Healthcare, medicine & pharmaceuticals

A community of self-trackers

Social media help us focus on ourselves, but some are taking it a step further and tracking their every move with wearable wireless devices. Nearly 10 million of these devices were sold in North America in 2011 so people can track their sleep patterns, walking speeds, heart rates and calories consumed. What’s the point? In many cases, it is to provoke a behavioural change, but used wisely, it could also transform medicine.

With the rise of smartphones (predicted to be 84.4 million in the US by end 2012) and tablet computers, it has become easier to create and track your own personal data. There are already websites to track and share data about health, exercise and diet. For example, RunKeeper has 6 million runners who log on with their details. PEW Research shows 27% of net users have tracked their weight, diet or exercise or monitored their symptoms online.

Where most tracking devices can only track particular things, a Google app called PACO (Personal Analytics Companion), can be set up to track any kind of behaviour or event. You might want to track how drinking coffee makes you more productive, or what makes you sleep best, or what brings on headaches. Your data may be private, or you can share it with somebody depending on your need. All your data need to be protected by some kind of “trust network”.

The value of self-tracking regularly is it doesn’t rely on memory, it can be used over time, and it’s easy to do. In the medical world, trials are expensive, hard to administer and short. Data tracking could help monitor cognitive impairment, clinical depression or the onset of infectious disease – and reassure people who falsely represent their own symptoms or habits. A social worker might be able to find out the triggers for feeling negative towards clients, or a teacher might want to monitor how exercise and food affect the behaviour of her class.

There are several gadgets, worn on the wrist, that can be used for self-tracking and even to communicate with the building you are in! For example, WristQue has a low-power wristband device embedded with sensors that monitors how you feel and adjusts the lighting and temperature in a room to keep you comfortable.

Meanwhile, the fitness industry, worth 3.8 billion UK pounds, has dived into wearable devices to monitor fitness lifestyle. Ki Fit is an armband that monitors calories burned, physical activity, and sleep – for a mere 268 UK pounds. Jawbone UP, for 80 UK pounds offers a fitness wristband and app that monitors your sleep quality, activity and inactivity. It has an “eat” mode (everyday activity), “move” mode (active), and “sleep” mode (while you sleep). Your phone camera tracks all your food and drink and how you feel after each meal. Zzz.

It’s big brother on a massive scale – except you’re your own brother. (See Does a black box make you see red? about black boxes in cars.) Given the right privacy protocols, it could still be helpful for making the healthcare industry more responsive.

Ref: Discover (US), December 2011, Our data, ourselves. K Greene.
New Scientist, 14 January 2012, Talk to the wrist. N Firth.
Sunday Telegraph Magazine, 24 November 2011, Arm forces. G Brett.
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Search words: self-tracking, smartphones, PACO (Personal Analytics Companion), health, wristband, data tracking, RunKeeper, wearable wireless device.
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Sleep is becoming unpopular

Sleep, while such a natural and important part of life, appears to be going into decline. It has to do with artificial light, caffeine, and the 24/7 society, which demands that we stay awake even when we’re tired. But sleep deprivation is dangerous and can cause all kinds of health problems.

One obvious sign is traffic accidents, because around a fifth are caused by lack of sleep. But sleep deprivation is also linked to obesity and diabetes as it causes people to feel hungry all the time. One study found civil servants who cut their sleep from 7 to fewer than 5 hours were 2.25 times more likely to die from heart disease. Sleeplessness is also linked to activity in the amygdala, which regulates anxiety and mood; many people with psychiatric problems have trouble sleeping.

How much sleep is enough? New Scientist says 7 is the magic number. But it varies according to age. Teenagers need more sleep, just under 9 hours, to feel rested and, it has been suggested, should not have to get to school so early. Older people tend to sleep for 7.5 hours and young children need 10.5 hours. Curiously, children are sleeping 70 minutes less than they did 100 years ago and recommendations for sleep have also dropped, for example, from 17 to 13 hours for a one year-old.

One contributor to insomnia is exposure to light from mobile phones, TVs and computers in the evening. Another cause of insufficient sleep is being woken up by an alarm clock at the wrong time for our sleep patterns. For example, it is easer to wake from REM sleep than deep sleep. Perhaps light or darkness in the room remains the best alarm clock of all.

The reason why we need to rest is to save energy, regulate emotions and the autonomic nervous system, process information, and consolidate memory. It helps prevent the nervous system from becoming overloaded. Small wonder then that overstimulation in our 24/7 world tends to inhibit sleep. Sleep is also out of fashion – there seems to be pressure to go without it. Judging by these studies, the results are not pretty.

Ref: The Daily Telegraph (UK), 13 February 2012, The young are getting less sleep than a century ago.
New Scientist, 4 February 2012, The future of sleep. DJ Dijk and R Winsky-Sommererl.
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Search words: sleep, artificial light, caffeine, insomnia, appetite, obesity, heart disease, anxiety, teenagers, children, shift work, melatonin, over-stimulation.
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We have ways to make you forget

When somebody endures a very traumatic event, for example, war service, they may suffer later from post-traumatic stress disorder (PTSD). But in 1983 a volunteer firefighter in the US had the idea of critical incident stress debriefing (CISD): talking about it as soon as possible after the event. This seemed to relieve the pressure of memories and prevent them from festering into PTSD.

Recent studies found it doesn’t help at all and, in one study, CISD made people three times as likely to suffer from PTSD. There is a good reason why. Memories are not static. Every time we remember an event, it is altered in the light of the present moment and what we now know and feel. This is called memory reconsolidation. But if we talk about it straight after the event, not only are the facts reinforced, but the fear and traumatic feelings are reinforced too. This means we are better off talking about an event after the overwhelming feelings have passed, so they are not reinforced.

People mistakenly believe human memory is like a camera, but in fact it continually takes the picture in different ways. Flashbulb memories, for example, are vivid, detailed memories of terrible events but, one study found, after 12 months, 37% of people’s recalled details had changed. It begs the question why our justice system relies so heavily on memory.

There are ways to inhibit memory and the emotions that accompany memory. In an experiment with rats, researchers found they could inhibit memory by using a chemical that inhibits protein synthesis. Without this protein, they were unable to remember the traumatic event while still recalling other, innocuous things (such as the location of cheese).

Subjects suffering from PTSD have been given ecstacy while talking about their experience and they felt much less overwhelmed. Propranolol, a beta-blocker, can also suppress difficult feelings in people with PTSD. Researchers have identified a protein that stabilizes memories in the brain, called PKMzeta, and found that when they block PKMzeta with a drug, the person is unable to recall the traumatic event.

This knowledge may well be helpful in people with chronic pain, obsessive-compulsive disorder and drug addictions. In many cases, their memories of original traumatic events, even physical pain, have become distorted over time. While they continue to associate them with powerful emotions, sufferers will be held back from living more satisfying lives.

Wired Magazine (UK), 4 December 2011, The forgetting pill. J Lehrer.
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Search words: Critical Incident Stress Debriefing (CISD), Post-Traumatic Stress Disorder (PTSD), protein synthesis, memories, flashbulb memory, survivor, Propranolol, fear, trauma, PKMzeta, pain, protein kinase C.
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The zipless DNA

DNA sequencing is a valuable part of biological and medical research and has allowed us to sequence the human genome. Now there is a gadget, just like a memory stick, that can sequence DNA while plugged into your laptop. One device, called the MinION can sequence genomes like simple viruses and bacteria in seconds. The company behind it, Oxford Nanopore Technologies, also built the more robust GridION for lab use. It works like this:

Add DNA to a solution containing enzymes that bind to the end of each strand. Apply a current and these enzymes and DNA are drawn to hundreds of wells in a membrane at the bottom of the solution. Within each well is the protein alpha hemolysin (AHL), with a hollow tube at its core. As DNA draws towards each protein, the enzyme attaches itself to the AHL and begins to unzip the DNA, threading one strand of double helix through the pore. The device notes how each of the 4 bases along the strand disrupt the electrical current differently.

This technique can sequence DNA as long as 10,000 bases continuously and means they do not have to be broken up as in the past. For instance, the human genome could be sequenced in 2 hours using Ion Proton, a desktop sequencing machine in competition with MinION, which takes 6 hours and GridION, which takes 15 minutes. The MinION device will sell for around $US900 later this year, which is not much for such a startling new technology. Anyone want their DNA unzipped?

New Scientist (UK), 25 February 2012, Sequence DNA in seconds. D Graham-Rowe.
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Search words: memory stick, DNA sequencing, MinION, cancer, Phi X virus, GridION, enzymes, Ion Torrent, human genome.
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How games do your head in

We are still discovering the effects of playing games on real life experience. A new phenomenon, “game transfer” (GTP), describes how people react in the real world the way they would in a game. Researchers in the UK and Stockholm found people experience a brief mental hiccup as if they are in another world. A similar phenomenon, “the Tetris effect” was coined in 1996 to describe the way players moving falling blocks in Tetris experienced bathroom tiles trembling or a bookcase falling down the wall.

Researchers agree that doing any task repetitively tends to have these kinds of consequences. For example, if you spend all day driving, you tend to see the road ahead when you close your eyes. But GTP is different because it is felt in broad daylight while doing other tasks: you overlay another reality onto the current one.

The average player today, 40% female, spends about 8 hours a week playing and is on average 34 and employed. People who play games often tend to score higher on measures of perception and cognition than non-gamers. They may also have better hand-eye coordination. Thus the brain continually creates “schemata”, or behavioural patterns, so it knows what to do when a certain set of circumstances arises. Its plasticity causes the brain to be less efficient at switching from one reality to another. Seems gaming may do your head in, sometimes.

New Scientist (UK), 24-31 December 2011, Game of life. S Adee.
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Search words: Mario Kart, “game transfer phenomenon” (GTP), female, “Tetris effect”, repetitive, reality, perception, cognition, schemata, plasticity, virtual.
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