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Psychiatrists From Another Dimension (Part 1)

Psychiatrists From Another Dimension (Part 1) | E-mental health: digital, mobile and tele tech for the brain! | Scoop.it

Remember DSM-5?

After all the criticisms, the street protests and the scholarly debates, the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders was finally published by the American Psychiatric Association (APA) in May 2013. And then… well, that was it. The launch itself was a something of an anticlimax – as I predicted in 2010, “When DSM-5 does arrive… it will be a non-event. By then the debates will have happened.”

But now a strange story is emerging that could reignite the controversy.

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E-mental health: digital, mobile and tele tech for the brain!
How brain and mental care can benefit from the technological revolution of health care
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The brain and mental health voice

The brain and mental health voice | E-mental health: digital, mobile and tele tech for the brain! | Scoop.it

The brain and mental health voice, by Valeria Duflot:  a curated selection of articles, blog posts, videos and photos.

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Beth Israel launches pilot that lets patients read therapists’ notes | mobihealthnews

Beth Israel launches pilot that lets patients read therapists’ notes | mobihealthnews | E-mental health: digital, mobile and tele tech for the brain! | Scoop.it

Boston’s Beth Israel Deaconess Medical Center has launched a pilot in which 700 mental health patients receive access to their therapists’ notes on their laptop or smartphone, according to a must-read report in the New York Times.

“Nationally, the momentum is shifting in favor of transparency in the medical record, but understandable caution and controversy remain when it comes to mental health notes,” lead author and assistant professor of psychiatry at Harvard Medical School, Dr Michael Kahn, wrote in a Journal of the American Medical Association (JAMA) article on the pilot.

This pilot is an extension of a rather famous trial that Beth Israel participated in a few years ago, called OpenNotes. In the OpenNotes program, which was funded by the Robert Wood Johnson Foundation, more than 13,500 primary care patients were given access to their physicians’ notes via an online portal and electronic messaging. More than 100 physicians participated in that trial. In the end, close to 11,800 patients opened at least one note during the study, which took place at two other healthcare facilities as well: Geisinger Health System (GHS) in Pennsylvania and Harborview Medical Center (HMC) in Washington. 

At the time, the study authors explained that a vast majority of the participating patients said they could understand their medical issues more easily, better remember their treatment plans, and prepare for future visits. Patients also found that they felt an increased sense of control.

Since then, more than 2.5 million American patients from several healthcare institutions including MD Anderson, Mayo Clinic, Cleveland Clinic, and the Department of Veteran’s Affairs (VA) have been given access to their medical notes. Still, with the exception of the VA, a release from the researchers explained these institutions do not share notes written by psychiatrists, psychologists, and social workers. The researchers write in the JAMA article that they find these exclusions unnecessary.

“Inviting patients to read what clinicians write about their feelings, thoughts and behaviors does seem different from sharing assessments of their hypertension or diabetes,” Kahn said. “Bringing transparency into mental health feels like entering a minefield, triggering clinicians’ worst fears about sharing notes with patients.”

Some concerns that exist, according to Kahn, include how a patient will react to reading a diagnosis of his personality disorder and what a patient with schizophrenia will feel when a therapist writes that her “firm convictions” are delusional. Still, according to the researchers, allowing patients to read therapist notes might help them address their mental health issues actively and reduce the stigma that they feel around mental health.

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What does the Facebook experiment teach us? — The Message — Medium

What does the Facebook experiment teach us? — The Message — Medium | E-mental health: digital, mobile and tele tech for the brain! | Scoop.it

I’m intrigued by the reaction that has unfolded around the Facebook “emotion contagion” study. (If you aren’t familiar with it, read this primer.) As others have pointed out, the practice of A/B testing content is quite common. And Facebook has a long history of experimenting on how it can influence people’s attitudes and practices, even in the realm of research. An earlier study showed that Facebook decisions could shape voters’ practices. But why is it that this study has sparked a firestorm?

In asking people about this, I’ve been given two dominant reasons:

  • People’s emotional well-being is sacred.
  • Research is different than marketing practices.

I don’t find either of these responses satisfying.

The Consequences of Facebook’s Experiment

Facebook’s research team is not truly independent of product. They have a license to do research and publish it, provided that it contributes to the positive development of the company. If Facebook knew this research would spark this kind of negative PR backlash, they never would’ve allowed it to go forward or be published. I can only imagine the ugliness of the fight inside the company now, but I’m confident that PR is demanding silence from researchers.

I do believe the research was intended to be helpful to Facebook. So what was the intended positive contribution of this study? I get the sense fromAdam Kramer’s comments that the goal was to determine if content sentiment could affect people’s emotional response after being on Facebook. In other words, given that Facebook wants to keep people on Facebook, if people came away from Facebook feeling sadder, presumably they’d be less likely to want to come back to Facebook again. Thus, it’s in Facebook’s better interest to leave people feeling happier. And this study suggests the sentiment of the content influences how people feel. This suggests that one applied take-away for product is to downplay negative content. Presumably this is better for users and better for Facebook.

We can debate all day long as to whether or not this is what that study actually shows, but let’s work with this for a second. Let’s say that pre-study Facebook showed 1 negative post for every 3 positive and now, because of this study, Facebook shows 1 negative post for every 10 positive ones. If that’s the case, was the one week treatment worth the outcome for longer term content exposure? Who gets to make that decision?

Folks keep talking about all of the potential harm that could’ve happened by the study — the possibility of suicides, the mental health consequences. But what about the potential harm of negative content on Facebook more generally? Even if we believe that there were subtle negative costs to those who received the treatment, the ongoing costs of negative content on Facebook every week other than that 1 week experiment must be more costly. How then do we account for positive benefits to users if Facebook increased positive treatments en masse as a result of this study? Of course, the problem is that Facebook is a black box. We don’t know what they did with this study. The only thing we know is what is published in PNAS and that ain’t much.

Of course, if Facebook did make the content that users see more positive, should we simply be happy? What would it mean that you’re more likely to see announcements from your friends when they are celebrating a new child or a fun night on the town, but less likely to see their posts when they’re offering depressive missives or angsting over a relationship in shambles? If Alice is happier when she is oblivious to Bob’s pain because Facebook chooses to keep that from her, are we willing to sacrifice Bob’s need for support and validation? This is a hard ethical choice at the crux of any decision of what content to show. And the reality is that Facebook is making these choices every day without oversight, transparency, or informed consent.


Algorithmic Manipulation of Attention and Emotions

Facebook actively alters the content you see. Most people focus on the practice of marketing, but most of what Facebook’s algorithms do involve curating content to provide you with what they think you want to see. Facebook algorithmically determines which of your friends’ posts you see. They don’t do this for marketing reasons. They do this because they want you to want to come back to the site day after day. They want you to be happy. They don’t want you to be overwhelmed. Their everyday algorithms are meant to manipulate your emotions. What factors go into this? We don’t know.

Facebook is not alone in algorithmically predicting what content you wish to see. Any recommendation system or curatorial system is prioritizing some content over others (including the one used here on Medium). But let’s compare what we glean from this study with standard practice. Most sites, from major news media to social media, have some algorithm that shows you the content that people click on the most. This is what drives media entities to produce listicals, flashy headlines, and car crash news stories. What do you think garners more traffic — a detailed analysis of what’s happening in Syria or 29 pictures of the cutest members of the animal kingdom? Part of what media learned long ago is that fear and salacious gossip sell papers. 4chan taught us that grotesque imagery and cute kittens work too. What this means online is that stories about child abductions, dangerous islands filled with snakes, and celebrity sex tape scandals are often the most clicked on, retweeted, favorited, etc. So an entire industry has emerged to produce crappy click bait content under the banner of “news.”

Guess what? When people are surrounded by fear-mongering news media, they get anxious. They fear the wrong things. Moral panics emerge. And yet, we as a society believe that it’s totally acceptable for news media — and its click bait brethren — to manipulate people’s emotions through the headlines they produce and the content they cover. And we generally accept that algorithmic curators are perfectly well within their right to prioritize that heavily clicked content over others, regardless of the psychological toll on individuals or the society. What makes their practice different? (Other than the fact that the media wouldn’t hold itself accountable for its own manipulative practices…)

Somehow, shrugging our shoulders and saying that we promoted content because it was popular is acceptable because those actors don’t voice that their intention is to manipulate your emotions so that you keep viewing their reporting and advertisements. And it’s also acceptable to manipulate people for advertising because that’s just business. But when researchers admit that they’re trying to learn if they can manipulate people’s emotions, they’re shunned. What this suggests is that the practice is acceptable, but admitting the intention and being transparent about the process is not.


But Research is Different!!

As this debate has unfolded, whenever people point out that these business practices are commonplace, folks respond by highlighting that research or science is different. What unfolds is a high-browed notion about the purity of research and its exclusive claims on ethical standards.

Do I think that we need to have a serious conversation about informed consent? Absolutely. Do I think that we need to have a serious conversation about the ethical decisions companies make with user data? Absolutely. But I do not believe that this conversation should ever apply just to that which is categorized under “research.” Nor do I believe that academe is necessarily providing a golden standard.

Academe has many problems that need to be accounted for. Researchers are incentivized to figure out how to get through IRBs (Institutional Review Boards) rather than to think critically and collectively about the ethics of their research protocols. IRBs are incentivized to protect the university rather than truly work out an ethical framework for these issues. Journals relish corporate datasets even when replicability is impossible. And for that matter, even in a post-paper era, journals have ridiculous word count limits that demotivate researchers from spelling out all of the gory details of their methods. But there are also broader structural issues. Academe is so stupidly competitive and peer review is so much of a game that researchers have little incentive to share their studies-in-progress with their peers for true feedback and critique. And the status games of academe reward those who get access to private coffers of data while prompting those who don’t to chastise those who do. And there’s generally no incentive for corporates to play nice with researchers unless it helps their prestige, hiring opportunities, or product.

IRBs are an abysmal mechanism for actually accounting for ethics in research. By and large, they’re structured to make certain that the university will not be liable. Ethics aren’t a checklist. Nor are they a universal. Navigating ethics involves a process of working through the benefits and costs of a research act and making a conscientious decision about how to move forward. Reasonable people differ on what they think is ethical. And disciplines have different standards for how to navigate ethics. But we’ve trained an entire generation of scholars that ethics equals “that which gets past the IRB” which is a travesty. We need researchers to systematically think about how their practices alter the world in ways that benefit and harm people. We need ethics to not just be tacked on, but to be an integral part of how everyone thinks about what they study, build, and do.

There’s a lot of research that has serious consequences on the people who are part of the study. I think about the work that some of my colleagues do with child victims of sexual abuse. Getting children to talk about these awful experiences can carry quite a psychological toll. Yet, better understanding what they experienced has huge benefits for society. So we make our trade-offs and we do research that can have consequences. But what warms my heart is how my colleagues work hard to help those children by providing counseling immediately following the interview (and, in some cases, follow-up counseling). They think long and hard about each question they ask, and how they go about asking it. And yet most IRBs wouldn’t let them do this work because no university wants to touch anything that involves kids and sexual abuse. Doing research involves trade-offs and finding an ethical path forward requires effort and risk.

It’s far too easy to say “informed consent” and then not take responsibility for the costs of the research process, just as it’s far too easy to point to an IRB as proof of ethical thought. For any study that involves manipulation — common in economics, psychology, and other social science disciplines — people are only so informed about what they’re getting themselves into. You may think that you know what you’re consenting to, but do you? And then there are studies like discrimination audit studies in which we purposefully don’t inform people that they’re part of a study. So what are the right trade-offs? When is it OK to eschew consent altogether? What does it mean to truly be informed? When is being informed not enough? These aren’t easy questions and there aren’t easy answers.

I’m not necessarily saying that Facebook made the right trade-offs with this study, but I think that the scholarly reaction that research is only acceptable with an IRB plus informed consent is disingenuous. Of course, a huge part of what’s at stake has to do with the fact that what counts as a contract legally is not the same as consent. Most people haven’t consented to all of Facebook’s terms of service. They’ve agreed to a contract because they feel as though they have no other choice. And this really upsets people.


A Different Theory

The more I read people’s reactions to this study, the more I’ve started to think the outrage has nothing to do with the study at all. There is a growing amount of negative sentiment towards Facebook and other companies that collect and use data about people. In short, there’s anger at the practice of big data. This paper provided ammunition for people’s anger because it’s so hard to talk about harm in the abstract.

For better or worse, people imagine Facebook is run by a benevolent dictator, that the site is there to enable people to better connect with others. In some senses, this is true. But Facebook is also a company. And a public company for that matter. It has to find ways to become more profitable with each passing quarter. This means it designs its algorithms not just to market to you directly but to convince you to keep coming back over and over again. People have an abstract notion of how that operates, but they don’t really know, or even want to know. They just want the hot dog to taste good. Whether it’s couched as research or operations, people don’t want to think they’re being manipulated. So when they find out what soylent green is made of, they’re outraged. This study isn’t really what’s at stake. What’s at stake is the underlying dynamic of how Facebook runs its business, operates its system, and makes decisions that have nothing to do with how its users want Facebook to operate. It’s not about research. It's a question of power.

I get the anger. I personally loathe Facebook and I have for a long time, even as I appreciate and study its importance in people’s lives. But on a personal level, I hate the fact that Facebook thinks it’s better than me at deciding which of my friends’ posts I should see. I hate that I have no meaningful mechanism of control on the site. And I am painfully aware of how my sporadic use of the site has confused their algorithms so much that what I see in my newsfeed is complete garbage. And I resent the fact that because I barely use the site, the only way that I could actually get a message out to friends is to pay to have it posted. My minimal use has made me an algorithmic pariah and if I weren’t technologically savvy enough to know better, I would feel as though I’ve been shunned by my friends rather than simply deemed unworthy by an algorithm. I also refuse to play the game to make myself look good before the altar of the algorithm. And every time I’m forced to deal with Facebook, I can’t help but resent its manipulations.

There’s also a lot that I dislike about the company and its practices. At the same time, I’m glad that they’ve started working with researchers and started publishing their findings. I think we need more transparency in the algorithmic work done by these kinds of systems and their willingness to publish has been one of the few ways we’ve gleaned insight into what’s going on. Of course, I also suspect the angry reaction from this study will prompt them to clamp down on allowing researchers to be remotely public. My gut says they will naively respond to this situation as though the practice of research is what makes them vulnerable rather than their practices as a company as a whole. Beyond what this means for researchers, I’m concerned about what increased silence will mean for a public who has no clue of what’s being done with their data, who will think that no new report of terrible misdeeds means Facebook has stopped manipulating data.

Information companies aren’t the same as pharmaceuticals. They don’t need to do clinical trials before they put a product on the market. They can psychologically manipulate their users all they want without being remotely public about exactly what they’re doing. And as the public, we can only guess what the black box is doing.

There’s a lot that needs reform here. We need to figure out how to have a meaningful conversation about corporate ethics, regardless of whether it’s couched as research or not. But it’s not so simple as saying that a lack of a corporate IRB or a lack of an “informed consent” gold standard means a practice is unethical. Almost all manipulations that take place by these companies occur without either one of these. And they go unchecked because they aren’t published or public.

Ethical oversight isn’t easy and I don’t have a quick and dirty solution for how it should be implemented. But I do have a few ideas. For starters, I’d like to see any company that manipulates user data create an ethics board. Not an IRB that approves research studies, but an ethics board that has visibility into all proprietary algorithms that could affect users. For public companies, this could be done through the ethics committee of the Board of Directors. But rather than simply consisting of board members, it should consist of scholars and users. I also think that there needs to be a mechanism for whistleblowing regarding ethics from within companies because I’ve found that many employees of companies like Facebook are quite concerned by certain algorithmic decisions, but feel as though there’s no path to responsibly report concerns without going fully public. This wouldn’t solve all of the problems, nor am I convinced that most companies would do so voluntarily, but it is certainly something to consider. More than anything, I want to see users have the ability to meaningfully influence what’s being done with their data and I’d love to see a way for their voices to be represented in these processes.

I’m glad this study has prompted an intense debate among scholars and the public, but I fear it’s turned into a simplistic attack on Facebook over this particular study, rather than a nuanced debate over how we create meaningful ethical oversight in research and practice. The lines between research and practice are always blurred and information companies like Facebook make this increasingly salient. No one benefits by drawing lines in the sand. We need to address the problem more holistically. And, in the meantime, we need to hold companies accountable for how they manipulate people across the board, regardless of whether or not it’s couched as research. If we focus too much on this study, we’ll lose track of the broader issues at stake.



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China to build brain database

China to build brain database | E-mental health: digital, mobile and tele tech for the brain! | Scoop.it
Chinese scientists are planning to build a “brain database” in a bid to identify clues to tackling cerebral diseases and related disorders.
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Facebook app to predict mental health relapse, Monash University

Facebook app to predict mental health relapse, Monash University | E-mental health: digital, mobile and tele tech for the brain! | Scoop.it
Can social media be used to prevent relapse in bipolar disorder patients? http://t.co/2jdMhICOjW
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This wearable device reads your brain waves. Is there a market for it?

This wearable device reads your brain waves. Is there a market for it? | E-mental health: digital, mobile and tele tech for the brain! | Scoop.it

The chief executive of the young Canadian company Interaxon, Garten sought to use brain-controlled interface technology -- a science fiction-like development that allows a device to be controlled by the brain's electrical activity -- in a wearable device. With Google's Glass and Nike's FuelBand leading the way, so-called wearables are expected to grow from an $8 billion (in annual revenue) market today to a $20 billion one by 2017, according to Futuresource Consulting. Using brainwaves to control them seemed like, well, a no-brainer.

But Garten wanted to create something meaningful -- something that people would use every day. Not a gadget or novelty. So she watched and waited for the market to develop. Muse, the company's new $299 brainwave-controlled headband, will start shipping in May. With a splashy debut at this year's Consumer Electronics Show and what Garten reports as strong pre-orders from consumers and corporate employee assistance programs, the company's wait to go into hardware appears to be paying off.

Garten and her two co-founders, Trevor Coleman and Chris Aimone, started their Toronto-based company in 2009 and spent its first three years creating experiences driven by technology based on electroencepholagraphy, or EEG for short. Whether it was a chair that levitated into the air as a person became more relaxed or giving several thousand visitors to the 2010 Olympic Games the chance to change the lighting on Toronto's CN Tower, Canada's Parliament Building and Niagara Falls, the company showed users that their minds could influence the world.

MORE: Is wearable technology just for geeks?

The company earned roughly a million dollars per year doing branded installations. More importantly, though, the efforts yielded insights into how people interacted with the technology, helping Interaxon better understand how to apply EEG tech to a consumer product.

Garten described a day when someone came into the lab to do one of their user tests. "It was the first time we had really test-run the algorithm which could tell when you were focused and when you got stressed," she says. "There was a little bleep on the screen every time he got distracted. My heart sort of jumped every time I saw that bleep." Her team realized what they had to offer people was a way to learn to exercise control over themselves.

For the last two years the team has largely shut down its demonstration and consulting operations to focus on developing Muse, a personal EEG device that sends readings to your phone or tablet. "Basically, [it] teaches you to calm your mind," Garten says. "With a calm mind, you can do more in life."

Muse is shaped like a conventional headband, but it sits on your ears like eyeglasses and runs across your face, just above the eyebrows. It has seven sensors that collect data. Garten says the included application has activities on it that help to calm and settle the mind, such as before bed. Soon, it might also be helpful for noticing when your mind has wandered during a task.

MORE: Nike+ Fuelband SE: What wearables should be

The company has raised about $7.5 million to date, Garten says. It closed a $6 million round last year, on an offered $5 million. One of its investors is the actor Ashton Kutcher, who worked references to a company resembling Interaxon into an episode of the CBS sitcom Two and a Half Men. Another part of their funding has come from an IndieGogo campaign, where it beat its $150,000 goal by $137,000.

At this year's Consumer Electronics Show, people waited as long as an hour just to get a chance to try the Muse device. Garten estimated a 75% conversion rate for pre-order sales at the show. "As soon as people try it, they get it," she says. Muse is also already generating corporate sales. Garten declined to share specific figures but says that employee assistance programs are pre-ordering the device to help staff with stress, attention, and overall wellness.

There may also be a market for inattentive children. Research from 2003 has shown that EEG based training can serve as a drug free alternative for treating ADHD.

Still, similar devices didn't deliver. Zeo was a device that also took EEG readings of people to help them get better rest. The sleep industry is a $32 billion industry, and Zeo had $12.3 million in equity funding, according to a 2010 SEC filing. That's nearly twice what Interaxon has. But the company shut down. One reason it failed? Because the public didn't understand it. Less accurate sleep monitors that also measured other activities, such as the Fitbit or Jawbone's Up, undermined Zeo's market.

User education, Garten says, is the biggest hurdle Interaxon faces.

MORE: The third wave of computing

There are a number of EEG products on the market, including those by the companies NeuroSky, Emotiv, and Mindwave. Garten believes that Interaxon is different because the company is vertically integrated -- even the algorithms, which are sophisticated enough to accommodate for different sleep patterns, moods, and sweat, are developed in house.

Further research will extend its functionality, Garten says. "As we start to expand what Muse can do, those applications will be provided to Musers." Each headset will come with a software development kit to allow third-party developers to build upon that foundation.

For professionals and creatives, the possibilities the technology creates could be game changing. Improving attention alone could be enough, but Microsoft's Head of Thought Leadership Kelly Jones recently wrote on Huffington Post that consumers are demanding technology that's "Intelligently On" -- technology that knows a movie is no time for a phone to ring and a software update notification that can wait until you've met your deadline.

In other words, future technology ought to read your mind. Interaxon hopes that such a statement is as much literal as figurative.

Posted in: electroencephalography (EEG), Interaxon, Muse, Wearables


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The Psychology of Gamification: Can Apps Keep You Motivated?

The Psychology of Gamification: Can Apps Keep You Motivated? | E-mental health: digital, mobile and tele tech for the brain! | Scoop.it
Gamification is a buzzword that gets tossed around all the time, but the basic idea is simple: if you turn your life into a game, with digital rewards for real life achievements, you'll be more motivated to do something--or so the theory goes. Does it actually work? Let's take a look at what we know.
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GE launches iPad app GE MIND to track neurological disorders

GE launches iPad app GE MIND to track neurological disorders | E-mental health: digital, mobile and tele tech for the brain! | Scoop.it

GE Healthcare launched a new app and website this month called GE MIND, which stands for Make an Impact on Neurological Disorders.

GE MIND aims to identify ”gaps in current frameworks for the prediction, detection, diagnosis, and care of people with neurological disorders and to propose viable solutions,” according to the app’s description.

GE worked with Dr. Monica M. Kurtis, a consulting neurologist for patients with movement disorders based out of Madrid, Spain, on the app’s medical content.

On the website, users can share their story of living with a neurological disorder, read about about the disorders and their treatments, or listen to music on GE MIND’s MoveMINDs page. According to the website, music helps users remember special memories, make more fluid movements and improve communication skills, which is why music is often used for therapies on patients with neurological diseases. GE MIND’s playlists have artists that span from Bob Dylan to The Jackson 5, and the website encourages users to add songs to their own playlist and share them on Twitter using the hashtag #MoveMINDs.

The app offers additional features including the option to watch or move along with dance videos, interact with paintings and a compose music on a virtual keyboard.

To encourage early diagnosis of diseases, the website will have a section, which has not yet launched, with online tests for Alzheimer’s, Parkinson’s, essential tremor, stroke and traumatic brain injury. The tests are made up of a series of questions and exercises.

In August, the CJE Senior Life (formerly Council for Jewish Elderly) and The Art Institute of Chicago launched a somewhat similar iPad app, Art in the Moment, to encourage conversation and engagement in older adults with cognitive disabilities by way of art.

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Mobile phones, apps, throw lifeline to sufferers of brain and mental disorders in remote world corners

Mobile phones, apps, throw lifeline to sufferers of brain and mental disorders in remote world corners | E-mental health: digital, mobile and tele tech for the brain! | Scoop.it
Grand Challenges Canada, funded by the Government of Canada, today announces 22 new global mental health projects worldwide to improve the quality of mental health care in developing countries.
Thirteen projects include novel deployments of mobile phone technologies -- in several cases connecting specialists with mental health patients directly or with lay health workers identifying sufferers in some of the world's most remote corners.
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StrokeApp aims to deliver context-dependent patient information

StrokeApp aims to deliver context-dependent patient information | E-mental health: digital, mobile and tele tech for the brain! | Scoop.it

A new patient-facing educational app for stroke patients is due to start proof-of-concept testing in hospitals next month. Hermosa Beach, California-based personalRN is developing StrokeApp, a context-dependent app that will anticipate the particular questions stroke patients have based on their demographics, the kind of stroke they’re suffering from, and whether they’re receiving care in the emergency room, the intensive care unit, or inpatient rehab.

“When patients come in, regardless of their care setting, they basically have three questions,” Chief Medical Officer Kourosh Parsapour told MobiHealthNews. “What happened (How’d I end up in the ER, how’d I end up getting a stroke)?; what’s happening right now (What are you guys doing to me, why are you putting needles in my arm)?; and then what’s going to happen (what’s next, where am I going to after the ER or the ICU, will I be able to walk again, will I be able to talk again)? … If you give me seven or eight data points on any patient with most diseases, I would probably be able to predict, relatively accurately where that patient should be in their continuum of care and what questions are going to be relevant to them.”

PersonalRN plans to offer point-of-care patient education apps for a number of different diseases, but they are starting with stroke because they see it as having the most potential for reducing hospital readmissions by improving education. 

“One out of four patients gets readmitted after a stroke, and 90 percent of those get readmitted within the first 30 days,” he said. “A second stroke happens because they’re not being compliant with their blood pressure medication or they don’t understand the importance of avoiding hypertension, so they come back sicker with a second stroke.”

Parsapour said the app will emphasize a simplified user experience for doctors or nurses, who will be able to customize the content to their patients in less than 90 seconds by answering just seven questions. The app will deliver content to patients based on the three questions described above — what happened, what’s happening, and what’s going to happen — using the answers as opportunities to explain different facets of the disease and treatment. For instance, the patient might ask the app why doctors are taking their blood pressure so often. The app would answer that question by explaining what blood pressure is and why it’s important in the treatment of a stroke.

The app aims to improve on both the paper handouts that are the current standard of care and other mobile and web-based patient education platforms. This is because the app takes into account the patient’s level of education, and also eliminates information that might be irrelevant to them because it pertains to a different kind of stroke, for instance.

PersonalRN is in talks with several hospitals to launch proof-of-concept testing in the next month. The startup is also raising money from investors: It has currently raised about $75,000 raised so far from friends and family, mostly other doctors, nurses, and hospital information officers. The current version of the software sees the patient from admittance to the ICU to recovery and discharge, but Parsapour said the ultimate goal is for it to take the form of an iPad that patients can take home. Then it can then be used to facilitate medication compliance and rehabilitation as well. At that point it could potentially interface with Parsapour’s other startup, 5plus Therapy, by delivering rehabilitation neurogames on the same platform.

“Anyone who gets an immediate diagnosis of a severe illness — stroke, heart attack, cancer — they basically hear ‘You’ve been diagnosed with cancer. Blah blah blah,’” said Parsapour. “Because they’re still processing that one chunk of information. That’s why you need something like a health coach. This is a health coach in an app format that stays with the patient in their entire continuum of care, and then goes home with them.”

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Community specialist services - Joint Commissioning Panel for Mental Health

Community specialist services - Joint Commissioning Panel for Mental Health | E-mental health: digital, mobile and tele tech for the brain! | Scoop.it
This guide is about the commissioning of specialist community mental health services. It explores the role of Community Mental Health Teams (CMHTs), Assertive Outreach Teams and Early Intervention Teams among others. Download Guidance for commissioners of community specialist mental health… Read more »
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Alzheimer's awareness campaign shows people at events they never attended

At the start of collection week, Alzheimer Nederland launched a unique Facebook campaign to engage younger audiences more in the fight against dementia.

 

The simple tag and photo functionalities of Facebook are being ingeniously employed in this campaign to let people experience just for a moment the impact of Alzheimer’s disease in their own familiar surroundings.

 


Via Andrew Spong
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Training the brain using neurofeedback

Training the brain using neurofeedback | E-mental health: digital, mobile and tele tech for the brain! | Scoop.it
A new brain-imaging technique enables people to "watch" their own brain activity in real time and to control or adjust function in predetermined brain regions.
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» New Brain Stimulation Technique May Provide Rapid Depression Relief - Psych Central News

» New Brain Stimulation Technique May Provide Rapid Depression Relief  - Psych Central News | E-mental health: digital, mobile and tele tech for the brain! | Scoop.it

Brain stimulation treatments are often used to treat depression. However, protocols of electroconvulsive therapy (ECT) and transcranial magnetic stimulation

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Brain stimulation treatments are often used to treat depression.

However, protocols of electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS), often have a delayed onset — similar to depressant medications.

For example, a patient may receive several weeks of regular ECT treatments before a full response is achieved.

As a result, researchers are searching for an antidepressanttreatment that acts to rapidly improve mood.

Low field magnetic stimulation (LFMS) is one such potential new treatment with rapid mood-elevating effects, say researchers at Harvard Medical School and Weill Cornell Medical College.

“LFMS is unlike any current treatment. It uses magnetic fields that are a fraction of the strength but at higher frequency than the electromagnetic fields used in TMS and ECT,” explained first author Dr. Michael Rohan.

The potential antidepressant properties of LFMS were discovered by accident, while researchers were conducting an imaging study in healthy volunteers.

This led Rohan and his colleagues to conduct a preliminary study in which they identified the imaging parameters that seemed to be causing the antidepressant effect.

They then designed and constructed a portable LFMS device, which delivers a low strength, high frequency, electromagnetic field waveform to the brain.

The next step was to test the device in depressed patients, the results of which are published in the current issue of Biological Psychiatry.

A total of 63 currently depressed patients, diagnosed with either major depressive disorder or bipolar disorder, participated in the study and were randomized to receive a single 20-minute treatment of real LFMS or sham LFMS, where the device was on but the electromagnetic fields were inactive.

Since neither the patients nor the researchers knew which treatment each person actually received, the true effect of the LFMS could be measured.

An immediate and substantial improvement in mood was observed in the patients who received real LFMS, compared to those who received the sham treatment. There were no reported side effects.

This finding suggests that LFMS may have the potential to provide immediate relief of depressed mood, perhaps even in emergency situations. It also confirms the success of the device’s design.

“The idea that weak electrical stimulation of the brain could produce beneficial effects on depression symptoms is somewhat surprising,” said Dr. John Krystal, Editor of Biological Psychiatry.

“Yet the data make a compelling case that this safe approach deserves further study.”

Rohan confirmed that additional research is underway to find the best parameters for LFMS use in the clinical treatment of depression.

Further research will also be necessary to evaluate the effects of multiple compared to single treatments, and how long the antidepressant effects last following treatment.

Source: Elsevier

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Don’t Worry, Facebook Still Has No Clue How You Feel | Business | WIRED

Don’t Worry, Facebook Still Has No Clue How You Feel | Business | WIRED | E-mental health: digital, mobile and tele tech for the brain! | Scoop.it
The claim is as bold as it is creepy: “Emotional states can be transferred to others via emotional contagion, leading people to experience the same emotions without their awareness.” The data backing this claim—as you’ve likely heard by now—comes from an experiment conducted by Facebook on nearly 700,000 of its users without their knowledge. When…
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New Device Allows Brain To Bypass Spinal Cord, Move Paralyzed Limbs

New Device Allows Brain To Bypass Spinal Cord, Move Paralyzed Limbs | E-mental health: digital, mobile and tele tech for the brain! | Scoop.it
For the first time ever, a paralyzed man can move his fingers and hand with his own thoughts thanks to an innovative partnership between The Ohio State University Wexner Medical Center and Battelle...
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Lead Facebook researcher expresses regret over secret 2012 'mood' study

Lead Facebook researcher expresses regret over secret 2012 'mood' study | E-mental health: digital, mobile and tele tech for the brain! | Scoop.it

After the story broke Saturday that Facebook had experimented with the moods of 700,000 of its users, the lead researcher on the project, Facebook data scientist Adam Kramer, sent VentureBeat an email Sunday pointing to his statement on the affair.

The research, which Kramer says was completed in 2012, manipulated the news feeds of only a small percentage of Facebook users, and then only for a small number of posts.

Kramer says the reason for the research was to “investigate the common worry that seeing friends post positive content leads to people feeling negative or left out.”

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Tune your meditation with a metal flower that tracks your brainwaves -- and those of your friends

Tune your meditation with a metal flower that tracks your brainwaves -- and those of your friends | E-mental health: digital, mobile and tele tech for the brain! | Scoop.it
Can a handmade metal lotus flower, audio snippets of a teacher's voice, and a brainwave headset reader help your meditation? One startup, Mindfulness, thinks so. T

The San Francisco-based company has launched a Kickstarter campaign that seeks $64,000 by July 23 to manufacture its first product, The Lotus. It features a colorful metal lotus flower — handmade in India — that fully opens when your brainwaves reach the set threshold. As you get there, an accompanying app on your smartphone offers audio feedback from a meditation instructor.

“Come back to your breath,” the instructor’s voice might say if your alpha brainwaves start to lag. Once the flower completely opens, it then slowly closes over a pre-set time, with the default being a day.

The brainwave headset — made by either InterAxon Muse or the NeuroSky MindWave Mobile —sends EEG output to the smartphone app. The smartphone communicates via Bluetooth with the metal lotus flower."

 

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Monitoring sleep for stress signs, and early Alzheimer's detection.

Monitoring sleep for stress signs, and early Alzheimer's detection. | E-mental health: digital, mobile and tele tech for the brain! | Scoop.it

We’re learning more about how Alzheimer’s affects the brain — and when — by looking into it, but what if there is a way to more quickly spot early signs of the disease by observing how the brain looks at the world?

The premise of a technology developed by Neurotrack is deceptively simple:  Subjects are given a computer-based test that measures how well they remember images on a screen via an eye-tracking device. An algorithm analysis detects Alzheimer’s in relatively early stages, before behavioral symptoms appear and allowing early intervention. The program was developed by neuroscientists from Emory University and the University of Washington, who brought on an entrepreneur to help them bring their idea to market.

Testing so far bodes very well for its predictive value: Of subjects who scored below 50 percent, all went on to develop full-blown Alzheimer’s within six years. The test has other big advantages: It’s noninvasive, requires no special training to administer and is easy and relatively inexpensive to disseminate.

Neurotrack, one of the companies represented at TEDMED’s 2013 Hive, finished Series A funding with $2 million from Founders Fund and Social+Capital, and has begun the long trek toward FDA approval.

Elli Kaplan, co-founder and CEO, says the road to recognition hasn’t been easy for a start-up that grew from academia and continues to progress independently – versus flying under the wing of a pharmaceutical sponsor – but it also has creative advantages. An idea developed by a smaller group is less likely to get lost in the shuffle of a larger organization, and to be discarded if it doesn’t fit a predestined outcome.

“For us, if it doesn’t work for ‘x’ it might work for ‘y.’ We’re a young company, so we think instead, ‘We put all this work into this, so if something’s not working how can we change our plan to bring things to life?” she says.

Stress, the Ill Felt ‘Round the World

If you’re stressed and you know it, raise your hand.

You probably can read stress signals, especially thanks to attention from health care providers and the media. Your breathing becomes more rapid; your muscles rigid; your skin flushes. And even if you don’t notice, there are great gadgets out there that can clue you in.

But what about the other, less hidden symptoms, like poor sleep and varied speech patterns?

SOMA Analytics, a London-based start-up, has developed a smartphone app that tracks these less-noted symptoms. Named after the mood-regulating drug taken by the populace in Aldous Huxley’s “Brave New World,” SOMA’s app monitors movement patterns at night (yes, you have to sleep with your phone), and voice and typing during the day. It then offers interventions tailored to observed needs. For example, not all sleepers are the same; some do better waking early, some sleeping fewer hours; thanks to genetics. There’s no way to scientifically know which group you’re in, short of spending a weekend at a sleep lab.

Co-founder Johann Huber and two friends came up with the idea after watching a fourth friend slide incrementally into depression.

“We had the feeling there was something going on with him, and in between [times we saw him] he got bags under his eyes and had incredible mood swings. He himself didn’t feel it. Humans don’t notice gradual changes over time,” Huber says.

Why not, then, invent something that does and couple it with something so many of us own and know how to use – the smartphone?  The group worked with a number of hospitals to refine its product, which is already in market and geared towards businesses with a concern for employees’ productivity and well-being.  It stacks up well against metrics gathered in sleep labs.

A native of Germany, Huber said the company moved to London for what he says is a business environment more fertile for start-ups. The world seems ready for SOMA; the company was one of 50 companies selected to join TEDMED’s Hive innovation showcase in 2013 and was one of only 20 Digital Health startups on the continent to be part of the Johnson & Johnson Digital Health Masterclass.

With experience in so many countries, will SOMA’s leadership be able to determine who is less stressed, Americans or Europeans?

Pondering, Huber says, “I studied in the U.S. and I had the impression than Americans are far more laid back than Germans especially,” he says, but allows that intense U.S. work schedules may flip the equation.

“The big question is — who is more productive?  If it helps productivity to rest then I would strongly argue for testing that,” he says.

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Study Shows Telepsychiatry Effective for Alaska Elders

Study Shows Telepsychiatry Effective for Alaska Elders | E-mental health: digital, mobile and tele tech for the brain! | Scoop.it
New America Media is a nationwide association of over 3000 ethnic media organizations representing the development of a more inclusive journalism. Founded in 1996 by Pacific News Service, New America Media promotes ethnic media by strengthening the editorial and economic viability of this increasingly influential segment of America's communications industry.
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New Website Aims to Reinvent Psychology Education - Association for Psychological Science

New Website Aims to Reinvent Psychology Education - Association for Psychological Science | E-mental health: digital, mobile and tele tech for the brain! | Scoop.it

APS Fellow Ed Diener and his wife Carol Diener want you to imagine taking chapters from various introductory textbooks, then shuffling them in any order you want to best fit the course you are teaching — all within minutes on a computer. Oh, and the book is free to your students. Chapters can also be used as supplementary readings, free of charge.


Via Allison Hermann, PhD
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Allison Hermann, PhD's curator insight, February 10, 6:19 PM

"Giving psychology away" via free online psychology courses and textbooks

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Phone device that 'sends' smells could help treat Alzheimer's

We are all familiar with "scratch-and-sniff" products. They have been around since the 1970s - mainly in the form of stickers. But these products are yesterday's news. Researchers have now created a device that could allow us to "text-and-sniff." It is called the oPhone.

Created by David Edwards and colleagues at the Harvard School of Engineering and Applied Sciences in Massachusetts, the oPhone enables odors - labeled "oNotes" - to be sent via email, tweet or text to other oPhones using bluetooth and smartphone attachments.

Edwards, also a student at Michigan Technological University, says the technology may be useful in the world of health care - particularly for the treatment of Alzheimer's disease and mental illness.

The oPhone does not work like a normal cell phone. It does not transmit or receive sounds.

Instead, the cylinder-shaped device consists of a set of disposable "oChips" that can store and emit hundreds of different odors for between 20 and 30 seconds.

The fragrances are created by Marlène Staiger, an aroma expert at a laboratory in France called Le Laboratoire. She deconstructs the scents before capturing them in wax.


The oPhone can text, tweet or email an array of scents via bluetooth and smartphone attachments.
Image credit: Michigan Technological University.

"The oPhone works like a phone for odors. It delivers complex compositions of odors remotely and in a very personal intimate way, in the manner of a standard telephone. Only here the 'words' are aromas," Edwards told Medical News Today.

"This is not just to deliver one odor, but to deliver a sequence of odors, as may happen when you enjoy a meal, or a walk through the forest, or a city."

Edwards said that when the product first launches, the oChips will produce over 300 scents. But he added that one day, it could produce 50,000 or more.

The oPhone is already being tested in conjunction with a coffee shop in Paris, France, called Café Coutume. The aim is to provide customers with a sensory experience.

"Imagine you are online and want to know what a particular brand of coffee would smell like. Or, you are in an actual long line waiting to order. You just tap on the oNote and get the experience," explains Edwards.

Potential treatment for Alzheimer's disease and mental disorders

But more importantly, Edwards says the oPhone could be used to help individuals who suffer from Alzheimer's disease, stress or mental disorders.

At an exhibition in the UK last year, Edwards says he came across a man who had brain damage. As a result, he had lost his memory and his sense of taste and smell.

He believes the oPhone could be used to help restore a person's memory.

He told us:

"We know that olfaction is a strong stimulator of memory, and of course tightly related to taste sensation.

For those dealing with memory loss, or the chance of it, or for those dealing with recovery of mental function, the ability to deliver complex odor sequences coupled with visual signals is an exciting opportunity to improve mental health."

The oPhone will be released to a limited audience for beta testing later this year, which will provide the research team with feedback before releasing a first commercial product at the end of the year.

The team has created a company called Vapor Communications to help develop the technology further and raise investment.

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Cleveland Clinic offers patients an epilepsy management app | mobihealthnews

Cleveland Clinic offers patients an epilepsy management app | mobihealthnews | E-mental health: digital, mobile and tele tech for the brain! | Scoop.it

The Cleveland Clinic has released a patient-facing iPad app to help users manage epilepsy, a chronic neurological condition characterized by recurrent seizures. The app, called MyEpilepsy, contains both educational materials and tracking tools for patients. According to the CDC, about 2.8 million people in the United States have epilepsy.

The informational features on the app include epilepsy facts and myths, an explanation of how epilepsy is diagnosed, medical and surgical treatment information, first aid information for seizures, and links out to the Cleveland Clinic Epilepsy Center website.

In addition, the app provides the user with disease-tracking tools like a seizure diary, where patients can log the time and characteristic symptoms of epileptic seizures, then display that history in graph form. A questionnaire on the app allows the user to enter information about his or her diagnosis, and returns suggestions for additional treatment options.

The app also has tools built in for managing appointments and medications, including calendars and reminders.

Over the past few years, the Cleveland Clinic has released a number of branded apps, but this is the provider organization’s first interactive app focused on a particular disease state.

Epic’s MyChart has been available to Cleveland Clinic patients for some time. Last year, the Cleveland Clinic expanded on that offering by launching its own iPad app for patients, called Today. Today includes health and wellness tips, quizzes, and an interactive model of the human body. While anyone can download the app, Cleveland Clinic patients can access its full feature set, including resources to navigate the provider’s network to find a doctor, access contact information, or request an appointment.

About a month later, the hospital system launched an app for connecting cancer patients with clinical trials, this time for both iPhone and iPad. Additionally, the Cleveland Clinic Concussion Center has been using an app for a few years for on-the-scene concussion diagnosis.

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UF finding great success with online anxiety counseling

UF finding great success with online anxiety counseling | E-mental health: digital, mobile and tele tech for the brain! | Scoop.it
The University of Florida's counseling and wellness center has launched a novel program that provides therapy to patients with anxiety disorders -- all over a computer screen.

Via Allison Hermann, PhD
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Allison Hermann, PhD's curator insight, January 31, 8:17 PM

This therapeutic approach to anxiety couples therapy-assisted online counseling with a smartphone app for homework and reminders. In the short-term it appears to show real promise. The question is, will the intervention show a long-term benefit?

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One in 10 experience daily mental health stigma, survey finds

One in 10 experience daily mental health stigma, survey finds | E-mental health: digital, mobile and tele tech for the brain! | Scoop.it
More than a third of people say they come up against discrimination because of their mental ill health on a weekly or monthly basis, according to a survey.
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Build Your Own Brain-Computer Interface with OpenBCI (INTERVIEW)

Build Your Own Brain-Computer Interface with OpenBCI (INTERVIEW) | E-mental health: digital, mobile and tele tech for the brain! | Scoop.it
Have you ever wanted to build your own (safe) brain-computer interface device? This is the year you may be able to do that, thanks to the folks at OpenBCI.
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