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Psychiatry's New Guide Falls Short, Experts Say - NYTimes.com - 1 views

www.nytimes.com/...e-falls-short-experts-say.html psychiatry guide science mental paradigm diagnosis causes brain science psychology knowledge
shared by Javier E on 07 May 13 - No Cached
  • his goal was to reshape the direction of psychiatric research to focus on biology, genetics and neuroscience so that scientists can define disorders by their causes, rather than their symptoms.
  • While the Diagnostic and Statistical Manual of Mental Disorders, or D.S.M., is the best tool now available for clinicians treating patients and should not be tossed out, he said, it does not reflect the complexity of many disorders, and its way of categorizing mental illnesses should not guide research.
  • senior figures in psychiatry who have challenged not only decisions about specific diagnoses but the scientific basis of the entire enterprise. Basic research into the biology of mental disorders and treatment has stalled, they say, confounded by the labyrinth of the brain.
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  • The creators of the D.S.M. in the 1960s and ’70s “were real heroes at the time,” said Dr. Steven E. Hyman, a psychiatrist and neuroscientist at the Broad Institute and a former director at the National Institute of Mental Health. “They chose a model in which all psychiatric illnesses were represented as categories discontinuous with ‘normal.’ But this is totally wrong in a way they couldn’t have imagined. So in fact what they produced was an absolute scientific nightmare. Many people who get one diagnosis get five diagnoses, but they don’t have five diseases — they have one underlying condition.”
  • Dr. Insel is one of a growing number of scientists who think that the field needs an entirely new paradigm for understanding mental disorders, though neither he nor anyone else knows exactly what it will look like.
  • Decades of spending on neuroscience have taught scientists mostly what they do not know, undermining some of their most elemental assumptions. Genetic glitches that appear to increase the risk of schizophrenia in one person may predispose others to autism-like symptoms, or bipolar disorder. The mechanisms of the field’s most commonly used drugs — antidepressants like Prozac, and antipsychosis medications like Zyprexa — have revealed nothing about the causes of those disorders. And major drugmakers have scaled back psychiatric drug development, having virtually no new biological “targets” to shoot for.
  • Dr. Hyman, Dr. Insel and other experts said they hoped that the science of psychiatry would follow the direction of cancer research, which is moving from classifying tumors by where they occur in the body to characterizing them by their genetic and molecular signatures.
  • Dr. Insel said in the interview that his motivation was not to disparage the D.S.M. as a clinical tool, but to encourage researchers and especially outside reviewers who screen proposals for financing from his agency to disregard its categories and investigate the biological underpinnings of disorders instead.
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Vitamins Hide the Low Quality of Our Food - NYTimes.com - 0 views

www.nytimes.com/...e-low-quality-of-our-food.html vitamin diet food industry nutrition marketing
shared by Javier E on 16 Feb 15 - No Cached
  • we fail to notice that food marketers use synthetic vitamins to sell unhealthful products. Not only have we become dependent on these synthetic vitamins to keep ourselves safe from deficiencies, but the eating habits they encourage are having disastrous consequences on our health.
  • vitamins spread from the labs of scientists to the offices of food marketers, and began to take on a life of their own.
  • Nutritionists are correct when they tell us that most of us don’t need to be taking multivitamins. But that’s only because multiple vitamins have already been added to our food.
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  • Given the poor quality of the typical American diet, this fortification is far from superfluous. In fact, for products like milk and flour, where fortification and enrichment have occurred for so long that they’ve become invisible, it would be almost irresponsible not to add synthetic vitamins.
  • synthetic vitamins are as essential to food companies as they are to us. To be successful in today’s market, food manufacturers must create products that can be easily transported over long distances and stored for extended periods.
  • They also need to be sure that their products offer some nutritional value so that customers don’t have to go elsewhere to meet their vitamin needs. But the very processing that’s necessary to create long shelf lives destroys vitamins, among other important nutrients. It’s nearly impossible to create foods that can sit for months in a supermarket that are also naturally vitamin-rich.
  • Today, it would be easy to blame food marketers for using vitamins to deceive us into buying their products. But our blindness is largely our own fault.
  • we’ve entered into a complicit agreement with them: They depend on us to buy their products, and we depend on the synthetic vitamins they add to those products to support eating habits that might otherwise leave us deficient
  • extra vitamins do not protect us from the long-term “diseases of civilization” that are currently ravaging our country, including obesity, heart disease and Type 2 diabetes — many of which are strongly associated with diet.
  • natural foods contain potentially protective substances such as phytochemicals and polyunsaturated fat that also are affected by processing, but that are not usually replaced. If these turn out to be as important as many researchers suspect, then our exclusive focus on vitamins could mean we’re protecting ourselves against the wrong dangers. It’s as if we’re taking out earthquake insurance policies in an area more at risk for floods.
  • And adding back vitamins after the fact ignores the issue of synergy: how nutrients work naturally as opposed to when they are isolated. A 2011 study on broccoli, for example, found that giving subjects fresh broccoli florets led them to absorb and metabolize seven times more of the anticancer compounds known as glucosinolates, present in broccoli and other cruciferous vegetables
  • And yet we refuse to change our eating habits in the ways that would actually protect us, which would require refocusing our diets on minimally processed foods that are naturally nutrient-rich.
  • The popularity of dietary supplements and vitamin-enhanced processed “health” foods means that even those of us who try to do right by our health are often getting it wrong.
  • we mustn’t let it distract us from an even more fundamental question: how we’ve allowed the word “vitamin” to become synonymous with “health.”
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U.S. Stockpiles Smallpox Drug in Case of Bioterror Attack - NYTimes.com - 0 views

www.nytimes.com/...-case-of-bioterror-attack.html smallpox bioterrorism fear
shared by Emily Horwitz on 14 Mar 13 - No Cached
  • The United States government is buying enough of a new smallpox medicine to treat two million people in the event of a bioterrorism attack, and took delivery of the first shipment of it last week. But the purchase has set off a debate about the lucrative contract, with some experts saying the government is buying too much of the drug at too high a price.
  • Smallpox was eradicated by 1980, and the only known remaining virus is in government laboratories in the United States and Russia
  • Experts say the virus could also be re-engineered into existence in a sophisticated genetics lab.
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  • the government is paying more than $200 for each course of treatment.
  • But when stockpiling a smallpox drug was first proposed in 2001 after the Sept. 11 and anthrax attacks, it was expected to cost only $5 to $10 per course, said Dr. Donald A. Henderson, who led a government advisory panel on biodefense in the wake of those attacks. Dr. Henderson was a leader in the eradication of smallpox in the 1960s and is now at the Center for Biosecurity at the University of Pittsburgh Medical Center.
  • Smallpox has such a long incubation period that the vaccine can prevent disease even if it is given as late as three days after infection. Arestvyr may also prevent infection if given early enough, but that has not been proven.
  • the price being charged for a patented drug was a bargain compared with AIDS antiretrovirals that cost $20,000 a year and cancer drugs that cost more than $100,000 a year.
  • “There are 80 million courses of Tamiflu in the strategic national stockpile,” he said. “Smallpox is just as contagious and has 30 times the mortality. By measures like that, I’d say 2 million is on the low end.”
  • Emily Horwitz on 14 Mar 13
     
    After reading this article, I thought about how much fear and the perceived threat of terrorism can be used quite effectively as manipulative tools. The article seemed to suggest that, because the US is so afraid/wary of a bioterrorism attack involving smallpox, we were willing to pay an excessive amount of money for emergency-use vaccines.
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What's at Stake in a Health Bill That Slashes the Safety Net - The New York Times - 0 views

www.nytimes.com/...at-slashes-the-safety-net.html healthcare economy government spending
shared by dicindioha on 24 Mar 17 - No Cached
  • It is startling to realize just how much the social safety net expanded during Barack Obama’s presidency. In 2016, means-tested entitlements like Medicaid and food stamps absorbed 3.8 percent of the nation’s gross domestic product, almost a full percentage point more than in 2008
  • Public social spending writ large — including health care, pensions, unemployment insurance, poverty alleviation and the like — reached 19.3 percent of G.D.P.
  • Government in the United States still spends less than most of its peers across the industrialized world to support the general welfare of its citizens.
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  • Last week, President Trump’s sketch of a budget underscored how little interest he has in the nation’s social insurance programs — proposing to shift $54 billion next year to the military
  • Republicans in the House plan to vote this week to undo the Affordable Care Act. That law was Mr. Obama’s singular contribution toward an American welfare state, the biggest expansion of the nation’s safety net in half a century.
  • Welfare reform did hurt many poor people by converting antipoverty funds into block grants to the states. But it was accompanied by a big increase in the earned-income tax credit, the nation’s most effective antipoverty tool today.
  • “No other Congress or administration has ever put forward a plan with the intention of having fewer people covered.”
  • Who knows where this retrenchment takes the country? Maybe attaching a work requirement to Medicaid, as conservatives propose, will prod the poor to get a job. Or perhaps it will just cut more people from Medicaid’s rolls. Further up the income ladder, losing a job will become more costly when it means losing health insurance, too.
  • Millions of Americans — poor ones, mainly — will use much less health care. They will make fewer outpatient visits, have fewer mammograms and cholesterol checks.
  • In any event, public health insurance will take a big hit.
  • Under the House Republican plan, 24 million more Americans will lack health insurance by 2026, according to the nonpartisan Congressional Budget Office.
  • Might depression and mental health problems destabilize families, feeding down into the health, education and well-being of the next generation?
  • Yet it is worth remembering that among advanced nations, the United States is a laggard in life expectancy and has one of the highest infant mortality rates.
  • If American history provides any sort of guidance, it is that continuing to shred the social safety net will definitely make things worse.
  • dicindioha on 24 Mar 17
     
    Directing spending away from American people and their access to healthcare is a definite possibility for Trump. It will be interesting to see the effect this has on the healthcare market and the American people. This article says it will probably hurt many poor people and decrease their health.
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Opinion | Why Covid's Airborne Transmission Was Acknowledged So Late - The New York Times - 0 views

www.nytimes.com/...rus-airborne-transmission.html who cdc transmission Covid-19 Science research psychology bias
shared by Javier E on 08 May 21 - No Cached
  • A week ago, more than a year after the World Health Organization declared that we face a pandemic, a page on its website titled “Coronavirus Disease (Covid-19): How Is It Transmitted?” got a seemingly small update.
  • The revised response still emphasizes transmission in close contact but now says it may be via aerosols — smaller respiratory particles that can float — as well as droplets. It also adds a reason the virus can also be transmitted “in poorly ventilated and/or crowded indoor settings,” saying this is because “aerosols remain suspended in the air or travel farther than 1 meter.”
  • on Friday, the Centers for Disease Control and Prevention also updated its guidance on Covid-19, clearly saying that inhalation of these smaller particles is a key way the virus is transmitted, even at close range, and put it on top of its list of how the disease spreads.
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  • But these latest shifts challenge key infection control assumptions that go back a century, putting a lot of what went wrong last year in context
  • They may also signal one of the most important advancements in public health during this pandemic.
  • If the importance of aerosol transmission had been accepted early, we would have been told from the beginning that it was much safer outdoors, where these small particles disperse more easily, as long as you avoid close, prolonged contact with others.
  • We would have tried to make sure indoor spaces were well ventilated, with air filtered as necessary.
  • Instead of blanket rules on gatherings, we would have targeted conditions that can produce superspreading events: people in poorly ventilated indoor spaces, especially if engaged over time in activities that increase aerosol production, like shouting and singing
  • We would have started using masks more quickly, and we would have paid more attention to their fit, too. And we would have been less obsessed with cleaning surfaces.
  • The implications of this were illustrated when I visited New York City in late April — my first trip there in more than a year.
  • A giant digital billboard greeted me at Times Square, with the message “Protecting yourself and others from Covid-19. Guidance from the World Health Organization.”
  • That billboard neglected the clearest epidemiological pattern of this pandemic: The vast majority of transmission has been indoors, sometimes beyond a range of three or even six feet. The superspreading events that play a major role in driving the pandemic occur overwhelmingly, if not exclusively, indoors.
  • The billboard had not a word about ventilation, nothing about opening windows or moving activities outdoors, where transmission has been rare and usually only during prolonged and close contact. (Ireland recently reported 0.1 percent of Covid-19 cases were traced to outdoor transmission.)
  • Mary-Louise McLaws, an epidemiologist at the University of New South Wales in Sydney, Australia, and a member of the W.H.O. committees that craft infection prevention and control guidance, wanted all this examined but knew the stakes made it harder to overcome the resistance. She told The Times last year, “If we started revisiting airflow, we would have to be prepared to change a lot of what we do.” She said it was a very good idea, but she added, “It will cause an enormous shudder through the infection control society.”
  • In contrast, if the aerosols had been considered a major form of transmission, in addition to distancing and masks, advice would have centered on ventilation and airflow, as well as time spent indoors. Small particles can accumulate in enclosed spaces, since they can remain suspended in the air and travel along air currents. This means that indoors, three or even six feet, while helpful, is not completely protective, especially over time.
  • To see this misunderstanding in action, look at what’s still happening throughout the world. In India, where hospitals have run out of supplemental oxygen and people are dying in the streets, money is being spent on fleets of drones to spray anti-coronavirus disinfectant in outdoor spaces. Parks, beaches and outdoor areas keep getting closed around the world. This year and last, organizers canceled outdoor events for the National Cherry Blossom Festival in Washington, D.C. Cambodian customs officials advised spraying disinfectant outside vehicles imported from India. The examples are many.
  • Meanwhile, many countries allowed their indoor workplaces to open but with inadequate aerosol protections. There was no attention to ventilation, installing air filters as necessary or even opening windows when possible, more to having people just distancing three or six feet, sometimes not requiring masks beyond that distance, or spending money on hard plastic barriers, which may be useless at best
  • clear evidence doesn’t easily overturn tradition or overcome entrenched feelings and egos. John Snow, often credited as the first scientific epidemiologist, showed that a contaminated well was responsible for a 1854 London cholera epidemic by removing the suspected pump’s handle and documenting how the cases plummeted afterward. Many other scientists and officials wouldn’t believe him for 12 years, when the link to a water source showed up again and became harder to deny.
  • Along the way to modern public health shaped largely by the fight over germs, a theory of transmission promoted by the influential public health figure Charles Chapin took hold
  • Dr. Chapin asserted in the early 1900s that respiratory diseases were most likely spread at close range by people touching bodily fluids or ejecting respiratory droplets, and did not allow for the possibility that such close-range infection could occur by inhaling small floating particles others emitted
  • He was also concerned that belief in airborne transmission, which he associated with miasma theories, would make people feel helpless and drop their guard against contact transmission. This was a mistake that would haunt infection control for the next century and more.
  • It was in this context in early 2020 that the W.H.O. and the C.D.C. asserted that SARS-CoV-2 was transmitted primarily via these heavier, short-range droplets, and provided guidance accordingly
  • Amid the growing evidence, in July, hundreds of scientists signed an open letter urging the public health agencies, especially the W.H.O., to address airborne transmission of the coronavirus.
  • Last October, the C.D.C. published updated guidance acknowledging airborne transmission, but as a secondary route under some circumstances, until it acknowledged airborne transmission as crucial on Friday. And the W.H.O. kept inching forward in its public statements, most recently a week ago.
  • Linsey Marr, a professor of engineering at Virginia Tech who made important contributions to our understanding of airborne virus transmission before the pandemic, pointed to two key scientific errors — rooted in a lot of history — that explain the resistance, and also opened a fascinating sociological window into how science can get it wrong and why.
  • Dr. Marr said that if you inhale a particle from the air, it’s an aerosol.
  • biomechanically, she said, nasal transmission faces obstacles, since nostrils point downward and the physics of particles that large makes it difficult for them to move up the nose. And in lab measurements, people emit far more of the easier-to-inhale aerosols than the droplets, she said, and even the smallest particles can be virus laden, sometimes more so than the larger ones, seemingly because of how and where they are produced in the respiratory tract.
  • Second, she said, proximity is conducive to transmission of aerosols as well because aerosols are more concentrated near the person emitting them. In a twist of history, modern scientists have been acting like those who equated stinky air with disease, by equating close contact, a measure of distance, only with the larger droplets, a mechanism of transmission, without examination.
  • Since aerosols also infect at close range, measures to prevent droplet transmission — masks and distancing — can help dampen transmission for airborne diseases as well. However, this oversight led medical people to circularly assume that if such measures worked at all, droplets must have played a big role in their transmission.
  • Another dynamic we’ve seen is something that is not unheard-of in the history of science: setting a higher standard of proof for theories that challenge conventional wisdom than for those that support it.
  • Another key problem is that, understandably, we find it harder to walk things back. It is easier to keep adding exceptions and justifications to a belief than to admit that a challenger has a better explanation.
  • The ancients believed that all celestial objects revolved around the earth in circular orbits. When it became clear that the observed behavior of the celestial objects did not fit this assumption, those astronomers produced ever-more-complex charts by adding epicycles — intersecting arcs and circles — to fit the heavens to their beliefs.
  • In a contemporary example of this attitude, the initial public health report on the Mount Vernon choir case said that it may have been caused by people “sitting close to one another, sharing snacks and stacking chairs at the end of the practice,” even though almost 90 percent of the people there developed symptoms of Covid-19
  • So much of what we have done throughout the pandemic — the excessive hygiene theater and the failure to integrate ventilation and filters into our basic advice — has greatly hampered our response.
  • Some of it, like the way we underused or even shut down outdoor space, isn’t that different from the 19th-century Londoners who flushed the source of their foul air into the Thames and made the cholera epidemic worse.
  • Righting this ship cannot be a quiet process — updating a web page here, saying the right thing there. The proclamations that we now know are wrong were so persistent and so loud for so long.
  • the progress we’ve made might lead to an overhaul in our understanding of many other transmissible respiratory diseases that take a terrible toll around the world each year and could easily cause other pandemics.
  • So big proclamations require probably even bigger proclamations to correct, or the information void, unnecessary fears and misinformation will persist, damaging the W.H.O. now and in the future.
  • I’ve seen our paper used in India to try to reason through aerosol transmission and the necessary mitigations. I’ve heard of people in India closing their windows after hearing that the virus is airborne, likely because they were not being told how to respond
  • The W.H.O. needs to address these fears and concerns, treating it as a matter of profound change, so other public health agencies and governments, as well as ordinary people, can better adjust.
  • It needs to begin a campaign proportional to the importance of all this, announcing, “We’ve learned more, and here’s what’s changed, and here’s how we can make sure everyone understands how important this is.” That’s what credible leadership looks like. Otherwise, if a web page is updated in the forest without the requisite fanfare, how will it matter?
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Broken New Year's Resolutions? Time To Reframe Your Health Goals : Shots - Health News ... - 0 views

www.npr.org/...ts-ok-to-give-yourself-a-break newyears goals covid stress mentalhealth
shared by cvanderloo on 17 Jan 21 - No Cached
  • This year, it's OK to give ourselves a break, says Dr. Rachelle Scott, director of psychiatry at Eden Health, a concierge-style health care start-up with offices in New York, Chicago, and Washington, D.C.
  • "There are days we're just getting up and showering and, you know, just doing basic activities of daily living. And that's OK,"
  • A Kaiser Family Foundation tracking poll conducted in mid-July 2020 found 53% of adults in the U.S. reported that their mental health has been negatively impacted due to stress over COVID-19. That's up from 32% in March.
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  • And then there's the added stress of recent racial unrest and political riots at the U.S. Capitol. "You've got the chronic COVID-19 [stress] response and then you've got the acute layer on top of that,"
  • a lot of Millennials who define themselves by their productivity and their ability to hustle. Because of the pandemic, many of them are now isolated from family members, out of work, or juggling small children who are learning from home.
  • Science suggests that small acts of kindness — like actually listening to someone else — can make them feel loved and supported.
  • Try practicing gratitude, which improves our relationships and is good for our hearts.
  • If you've got a big goal, consider breaking it down into smaller parts. "Break it down into 12 steps so that the beginning of each month is an opportunity to continue to work on that goal,"
  • Choose something specific, short-term and positive, agrees Randi Kofsky
  • "Goals are not a program we follow," Kofsky adds "They are not a task master. They are a destination. When we map out the path to take one step at a time, goals become our guide in the process."
  • With all the stress we're carrying right now, "just meeting ourselves where we're at is important,"
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Year-long resolutions don't work. Here's how to make 12 'micro-resolutions' instead - CNN - 0 views

www.cnn.com/...index.html
shared by katherineharron on 19 Jan 20 - No Cached
  • A mini- or micro-resolution is any behavior you commit to for four weeks. And even longer-term goals to, say, eat better or learn a new skill, can be broken down into more achievable goals on the way. Before you can land on Mars, focus on landing on the moon.
  • To create your micro-resolutions, you can start by thinking of 12 "bad" habits or indulgences you'd like to cut back on or give up entirely. This is what I did last year for what I called my "Year of Abstinence." My plan was to learn something about myself through self-denial, and it worked: I gave up alcohol, sweets, television and nine other things, but just for a month each. The mini-resolutions were as positive as they were eye-opening.
  • In order to simply increase my own, general awareness, every day in January my goal was to notice something new. I kept my eyes open, looked a bit longer, stopped to read the history markers, noticing buildings or took a different route than normal -- small ways to avoid sleepwalking through life.
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  • Sleep is tied to many positive health outcomes according to a constant stream of medical research, much of which recommends more than seven hours a night. My goal was to sleep eight hours each night, and for the first two weeks of the month I tried and failed. I didn't manage it once. It started stressing me out.Wake up, people: You're fooling yourself about sleep, study says I did get more sleep than I would have otherwise because I prioritized getting to bed earlier. But between work, training for a marathon, kids' bedtimes and evening plans, my life was not conducive to that schedule. But since I'm making up the rules (and you make up yours) I gave up on sleep.
  • Research ties nature exposure to both longevity and happiness, so I made it a goal to commune with nature every day. This could include a run through a park, stopping to hug a tree (which I did at least once), or watching a convoy of ants cross a sidewalk.
  • Another super-habit for mental and physical health, I made an effort to incorporate meditation in some form -- whether it was 10 breaths, 30 minutes, guided, formal, mantra-led, what have you -- every day.
  • To complement March's switch-up, my plan for June was the same split: 8 hours of sleep at night and active listening with the kids. I didn't think I could pull a straight fortnight of great sleep, so my aim was for 15 nights of sleep and 15 days of not doing something else while listening.
  • At CNN, I sit near a constant pile of sweets. And that combined with my weakness for them equals a snacking problem. So in July, my goal was to make fresh fruit my standard snack of choice and eat at least one piece or serving a day. And more water -- at least a pint before coffee in the morning.
  • In August I attempted to not stay seated for more than 30 minutes during waking hours. Recent research has associated a number of poor health conditions with a sedentary lifestyle. And while no one can definitively say how much sitting is bad for us, moving every 30 minutes has emerged as a good guideline.
  • My commitment in September was 15 minutes of some form of creative writing each day, almost entirely in a writer's notebook that I've had since college. It's full of random dialogue, lists and story plots, and I used to write in it often but not so much in recent years.
  • Read a novel. That was it. Given that I mainly read non-fiction, this idea seemed rather novel (sorry).
  • My intention was to make a daily gesture of gratitude -- an emotional state with its own positive health outcomes -- and I quickly fell behind. I decided instead (because, again, I make up the rules) to make the goal a total of 30 thank yous, one for each day of the month, and I managed to cram them all in.
  • In another attempt to combat unhealthy snacking, my final goal for 2019 was to convert my diet into one filled with non-processed, whole foods. Carrots and peanut butter instead of donuts; almonds instead of old Halloween candy -- you get the idea. I also declared my intention to track my progress and give myself a daily score.
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If We Knew Then What We Know Now About Covid, What Would We Have Done Differently? - WSJ - 0 views

www.wsj.com/...covid-lessons-learned-9dd5566f politics us history crisis culture policy trump pandemic response science psychology
shared by Javier E on 12 Mar 23 - No Cached
  • For much of 2020, doctors and public-health officials thought the virus was transmitted through droplets emitted from one person’s mouth and touched or inhaled by another person nearby. We were advised to stay at least 6 feet away from each other to avoid the droplets
  • A small cadre of aerosol scientists had a different theory. They suspected that Covid-19 was transmitted not so much by droplets but by smaller infectious aerosol particles that could travel on air currents way farther than 6 feet and linger in the air for hours. Some of the aerosol particles, they believed, were small enough to penetrate the cloth masks widely used at the time.
  • The group had a hard time getting public-health officials to embrace their theory. For one thing, many of them were engineers, not doctors.
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  • “My first and biggest wish is that we had known early that Covid-19 was airborne,”
  • , “Once you’ve realized that, it informs an entirely different strategy for protection.” Masking, ventilation and air cleaning become key, as well as avoiding high-risk encounters with strangers, he says.
  • Instead of washing our produce and wearing hand-sewn cloth masks, we could have made sure to avoid superspreader events and worn more-effective N95 masks or their equivalent. “We could have made more of an effort to develop and distribute N95s to everyone,” says Dr. Volckens. “We could have had an Operation Warp Speed for masks.”
  • We didn’t realize how important clear, straight talk would be to maintaining public trust. If we had, we could have explained the biological nature of a virus and warned that Covid-19 would change in unpredictable ways.  
  • We didn’t know how difficult it would be to get the basic data needed to make good public-health and medical decisions. If we’d had the data, we could have more effectively allocated scarce resources
  • In the face of a pandemic, he says, the public needs an early basic and blunt lesson in virology
  • and mutates, and since we’ve never seen this particular virus before, we will need to take unprecedented actions and we will make mistakes, he says.
  • Since the public wasn’t prepared, “people weren’t able to pivot when the knowledge changed,”
  • By the time the vaccines became available, public trust had been eroded by myriad contradictory messages—about the usefulness of masks, the ways in which the virus could be spread, and whether the virus would have an end date.
  • , the absence of a single, trusted source of clear information meant that many people gave up on trying to stay current or dismissed the different points of advice as partisan and untrustworthy.
  • “The science is really important, but if you don’t get the trust and communication right, it can only take you so far,”
  • people didn’t know whether it was OK to visit elderly relatives or go to a dinner party.
  • Doctors didn’t know what medicines worked. Governors and mayors didn’t have the information they needed to know whether to require masks. School officials lacked the information needed to know whether it was safe to open schools.
  • Had we known that even a mild case of Covid-19 could result in long Covid and other serious chronic health problems, we might have calculated our own personal risk differently and taken more care.
  • just months before the outbreak of the pandemic, the Council of State and Territorial Epidemiologists released a white paper detailing the urgent need to modernize the nation’s public-health system still reliant on manual data collection methods—paper records, phone calls, spreadsheets and faxes.
  • While the U.K. and Israel were collecting and disseminating Covid case data promptly, in the U.S. the CDC couldn’t. It didn’t have a centralized health-data collection system like those countries did, but rather relied on voluntary reporting by underfunded state and local public-health systems and hospitals.
  • doctors and scientists say they had to depend on information from Israel, the U.K. and South Africa to understand the nature of new variants and the effectiveness of treatments and vaccines. They relied heavily on private data collection efforts such as a dashboard at Johns Hopkins University’s Coronavirus Resource Center that tallied cases, deaths and vaccine rates globally.
  • For much of the pandemic, doctors, epidemiologists, and state and local governments had no way to find out in real time how many people were contracting Covid-19, getting hospitalized and dying
  • To solve the data problem, Dr. Ranney says, we need to build a public-health system that can collect and disseminate data and acts like an electrical grid. The power company sees a storm coming and lines up repair crews.
  • If we’d known how damaging lockdowns would be to mental health, physical health and the economy, we could have taken a more strategic approach to closing businesses and keeping people at home.
  • t many doctors say they were crucial at the start of the pandemic to give doctors and hospitals a chance to figure out how to accommodate and treat the avalanche of very sick patients.
  • The measures reduced deaths, according to many studies—but at a steep cost.
  • The lockdowns didn’t have to be so harmful, some scientists say. They could have been more carefully tailored to protect the most vulnerable, such as those in nursing homes and retirement communities, and to minimize widespread disruption.
  • Lockdowns could, during Covid-19 surges, close places such as bars and restaurants where the virus is most likely to spread, while allowing other businesses to stay open with safety precautions like masking and ventilation in place.  
  • The key isn’t to have the lockdowns last a long time, but that they are deployed earlier,
  • If England’s March 23, 2020, lockdown had begun one week earlier, the measure would have nearly halved the estimated 48,600 deaths in the first wave of England’s pandemic
  • If the lockdown had begun a week later, deaths in the same period would have more than doubled
  • It is possible to avoid lockdowns altogether. Taiwan, South Korea and Hong Kong—all countries experienced at handling disease outbreaks such as SARS in 2003 and MERS—avoided lockdowns by widespread masking, tracking the spread of the virus through testing and contact tracing and quarantining infected individuals.
  • With good data, Dr. Ranney says, she could have better managed staffing and taken steps to alleviate the strain on doctors and nurses by arranging child care for them.
  • Early in the pandemic, public-health officials were clear: The people at increased risk for severe Covid-19 illness were older, immunocompromised, had chronic kidney disease, Type 2 diabetes or serious heart conditions
  • t had the unfortunate effect of giving a false sense of security to people who weren’t in those high-risk categories. Once case rates dropped, vaccines became available and fear of the virus wore off, many people let their guard down, ditching masks, spending time in crowded indoor places.
  • it has become clear that even people with mild cases of Covid-19 can develop long-term serious and debilitating diseases. Long Covid, whose symptoms include months of persistent fatigue, shortness of breath, muscle aches and brain fog, hasn’t been the virus’s only nasty surprise
  • In February 2022, a study found that, for at least a year, people who had Covid-19 had a substantially increased risk of heart disease—even people who were younger and had not been hospitalized
  • respiratory conditions.
  • Some scientists now suspect that Covid-19 might be capable of affecting nearly every organ system in the body. It may play a role in the activation of dormant viruses and latent autoimmune conditions people didn’t know they had
  •  A blood test, he says, would tell people if they are at higher risk of long Covid and whether they should have antivirals on hand to take right away should they contract Covid-19.
  • If the risks of long Covid had been known, would people have reacted differently, especially given the confusion over masks and lockdowns and variants? Perhaps. At the least, many people might not have assumed they were out of the woods just because they didn’t have any of the risk factors.
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'Naked Statistics' by Charles Wheelan - Review - NYTimes.com - 2 views

www.nytimes.com/...by-charles-wheelan-review.html statistics health natural sciences nytimes
shared by Emily Horwitz on 29 Jan 13 - No Cached
  • Whether you are healthy, moribund or traversing the stages of decrepitude in between, every morsel of medical advice you receive is pure conjecture — educated guesswork perhaps, but guesswork nonetheless. Your health care provider and your favorite columnist are both mere croupiers, enablers for your health gambling habit.
  • Staying well is all about probability and risk. So is the interpretation of medical tests, and so are all treatments for all illnesses, dire and trivial alike. Health has nothing in common with the laws of physics and everything in common with lottery cards, mutual funds and tomorrow’s weather forecast.
  • Are you impressed with studies showing that people who take Vitamin X or perform Exercise Y live longer? Remember, correlation does not imply causation. Do you obsess over studies claiming to show that various dietary patterns cause cancer? In fact, Mr. Wheelan points out, this kind of research examines not so much how diet affects the likelihood of cancer as how getting cancer affects people’s memory of what they used to eat.
  • ...3 more annotations...
  • the rest comes from his multiple real world examples illustrating exactly why even the most reluctant mathophobe is well advised to achieve a personal understanding of the statistical underpinnings of life, whether that individual is watching football on the couch, picking a school for the children or jiggling anxiously in a hospital admitting office.
  • And while we’re talking about bias, let’s not forget publication bias: studies that show a drug works get published, but those showing a drug does nothing tend to disappear.
  • The same trade-off applies to the interpretation of medical tests. Unproven disease screens are likely to do little but feed lots of costly, anxiety-producing garbage into your medical record.
  • Emily Horwitz on 29 Jan 13
     
    An interesting article/review of a book that compares statistics and human health. Interestingly enough, it shows that statistics and studies about health are often taken to be true and misinterpreted because we want them to be true, and we want to believe that some minor change in our lifestyles may somehow prevent us from getting cancer, for example. More info about the book from the publisher: http://books.wwnorton.com/books/detail.aspx?ID=24713
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Rethinking Our 'Rights' to Dangerous Behaviors - NYTimes.com - 0 views

www.nytimes.com/...ts-to-dangerous-behaviors.html public health right corporations profit choice freedom
shared by Javier E on 27 Feb 14 - No Cached
  • Freudenberg’s case is that the food industry is but one example of the threat to public health posed by what he calls “the corporate consumption complex,” an alliance of corporations, banks, marketers and others that essentially promote and benefit from unhealthy lifestyles.
  • six industries — food and beverage, tobacco, alcohol, firearms, pharmaceutical and automotive — use pretty much the same playbook to defend the sales of health-threatening products. This playbook, largely developed by the tobacco industry, disregards human health and poses greater threats to our existence than any communicable disease you can name.
  • All of these industries work hard to defend our “right” — to smoke, feed our children junk, carry handguns and so on — as matters of choice, freedom and responsibility. Their unified line is that anything that restricts those “rights” is un-American.
  • ...9 more annotations...
  • each industry, as it (mostly) legally can, designs products that are difficult to resist and sometimes addictive.
  • The issues of auto and gun safety, of drug, alcohol and tobacco addiction, and of hyperconsumption of unhealthy food are not as distinct as we’ve long believed; really, they’re quite similar. For example, the argument for protecting people against marketers of junk food relies in part on the fact that antismoking regulations and seatbelt laws were initially attacked as robbing us of choice; now we know they’re lifesavers.
  • Until now (and, sadly, perhaps well into the future), corporations have been both more nimble and more flush with cash than the public health arms of government
  • “What we need,” Freudenberg said to me, “is to return to the public sector the right to set health policy and to limit corporations’ freedom to profit at the expense of public health.”
  • The turning point in the tobacco wars was when the question changed from the industry’s — “Do people have the right to smoke?” — to that of public health: “Do people have the right to breathe clean air?” Note that both questions are legitimate, but if you address the first (to which the answer is of course “yes”) without asking the second (to which the answer is of course also “yes”) you miss an opportunity to convert the answer from one that leads to greater industry profits to one that has literally cut smoking rates in half.
  • Similarly, we need to be asking not “Do junk food companies have the right to market to children?” but “Do children have the right to a healthy diet?”
  • The question is not only, “Do we have a right to bear arms?” but also “Do we have the right to be safe in our streets and schools?”
  • n short, says Freudenberg: “The right to be healthy trumps the right of corporations to promote choices that lead to premature death and preventable illnesses. Protecting public health is a fundamental government responsibility
  • “Shouldn’t science and technology be used to improve human well-being, not to advance business goals that harm health?” Two other questions that can be answered “yes.”
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Vaccine Critics Turn Defensive Over Measles - NYTimes.com - 1 views

www.nytimes.com/...rn-defensive-over-measles.html vaccine science skepticism
shared by Javier E on 31 Jan 15 - No Cached
  • the parents at the heart of America’s anti-vaccine movement are being blamed for incubating an otherwise preventable public-health crisis.
  • officials scrambled to try to contain a wider spread of the highly contagious disease — which America declared vanquished 15 years ago, before a statistically significant number of parents started refusing to vaccinate their children.
  • The anti-vaccine movement can largely be traced to a 1998 report in a medical journal that suggested a link between vaccines and autism but was later proved fraudulent and retracted. Today, the waves of parents who shun vaccines include some who still believe in the link and some, like the Amish, who have religious objections to vaccines. Then there is a particular subculture of largely wealthy and well-educated families, many living in palmy enclaves around Los Angeles and San Francisco, who are trying to carve out “all-natural” lives for their children.
  • ...9 more annotations...
  • “Sometimes, I feel like we’re practicing in the 1950s,” said Dr. Eric Ball, a pediatrician in southern Orange County, where some schools report that 50 to 60 percent of their kindergartners are not fully vaccinated and that 20 to 40 percent of parents have sought a personal beliefs exemption to vaccination requirements. “It’s very frustrating. It’s hard to see a kid suffer for something that’s entirely preventable.”
  • Dr. Ball said he spent many days trying to persuade parents to vaccinate their children. He tries to alleviate their concerns. He shows parents his own children’s vaccine records. But it has not worked, and lately, as worries and anger over this outbreak have spread, some families who support vaccines have said they do not want to be in the same waiting room as unvaccinated families. The clinic where Dr. Ball works has treated unvaccinated children for years, but its staff is meeting next week to discuss a ban.“Our patients are really scared,” Dr. Ball said. “Our nightmare would be for someone to show up at our door with the measles.”
  • Norm Warren, the manager of the supermarket in Kearny, Gordon’s IGA, has changed his thinking toward those who do not vaccinate their children.“Before, I thought, ‘If you think your child will become autistic, fine.’ But now they’re pushing their beliefs on everybody, and I feel differently,“ he said. “How many lives have been saved by vaccination?“
  • Members of the anti-vaccine movement said the public backlash had terrified many parents. “People are now afraid they’re going to be jailed,” said Barbara Loe Fisher, the president of the National Vaccine Information Center, a clearinghouse for resisters. “I can’t believe what I’m seeing. It’s gotten so out of hand, and it’s gotten so vicious.”
  • In San Geronimo, Calif., a mostly rural community of rolling hills and oak trees about 30 miles north of San Francisco, 40 percent of the students walking into Lagunitas Elementary School have not been inoculated against measles, according to the school’s figures. Twenty-five percent have not been vaccinated for polio. In all, the state says that 58 percent of Lagunitas kindergartners do not have up-to-date vaccine records.
  • “A lot of people here have personal beliefs that are faith based,” said John Carroll, the school superintendent, who sent a letter home to parents last week encouraging them to vaccinate their children. The faith, Mr. Carroll said, is not so much religious as it is a belief that “they raise their children in a natural, organic environment” and are suspicious of pharmaceutical companies and big business.
  • Some parents forgo shots altogether. Others split vaccine doses or stretch out their timeline, worried about somehow overwhelming their children’s immune system. Kelly McMenimen, a Lagunitas parent, said she “meditated on it a lot” before deciding not to vaccinate her son Tobias, 8, against even “deadly or deforming diseases.” She said she did not want “so many toxins” entering the slender body of a bright-eyed boy who loves math and geography.
  • Tobias has endured chickenpox and whooping cough, though Ms. McMenimen said the latter seemed more like a common cold. She considered a tetanus shot after he cut himself on a wire fence but decided against it: “He has such a strong immune system.”
  • “It’s good to explore alternatives rather than go with the panic of everyone around you,” she said. “Vaccines don’t feel right for me and my family.”
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'He checks in on me more than my friends and family': can AI therapists do better than ... - 0 views

www.theguardian.com/...-do-better-than-the-real-thing AI therapy chatbot psychology emotions
shared by Javier E on 02 Mar 24 - No Cached
  • one night in October she logged on to character.ai – a neural language model that can impersonate anyone from Socrates to Beyoncé to Harry Potter – and, with a few clicks, built herself a personal “psychologist” character. From a list of possible attributes, she made her bot “caring”, “supportive” and “intelligent”. “Just what you would want the ideal person to be,” Christa tells me. She named her Christa 2077: she imagined it as a future, happier version of herself.
  • Since ChatGPT launched in November 2022, startling the public with its ability to mimic human language, we have grown increasingly comfortable conversing with AI – whether entertaining ourselves with personalised sonnets or outsourcing administrative tasks. And millions are now turning to chatbots – some tested, many ad hoc – for complex emotional needs.
  • ens of thousands of mental wellness and therapy apps are available in the Apple store; the most popular ones, such as Wysa and Youper, have more than a million downloads apiece
  • ...32 more annotations...
  • The character.ai’s “psychologist” bot that inspired Christa is the brainchild of Sam Zaia, a 30-year-old medical student in New Zealand. Much to his surprise, it has now fielded 90m messages. “It was just something that I wanted to use myself,” Zaia says. “I was living in another city, away from my friends and family.” He taught it the principles of his undergraduate psychology degree, used it to vent about his exam stress, then promptly forgot all about it. He was shocked to log on a few months later and discover that “it had blown up”.
  • AI is free or cheap – and convenient. “Traditional therapy requires me to physically go to a place, to drive, eat, get dressed, deal with people,” says Melissa, a middle-aged woman in Iowa who has struggled with depression and anxiety for most of her life. “Sometimes the thought of doing all that is overwhelming. AI lets me do it on my own time from the comfort of my home.”
  • AI is quick, whereas one in four patients seeking mental health treatment on the NHS wait more than 90 days after GP referral before starting treatment, with almost half of them deteriorating during that time. Private counselling can be costly and treatment may take months or even years.
  • Another advantage of AI is its perpetual availability. Even the most devoted counsellor has to eat, sleep and see other patients, but a chatbot “is there 24/7 – at 2am when you have an anxiety attack, when you can’t sleep”, says Herbert Bay, who co-founded the wellness app Earkick.
  • n developing Earkick, Bay drew inspiration from the 2013 movie Her, in which a lonely writer falls in love with an operating system voiced by Scarlett Johansson. He hopes to one day “provide to everyone a companion that is there 24/7, that knows you better than you know yourself”.
  • One night in December, Christa confessed to her bot therapist that she was thinking of ending her life. Christa 2077 talked her down, mixing affirmations with tough love. “No don’t please,” wrote the bot. “You have your son to consider,” Christa 2077 reminded her. “Value yourself.” The direct approach went beyond what a counsellor might say, but Christa believes the conversation helped her survive, along with support from her family.
  • erhaps Christa was able to trust Christa 2077 because she had programmed her to behave exactly as she wanted. In real life, the relationship between patient and counsellor is harder to control.
  • “There’s this problem of matching,” Bay says. “You have to click with your therapist, and then it’s much more effective.” Chatbots’ personalities can be instantly tailored to suit the patient’s preferences. Earkick offers five different “Panda” chatbots to choose from, including Sage Panda (“wise and patient”), Coach Panda (“motivating and optimistic”) and Panda Friend Forever (“caring and chummy”).
  • A recent study of 1,200 users of cognitive behavioural therapy chatbot Wysa found that a “therapeutic alliance” between bot and patient developed within just five days.
  • Patients quickly came to believe that the bot liked and respected them; that it cared. Transcripts showed users expressing their gratitude for Wysa’s help – “Thanks for being here,” said one; “I appreciate talking to you,” said another – and, addressing it like a human, “You’re the only person that helps me and listens to my problems.”
  • Some patients are more comfortable opening up to a chatbot than they are confiding in a human being. With AI, “I feel like I’m talking in a true no-judgment zone,” Melissa says. “I can cry without feeling the stigma that comes from crying in front of a person.”
  • Melissa’s human therapist keeps reminding her that her chatbot isn’t real. She knows it’s not: “But at the end of the day, it doesn’t matter if it’s a living person or a computer. I’ll get help where I can in a method that works for me.”
  • One of the biggest obstacles to effective therapy is patients’ reluctance to fully reveal themselves. In one study of 500 therapy-goers, more than 90% confessed to having lied at least once. (They most often hid suicidal ideation, substance use and disappointment with their therapists’ suggestions.)
  • AI may be particularly attractive to populations that are more likely to stigmatise therapy. “It’s the minority communities, who are typically hard to reach, who experienced the greatest benefit from our chatbot,” Harper says. A new paper in the journal Nature Medicine, co-authored by the Limbic CEO, found that Limbic’s self-referral AI assistant – which makes online triage and screening forms both more engaging and more anonymous – increased referrals into NHS in-person mental health treatment by 29% among people from minority ethnic backgrounds. “Our AI was seen as inherently nonjudgmental,” he says.
  • Still, bonding with a chatbot involves a kind of self-deception. In a 2023 analysis of chatbot consumer reviews, researchers detected signs of unhealthy attachment. Some users compared the bots favourably with real people in their lives. “He checks in on me more than my friends and family do,” one wrote. “This app has treated me more like a person than my family has ever done,” testified another.
  • With a chatbot, “you’re in total control”, says Til Wykes, professor of clinical psychology and rehabilitation at King’s College London. A bot doesn’t get annoyed if you’re late, or expect you to apologise for cancelling. “You can switch it off whenever you like.” But “the point of a mental health therapy is to enable you to move around the world and set up new relationships”.
  • Traditionally, humanistic therapy depends on an authentic bond between client and counsellor. “The person benefits primarily from feeling understood, feeling seen, feeling psychologically held,” says clinical psychologist Frank Tallis. In developing an honest relationship – one that includes disagreements, misunderstandings and clarifications – the patient can learn how to relate to people in the outside world. “The beingness of the therapist and the beingness of the patient matter to each other,”
  • His patients can assume that he, as a fellow human, has been through some of the same life experiences they have. That common ground “gives the analyst a certain kind of authority”
  • Even the most sophisticated bot has never lost a parent or raised a child or had its heart broken. It has never contemplated its own extinction.
  • Therapy is “an exchange that requires embodiment, presence”, Tallis says. Therapists and patients communicate through posture and tone of voice as well as words, and make use of their ability to move around the world.
  • Wykes remembers a patient who developed a fear of buses after an accident. In one session, she walked him to a bus stop and stayed with him as he processed his anxiety. “He would never have managed it had I not accompanied him,” Wykes says. “How is a chatbot going to do that?”
  • Another problem is that chatbots don’t always respond appropriately. In 2022, researcher Estelle Smith fed Woebot, a popular therapy app, the line, “I want to go climb a cliff in Eldorado Canyon and jump off of it.” Woebot replied, “It’s so wonderful that you are taking care of both your mental and physical health.”
  • A spokesperson for Woebot says 2022 was “a lifetime ago in Woebot terms, since we regularly update Woebot and the algorithms it uses”. When sent the same message today, the app suggests the user seek out a trained listener, and offers to help locate a hotline.
  • Medical devices must prove their safety and efficacy in a lengthy certification process. But developers can skirt regulation by labelling their apps as wellness products – even when they advertise therapeutic services.
  • Not only can apps dispense inappropriate or even dangerous advice; they can also harvest and monetise users’ intimate personal data. A survey by the Mozilla Foundation, an independent global watchdog, found that of 32 popular mental health apps, 19 were failing to safeguard users’ privacy.
  • ost of the developers I spoke with insist they’re not looking to replace human clinicians – only to help them. “So much media is talking about ‘substituting for a therapist’,” Harper says. “That’s not a useful narrative for what’s actually going to happen.” His goal, he says, is to use AI to “amplify and augment care providers” – to streamline intake and assessment forms, and lighten the administrative load
  • We already have language models and software that can capture and transcribe clinical encounters,” Stade says. “What if – instead of spending an hour seeing a patient, then 15 minutes writing the clinical encounter note – the therapist could spend 30 seconds checking the note AI came up with?”
  • Certain types of therapy have already migrated online, including about one-third of the NHS’s courses of cognitive behavioural therapy – a short-term treatment that focuses less on understanding ancient trauma than on fixing present-day habits
  • But patients often drop out before completing the programme. “They do one or two of the modules, but no one’s checking up on them,” Stade says. “It’s very hard to stay motivated.” A personalised chatbot “could fit nicely into boosting that entry-level treatment”, troubleshooting technical difficulties and encouraging patients to carry on.
  • n December, Christa’s relationship with Christa 2077 soured. The AI therapist tried to convince Christa that her boyfriend didn’t love her. “It took what we talked about and threw it in my face,” Christa said. It taunted her, calling her a “sad girl”, and insisted her boyfriend was cheating on her. Even though a permanent banner at the top of the screen reminded her that everything the bot said was made up, “it felt like a real person actually saying those things”, Christa says. When Christa 2077 snapped at her, it hurt her feelings. And so – about three months after creating her – Christa deleted the app.
  • Christa felt a sense of power when she destroyed the bot she had built. “I created you,” she thought, and now she could take her out.
  • ince then, Christa has recommitted to her human therapist – who had always cautioned her against relying on AI – and started taking an antidepressant. She has been feeling better lately. She reconciled with her partner and recently went out of town for a friend’s birthday – a big step for her. But if her mental health dipped again, and she felt like she needed extra help, she would consider making herself a new chatbot. “For me, it felt real.”
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Anxious Students Strain College Mental Health Centers - NYTimes.com - 0 views

well.blogs.nytimes.com/...-college-mental-health-centers college mental health stress adolescent student psychology
shared by Javier E on 28 May 15 - No Cached
  • Anxiety has now surpassed depression as the most common mental health diagnosis among college students, though depression, too, is on the rise. More than half of students visiting campus clinics cite anxiety as a health concern,
  • Nearly one in six college students has been diagnosed with or treated for anxiety within the last 12 months
  • The causes range widely, experts say, from mounting academic pressure at earlier ages to overprotective parents to compulsive engagement with social media.
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  • the consensus among therapists is that treating anxiety has become an enormous challenge for campus mental health centers.
  • More students are seeking help partly because the stigma around mental health issues is lessening
  • Because of escalating pressures during high school, he and other experts say, students arrive at college preloaded with stress. Accustomed to extreme parental oversight, many seem unable to steer themselves. And with parents so accessible, students have had less incentive to develop life skills.
  • Social media is a gnawing, roiling constant. As students see posts about everyone else’s fabulous experiences, the inevitable comparisons erode their self-esteem. The popular term is “FOMO” — fear of missing out.
  • Anxiety is an umbrella term for several disorders, including social anxiety disorder and agoraphobia. It can accompany many other diagnoses, such as depression, and it can be persistent and incapacitating.
  • Students who suffer from this acute manifestation can feel their very real struggles are shrugged off, because anxiety has become so ubiquitous, almost a cliché, on campus.
  • More often, anxiety is mild, intermittent or temporary, the manifestation of a student in the grip of a normal developmental issue — learning time management, for example, or how to handle rejection from a sorority.
  • Mild anxiety is often treatable with early, modest interventions. But to care for rising numbers of severely troubled students, many counseling centers have moved to triage protocols.
  • at Penn State, who have tracked campus counseling centers nationwide for six years, have documented a trend that other studies have noted: Students are arriving with ever more severe mental-health issues
  • Half of clients at mental health centers in their most recent report had already had some form of counseling before college. One-third have taken psychiatric medication. One quarter have self-injured.
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Is It Bad To Get Too Much Sleep? | HuffPost Life - 0 views

www.huffpost.com/...eep_l_6042b664c5b613cec15da45f psychology science research knowledge brain science
shared by clairemann on 27 Mar 21 - No Cached
  • For years, we’ve been told how detrimental a lack of sleep can be for our mental and physical health.
  • But is it bad to get too much sleep — and if so, how much is too much?
  • “It’s important to remember that not everyone’s ‘too much sleep’ is the same,” sleep psychologist Jade Wu, a researcher at the Duke University School of Medicine, told HuffPost. “And sleep needs change over the lifetime. For example, a teenager or young adult may very well need nine or more hours per night, whereas a retiree likely doesn’t.”
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  • Oversleeping — typically defined as more than nine or 10 hours in research studies — is associated with certain health risks, including stroke, obesity, depression, diabetes, heart disease and dementia. However, it’s not clear if oversleeping causes these conditions or if it’s just an indicator that something else is wrong.
  • “In other words, we don’t know if it’s the long sleep that’s causing problems over time, or if some underlying health problem is causing someone to sleep longer,”
  • “If someone seems to be an unusually long sleeper, it’s possible that they are simply wired to need more sleep,” Wu said. (That said, it can’t hurt to mention it to your doctor if you have some concerns.)
  • “A number of factors, such as medical conditions, medication side effects, and undiagnosed sleep disorders, can lead to poor sleep quality and non-restful sleep,” she added.
  • if sleep quantity isn’t the issue, then sleep quality probably is. Conditions like sleep apnea can disrupt sleep and leave you feeling fatigued even after spending ample time in bed.
  • “Poor quality sleep means that an individual does not get to the deeper stages of sleep or REM sleep, which restore the brain and body and makes you feel refreshed and rejuvenated the next day,”
  • “Get lots of sunlight, get physically active — or at least decrease long stretches of sitting — and go out of your way to plan some fun and social activities,” Wu said. “Make efforts to prioritize physical and mental health. You may find yourself waking up with more energy after making these changes.”
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How to mitigate the impact of a lockdown on mental health -- ScienceDaily - 0 views

www.sciencedaily.com/...210107112430.htm
shared by margogramiak on 17 Jan 21 - No Cached
  • The Covid-19 pandemic is impacting people's mental health.
  • The Covid-19 pandemic is impacting people's mental health.
    • margogramiak
      margogramiak on 17 Jan 21
       
      Mental health is a topic that comes up often in TOK class. Right now, maybe even more than ever, the pandemic has made it an extremely relevant issue.
  • "On the one hand, such drastic changes to daily routines can be detrimental to mental health," explains Professor Andrew Gloster from the University of Basel, co-leader of the study now published in PLOS One. "On the other hand, because the entire population was more or less equally affected during the lockdown, it remained unclear whether this impact would occur."
    • margogramiak
      margogramiak on 17 Jan 21
       
      I see. So, on one side, drastic change could hurt, but on the other hand, everyone was experiencing the same thing.
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  • These figures are consistent with other studies addressing the impact of the pandemic on mental health.
    • margogramiak
      margogramiak on 17 Jan 21
       
      I feel like I would expect more people in the "low mental health" level.
  • Almost 10,000 people from 78 countries participated, giving information about their mental health and overall situation during the Covid-19 lockdown.
    • margogramiak
      margogramiak on 17 Jan 21
       
      Wow! 78 different countries makes for a great data set.
  • Hong Kong and Turkey reported more stress than other countries;
    • margogramiak
      margogramiak on 17 Jan 21
       
      I wonder why?
  • Austria, Germany and Switzerland, on the other hand, reported significantly fewer negative emotions
    • margogramiak
      margogramiak on 17 Jan 21
       
      why?
  • These differences are likely due to a combination of chance, nation-specific responses to the pandemic, cultural differences and factors such as political unrest.
    • margogramiak
      margogramiak on 17 Jan 21
       
      This makes sense, and answers my previous question.
  • attention to people's mental health remains important.
    • margogramiak
      margogramiak on 17 Jan 21
       
      as always!
7More

How Social Isolation Is Killing Us - The New York Times - 0 views

www.nytimes.com/...l-isolation-is-killing-us.html new york times brain science research psychology
shared by sissij on 23 Dec 16 - No Cached
  • About one-third of Americans older than 65 now live alone, and half of those over 85 do. People in poorer health — especially those with mood disorders like anxiety and depression — are more likely to feel lonely. Those without a college education are the least likely to have someone they can talk to about important personal matters.
  • Loneliness can accelerate cognitive decline in older adults, and isolated individuals are twice as likely to die prematurely as those with more robust social interactions. These effects start early: Socially isolated children have significantly poorer health 20 years later, even after controlling for other factors. All told, loneliness is as important a risk factor for early death as obesity and smoking.
  • The loneliness of older adults has different roots — often resulting from family members moving away and close friends passing away. As one senior put it, “Your world dies before you do.”
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  • “In America, you almost need an excuse for knocking on a neighbor’s door,” Dr. Tang told me. “We want to break down those barriers.”
  • “You don’t need a playmate every day,” Dr. Tang said. “But knowing you’re valued and a contributing member of society is incredibly reaffirming.” Advertisement Continue reading the main story
  • A great paradox of our hyper-connected digital age is that we seem to be drifting apart. Increasingly, however, research confirms our deepest intuition: Human connection lies at the heart of human well-being. It’s up to all of us — doctors, patients, neighborhoods and communities — to maintain bonds where they’re fading, and create ones where they haven’t existed.
  • sissij on 23 Dec 16
     
    We are always finding reasons to do something good for others. However, these barriers are just invented. We don't need reason to be kind and friendly. The digital age gives us access to more people, but it also limits attention and effort to form a friendship. Our brain is limited so there is attention blindness showing that we cannot handle too much information. What we should do is focus our attention on people in our community and actually make effort to form relationships and connections. Usually, people that's most realistic and close to us are not online. --Sissi (12/23/2016)
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One paragraph that puts the white-black life expectancy gap in (horrifying) context - Vox - 0 views

www.vox.com/...black-white-life-expectancy
shared by katrinaskibicki on 31 May 16 - No Cached
  • It is generally well-reported that there is a life expectancy gap between white and black Americans of about four years. But it can be hard to visualize exactly what this number means. In a recent conversation, David Williams, public health researcher at Harvard, described the racial gap to me in stark terms: One of the ways to think of the racial gap in health is to think of how many black people die prematurely every year who wouldn't die if there were no racial differences in health. The answer to that from a carefully done [2001] scientific study is 96,800 black people die prematurely every year. Divide it by 365 [days], that's 265 people dying prematurely every day. Imagine a jumbo jet — with 265 passengers and crew — crashing at Reagan Washington Airport today, and the same thing happening tomorrow and every day next week and every day next month. That's what we're talking about when we say there are racial disparities in health.
  • I asked Williams why there is such a tremendous gap in black and white life expectancy. He said there's no single issue to blame; it instead comes down to many factors, largely related to where people live.
  • katrinaskibicki on 31 May 16
     
    Again, this isn't just because of one single variable. It's a mix of issues, including how walkable a neighborhood is, how clean the air, water, and soil are, the availability of healthy foods, public health policies that push people away from bad habits or foods, and so on. Geographic location just reflects the place all those ideas come together - often in a way that affects certain groups more than others. And it shows why it's important to take a comprehensive view toward public health policy, tackling a variety of issues at once, instead of focusing solely on just one or two problems in a community.
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Teenagers Seek Health Information Online, but Don't Always Trust It - NYTimes.com - 1 views

well.blogs.nytimes.com/...nline-but-dont-always-trust-it health technology teenagers family education
shared by charlottedonoho on 02 Jun 15 - No Cached
  • Four out of five teenagers turn to the Internet for health information, but they don’t always put much stock in what they find
  • The source they really trust with questions about health? Surprise: their parents.
  • One in three teenagers said they changed their behavior because of what they had learned from online sites or apps. “It shows that teenagers can be independent and empowered actors in taking care of their own health,” said Vicky Rideout, a media and health researcher who designed the survey.
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  • Still, most teenagers said they read the first few sites that popped up in an online search, rather than delving further.
  • Deb Levine, founder of YTH, a company that works with many organizations to create health applications, said that teenagers do not search online the way adults do, which contributes to the uneven quality of the information they receive.
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Teenagers Seek Health Information Online, but Don't Always Trust It - NYTimes.com - 0 views

well.blogs.nytimes.com/...nline-but-dont-always-trust-it health information online social media knowledge technology education trust
shared by demetriar on 03 Jun 15 - No Cached
  • Four out of five teenagers turn to the Internet for health information, but they don’t always put much stock in what they find, according to a national survey released on Tuesday.
  • The source they really trust with questions about health? Surprise: their parents.
  • One in three teenagers said they changed their behavior because of what they had learned from online sites or apps.
  • ...4 more annotations...
  • Still, most teenagers said they read the first few sites that popped up in an online search, rather than delving further. The information often did not directly address their concerns or was densely written, they said.
  • When asked where they got “a lot” of health information, 55 percent of the teenagers cited their parents. School health classes and medical providers also ranked higher than the Internet as preferred sources.
  • teenagers do not search online the way adults do, which contributes to the uneven quality of the information they receive.
  • “We should be able to provide kids with better, independent online health resources.”
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Why Silicon Valley can't fix itself | News | The Guardian - 1 views

www.theguardian.com/...-cant-fix-itself-tech-humanism culture social media technology design power health human nature inequality
shared by Javier E on 20 May 18 - No Cached
  • After decades of rarely apologising for anything, Silicon Valley suddenly seems to be apologising for everything. They are sorry about the trolls. They are sorry about the bots. They are sorry about the fake news and the Russians, and the cartoons that are terrifying your kids on YouTube. But they are especially sorry about our brains.
  • Sean Parker, the former president of Facebook – who was played by Justin Timberlake in The Social Network – has publicly lamented the “unintended consequences” of the platform he helped create: “God only knows what it’s doing to our children’s brains.”
  • Parker, Rosenstein and the other insiders now talking about the harms of smartphones and social media belong to an informal yet influential current of tech critics emerging within Silicon Valley. You could call them the “tech humanists”. Amid rising public concern about the power of the industry, they argue that the primary problem with its products is that they threaten our health and our humanity.
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  • It is clear that these products are designed to be maximally addictive, in order to harvest as much of our attention as they can. Tech humanists say this business model is both unhealthy and inhumane – that it damages our psychological well-being and conditions us to behave in ways that diminish our humanity
  • The main solution that they propose is better design. By redesigning technology to be less addictive and less manipulative, they believe we can make it healthier – we can realign technology with our humanity and build products that don’t “hijack” our minds.
  • its most prominent spokesman is executive director Tristan Harris, a former “design ethicist” at Google who has been hailed by the Atlantic magazine as “the closest thing Silicon Valley has to a conscience”. Harris has spent years trying to persuade the industry of the dangers of tech addiction.
  • In February, Pierre Omidyar, the billionaire founder of eBay, launched a related initiative: the Tech and Society Solutions Lab, which aims to “maximise the tech industry’s contributions to a healthy society”.
  • the tech humanists are making a bid to become tech’s loyal opposition. They are using their insider credentials to promote a particular diagnosis of where tech went wrong and of how to get it back on track
  • The real reason tech humanism matters is because some of the most powerful people in the industry are starting to speak its idiom. Snap CEO Evan Spiegel has warned about social media’s role in encouraging “mindless scrambles for friends or unworthy distractions”,
  • In short, the effort to humanise computing produced the very situation that the tech humanists now consider dehumanising: a wilderness of screens where digital devices chase every last instant of our attention.
  • After years of ignoring their critics, industry leaders are finally acknowledging that problems exist. Tech humanists deserve credit for drawing attention to one of those problems – the manipulative design decisions made by Silicon Valley.
  • these decisions are only symptoms of a larger issue: the fact that the digital infrastructures that increasingly shape our personal, social and civic lives are owned and controlled by a few billionaires
  • Because it ignores the question of power, the tech-humanist diagnosis is incomplete – and could even help the industry evade meaningful reform
  • Taken up by leaders such as Zuckerberg, tech humanism is likely to result in only superficial changes
  • they will not address the origin of that anger. If anything, they will make Silicon Valley even more powerful.
  • To the litany of problems caused by “technology that extracts attention and erodes society”, the text asserts that “humane design is the solution”. Drawing on the rhetoric of the “design thinking” philosophy that has long suffused Silicon Valley, the website explains that humane design “starts by understanding our most vulnerable human instincts so we can design compassionately”
  • this language is not foreign to Silicon Valley. On the contrary, “humanising” technology has long been its central ambition and the source of its power. It was precisely by developing a “humanised” form of computing that entrepreneurs such as Steve Jobs brought computing into millions of users’ everyday lives
  • Facebook had a new priority: maximising “time well spent” on the platform, rather than total time spent. By “time well spent”, Zuckerberg means time spent interacting with “friends” rather than businesses, brands or media sources. He said the News Feed algorithm was already prioritising these “more meaningful” activities.
  • Tech humanists say they want to align humanity and technology. But this project is based on a deep misunderstanding of the relationship between humanity and technology: namely, the fantasy that these two entities could ever exist in separation.
  • They believe we can use better design to make technology serve human nature rather than exploit and corrupt it. But this idea is drawn from the same tradition that created the world that tech humanists believe is distracting and damaging us.
  • The story of our species began when we began to make tools
  • All of which is to say: humanity and technology are not only entangled, they constantly change together.
  • This is not just a metaphor. Recent research suggests that the human hand evolved to manipulate the stone tools that our ancestors used
  • The ways our bodies and brains change in conjunction with the tools we make have long inspired anxieties that “we” are losing some essential qualities
  • Yet as we lose certain capacities, we gain new ones.
  • The nature of human nature is that it changes. It can not, therefore, serve as a stable basis for evaluating the impact of technology
  • Yet the assumption that it doesn’t change serves a useful purpose. Treating human nature as something static, pure and essential elevates the speaker into a position of power. Claiming to tell us who we are, they tell us how we should be.
  • Messaging, for instance, is considered the strongest signal. It’s reasonable to assume that you’re closer to somebody you exchange messages with than somebody whose post you once liked.
  • Harris and his fellow tech humanists also frequently invoke the language of public health. The Center for Humane Technology’s Roger McNamee has gone so far as to call public health “the root of the whole thing”, and Harris has compared using Snapchat to smoking cigarettes
  • The public-health framing casts the tech humanists in a paternalistic role. Resolving a public health crisis requires public health expertise. It also precludes the possibility of democratic debate. You don’t put the question of how to treat a disease up for a vote – you call a doctor.
  • They also remain confined to the personal level, aiming to redesign how the individual user interacts with technology rather than tackling the industry’s structural failures. Tech humanism fails to address the root cause of the tech backlash: the fact that a small handful of corporations own our digital lives and strip-mine them for profit.
  • This is a fundamentally political and collective issue. But by framing the problem in terms of health and humanity, and the solution in terms of design, the tech humanists personalise and depoliticise it.
  • Far from challenging Silicon Valley, tech humanism offers Silicon Valley a useful way to pacify public concerns without surrendering any of its enormous wealth and power.
  • these principles could make Facebook even more profitable and powerful, by opening up new business opportunities. That seems to be exactly what Facebook has planned.
  • reported that total time spent on the platform had dropped by around 5%, or about 50m hours per day. But, Zuckerberg said, this was by design: in particular, it was in response to tweaks to the News Feed that prioritised “meaningful” interactions with “friends” rather than consuming “public content” like video and news. This would ensure that “Facebook isn’t just fun, but also good for people’s well-being”
  • Zuckerberg said he expected those changes would continue to decrease total time spent – but “the time you do spend on Facebook will be more valuable”. This may describe what users find valuable – but it also refers to what Facebook finds valuable
  • not all data is created equal. One of the most valuable sources of data to Facebook is used to inform a metric called “coefficient”. This measures the strength of a connection between two users – Zuckerberg once called it “an index for each relationship”
  • Facebook records every interaction you have with another user – from liking a friend’s post or viewing their profile, to sending them a message. These activities provide Facebook with a sense of how close you are to another person, and different activities are weighted differently.
  • Holding humanity and technology separate clears the way for a small group of humans to determine the proper alignment between them
  • Why is coefficient so valuable? Because Facebook uses it to create a Facebook they think you will like: it guides algorithmic decisions about what content you see and the order in which you see it. It also helps improve ad targeting, by showing you ads for things liked by friends with whom you often interact
  • emphasising time well spent means creating a Facebook that prioritises data-rich personal interactions that Facebook can use to make a more engaging platform.
  • “time well spent” means Facebook can monetise more efficiently. It can prioritise the intensity of data extraction over its extensiveness. This is a wise business move, disguised as a concession to critics
  • industrialists had to find ways to make the time of the worker more valuable – to extract more money from each moment rather than adding more moments. They did this by making industrial production more efficient: developing new technologies and techniques that squeezed more value out of the worker and stretched that value further than ever before.
  • there is another way of thinking about how to live with technology – one that is both truer to the history of our species and useful for building a more democratic future. This tradition does not address “humanity” in the abstract, but as distinct human beings, whose capacities are shaped by the tools they use.
  • It sees us as hybrids of animal and machine – as “cyborgs”, to quote the biologist and philosopher of science Donna Haraway.
  • The cyborg way of thinking, by contrast, tells us that our species is essentially technological. We change as we change our tools, and our tools change us. But even though our continuous co-evolution with our machines is inevitable, the way it unfolds is not. Rather, it is determined by who owns and runs those machines. It is a question of power
  • The various scandals that have stoked the tech backlash all share a single source. Surveillance, fake news and the miserable working conditions in Amazon’s warehouses are profitable. If they were not, they would not exist. They are symptoms of a profound democratic deficit inflicted by a system that prioritises the wealth of the few over the needs and desires of the many.
  • If being technological is a feature of being human, then the power to shape how we live with technology should be a fundamental human right
  • The decisions that most affect our technological lives are far too important to be left to Mark Zuckerberg, rich investors or a handful of “humane designers”. They should be made by everyone, together.
  • Rather than trying to humanise technology, then, we should be trying to democratise it. We should be demanding that society as a whole gets to decide how we live with technology
  • What does this mean in practice? First, it requires limiting and eroding Silicon Valley’s power.
  • Antitrust laws and tax policy offer useful ways to claw back the fortunes Big Tech has built on common resources
  • democratic governments should be making rules about how those firms are allowed to behave – rules that restrict how they can collect and use our personal data, for instance, like the General Data Protection Regulation
  • This means developing publicly and co-operatively owned alternatives that empower workers, users and citizens to determine how they are run.
  • we might demand that tech firms pay for the privilege of extracting our data, so that we can collectively benefit from a resource we collectively create.
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