care. The process involves “natural language processing and sentiment analysis to transform unstructured descriptions of patient experience on the internet into usable measures of healthcare performance.” The authors conclude by discussing whether these new techniques could detect poor performance before conventional measures of healthcare quality could.

My Take

Many industries use data mining to gather business intelligence and detect trends in markets. The financial industry uses it to develop credit scores. Actuaries use it to assess risk for insurance companies. Other applications include quality assurance, cross-selling, fraud detection, stock market prediction, direct marketing and customer retention, to name just a few.

In all of these examples, people use computers to turn large amounts of unstructured data into usable knowledge that can help predict outcomes and improve performance.

If you’ve had a hospital stay recently, you probably received a questionnaire asking you to rate your experience. The purpose of these questionnaires is to gather feedback that leads to improved performance. A local hospital administrator told me recently that these ratings affect hospitals’ compensation by several percent – a powerful motive to improve.

But people are often reluctant to offer negative feedback – especially to people that their health depends on. They don’t want to be “problem patients” that providers shun; they have a natural tendency to want to say positive things TO the people they deal with. However, under the veil of anonymity that the Internet provides, they frequently show no restraint in saying negative things ABOUT their experiences with people, companies and institutions. I call this the Venting Effect. When you have a negative experience, just getting all those boiling feelings out of your head helps manage the pain.

Professionals can improve healthcare by capturing and analyzing this information. The hospital administrator mentioned above told me a poignant story about how his staff reduced lung infections after surgery from nearly 50 percent to virtually zero within five years. They used “best practices” determined from mining CDC data. Broadening the scope to include data mined from social networks may yield equally beneficial results.

Impact of TV Commercials on Preschooler Food Preferences

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The Journal of the American Dietetic Association published a study from the Stanford Center for Research in Disease Prevention in January 2001 titled: The 30-second effect: an experiment revealing the impact of television commercials on food preferences of preschoolers.

DL Borzekowski and TN Robinson, the study’s authors, sought to determine whether televised food commercials influence preschool children’s food preferences.

Study Design

They divided 46 2- to 6-year-old preschool children into two groups. One saw a videotape of a popular cartoon with a commercial embedded in it. The control group saw the cartoon, but without the commercial. The children, from a Head Start program in northern California, were then asked to identify their preferences from pairs of similar products, one of which had been advertised in the embedded commercials.

Findings and Implications

They found that children exposed to commercials were significantly more likely to choose the advertised items than children who were not. They concluded that even brief exposures to televised food commercials can influence food preferences within this age group.

Further, the authors advised adults to limit  preschooler’s exposure to television advertisements. They also raised a public policy issue – given the epidemic of childhood obesity – about advertising to young children.

My Take

From personal experience, both as a parent and advertising-industry professional, I believe that this age group lacks the cognitive capabilities to differentiate commercials from programming. Thus, they are exceptionally vulnerable at a time when they are forming preferences and habits that could influence the trajectory of their lives.

Hit the pause button for a moment of ethical reflection.

Kids like “fun.” (Don’t we all?) Advertisers know this and so they pack commercials targeted at kids with flashy animation, bright colors, happy music and fantasy characters. These are the tools of the trade. Advertising targeted at adults uses the same tools for the same reasons.

VeggieHeartIf the products and services being advertised are not harmful, I believe that there is nothing inherently wrong with this. We should also remember that television is a competitive marketplace of ideas. Nothing prevents anyone from using the same tools to encourage consumption of healthy foods like Popeye cartoons once did.

Late in life, I gained a significant amount of weight from eating too much unhealthy food. After nutritional counseling, I began eating virtually nothing but lean meats, vegetables and fruits. I lost eighty pounds, nine inches from my waistline, and feel infinitely better now.

However, a curious thing happened in the process. Much of the food advertising I see on TV now repulses me. What used to make me drool – gooey cheese in pizza commercials, for instance – now makes my stomach turn back-flips. Seriously, it’s such an unpleasant feeling that I must look away from the TV. Someone needs to research this phenomenon to see if a heart healthy diet is the best defense against the seductive pull of advertising for less healthy foods – among children and adults. There could be something happening on a cellular level here. When I was fat and tried to diet, the first two weeks were always the hardest. Every time I saw one of those gooey pizza commercials, it triggered cravings. Now, the opposite happens.

Anncr VO:  “And now we return to our regularly scheduled programming.”