Friday, March 18, 2016

Many mHealth Apps Share Personal Health Info Without Permission

             health 7 module
The number of mobile health applications (mHealth apps) available to consumers now surpasses 165,000 (here). One-fifth of smartphone owners had health apps in 2012, and 7% of primary care physicians recommended a health app.

The FDA has even approved the prescribing of mHealth such as the DiabetesManager System, which captures, stores and transmits blood glucose levels.

Unfortunately, many health apps do not have privacy policies informing users of how personal health data is collected, stored, transmitted, and shared with third parties. Even when there are privacy policies, many health apps do not fully inform patients of how their data will be used or shared.

In a study appearing in the March 8 issue of JAMA, Sarah R. Blenner, J.D., M.P.H., of the Illinois Institute of Technology Chicago-Kent College of Law, Chicago, and colleagues examined the privacy policies of Android diabetes apps and the sharing of health information. They found that 81% of the apps did not have privacy policies. Of the apps with privacy policies, only 4 said they would ask users for permission to share data.

The authors noted:
"Sensitive health information from diabetes apps (eg, insulin and blood glucose levels) was routinely collected and shared with third parties, with 56 of 65 apps (86.2%) placing tracking cookies; 31 of the 41 apps (76%) without privacy policies, and 19 of 24 apps (79%) with privacy policies shared user information... Of the 19 apps with privacy policies that shared data with third parties, 11 apps disclosed this fact, whereas 8 apps did not."
The authors concluded:
"Patients might mistakenly believe that health informa- tion entered into an app is private (particularly if the app has a privacy policy), but that generally is not the case. Medical professionals should consider privacy implications prior to encouraging patients to use health apps."
Many mHealth apps -- including apps developed by pharmaceutical companies -- have other problems such as unproven efficacy, undocumented sources of statistics or algorithms, etc. See my presentation below for more information about that.

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Taking a Mental Health Break from My Dissertation

Today's guest post is by Nicole Cabrera Salazar. Nicole is an NSF Graduate Research Fellow at Georgia State University. She plans to pursue a career in science communication/outreach focusing on equity in STEM.

About a month ago, I got sick with a simple cold. I was in the middle of writing the third chapter of my dissertation and had just taken time off to get over another cold two weeks before. I was also behind on the timeline to defend my thesis next year, and more delays didn’t seem like the best idea. So I did what any other grad student in my position would: I tried to power through.

Ten days later, my cold was still going strong. I was worried because I had been waking up with panic attacks in the middle of the night for no apparent reason, hyperventilating and shaking uncontrollably. Sick, sleep deprived, and anxious, I gave in and went to the doctor. I burst into tears as soon as she came into the room.

The doctor calmed me down and tested for signs of a bacterial infection. Nothing. “It’s just a viral cold,” she said. It wasn’t going away because the anxiety was preventing me from sleeping, which prevented me from getting better. She asked what was causing so much stress and gave me a sympathetic look when I said I was writing my dissertation. “Go home and just watch a movie. Don’t try to work. It’s really okay.”

With the doctor’s blessing, I took a few days off. The sleep aid she prescribed helped me sleep through the night and I was certain I would quickly get better. But even though the cold symptoms slowly started to wane, my anxiety did not. I constantly felt as if my heart was being squeezed and breathing felt like I had a stack of books on my chest. Imagine the rollercoaster, butterflies-in-your-stomach jitters you might get before a big talk or an interview, but stretched out over days.

When I realized the anxiety wasn’t going away on its own, I began to seriously worry about my mental health. I remember waking up one night after another panic attack and being afraid that if I didn’t do something soon, I was going to have a nervous breakdown. I worked up the courage to tell my adviser exactly what was happening, scared to admit it but knowing I had no other choice. Although it was hard to get the words out, my adviser was patient and sympathetic. He agreed that my mental health took priority over my work and told me not to worry about deadlines. He granted me a three week break from research, and I resolved to stop thinking about my dissertation and stay off campus as much as possible.

At my follow-up appointment that week, I told the doctor about the anxiety I was still feeling. She knew I was already seeing a therapist weekly, had stopped working, and was focusing my energy on getting better. After a long discussion, she recommended I start taking a selective serotonin re-uptake inhibitor (SSRI). “When you’re doing everything right and the anxiety is still there, it may be time to change the chemistry.”

Since the dissertation seemed to be my biggest trigger, she suggested that I keep taking SSRIs until after I finished my PhD -- at least a year away. It was a scary decision to make because I had never been on medication. What if it changed my personality? What about the side effects? She answered all my questions and assured me that I would be checking in every few weeks to see how it was affecting me. If it didn’t work or if the side effects were intolerable, we could always adjust the dosage or even the type of SSRI.

Still, medication is only one part of the equation. In my time away from research, I’ve been working on projects that I love but don’t bring more stress, things like mentoring and the long-overdue process of updating my CV. I’ve also set aside time for self-care, which in my case involves cooking and eating regular meals, working on crafts, spending time with friends and family, and reading about things not related to astronomy. And very slowly, I am starting to feel better.

I am following this emergency self-care plan out of sheer necessity. Most of us make this mistake, turning to self-care for survival in a crisis. In reality, self-care should be a daily practice that prevents us from needing this sort of intervention. I thought that taking time away from work would delay my progress, but ironically I’ve lost much more time because I did not take proper care of myself first. I’m learning this the hard way, but I hope that my experience will serve as a gentle reminder to myself and others to prioritize health over work. As Drs. Sarah Ballard and Rugheimer point out in their podcast, self-care is part of the job. I cannot do my best scientific work if I am stressed, unhappy, or burned out.

When I do feel okay enough to get back to work, I’m going to have to pace myself. Yes, I want that PhD more than anything. No, it is not worth my physical or mental health to race there. I’ll have to remember that I deserve to sleep enough, eat at regular intervals, and constrain my work to daytime hours so I can recharge when I get home. I’ll have to reward myself for small accomplishments like writing a section or getting all my citations in order. I’ll have to be mindful not to withdraw from my loved ones when I get overwhelmed. Otherwise, the incremental path toward success will be too bleak.

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Mike Thompson - Conference on the Physics, Chemistry and Biology of Water 2014

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iomedical Optics & Medical Imaging: Applying photonics to develop new medical treatments

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How Statins Really Work Explains Why They Don't Really Work

The statin industry has enjoyed a thirty year run of steadily increasing profits, as they find ever more ways to justify expanding the definition of the segment of the population that qualify for statin therapy. Large, placebo-controlled studies have provided evidence that statins can substantially reduce the incidence of heart attack. High serum cholesterol is indeed correlated with heart disease, and statins, by interfering with the body's ability to synthesize cholesterol, are extremely effective in lowering the numbers. Heart disease is the number one cause of death in the U.S. and, increasingly, worldwide. What's not to like about statin drugs?

I predict that the statin drug run is about to end, and it will be a hard landing. The thalidomide disaster of the 1950's and the hormone replacement therapy fiasco of the 1990's will pale by comparison to the dramatic rise and fall of the statin industry. I can see the tide slowly turning, and I believe it will eventually crescendo into a tidal wave, but misinformation is remarkably persistent, so it may take years.

I have spent much of my time in the last few years combing the research literature on metabolism, diabetes, heart disease, Alzheimer's, and statin drugs. Thus far, in addition to posting essays on the web, I have, together with collaborators, published two journal articles related to metabolism, diabetes, and heart disease (Seneff1 et al., 2011), and Alzheimer's disease (Seneff2 et al., 2011). Two more articles, concerning a crucial role for cholesterol sulfate in metabolism, are currently under review (Seneff3 et al., Seneff4 et al.). I have been driven by the need to understand how a drug that interferes with the synthesis of cholesterol, a nutrient that is essential to human life, could possibly have a positive impact on health. I have finally been rewarded with an explanation for an apparent positive benefit of statins that I can believe, but one that soundly refutes the idea that statins are protective. I will, in fact, make the bold claim that nobody qualifies for statin therapy, and that statin drugs can best be described as toxins.

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Eating Disorders - Awareness and Prevention

It is common to see a person go on a strict diet, in order to lose weight. However, there is a fine line between following a strict diet and suffering from an eating disorder. Several people are not even aware that such a thing exists, which prompts them to ask “What are eating disorders?”, in spite of the fact that eating disorders affect about 2% of the student population in the United States. An eating disorder goes beyond a strict diet for weight loss or following unhealthy eating habits. It could be described as a complex condition, which is normally caused by a number of factors that are psychological, behavioral, interpersonal, social and emotional. Various types of eating disorders are related to abnormal dietary habits, such as the eating too little or too much food, to an extent which could be harmful to a person’s health. It has been seen that people who suffer from eating disorders use food to control their emotions and feelings. Such people believe that they are in control of their lives, through activities like purging, dieting or binging, all of which are examples of eating disorders. Some of the most common types of eating disorders that have been identified are anorexia, bulimia and binge eating.

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eating disorders
People, who avoid eating normal amounts of food, or eat the bare minimal amount and then obsess over how much they ate for hours, are said to suffer from anorexia nervosa. One of the main causes of anorexia is the obsession of being thin. It has been seen that people who suffer from anorexia have a distorted view about their bodies, because of which they cannot maintain a normal weight. However, weight is not the only reason for anorexia in all cases. This condition has also been observed in people who have been through childhood abuse, trauma, a breakup and other such disturbing experiences. Bulimia nervosa is usually very hard to spot, because people who are bulimic probably go on an eating binge, (mainly in front of other people), but force themselves to throw up a little later. At times, bulimic people may also use a high amount of laxatives or may exercise excessively. Peer pressure, weight obsession, low self esteem, anxiety and depression are the main causes for bulimia in a person. Binge eating is probably the most common eating disorder in the United States, which affects about 2% of the male and 3.5% of the female population. It refers to an eating disorder, where a person consumes a large amount of food, even if it is not required by the body, mainly because the person cannot control the urge to eat.

Treating an eating disorder is possible, but it requires a lot of time, determination and patience. It is important to seek professional and family help to overcome the different types of eating disorders.

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