Busy Mom Frustrated with Finding STEM Classes for Daughter Starts Online Learning Platform
Learning is always healthy, so today we’re excited to tell you about a new way to keep your brain cells sharp. Meet Amy Olivieri,President and CEO of TakeAClass. TakeAClass is an online resource to support academic, recreational, and professional class searches, payment processing, live stream technology, and Classalytics – an event management tool for instructors, schools, and organizations.
It seeks to revolutionize educational options for adults and children by providing access to local and online classes to anyone in the world.
Turns out, the Global E-Learning Market is expected to reach $325 Billion by 2025.
Welcome Amy. Tell me more about what prompted you to start TakeAClass?
AMY OLIVIERI: “As a busy mom and professional the last thing I have time for is to spend hours online searching for swim or piano classes for my daughter or a salsa dancing computer class for me. I discovered that when needing to take a class there was no online platform that immediately came to mind. So, I would have to search the internet or ask my friends and family for recommendations. So, I created TakeAClass!
Name is easy for everyone to remember. That’s a major plus right there.
AMY OLIVIERI: “Yes! And TakeAClass takes the drama out of the class search process, making it easy for consumers to find exactly what they want – including fitness, cooking, dance, computer, skydiving classes and thousands of other classes. The idea behind TakeAClass is to organize all the information needed to make an informed decision in one place. We allow consumers to search class listings for free.”
Who can use it?
AMY OLIVIERI: “Instructors, schools, and organizations will have the convenience of listing their classes, which will help increase their visibility and get more students with stunning profiles, photos, class descriptions and schedules.”
What if someone wants to teach cooking or how to knit or play basketball on the site, how does it work? Do they get paid?
We charge a 18% booking fee for every class purchased through our website. There is no monthly subscription. We don’t get paid unless a class is paid for.
AMY OLIVIERI: “Teachers are our class vendors. They get to set their own price for teaching and get paid weekly for all completed classes.”
Let’s say there’s a local kid’s cooking class in town or yoga class for adults and they want to fill those classes locally — can they utilize the site to fill classes?
AMY OLIVIERI: “Yes. Right now, we’re launching in Houston, Texas. But we will be available everywhere soon.”
Great. What about the person wanting to take the class? Do they pay?
“It’s free for consumers to search through our marketplace of classes. They simply search, find, and buy the class they wish to take.”
You also intend to utilize blockchain technology. Tell me about that.
AMY OLIVIERI: “We seek to take advantage of the exciting blockchain technology by offering global access to education while removing the barriers to pay for it by introducing our own cryptocurrency, which we hope will change the way payments are accepted for academic institutions.”
You were raised by a single mother who is now a retired nurse. Tell me what role your upbringing played in what you’re doing today.
AMY OLIVIERI: “My mother instilled in me at an early age that if I wanted to be successful I needed an education. So education was my first passion. She raised two children and worked multiple jobs. She was my first role model and gave me my work ethic. She taught me that I could pave my own path, which gave me the confidence to excel in my professions as an African-American woman in male dominated industries.”
What are some challenges you faced launching it and how did you overcome them?
AMY OLIVIERI: “My greatest challenge was finding trusted service providers who didn’t over promise and under deliver. It’s not easy to find the right team ofpeople who see your vision and are willing to move with that vision to make your idea a reality. And as a female founder of a tech company there are many obstacles you must overcome in this space. I have an amazing support infrastructure that helps me navigate around the challenges and stay focused.”
Part of that supportive infrastructure is from you forming a strategic partnership with KiwiTech, where we met.
AMY OLIVIERI: “Yes, we’re pleased to join hands with KiwiTech and view them as the ideal technology partner to help us launch our platform and take it to the next level.”
Explain to our readers what KiwiTech does.
AMY OLIVIERI: “KiwiTech, LLC, is a technology services provider that invests in tech startups. Most recently, they featured their first all Female Founders Demo Day in New York City. As part of the partnership, KiwiTech will provide exclusive technology development capabilities to TakeAClass.”
CEO of KiwiTech says:
“KiwiTech is excited to partner with TakeAClass,” says Rakesh Gupta, CEO of KiwiTech. “Their platform offers consumers fast access to academic and recreational local and online classes. Leveraging our deep domain expertise, we’re committed to helping TakeAClass achieve their mission.”
When do you launch?
AMY OLIVIERI: “We’re real excited to go live Monday, June 25, 2018.
How can be people sign up for a class or offer one on the site?
Thank you, Amy! Congratulations and continued success. You’re a great role model.
More About KiwiTech
KiwiTech provides end-to-end digital technology solutions across a wide range of industries, including publishing, healthcare, media & entertainment, education, financial services, energy and nonprofit & government.
KiwiTech has quickly gained recognition as an innovator by investing in numerous early-stage startups and partnering with large enterprises. Drawing on its deep expertise across mobile and web technologies, KiwiTech enables companies to create groundbreaking digital experiences. KiwiTech is based in Washington DC, with additional offices in New York and New Delhi.
Super excited to tell you about a new smart heart monitor you can use at home. It will help 28 million heart disease patients in the U.S. keep track of their heart.
Keep track from the comfort of their home at any time. And it’s just been FDA approved.
Meet Eko DUO. The first handheld mobile, wireless, EHR-connected stethoscope, which connects to your smart phone.
It allows you to amplify, visualize and record crystal clear heart and lung sounds.
Imagine not needing to wait for your next followup appointment to transmit a concern to your physician. It works under the supervision or prescription from a physician.
Eko Duo is set to help millions of heart disease patients who are often discharged with little more than an info packet and instructions to monitor their weight.
Now patients can be sent home from the hospital with a direct link back to their physician, helping reduce readmissions and false alarms.
“The goal is to bring hospital-quality care to the home.”
–Connor Landgraf, CEO and co-founder, Eko DUO
The device wirelessly pairs with Eko’s secure, HIPAA-compliant app, enabling remote monitoring and diagnosis by a clinician or specialist.
It works with the Eko app on any iPhone, iPad, Windows PC or Android device.
Eko DUO can also be used by clinicians as an enhanced stethoscope for in-clinic cardiac screenings, enabling physicians to quickly diagnose and monitor patients.
Clinicians can use it bedside or remotely to quickly spot heart abnormalities including arrhythmias, heart murmurs, and valvular heart diseases.
I interviewed Ami Bhatt, M.D., a Cardiologist at Massachusetts General Hospital and Director of Outpatient Cardiology and the Adult Congenital Heart Disease Program at Massachusetts General Hospital and she believes Eko DUO will improve outcomes through early intervention.
Dr. Bhatt says, “Cardiology programs are looking for ways to deliver hospital-quality healthcare at home. The ability to capture digital heart sounds and an ECG expands our portfolio of mechanisms to remotely monitor the heart – and brings diagnosis and opportunities for early intervention even further upstream.”
Heart disease can strike people of all ages.
I spoke with Stacy Bingham, a registered nursefrom Oregon with 5 children, who knows this firsthand. She and her husband have no prior history of heart disease in their family, yet 3 of her 5 children end up needing heart transplants.
When Stacy noticed her oldest child, Sierra acting tired with a loss of appetite for a few weeks, she never suspected the cause was an underlying heart condition.
“I noticed her face and eyes were swollen. She complained her stomach hurt.”
That’s when Stacy and her husband took her to a family practitioner.
“The doctor told us it’s probably a flu bug and sent us home. When her condition worsened she had an x-ray.”
X-ray results revealed Sierra’s heart was enlarged. Dilated cardio myopathy. She later learned two of her other children also had heart problems.
“If they had not finally found Sierra’s heart condition, she may not have survived. We live in a really rural part of Eastern Oregon and we now have three kids with heart transplants that need to be monitored for life.”
Today, Stacy’s family takes nothing for granted, especially innovations that help.
“If this device can be used at home and we can rule out scary things and know when it’s not something we need to rush to a hospital for that would be wonderful.” –Stacy Bingham
James Young also knows how life can change in a heartbeat.
Young was just 40-years-old when he first experienced symptoms of heart failure. Symptoms he ignored until they were severe and his sister insisted on it.
“I was coughing in mornings and throughout the day. I thought it was simply allergies. I vomited phlegm some mornings and still didn’t see a doctor.”
But the coughing became more painful. While shoveling, it stopped him in his tracks.
“I was outside shoveling snow when I turn behind me and see a trail of blood.”
His sister noticed he didn’t look well and insisted he go see a physician.
“That’s when I was diagnosed with congestive heart failure. I was shocked.”
James felt anxiety, depression and uncertainty about his future at this time. Young believes Eko DUO will not only help alleviate false alarms and unnecessary hospital readmissions, but needless worrying as well.
“Eko DUO would have given me assurance the doctor knew where I stood daily. If there were any issues outstanding needing to be addressed immediately. It gives the doctor an opportunity to respond expeditiously to those concerns.”
Today, James is doing great and is a national spokesperson and heart failure Ambassador for the American Heart Association.
“I went from a 25% functioning heart to being an avid runner and cycler. I’ve taken on a new lease in life. As a community advocate I can help inspire others and give them hope.”
Ami Bhatt, M.D says that hope also translates to much needed continuous care rather than outpatient care.
“Robust toolkits for caring for patients in the community will hopefully lead to more appropriate healthcare utilization through continuous rather than episodic outpatient care.”
HERE’S HOW EKO WAS DEVELOPED:
Eko’s co-founder & CEO, Connor Landgraf, is also a heart disease patient.
Connor navigated countless cardiology visits, screenings and referrals.
In 2013, during his senior year as at the University of California at Berkeley, Connor attended a panel discussion at UC San Francisco on technological shortcomings facing modern medical practices.
One technical gap cardiologists claimed stood out beyond the rest: the stethoscope.
So Conner and his co-founders welcomed the stethoscope, a two-century old tool, into the 21st-century.
Photo: Connor and his co-founders, Jason Bellet and Tyler Crouch
The newly FDA approved Eko DUO brings that to the next level.
According to the CDC, heart disease is the leading cause of death in the U.S.
The American Heart Associations says the U.S. currently spends over $26 billion annually on heart failure hospitalization. 25% of heart failure patients are readmitted within 30 days — 50% are readmitted in 6 months with hospitals now being penalized for high readmission rates.
Fact: 83% of parents experience anxiety surrounding their child’s referral to a pediatric cardiologist for an innocent murmur.
Fact: Average cash price for an echocardiogram is $2,275 and even with insurance, patients can expect to pay 10 to 30% of this cost.
Fact: For a pediatric subspecialist such as a pediatric cardiologist, patients must wait between 5 weeks and 3 months to get an appointment.
Fact: Internal medicine residents misdiagnose more than 75% of cardiac events.
Fact: 70% of all pediatric cardiac referrals for murmurs are unnecessary.
Fact: Average PCP needs to coordinate care with 99 other physicians working across 53 practices.
Fact: Only 50% of initial referrals are accompanied by information from the PCP.
Fact: Patients in rural communities must travel an average of 56 miles to see a specialist.
Fact: About 46.2 million people, or 15% of the U.S. population, reside in rural counties.
Eko DUO. A real game changer for heart patients worldwide.
“It’s not a long term solution like bariatric surgery. The procedure is used for a quick, six-month weight loss to get rid of 10 percent of your body weight. After six months, the balloon is removed and you should see a pretty noticeable weight loss,” Dr. Chattoo says.
The end result is weight loss and reduced hunger.
After the procedure, ORBERA has a 12-month diet and exercise program to follow.
The biggest benefits about ORBERA, according to Dr. Chattoo, are that no abdominal surgery is needed and that the procedure is completed in the same day.
The procedure is recommended to those with a body mass index (BMI) of 30-40 or those who have other risk factors for heart disease such as diabetes or high blood pressure. A BMI or 30 or higher is defined as obese. More than a third of U.S. adults fit that range.
The procedure costs 6-8K and is not covered by insurance.
One procedure will be donated for free to one person in need who meets requirements. Contact: firstname.lastname@example.org Write: Orbera in Subject, include your contact information.
“Always remember the benefits of daily exercise for your mind, body and spirit. If you hate or dread exercise start with walking. Break it up into 15 minutes at a time until you reach 30 minutes. Then, increase it to 45 or 60 minutes. You don’t even need a gym to do that.
Remove all junk food from your home. Load up on healthy snacks. Remove all processed foods and soda. Drink lots of water. You’ll begin to notice a difference in 6 months. In one year, it will all be a habit.
No matter what help you get surgically or non-surgically, you always want to strive to develop lifelong healthy habits. Address the underlying of ‘why’ you select unhealthy foods. Stressed? Find someone to talk to. There are lots of free counselling services where you can call and talk to someone confidentially.
Rushed? Fix meals the night before. Hate your job? Start looking for a new one. Sit at a computer all day? Get up every 15 minutes and walk around office. Take stairs. Depressed? Again, find someone to talk to and exercise daily. Make an appointment with a professional psychologist if it’s really bad. When exercising, don’t focus on the physical. Focus on the mental benefits when you start. Physical has a way of catching up when you fix your mind and thoughts first. Stay positive.
Good things take commitment, dedication and time.
Your goal should never be a quick fix, but to change habits that got you to the place where you feel tired, sluggish and unhealthy and replace them with new, better, healthy ones. You can do it. One day at a time. ” -Maria Dorfner
Interesting research shared by Melissa Robinson:
Brown Fat, Triggered by Cold or Exercise, May Yield a Key to Weight Control
Fat people have less than thin people. Older people have less than younger people. Men have less than younger women.
It is brown fat, actually brown in color, and its great appeal is that it burns calories like a furnace. A new study finds that one form of it, which is turned on when people get cold, sucks fat out of the rest of the body to fuel itself. Another new study finds that a second form of brown fat can be created from ordinary white fat by exercise.
Of course, researchers say, they are not blind to the implications of their work. If they could turn on brown fat in people without putting them in cold rooms or making them exercise night and day, they might have a terrific weight loss treatment. And companies are getting to work.
But Dr. André Carpentier, an endocrinologist at the University of Sherbrooke in Quebec and lead author of one of the new papers, notes that much work lies ahead. It is entirely possible, for example, that people would be hungrier and eat more to make up for the calories their brown fat burns.
“We have proof that this tissue burns calories — yes, indeed it does,” Dr. Carpentier said. “But what happens over the long term is unknown.”
Until about three years ago, researchers thought brown fat was something found in rodents, which cannot shiver and use heat-generating brown fat as an alternate way to keep warm. Human infants also have it, for the same reason. But researchers expected that adults, who shiver, had no need for it and did not have it.
Then three groups, independently, reported that they had found brown fat in adults. They could see it in scans when subjects were kept in cold rooms, wearing light clothes like hospital gowns. The scans detected the fat by showing that it absorbed glucose.
There was not much brown fat, just a few ounces in the upper back, on the side of the neck, in the dip between the collarbone and the shoulder, and along the spine. Although mice and human babies have a lot more, and in different places, it seemed to be the same thing. So, generalizing from what they knew about mice, many researchers assumed the fat was burning calories.
But, notes Barbara Cannon, a researcher at Stockholm University, just because the brown fat in adults takes up glucose does not necessarily mean it burns calories.
“We did not know what the glucose actually did,” she said. “Glucose can be stored in our cells, but that does not mean that it can be combusted.”
A new paper in The Journal of Clinical Investigation by Dr. Carpentier and his colleagues answers that question and more. By doing a different type of scan, which shows the metabolism of fat, the group reports that brown fat can burn ordinary fat and that glucose is not a major source of fuel for these cells. When the cells run out of their own small repositories of fat, they suck fat out of the rest of the body.
In the study, the subjects — all men — were kept chilled, but not to the point of shivering, which itself burns calories. Their metabolic rates increased by 80 percent, all from the actions of a few ounces of cells. The brown fat also kept its subjects warm. The more brown fat a man had, the colder he could get before he started to shiver.
Brown fat, Dr. Carpentier and Jan Nedergaard, Dr. Cannon’s husband, wrote in an accompanying editorial, “is on fire.”
On average, Dr. Carpentier said, the brown fat burned about 250 calories over three hours.
But there is another type of brown fat. It has been harder to study because it often is interspersed in the white fat and does not occur in large masses. Investigators discovered it in mice years ago. Now, in a recent article, Bruce Spiegelman, professor of cell biology and medicine at the Dana-Farber Cancer Institute, and his colleagues report that, in mice at least, exercise can make it appear, by turning ordinary white fat brown.
When mice exercise, their muscle cells release a newly discovered hormone that the researchers named irisin. Irisin, in turn, converts white fat cells into brown ones. Those brown fat cells burn extra calories.
Dr. Spiegelman said the brown fat he studies is different from the type that appears in large, distinct masses in rodents, the type Dr. Carpentier was examining in his subjects. That brown fat is derived from musclelike cells and not from white fat.
Dr. Spiegelman suspects that humans, like mice, make brown fat from white fat when they exercise, because humans also have irisin in their blood. And human irisin is identical to mouse irisin.
“What I would guess is that this is likely to be the explanation for some of the effects of exercise,” Dr. Spiegelman says. The calories burned during exercise exceed the number actually used to do the work of exercising. That may be an effect of some white fat cells turning brown.
Many questions remain. The only brown fat that can be easily seen in people is the muscle-derived fat that shows up in scans. And that brown fat, notes Dr. C. Ronald Kahn, chief academic officer at the Joslin Diabetes Center in Boston, is visible in people only when it is turned on by making them cold.
Almost everyone of normal weight or below shows this brown fat if they are chilled, although individuals vary greatly in how much they have. But this brown fat almost never shows up in obese people. Is that one reason they are obese, or is their extra body fat keeping them so warm that there is no reason to turn on their brown fat?
There is also an intriguing relationship between the brown fat that emerges under the skin and the density of bone. Dr. Clifford Rosen, a professor of medicine at Tufts University School of Medicine in Boston, is studying mice that cannot make brown fat and was astonished by the state of their bones.
“The animals have the worst bone density we have ever seen,” Dr. Rosen said. “I see osteoporotic bones all the time,” he added, “but, oh my God, these are the extreme.”
And while exercise may induce brown fat in humans, it remains to be seen how important a source of calorie burning it is, researchers say.
As for deliberately making yourself cold if you want to lose weight, Dr. Carpentier said, “there is still a lot of research to do before this strategy can be exploited clinically and safely.”
MARIA DORFNER is the founder of NewsMD Communications and Healthy Within Network. This blog is a part of that. She began her career in 1983 at NBC News in NYC where she continued to work behind-the-scenes on TODAY SHOW, NIGHTLY NEWS and all programs until 1989 when she helped launch CNBC.
As a producer, she has produced talk shows, segments and series and travelled extensively. In 1993, she developed and senior produced 7 health series: Healthy Living, Healthcare Consumers, Healthcare Practitioners, Lifestyles and Longevity and Green Magazine.
She co-anchored Healthy Living and Healthcare Consumers airing on CNBC for three years before launching NewsMD Communications. Her clients include a Who’s Who in Medical/Health, the Journal of the American Medical Association (JAMA) which she shot, wrote and produced weekly segments for NBC, CBS, ABC, CNN and Fox. Discovery Health Channel, where she wrote, produced and directed the documentary series, 21st Century Medicine. She has helped raise multi-millions of dollars for hospitals in need and has been a part of several successful health startups. She has worked as Director of Research for Roger Ailes at Ailes Communications, his consulting and production company and again as a producer. Her articles have been published in Broadcasting & Cable Magazine and she has hosted The Secret to Success.
She has continued to be a go-to person for network heath shows, stories and content. She was awarded a health reporting scholarship from The American Medical Association (AMA), a Freddie Award for Excellence in Medical Reporting, an Outstanding Achievement Award from the March of Dimes, an Angel of a Sponsor Award from Make A Wish Foundation and an Outstanding Leadership Abilities from her alma mater, Pace University and Commitment to the Advancement of Women in Media Award.
In 2014, she published 3 books. She was also awarded a scholarship to Columbia University by NBC News. She also received Media Recognition Award from the American Heart Association for her series Heart Smart. She has been specializing in Medical/Health for 23 years, and has worked in Media for 33 years after starting as an intern during college. In her spare time, she enjoys reading, learning, writing, nature, hiking, swimming, bike riding, working out, cooking, exploring museums and travel. She is a certified scuba diver and aerobics swim instructor.
“Health has been a passion of mine since I was a kid. What I do and who I am are seamless. I come from a large Italian family. If someone is sick I’m the one they call for research. My best friend growing up in Brooklyn was my cousin Josephine, and we’re still close. We were little health nerds. She became a pediatric nurse. We loved researching everything to death and still do. Two things I love and know well. Media and Medical. Yet, I think in both, they’ve forgotten the most important person –the patient. So, I want to help put the ME back in MEdia and MEdical. Today, it’s SO hard to know who to trust in both. Fortunately, people are smart and they are now well aware of the various financial ties “experts” and physicians and media have to promoting certain medications or other large companies, products or services that absolutely do not serve our health or our best interests. The worst part is when we learn they knew and do not reveal it to consumers for decades, which contradicts the oath, “First do no harm.” So much damage has been done and no one is accountable. How do you like that. Well, ethics matter. People matter. And people want and will choose what is best for their health. People are empowered and will use their money to denounce those companies aligned with making them sick. I created this blog to be a trusted resource for people. I do it for free because I believe Virgil is right. There is no greater wealth than health and you absolutely have to trust who is telling you information and why more than any other time in your life. It’s even worse if you’re rich because then people try to sell you even more things. That may be fine when it’s a handbag, but your health is too precious and there are no returns or refunds if you end up paying a price for trusting the wrong advice. Remember, “expert” doesn’t always mean that. I feel extremely blessed to be healthy. I’ve been healthy all my life. I’ve never even had stitches. I love to help people and my career became a vocation when I was able to utilize my communication and journalism skills to do that.”
To help you slim down, My Diet Diary tracks your food (including calculating calories and personalized nutritional needs using a database of 150,000 foods), exercise, water consumption, and how your actual weight is trending against your goal weight. You can share your progress on social media and graph your results.
To boost your motivation, RunKeeper turns your mobile device into smart run or fitness tracker, using the GPS to track the speed, distance and duration of your workouts. You can calculate calories burned, share your results on social media, get audio feedback as to whether you are on your target pace, and create a personal data dashboard on the runkeeper.com site.
Widely used by doctors, this free drug reference tool provides details on thousands of medications. Not only can you look up potential side effects on Epocrates Rx, but if you take more than one medication, you can also check for potentially dangerous interactions and confirm drug coverage for many health plans, including Medicare Part D. And if you sometimes forget to take your medications, also check out RxmindMe, a free app that lets you create 9 types of reminders.
Developed by emergency physicians, iTriage lets you look up symptoms and possible causes, tap into a national directory of ERs, doctors, urgent care centers, and clinics, use your phone’s GPS to identify the closest medical facilities and get driving directions. This free app is designed to answer 2 questions: “What’s wrong with me?” and “Where can I get treatment?”
If you’re one of the 20 million Americans with chronic kidney disease, your doctor has probably told you to watch the potassium, protein, phosphorus and salt in your diet. The KidneyDiet app provides nutritional data on thousands of foods, including brand name products and menu items from some chain restaurants, to help you make the best choices. Foods that might be harmful for people on a kidney diet are highlighted in red.
Want to quit smoking? Developed by the National Cancer Institute, QuitGuide helps you prepare to kick the habit, provides support during the days and weeks after you quit, and discusses the challenges you may experience. For more free resources, visit smokefree.gov.
This free app lets you track blood sugar levels, carb intake, and insulin doses. WaveSense Diabetes Manager provides color-coded results—making it easy to see if your glucose results are in the high or low ranges—is customizable with target ranges, lets you tag your results with info on food, exercise, medication or health issues, and email reports to your healthcare team.
8. PTSD Coach
Up to 20 percent of veterans of the Iraq and Afghanistan wars suffer from flashbacks, nightmares, panic attacks and other symptoms of post-traumatic stress disorder (PTSD. Created by the VA and Department of Defense, PTSD Coach, a free iPhone and Android app, delivers information on the disorder and a self-assessment, along with insights into treatments and coping tools. Users can upload their contacts, photos and music.
AsthmaMD can track your asthma triggers, map “severity zones,” share your data with your doctor, and help researchers study asthma by pooling real-time data from thousands of patients through secure “cloud” storage.
10. Sleep on It
Rest assured that you’ll wake up on time. The free Sleep on It app combines an alarm clock with a variety of sounds with clever features to track how the duration and quality of your slumber is impacting your health and mood. You can record medications, symptoms, and naps to see which factors may explain poor sleep and generate graphs of overall sleep trends and hours snoozed in the last 7, 30, and 90 days.
Between 2006 and 2008, outbreaks of cholera—a deadly infection spread by contaminated drinking water—struck hundreds of victims in Rwanda. In response, Nathan Eagle, Harvard School of Public Health adjunct assistant professor of epidemiology and an engineer by training, tapped an unusual source to develop a simple model for predicting cholera outbreaks: cellphone data. His model was predicated on the hypothesis that he might find a telltale sign of an outbreak by tracking people’s locations. For instance, if the movements of 100 people within a 10-mile radius suddenly slow, the cause might be illness—and a looming epidemic.
“We could build a surveillance system that alerts local ministries of health if we detect what looks like an outbreak,” Eagle says.
Cellphones and incentives for better health
In addition to his role at HSPH, Nathan Eagle is CEO of Jana (formerly txteagle), a technology company that has built a platform capable of awarding billions of people with free mobile airtime in exchange for completing surveys or purchasing products.
This arrangement sprang from one of Eagle’s first mHealth projects, helping a hospital in rural Kenya prevent frequent blood supply shortages. He developed a text message application enabling nurses to alert the main blood bank about shortages before they became emergencies. But the project fell flat; the cost of sending daily text messages is a big chunk of a rural nurse’s income.
Eagle responded with airtime compensation, a system that automatically gives users free service in exchange for data transmission charges for each message sent. The scheme worked, and the nurses started texting again
Making this prediction model possible are giant data banks run by cellular service providers with records of every phone’s history. When a phone receives or sends a message, or moves in or out of a cell tower’s range, the network records it. In aggregate, all of the call data records from a given provider can give researchers an invaluable picture of how people behave.
Information that users generate as they move around and use their mobile phones, when combined with other data such as public health records, is called “Big Data” because of its volume and variety. But as Eagle discovered, moving from theory to practice in the emerging world of Big Data-driven public health still means working out the kinks.
“What I built turned out to be not a cholera predictor, but a flood detector,” he says with a laugh. People moved around less, not because they were sick, but because the roads were washing out. Yet fortuitously, Eagle’s prediction model also applied to cholera—because outbreaks generally erupt about two weeks after a flood.
The new field of “mHealth”
Eagle is part of a growing movement at HSPH and within the global health community to leverage the explosion in mobile phone availability—and the data cellphones can share and produce—to change how public health and medical problems are identified, prevented, and treated. This burgeoning field, which has expanded exponentially in the last five years, is called “mHealth.”
The variety of mHealth applications under development or available worldwide is staggering and ever evolving. In addition to using Big Data to track people’s movements and predict potential public health threats, mHealth is putting medical records, appointment reminders, health tips, and detailed standards of care literally in the hands of health workers and patients, whether in Tanzania or Tucson. Today, there are mHealth applications that diagnose medical ailments, manage chronic diseases, and support mental health therapies and addiction control.
mHealth has the potential to help patients, doctors, and researchers make healthier, more informed choices by doing what no other technology can do: deliver valuable, actionable information to the right people at the moment it is needed, no matter where they are. And with projects ranging from outbreak prediction to humanitarian aid, HSPH is among the vanguard institutions defining this new terrain.
“Our faculty have always been leaders in developing interventions to improve health,” says Karen Emmons, HSPH associate dean for research. “mHealth provides an important opportunity to explore how to take those interventions to scale, to deliver them in remote places, and to fundamentally change the access of whole populations to evidence-based interventions.”
Cellphones curbing drug-resistant malaria?
Caroline Buckee, HSPH assistant professor of epidemiology, uses call data records from the largest service provider in Kenya to track the movements of 15 million people and correlate those movements with data about malaria. Her work focuses on understanding how human behaviors, such as where people travel and with whom they interact, influence the spread of diseases.
Though using mobility data to make predictive models of the spread of disease is nothing new, the data have generally been either inaccurate or unfeasible to collect at large scales. “Never before have we been able to look at individual people on this scale, moving in real time,” says Buckee. “It’s a huge deal for infectious disease researchers.”
In the future, Buckee plans to use these models to intervene at key moments—by sending text messages to travelers heading into malaria-plagued zones, detecting when their phones enter the range of a cell tower in that zone and reminding individuals who have opted to receive notifications to take precautions such as wearing long sleeves and pants and sleeping under a mosquito net.
mHealth and women’s health
“Mothers wanted us to leverage the one piece of technology they have access to: the mobile phone,” says Priya Agrawal, a visiting scientist and obstetrician and gynecologist working with the Women and Health Initiative at HSPH. The resulting tool, the Mother/Baby 7-day mCheck, was designed by mothers, for mothers. The checklist-based intervention cues mothers to examine their infants for common danger signs during the first week after birth.Of mothers and babies who die during childbirth, two-thirds die in these critical first seven days. Mobile phones not only remind mothers to do the checks, but also help them connect to medical aid and transport, when needed.
Reaching the unreachable
One of the driving forces behind this new field, in addition to the emergence of the smartphone and other wireless devices, is the rapid spread of mobile phones into remote niches. According to the mHealth Alliance, a research and advocacy organization hosted by the United Nations Foundation, close to 90 percent of the world’s population has wireless coverage. There are 6 billion cellphones on the planet—and 7 billion people. Moreover, 65 percent of subscribers reside in the developing world.
While the Internet revolution passed by without appreciably changing the lives of many people in the developing world, mobile technologies offer immediate advantages: they are far cheaper, they don’t demand steady supplies of electricity, and they don’t require the same extensive infrastructure to reach into people’s homes. For all these reasons, mHealth technologies are leap-frogging ahead of the personal computer.
“The use of cellular phones for health care and public health is one of the most promising developments in the quest to achieve universal health coverage worldwide,” notes HSPH Dean Julio Frenk, “because mobile phones are rapidly becoming the communication technology of choice—and increasingly so among the poor.”
Improving maternal and child health
Marc Mitchell, a pediatrician, management specialist, and lecturer on global health at HSPH, says 70 percent of the population in Tanzania has access to a mobile phone. He is among those leading the way in evaluating potential mHealth interventions in the developing world, having spent 20 years designing, validating, and delivering clinical protocols to guide health workers through examinations, diagnoses, and treatments.
Mitchell is a firm believer in mHealth as an effective and inexpensive means of getting such step-by-step protocols into the hands of health care practitioners when and where they’re needed. mHealth extends the reach of these protocols to remote places and makes them easier to apply. Mobile technologies automatically keep protocols current with the latest medical advances and supplement them with other valuable features such as digital appointment management tools and electronic patient records, two systems that many clinics in the developing world lack. In some clinics, the only records of patient visits are logbooks that patients sign on arrival, and the only records of diagnoses and treatment plans are on index cards that patients themselves carry.
Mitchell has launched several pilot projects in Tanzania using mobile phones to improve maternal health, child health, and malnutrition using time-tested protocols. Through his not-for-profit organization D-Tree (which stands for “decision tree,” a type of flowchart that is part of many clinical protocols), Mitchell runs a maternal health program in Zanzibar funded by the Bill & Melinda Gates Foundation. Also in Zanzibar, in a project funded by UNICEF, a mobile app that assists health workers as they screen children for malnutrition has helped reduce errors in health care delivery. If pilot projects such as this prove effective, says Mitchell, the next step will be scale-up.
mHealth and human rights
In a decade-long mission asking survivors of war and mass conflict how they were faring and what they and their societies needed to heal, Patrick Vinck and his wife Phuong Pham often felt hampered by standard paper-and-pencil surveys. Both work at the Harvard Humanitarian Initiative (HHI)—Vinck as director of the Program on Vulnerable Populations, and Pham as the director of Evaluation and Implementation Science. Today, with open-source software that they themselves developed, called KoBo, the researchers are able to document both the complexities of postwar suffering and the most pressing public health needs in ravaged populations.“
mHealth technology represents the second wave of humanitarian assistance,” says Vinck. “When you ask victims how to redress war suffering, they will often say, ‘Help me get prosthetics for my injuries. Build a hospital for my children. Improve the health care system.’ In the past, we’ve seen billions of dollars poured into proceedings meant to help the victims—but nobody was asking the victims exactly what they wanted and needed. With digital technologies, we can do just that.”
Adds Pham, “We wanted smartphones that integrated audio, video, text, data, and geolocation all in one place, and we wanted it to be freely available.” Compared with conventional data-gathering tools, their mobile digital technology is more secure, more cost-effective, easier for trained health workers to use, and its results can be swiftly translated into case management and timely evidence-based policy recommendations. Ultimately, the phones could help health care workers diagnose disease, document human rights violations, photograph (through an attachment to a light microscope) a smear of blood potentially laced with malaria parasites, and even gauge through surveys how post-traumatic stress disorder colors postwar attitudes toward transitional justice and reconciliation.
Just a few years ago, according to Erica Kochi, co-lead of the Tech Innovations Team at UNICEF, people weren’t interested in using mobile technologies in health care in the developing world. “They laughed when we brought it up,” she says. After all, just five years ago, only the urban rich owned mobile phones in the developing world. Today, there are mobile phone owners in even the most remote villages. “Now, everyone is including mobile technology in their plans.”
mHealth applications enable aid workers to map where a crisis is unfolding in real time, giving researchers and aid workers a better shot at swiftly responding to threats of violence, disease, or malnutrition. Applications also provide patient monitoring, send text messages reminding patients to take needed medications, or offer suggestions for maintaining health while pregnant, even in war-ravaged places.
For organizations like the U.S. Centers for Disease Control and Prevention and the World Health Organization, with missions to avert dangerous epidemics, “this technology is a potential powerhouse,” adds Phuong Pham, a research scientist at HSPH and director of evaluation and implementation science at the Harvard Humanitarian Initiative, a University-wide program dedicated to developing ways to improve the delivery of health services in areas facing war, conflict, or natural disasters. “In epidemiology, determining person, place, and time are crucial. If you can look at those three components in real time, you can immediately make informed decisions and take action.”
Long-term research studies using mHealth
Mobile technologies are also energizing the workhorse of public health research—longitudinal studies, which collect behavioral and health data over time to reveal factors that may threaten or improve health.
For example, HSPH is developing a program to monitor the day-to-day behaviors of half a million people in sub-Saharan Africa over several decades, gathering information on what they eat and drink, where they live, and whether they smoke or exercise. The first study of its kind in this region, it will use an mHealth survey platform developed by Eagle that enables researchers to survey people in places too remote to reach with paper or personal interviews.
“Longitudinal data may be the most promising area in mHealth,” Eagle says. “It could change how we think about preventative health.”
Risks and obstacles
Scientific evidence that mHealth interventions actually work is beginning to emerge. Recent studies, for instance, have shown that mobile phones have assisted in relief effort coordination in Haiti and that text message reminders about proper malaria treatment have improved the care of sick children in Kenya.
Tracking pandemic flu
In 2009, HSPH graduate student Martin Lajous, SM ’04, SD ’11, successfully collaborated with a large cellphone company in Mexico, surveying Mexican residents to characterize outbreaks of H1N1 influenza. Lajous pitched the idea as a test to determine whether cellphone technology could be used for public health response and surveillance. The cellphone company agreed, and the effort showed that cellular surveys may be a practical, inexpensive, and timely complement to traditional surveillance.
But will mHealth deliver on its early promise? The answer depends largely on who invests in mHealth and how. If the biggest investments are made by those who stand to profit, then, according to Mitchell, “mHealth would not reach those who most need it,” particularly those who cannot afford mobile phones without assistance, such as under-resourced clinics, women, and the poorest of the poor. Mobile health care could become boutique health care.
Privacy is another issue. Even though Buckee and Eagle depersonalize the data they use, there are no international standards that define what needs to be done to call data before it is handed off to researchers.
Equity is also a key issue. In Africa, for example, mobile phone owners still tend to be male and relatively affluent. “We need to be cognizant of the bias,” says Eagle. “It’s easy to slip into the idea that we’ve discovered a universal law of human behavior, when really we’ve identified a pattern in a subset of behavioral data from a subset of mobile phone subscribers in one country.”
A major concern is that academia and technology don’t typically operate on the same time frames. In the years it takes an investigator to write a proposal, submit it, and get it reviewed and funded, what had been cutting-edge mobile technology may become obsolete. And if mHealth applications race ahead of scientific and regulatory safeguards, the trend could backfire and do more harm than good.
Despite these questions, there is a gathering momentum and sense of inevitability about the nascent technology. “I’m doing this because mHealth is going to happen no matter what,” Mitchell says. “I believe it can happen in one of two ways. In one, it benefits people equitably. In the other, it goes to the highest bidder.”
—Elizabeth Dougherty is a freelance science journalist and novelist living in central Massachusetts.
Love this gadget. BabyPing recently announced the arrival of its new high security Wi-Fi baby monitoring system. The product will allow parents to hear and view their baby utilizing an iPhone, iPad or iPod touch. The system also features double-layer security that alerts parents if their baby cries, if the Wi-Fi connection drops out or if their iOS device is out of range.
The BabyPing kit features all the specifications of a regular baby monitor, in the form of a full color video camera with 640×480 resolution and built-in microphone, a free monitoring app for the user’s iDevice, and wireless Wi-Fi connectivity. In addition, BabyPing has developed the Smart Filter which reduces background noise and static, and Constant-Connect technology which instantly notifies the user when the baby is upset or if the connection is lost. BabyPing is also reportedly the only Wi-Fi baby monitor on the market with infrared night vision.
ABC-TV is safe. Mark Cuban is safe. And so is Mr. Quiggly.
A start-up is a business or undertaking that has recently begun operation.
A Healthy Start-Up is one that has founders that make their mental, physical and spiritual health a priority. They know that if they are unhealthy, it infects the rest of their team and their company. The same is true if they are healthy. People emulate those they admire. If you’re a leader — you have the ability to influence others. Influence them towards daily healthy habits. Neglect your health. Neglect your company. Great leaders have already learned this valuable lesson.
Lead your team towards healthy habits. Build a healthy company.
Successful companies are built with a strong foundation. Think about it. If your own mind, body or spirit suffers, how can you possibly bring your best to team, employees, clients, customers, board or investors? The answer is you can not. Taking time to nourish those things daily is not selfish or time wasted, it’s actually selfless and time/energy gained to serve all the aforementioned best, as well as family and friends to bring life balance.
I believe Entrepreneurs need to think of their HEALTH as a BANK ACCOUNT.
Make deposits now.
Benefit later. Health is Your Greatest Wealth. Talk to any old rich person to confirm.
Here are 5 things you experience when working on a startup, which may affect health.
1. You will be excited. New start-up. Woo-hoo! I’ll work 24/7 on this!
2. You will get too busy to prepare meals. I’ll just order in a pizza. Again.
3. You will experience information overload and sit at a computer for hours on end.
4. You will get bummed out and not know why. (Refer back to #1, 2, 3)
5. You will get tired and have no time for family or friends.
REPEAT. WHAT GOOD IS IT WHEN YOU, THE FOUNDER, ARE NO LONGER AROUND TO REAP THE BENEFITS BECAUSE WHAT YOU’VE REALLY BUILT IS AN EARLY GRAVE. ALL 5 MAKE WITHDRAWALS IN YOUR ACCOUNT.
The good news is every day YOU get to decide which one you’ll do.
Your aim is to make DEPOSITS into what I call a HEALTHY START-UP ACCOUNT.
1. You will be excited.
You are running on adrenaline. Your dream team is in place. You have a great team in place. You have a vision. You’re executing on it. You’re making sales. You’re gaining traction. You’re meeting with potential investors. Exciting. So exciting you can’t sleep.
Tips to sleep: Create a dark area at room temperature (not too hot, not too cold) with a fan or quiet music (no gadgets!). Remember, you are excited and may be running off of adrenaline. But the same adrenaline will zap your energy and exhaust you if you don’t regulate your daily sleep. Set a regular time for turning in and try to get away from technology and relax your mind beforehand. Step outside, stretch, breathe.
SLEEP is a DEPOSIT. Repeat that with me. Sleep is a deposit into your Healthy Start-Up.
Here is expert advice from sleep specialists Dr. Kingman Strohl of University HospitalsCase Medical Center, Dr. Joe Golish of MetroHealth Medical Center, and Dr. Douglas Moul of the Cleveland Clinic Foundation:
Go to sleep an hour ahead of time. Same time. Every night.
Don’t just jump into bed — start your sleep ritual an hour or two ahead of time. And, this is crucial: Try to go to bed at the same time every single day. Discern what the best time for you is and go for that, consistently. Don’t tough your way through your sleepy hours and chance getting a second wind.
Avoid all stimulants.
• That means caffeine in any form (it’s OK to drink some in the morning, but not cup after cup after cup), watching TV, working out, doing anything online (the blue light given off by TV and computers have shown to be disruptive to the pre-sleep cycle), arguingwith a family member. Consciously cultivate peacefulness before bedtime. No alcohol before bedtime either (if you fall asleep, you’ll likely wake up again in a few hours).
• Let go of anxiety about going to sleep, and of worrisome thoughts. This isn’t easy, and it takes practice. “You can’t change the world,” Strohl says. “Remember that!” It’s okay to read an enjoyable, but not too stimulating book, which can take your mind off worries.
Lavender is surprisingly effective.
• Good sleep habits are imperative, says Strohl. It’s important to remember that everyone has insomnia at some point and hardly anyone falls asleep right away. We really shouldn’t, because it takes awhile for our bodies and brains to wind down. In fact, says Strohl, “If you are falling asleep within five minutes of your head hitting the pillow, then you are sleep-deprived.”
Cool, dark room with lavender mist.
Do things to create a supportive sleep environment: Make your room cool and dark, don’t have a TV or computer in it, spray a lavender mist on your pillow (it is supposed to be surprisingly effective for promoting drowsiness). If you still can’t fall asleep, get out of bed and read for a while in a chair or inanother room. When you get sleepy again, get back into bed. This way you won’t associate your bed with your inability to sleep.
What about herbs and supplements?
• Some people use melatonin, a dietary supplement available over the counter, to help them sleep. But be careful: the strength of it varies because the Food and Drug Administration does not regulate dietary supplements. Your doctor, however, can prescribe a melatoninlike drug (Rozerem orthegenericramelteon, a melatonin receptor) as an alternative. Some people say valerian, another herb, works for them, but doctors say studies have shown that might just be a placebo effect.
What about prescriptions?
• Try reconditioning your brain. If you are taking a prescription sleep aidand want to stop, start taking it with a glass of warm milk, Strohl says. Tell your brain the milk is making you sleepy. Then, after a week or two, just drink the milk. Your brain is highly suggestible, so this will work — you will establish the thought that milk is what makes you sleepy.
• If you decide to stop taking your prescription sleep medication, it’s best to do it on a weekend or when you have a couple of days off. You will toss and turn for a few nights, but, doctors say, your body will adjust. You have to be patient and give it a few days.
What about coffee during the day?
If you’re tired during the day as a result, beware of compensating with caffeine. As doctors point out, a regular cup of the coffee that we drink today (and it’s usually not a cup if you measure it out, but two or three) has twice as much caffeine as it used to. The same goes for energy drinks or caffeinated soft drinks. They will affect your ability to sleep.
I find it funny because I realize getting coffee away from people in Silicon Valley, NYC or any Urban Jungle is like getting shoes away from Imelda Marcos. Addictions to either (shoes or coffee) aren’t healthy. Period. One or two cups in the morning is fine, but most people crash mid-afternoon and reach for more.
It’s not going to be easy to stop drinking coffee if you’re addicted to it.
If it would completely stress you out to quit your coffee addiction right now, try taking breaks. Try white tea (15mg caffeine) vs. coffee (120 mg caffeine).
2. You will be too busy to eat right.
BREAKFAST, LUNCH and DINNER and spending time OUTDOORS are a DEPOSIT.
Remember when you wake up ready to go to work exclaiming you’re not hungry and just want coffee –that’s a withdrawal in a healthy company leader. That’s you. I’m a big fan of protein in the morning. Protein contains tyrosine, an amino acid that elevates the brain chemicals dopamine and norepinephrine. It makes you feel full too, so you don’t overeat. Protein keeps your metabolism steady. Two eggs in the morning. Ten almonds and water or tea mid-morning before lunch rolls around prevents rollercoaster highs and lows. If you can be outside –the fresh air will do you good. Breathe in the fresh air. If you’re in NYC, unless you can see trees, disregard. Also, whenever you have a meeting –if you can have it outdoors . If you can walk and talk (I always say, “Let’s be like West Wing…”) –even better. All healthy deposits in you and your team. Relaxing together eating a healthy and leisurely meal is wonderful too.
3. You will be on information overload.
MEDITATION is a DEPOSIT.
Emails, Meetings, Conferences, Phone, Facebook, Twitter, Linked In, Trade Magazines, Trade Shows, etc. can drain you mentally. Take breaks. Once you do, you’ll take more of them because you’ll notice a positive difference in how you feel engaging in your real community instead of the on-line one.
Computers can be illusions. You won’t recognize when your inbox or online activity really looks like THIS. But you’ll feel it. Before computers, we could visually see when we were “swamped.” Now, it’s hidden. Ten thousand emails. Five are vital. Don’t sweat it. Set technical boundaries. Give yourself at least an hour each day when you are away from all electronic devices. The more, the better.
Whenever you stop to check in with the real you without devices —it re-energizes you. Just 3-minutes of meditating will make you more alert. I recommend doing so first thing in the morning when you wake and again at noon and 3 p.m. These mini-meditation breaks will energize you and keep you focused. Smile at and deep breathe. Breathe 10 seconds (count to 10 slowly) inhale and 10 seconds exhale.
Science and technology reporter, Daniel Sieberg wrote a book called, “The Digital Diet” I recommend. His 4-step plan to help you regain control, focus, and true connection in your life are as follows (but pick up the book for details):
Step 1//Re: Think:
Consider how technology has overwhelmed our society and the effect it’s had on your physical, mental, and emotional health. Step 2//Re: Boot:
Take stock of your digital intake using Sieberg’s Virtual Weight Index and step back from the device.
Step 3//Re: Connect:
Focus on restoring the relationships that have been harmed by the technology in your life.
Step 4//Re: Vitalize:
Learn how to live with technology—the healthy way, by optimizing your time spent e-mailing, texting, on Facebook, and web surfing in this book.
4. You will get bummed out. Meetings will get cancelled. Things may not move as quickly as you’d like. Frustrations at limited resources to compete will happen. You will get bummed out. That is why it’s so important for you to stay in top mental, physical and spiritual form. You will be able to overcome challenges when you are healthy.
On a daily basis, projects can pile on stress. Get up every 15 minutes and stretch or walk around. Exercise. Break it up into 15 minutes of activity if you can’t break away for longer. Walk. Run. Climb stairs. Breathe deeply. Repeat. Take breaks to get outside as often as you can during the day.
Be centered. Centered people do not react. When something happens outside of them –they can reflect on it. Anyone who reacts immediately in a highly emotional state isn’t centered. No good decision is ever made out of anger. Remember that. If you are going to run a company –your ability to remain calm and make good decisions is a must. It sounds odd, but you actually have to practice being calm. Test it out with family members. When someone says something that pushes your buttons –practice not reacting. Breathe. Observe. Don’t react. If you have to silently count to 100 inside. The situation may diffuse by the time you get to one hundred.
Physical fitness is not only one of the most important keys to a healthy body, it is the basis of dynamic and creative intellectual activity. John F. Kennedy
5. You will get tired. – Start back at #1.
In summary, don’t be one of those founders that brags and boats about not getting any sleep or living on coffee. It sends the wrong message to your team. Be a healthy example. Surround yourself with a healthy team. Build a healthy company or companies.
Consider this advice (some is the same) from local CEOs, published in SMART CEO Magazine.
Meditate: You don’t have to be a monk,
but ﬁnd that one activity that can
always relax you to re-center your mind.
Make it a plan: Schedule your activities
like you would schedule a meeting –
and don’t skip it. Personal time is just
as important as business time.
events and nonproﬁ t organizations
provides a great opportunity for teambuilding and giving back.
Deﬁne your goals: What do you want to
accomplish? Deﬁ ne it, and chase after
it. You’ll be more likely to succeed if you
have a vision.
It is unwise to be too sure of one’s own wisdom. It is healthy to be reminded that the strongest might weaken and the wisest might err. Mohandas Gandhi
I recommend a copy of Mark Cuban’s book. In one day, the slim under-100-page book, titled “How to Win at the Sport of Business: If I Can Do It, You Can Do It,” soared to the top of the bestseller charts at the big online book-buying sites, with particularly strong sales onAmazon, iTunes and Barnes & Noble.
Surround yourself with healthy, positive, can-do/will-do people. It makes a huge difference in execution, results, growth, success and being a healthy founder with a thriving, healthy company that values a balanced life and health as your greatest wealth.
We now communicate in ways that are very different from those available just a decade ago. The iPhone, iPad, and similar devices also enable us to observe ourselves as we perform any number of activities. These and other new devices may have an application their designers never considered. I believe we can harness this technology to help us treat some of our patients.
Specifically, I propose that the ability of the iPhone and iPad to ”film” ourselves in real time could serve as an important therapeutic instrument in the treatment of patients with anorexia nervosa (AN).
We know patients with AN have a delusional sense that they are overweight and have a distorted body self-perception, even when they are undernourished and near death. To address the distorted self-image, we use various medications and forms of individual, group, and family psychotherapy along with nutritional support administered with the help of dieticians.
These treatments aim to correct the patient’s delusional perception of body image and to establish life sustaining eating patterns that will maintain body weight. Correcting the patient’s delusional self-perception is seen as critical in the patient developing life-sustaining eating patterns. Over time, and for some patients, however, these treatment approaches have limited success.
Mental health professionals typically employ verbal or written communications to address and alter an anorexic patient’s distorted self image. Patients may appear to accept our therapeutic pleadings and go along with varied elements of our treatments. Secretly, however, they often don’t believe what they tell us. Thus, even when we believe our treatment has been successful, seeds of relapse often exist.
If we focus on obtaining a better understanding of how patients with AN distort their body image, perhaps we can enhance our therapeutic approaches?
If a patient with AN sees her reflection in a mirror, she typically perceives herself as overweight. However, if she is shown an iPhone image of herself immediately after it is taken, I have found that she may see herself differently — in fact, as the undernourished person she really is.
When she sees herself in the mirror, the image she sees is instantaniously fused and distorted with her self-perception as overweight. When the same individual holds an iPhone with an image of herself immediately after it is taken, a different cognitive process is involved. First she observes in the iPhone a picture of a woman and that woman’s physical characteristics. She may be able to accurately describe the physicality of the woman in the picture as extremely thin. This may occur because thebrain first registers the physicality of the person. Quickly the patient will realize that she is, in fact, the woman in the iPhone image. At this point, she may or may not continue to be able to report accurately what she now knows is her own picture.
The therapist who treats patients with AN can use the patient’s potential capacity to correctly describe the iPhone images to help her correct distortions of body image. Let me describe an approach utilizing this knowledge that has successfully worked with some of my patients with AN.
First the patient is asked to observe and then describe her image as seen in a mirror with her therapist present. Then an iPhone image is taken. She is asked by her therapist to describe the iPhone image. If she can correctly describe her physicality in the iPhone image and distinguish it from her distorted view of the mirror image, her therapist can go on to address with the patient her distorted body image.
When a patient persistently describes the woman in the iPhone image in the same terms as she does when observing herself in the mirror, the therapist takes a picture with the patient. The therapist then asks the patient to describe separately their images. If she sees a distorted image of the therapist, the therapist and patient then work to develop a jointly shared description of the therapist. Once this is achieved, both re-examine the image of the other person in the phone image. . . the patient. They now work together to develop a jointly shared view of the patient.
The therapist does not correct the patient’s misinterpretation of the phone image. If she has correctly described the image of the the therapist but cannot accurately describe her own image, then the therapist may remind her that both agreed on the therapist’s image. At this point, they may again see if they can come to an agreement on a description of the woman in the image. If they now can not, the therapist can explore with the patient why she felt she could not.
The psychotherapeutic techniques used in this process are described by Frieda Fromm-Reichmann in Principles of Intensive Psychotherapy.1 “The psychiatrist should not argue . . . He should state quite simply that he does not share the patient’s . . . interpretation or evaluation of facts . . . He should try to interest the patient in the investigation of the following questions. . . why is there a difference in the patient’s interpretation or. . . perception from those of the psychiatrist.”
By reconciling the patient’s perception of herself in the phone image and in the mirror, the patient may actually be able to correct her errors of body image and would — with additional therapeutic interventions to sustain this corrected vision and — eventually be able to maintain her weight with little or no outside help.
The additional treatment would also utilize appropriate principles and techniques of Cognitive Behavioral Therapy as well as nutritional counseling.
Because of the risk that body image distortion and weight loss will recur, the patient may benefit from learning how to use the selective phone images throughout her life to ensure a reliable body image, regardless of whether she is in therapy.
Conclusion These therapeutic interactions may be a useful facet of a multifaceted therapeutic approach. They are intended to reduce the power of body distortion in perpetuating AN. CBT and nutritional counseling continue as important elements in the treatment of AN. The technique to address distortion of body image may also be of use in the treatment of patients with body dysmorphic disorder.
1. Fromm-Reichman F. Principles of Intensive Psychotherapy. University of Chicago Press, Chicago;1950:175.
The First Comprehensive Biological Treatment for Anorexia Nervosa in Fifty Years Revealed in New Book
One of America’s leading experts in eating disorders and integrative medicine presents a revolutionary new treatment plan for women and men with anorexia
Anorexia is not the disease we’ve always thought it was. It’s not just a psychiatric disorder. Anorexia is a medical illness of starvation that causes malnutrition in the body and the brain. Treatment needs to focus on correcting this malnutrition.
The first thing Dr. James M. Greenblatt wants you to know about anorexia nervosa in Answers to Anorexia (Sunrise River Press, softbound, $16.95), his breakthrough new treatment for treating and preventing the disease, is that this is no trivial condition.
“Anorexia nervosa is not just an eating disorder. It’s the most lethal psychiatric disorder on the planet. One of out of every five patients dies within twenty years of diagnosis, predominantly from suicide.”
The second thing Greenblatt, a noted expert in eating disorders and integrative medicine, wants perfectly clear is that the medical profession has failed the millions of young women—and increasingly men—ravaged by the spiral of self-imposed starvation that anorexia unleashes.
“Anorexia is not the disease we’ve always thought it was. It’s not just a psychiatric disorder. Anorexia is a medical illness of starvation that causes malnutrition in the body and the brain. Treatment needs to focus on correcting this malnutrition.”
By treating the underlying medical illness of brain starvation, Greenblatt has had success in helping anorexic patients recover. Armed with the latest research from the frontiers of brain chemistry and nutrition, he even believes that anorexia nervosa may be preventable. That’s the best news we’ve had in fifty years of treating the disease.
Greenblatt’s new nutritional paradigm resulted in his developing a highly accessible treatment regimen incorporating holistic and integrative/nutritional medicine. The nutritional model also enabled Greenblatt to develop a new diagnostic tool for determining the likely effectiveness of individual medications for the treatment of depression and anxiety that often accompany anorexia.
Many of the symptoms anorexics present, including ironically, self-starvation, are themselves expressions of a starving brain. A brain that convinces you it’s a good idea to starve is an insidious adversary. Fortunately, as Greenblatt’s research concludes, you can stop this life- threatening process with targeted nutritional interventions.
“There will always be a role for therapy and medications in the treatment of anorexia,” Greenblatt explains. “But for the first time there’s a treatment that stops the downward spiral of this disease long enough to provide effective treatment and facilitate sustained recovery.”
That will be world-changing news to the millions of families faced with the daily nightmare of “reasoning” with someone intent on starving herself. Greenblatt’s brain research has also led to the aforementioned diagnostic test—referenced electroencephalogram (rEEG)—that has been proven successful in helping doctors know which medications will work for individual patients. “It beats the trial and error method of polypharmacy hands down,” Greenblatt explains. “That’s important. The faster you can treat the symptoms of anorexia—the depression, the obsessive thoughts—the profound malnutrition—the better the chance of survival. Greenblatt has redefined our understanding of Anorexia Nervosa with his description of this life-threatening cycle that he refers to as “Malorexia.”
Answers to Anorexia presents these neurophysiological breakthroughs in language accessible to any layman. It’s a fascinating book for anyone interested in the physical damage and brain dysfunction that result from anorectic malnutrition. And a life-saver for anyone suffering through it.
Media contact: Victor Gulotta, Gulotta Communications, Inc.
617-630-9286, victor(at)booktours(dot)com http://www.booktours.com
Answers to Anorexia: A Breakthrough Nutritional Treatment That Is Saving Lives
By James M. Greenblatt, MD
Sunrise River Press
ISBN: 978-1-934716-07-6; softbound, 6 x 9, 224 pp., $16.95
A pioneer in the field of integrative medicine, James M. Greenblatt, MD, has treated patients with complex eating disorders since 1988. An acknowledged eating disorder and integrative medicine expert, Dr. Greenblatt has lectured throughout the United States on the scientific evidence for nutritional interventions in psychiatry and eating disorders.
In addition to being the Chief Medical Officer of Walden Behavioral Care, Dr. Greenblatt is the Founder and Medical Director of Comprehensive Psychiatric Resources, a private integrative psychiatric practice. Dr. Greenblatt also serves as an Assistant Clinical Professor at Tufts Medical School. After receiving his medical degree and completing his psychiatry residency at George Washington University, Dr. Greenblatt went on to complete a fellowship in child and adolescent psychiatry at Johns Hopkins Medical School.