Can Apple's ResearchKit change the face of medical research?

Every day, Medical News Today reports on a large number of studies. Many of these involve the recruitment of participants so researchers can obtain new and relevant data. The best of these studies will involve the participation of thousands of people, but getting hold of large numbers of willing volunteers can be difficult.

With access to a smartphone, anyone anywhere in the world can now potentially participate in a medical study.

"We have sent out over 60,000 letters," says Kathryn Schmitz, PhD, of Penn Medicine, explaining the recruitment process for a recent study. "Those 60,000 letters have netted 305 women."

Some researchers will acquire a large number of subjects for their studies by using data obtained by previous investigations. This method is much quicker than signing up thousands of volunteers, but it does not give the researcher the control and flexibility that comes with recruiting new volunteers.

In developed countries, smartphones are ubiquitous. Walk down a street in any city and you will likely encounter at least one person with one of these gadgets glued to their hand or head. More than just a way of communicating with other people, for many, smartphones have become an integral part of navigating life due to the wide variety of apps available to users.

iPhones, for example, do not just contain the necessary bits and bobs needed for people to initiate conversations or access the Internet. They contain a myriad of sensors and processors that can track and measure a host of different things. The combination of widespread usage and the capacity to collect data makes smartphones an ideal tool for researchers to utilize.

Here, then, could be a solution to one of the most pressing problems experienced by medical researchers. In this Spotlight, we take a brief look at ResearchKit, the latest initiative launched by Apple, attempting to harness the power of the smartphone to transform how scientists carry out research studies.

Getting started

Smartphone apps are being increasingly used for personal health purposes, both in tracking health and fitness and for detecting illness.

But while these apps can provide users with a perspective on their health, many experts have been critical about the worth of these perspectives, questioning whether they are actually beneficial to users' health.

Last year, Apple launched their Health app and a tool for developers called HealthKit, allowing them to develop software able to pool together health data collected by other apps. The aim of this was to create a range of more empowered health tracking programs, supposedly giving users greater insight into their health than before.

In March, Apple took this work a step further with the launch of ResearchKit, an open source framework that allows developers to create apps specifically for conducting medical research studies. In addition to using data obtained by the Health app, ResearchKit also allows researchers to obtain informed consent from participants remotely.

The Asthma Health app helps people with asthma treat their condition while helping researchers investigate new ways to personalize treatment.
Image credit: Icahn School of Medicine at Mount Sinai

Dr. Eric Schadt, from Icahn School of Medicine at Mount Sinai, NY, explained to MNT that electronic consenting would eliminate many of the limitations that the traditional consenting process brought to medical research.

"Traditional research has been constrained to informing potential participants about a study, the risks, the benefits and so on, by sitting directly with the participant (or on the phone) to step them through the paperwork and other material to complete the informed consent," he said.

For each participant enrolled into a study, it takes around 30 minutes for a researcher to go through the consenting process. The fact that the process is so time-consuming limits the number of people that can be signed up for a research project due to the amount of time available to researchers.

"With electronic consenting these limitations are all addressed," said Dr. Schadt. "Potential study participants can be stepped through the informed consent using their iPhone, advanced multimedia can be used to more efficiently inform the participant as to the details of the studies as well as the risks and potential benefits."

In order to prevent users from just skipping through the informing stages of the consent process, the apps feature questions to ensure that users can only consent to take part if they fully understand what they are signing up for.

Apple and the researchers behind the first five apps developed using ResearchKit that were launched in March have been very vocal about how the consenting process is a marked improvement on how studies have traditionally been set up.

Dr. Schadt has been involved with one of these first five apps, Asthma Health - an app that combines geolocating data from the phone with air quality information to help users avoid areas where asthma symptoms could be triggered, in turn, collecting data that the developers hope will allow them to discover new ways to personalize treatment of the condition.

On the first day the app was launched, Asthma Health was downloaded by 2,500 people. It would typically take researchers around 1-2 years to recruit this many subjects for a study. In the first month, 7,500 people with asthma had signed up.

This number pales in comparison, however, with the 11,000 people who downloaded the MyHeart Counts app within 24 hours of it becoming available. An element of this may well be the novelty value of being able to sign up to research studies with newfound ease, but initial signs are certainly promising.

Lots and lots of data

The other aspect of ResearchKit that Apple and the app developers are keen to promote is how much data will be obtained by studies built using the framework.

"For the researcher, especially disease research, it is all about the phenotypes," explained Dr. Schadt. "Today, cohorts assembled for disease collect very minimal numbers of phenotypes generally relating directly to the disease, and those phenotypes are collected infrequently - at most, once a year."

Studies conducted via iPhone app will differ in this respect. "With the health apps being built we can collect phenotypes that relate across the disease and wellness spectra and we can do it at high frequency, every day, or 10 or 100 times a day," said Dr. Schadt.

There are a number of inbuilt devices in iPhones that can prove useful to researchers. Data obtained by the microphone, gyroscope, accelerometer, touch screen and the global positioning system of the smartphone can all provide data relevant to research projects.

"All of these variables can be collected numerous times a day over any number of days or years, thus providing a far more detailed profile of the user than could ever be reasonably generated in a medical setting," stated Dr. Schadt.

Not only is the variety of forms of available data beneficial but the frequency by which it is collected is great for researchers too. Many studies are limited by only taking measurements at the baseline - the starting point of the study - and then one or two further times after that.

Infrequent measuring can make results unreliable. Let's say a study wants to examine the effects of a particular diet on body mass index (BMI), and then measures the participants' BMI at the beginning of the study, 6 months later and then after 1 year.

The results of such a study might then show minimal change in BMI after this period. But, if the two periods where BMI was measured came shortly after holidays where the participants drank a lot of alcoholic beverages and did not exercise, the results would inevitably be skewed. This skewing would be exacerbated if the study used a small number of participants.

Such a problem - the ebbing and flowing of symptoms as Apple describes it - is solved by gathering data far more regularly than many studies are able to.

In addition to this, the pool of potential volunteers is much larger with ResearchKit than it is for most studies, typically confined to a small geographic area. The ubiquity of the iPhone means that volunteers can sign up to take part no matter where they live in the world.

This also allows researchers to have access to more varied study populations, although they will be relying on participants that have access to smartphones, still a restricted demographic.

An open source framework for all

What is possibly the most interesting aspect of ResearchKit, however, is that Apple have made the whole thing open source. The core framework can be used by anyone who wishes to use the software to make their own study, and the codes for the five initial apps launched alongside the framework are also available for examination and customization.

While initial access to ResearchKit is confined to iPhones, thanks to the open sourcing of the framework, it will eventually be available to users of every kind of smartphone.

For a company that is renowned for keeping as many aspects of its products as exclusive to the brand as possible, this was a surprising move, but one that could prove incredibly beneficial.

ResearchKit was made available to developers to use from April. Although the initial apps were only available for iPhone users, the fact that the software is open source means that eventually studies will be accessible to users of Android and Windows products.

Science Practice had a go at trying out the newly available framework and commented on how quick it was to construct simple consent forms and participant surveys. Already, too, a small online community has developed in which new ideas and suggestions are being shared on how to use and improve the framework.

A major concern raised with ResearchKit is how private and secure the obtained data will be. Considering how data from the Health app could be loaded up onto the iCloud and how that platform has been hit with several high-profile hacking incidents, the concern is a valid one.

Dr. Schadt informed Yahoo! Tech that "the only people who have access to the data are the investigators of the study," stating that the data is encrypted and meets all industry standards for the transfer of sensitive data. "Apple never touches the data," he reported.

Being an open source framework may also help with privacy, according to Adrian Gropper, chief technology officer of the nonprofit group Patient Privacy Rights.

"Open source encourages people to report bugs in the software and get them fixed," he told Bloomberg Business. "The gold standard is open source because security by obscurity has been shown not to work."

Work in progress

"We believe that these studies represent an entirely new way to perform human health research, putting the participant truly at the center with frequent feedback and control of how their data are used," Dr. Andrew Trister.

"Furthermore, the power of these pervasive devices on quantifying health on an individual is tremendous, opening up real opportunities for truly personalized medicine."

Dr. Trister is a senior physician with Sage Bionetworks, a nonprofit research organization that has worked with Apple to develop ResearchKit.

There are still a number of limitations that the studies conducted by these apps will be subject to. Data provided by the instruments in a smartphone may not be as precise as those obtained using specifically-designed medical instruments. With the study being conducted remotely, it is also harder for investigators to assess the suitability of participants for their study.

Developers might argue that the sheer volume of participants now available to researchers may overshadow these limitations. At this stage, before the results of any of the studies have been processed, it feels as though the positive of having increased and easy access to large numbers of participants is the main point to take from the project.

The most reliable studies are those that are conducted over a long period of time and, as a result, it may be some time before we can effectively gauge the contribution that ResearchKit will make to the field of medical research.

Continue to Read more ...

The dangers of working in an office

The office here at Medical News Today HQ is a pleasant place to work. It is a largely tranquil place (until somebody decides to use the shredder) where the tea is plentiful and occasionally a passing dog can be spotted through the window.

Posture is crucial to keeping healthy when working for long periods of time at a desk. This woman risks injuring her back and neck by hunching forward.

On the idyllic surface, it seems as though it would be a perfectly safe and healthy place to work. There are certainly no obvious hazards of the kind that are commonplace on construction sites or in factories, and many office workers enjoy the benefits of rigid working days, rather than having their body clocks thrown by changing shift patterns.

But offices are not without their hazards, even if these are not as overt as those in other environments. One significant problem comes from being sat at a desk for most of the day. A recent study has suggested that the amount of time spent sitting each day is associated with a higher risk of various diseases.

According to the US Bureau of Labor Statistics (BLS), around 21,638,470 people are employed in jobs defined as office and administrative support occupations. However, this figure does not include other occupations, such as management roles, business and financial operations occupations or computer occupations that are also likely to be based in office environments.

In this Spotlight, we investigate what the health-conscious office worker needs to be wary of if they are going to complete their 9-5 with both body and mind intact, and if there are any ways for them to maintain peak fitness during their employment.

Chained to your desk

As mentioned above, sitting for long periods of time every day is bad for your health. While sitting reduces the amount of time individuals can spend exercising, researchers have demonstrated that prolonged sitting time is associated with poor health outcomes regardless of the amount of physical activity performed.

Although sitting at a desk is a seemingly simple task, it is an easy one for people to do wrong. Workers often complain of sore wrists and pain in the back and neck, and this will frequently be due to the way they position their body while working.

If an individual is sitting or typing in an unhealthy way, it is likely that they will be putting strain on their body for most of their working day. That is a lot of strain for a body to take over the course of a week. Unsurprisingly, back pain is one of the most common reasons for employees missing work and is the second most common reason for visits to the doctor.

The American Chiropractic Association (ACA) state that back pain can be caused by poor posture, obesity and psychological stress among other factors, all of which can easily come into play in an office environment if work is tense and not allowing for employees to take leave from their desks.

Good posture at the desk is the first step to be taken in protecting your health when working in the office. This can be achieved with efficient office ergonomics. Making sure that all objects that will be needed are situated close by reduces excessive stretching.

When sitting in front of a computer, the body should be positioned centrally to the monitor and keyboard. You should sit up straight with feet rested flat on the floor. If this is not possible, a footrest should be used. Thighs should ideally be horizontal with the knees and level with the hips.

The forearms should also be level or tilted up slightly. When typing, wrists should be in a straight and natural position. Using a wrist rest can reduce stress on the wrists and help prevent specific awkward positioning.

There are a number of common posture mistakes that can be made when sitting and can easily become part of a routine if not addressed:

• Slouching - this position places a lot of pressure on the lower back, damaging the ligaments, joints and soft tissue in this area and can lead to hunching
• Sitting cross-legged - this position tucks in the hip, making it difficult to sit up straight and leading to slouching. Sitting cross-legged can also lead to muscle imbalances in the hips that cause pain and stiffness
• Hunching forward - can lead to a tight chest and weak upper back, potentially leading to the development of a rounded upper back that is susceptible to pain and stiffness
• Poking the chin forward - sometimes a symptom of a hunched back or sitting too low as an attempt to compensate for excess downward pressure, this can lead to muscle weakness around the neck
• Phone cradling - employees that have to use a phone frequently may hold their phone handset between their ear and shoulder in order to leave their hands free to operate a computer or write. This can weaken the neck muscles and lead to muscle imbalances that cause headaches.

Office workers are advised to get up and move around whenever they can. The nature of many office jobs, however, usually results in long periods of sitting down. If you are going to be sitting down at a desk for any length of time, it is a good idea to get the basics right.

"The number one thing that gets people into trouble as far as a downgrade in their health is their posture," says Luis Feigenbaum, a director of sports physical therapy at the University of Miami's Miller School of Medicine, in conversation withABC News.

Computers: one-eyed monsters of the office

These days, most people sitting at a desk will have a computer sitting right in front of them. Although they make a lot of jobs easier, they also make keeping healthy in the office a lot harder.

Many office workers will be familiar with computers, and using them properly is important for keeping healthy.

Firstly, where a computer and its related hardware are positioned can drastically influence posture. The height of a computer monitor will affect the height of an office chair - a monitor should be positioned directly in front of the user, about an arm's length away, with the top of the screen just below eye level.

As well as posture, using a computer can wear down other parts of the body that are directly using it, namely the eyes and the wrists.

To avoid eye strain, both the computer monitor and the office lighting need to be addressed. The screen should be adjusted so that its brightness and contrast levels suit the lighting conditions in the room, which should not be too bright.

Screen glare is a major cause of eyestrain and can be reduced by ensuring that monitors are not positioned opposite windows where possible. If situated close to a window, use shades and blinds to reduce the amount of light that falls on the monitor.

If the font size of text being read on a computer is too small it can lead to eyestrain as well as harming posture, as a worker may be inclined to hunch forward to read text more closely. Increasing font size or zooming in on a page that is being read protects employees from this risk.

Typing is a repetitive action that puts the hands and wrists under great pressure. If performed forcefully enough and for long enough periods of time, it can lead to disabling pain. In office workers, it can lead to repetitive strain injuries, whereby the tissue surrounding the joints becomes inflamed or stress fractures develop.

Wrist injuries through typing can be prevented or at least reduced by maintaining a good typing posture. As mentioned earlier, wrists should be kept in a relaxed, natural position. Foam or gel wrist supports can provide extra protection.

One of the key messages when it comes to using computers in the office is how important it is to take regular breaks. The US Occupational Safety and Health Administration (OSHA) recommend that workers take a 10 minute break for every hour spent on a computer, allowing the body to recover and reducing the risk of strain.

These breaks can include working on other tasks that do not involve using a computer. They also represent an opportunity for employees to get out of the sitting position. Alternatively, if employees have the freedom to do so, breaks could involve seeking sustenance to refuel their bodies.

Here be vending machines

The office environment is often full of temptation when it comes to eating healthily. Many offices are home to vending machines filled with sugary drinks and fatty snacks that sing out to workers eager to get a quick energy boost.

Bringing a packed lunch from home is good for both your health and your wallet.

A desire for this kind of unhealthy food is increased if an individual hasn't eaten properly in the morning or obtained enough sleep the night before. Finding time for both sleep and breakfast helps reduce the lure of unhealthy food throughout the working day.

Bringing a lunch and snacks to work also helps keep office workers away from vending machines and restaurants, as well as saving them money. Snacking is fine if it is done healthily, and while vending machines are unlikely to stock fruit, vegetables, hummus and seeds, workers can bring these in themselves.

"It's really important to eat at least every four hours," Beth Thayer tells ABC. "You need to make sure you're setting some time aside to make sure you're getting food in."

Thayer, a registered dietitian and spokesperson for the American Dietetic Association, recommends packaging and preparing your own meals. "Small bags of nuts or snack mix you make yourself, or a small bag of fruit like apples or grapes," she suggested. "Fruit works well for people who drive a lot."

Eating is a great opportunity for workers to escape from their workstations, but few take advantage of it. According to a survey conducted by the American Dietetic Association in 2011, 62% of Americans eat lunch at their desks.

As well as preventing workers from getting away from work and keeping them sitting down in the same place, eating at the desk can lead to a build-up of bacteria if the correct hygiene precautions are not taken.

"We need to wash our hands and clean up the area after we eat at our desks," Thayer warns. "Don't let desks become places for bacterial growth."

Leaving the desk for a break allows workers to regroup and collect themselves away from their work. Doing this can be particularly important in mentally demanding roles. Taking a proper break can help reduce stress levels that can be responsible for a wide range of health problems.

How to improve your fitness at work

Although the office can often be a comfortable place to work, it is important that workers do not allow unhealthy practices to become comfortable and routine. Remaining sedentary, using office equipment incorrectly and eating unhealthily can eventually lead to debilitating health problems that could stop individuals from working altogether.

Thankfully, office work also provides a number of options for keeping fit, and if these are incorporated into a working routine then there is no reason why working in an office should condemn employees to a life of ill health.

• Travel to work by walking or biking. Get off public transport a stop earlier than normal or park your car further away from the office
• Stand instead of sitting when working as much as possible. Find as many excuses to get out of your chair as possible
• Spend time during breaks to go for a brisk walk or do some stretching to keep the muscles loose and strong.

On the surface, working in an office appears to be a simple form of employment. While that may be true in comparison with some other jobs, it is important that office workers do not get complacent and sit idly as their health runs away from them.

Dr. Timothy Church, from the Preventive Medicine Laboratory at Pennington Biomedical Research Center, Louisiana State University, told MNT that the biggest risk to the health of office workers is the sedentary lifestyle.

"The answer is getting active," he said. "Get up at least every 45 minutes and obtain at least 7,000 steps per day."

Continue to Read more ...

The dangers of working in an office

The office here at Medical News Today HQ is a pleasant place to work. It is a largely tranquil place (until somebody decides to use the shredder) where the tea is plentiful and occasionally a passing dog can be spotted through the window.

Posture is crucial to keeping healthy when working for long periods of time at a desk. This woman risks injuring her back and neck by hunching forward.

On the idyllic surface, it seems as though it would be a perfectly safe and healthy place to work. There are certainly no obvious hazards of the kind that are commonplace on construction sites or in factories, and many office workers enjoy the benefits of rigid working days, rather than having their body clocks thrown by changing shift patterns.

But offices are not without their hazards, even if these are not as overt as those in other environments. One significant problem comes from being sat at a desk for most of the day. A recent study has suggested that the amount of time spent sitting each day is associated with a higher risk of various diseases.

According to the US Bureau of Labor Statistics (BLS), around 21,638,470 people are employed in jobs defined as office and administrative support occupations. However, this figure does not include other occupations, such as management roles, business and financial operations occupations or computer occupations that are also likely to be based in office environments.

In this Spotlight, we investigate what the health-conscious office worker needs to be wary of if they are going to complete their 9-5 with both body and mind intact, and if there are any ways for them to maintain peak fitness during their employment.

Chained to your desk

As mentioned above, sitting for long periods of time every day is bad for your health. While sitting reduces the amount of time individuals can spend exercising, researchers have demonstrated that prolonged sitting time is associated with poor health outcomes regardless of the amount of physical activity performed.

Although sitting at a desk is a seemingly simple task, it is an easy one for people to do wrong. Workers often complain of sore wrists and pain in the back and neck, and this will frequently be due to the way they position their body while working.

If an individual is sitting or typing in an unhealthy way, it is likely that they will be putting strain on their body for most of their working day. That is a lot of strain for a body to take over the course of a week. Unsurprisingly, back pain is one of the most common reasons for employees missing work and is the second most common reason for visits to the doctor.

The American Chiropractic Association (ACA) state that back pain can be caused by poor posture, obesity and psychological stress among other factors, all of which can easily come into play in an office environment if work is tense and not allowing for employees to take leave from their desks.

Good posture at the desk is the first step to be taken in protecting your health when working in the office. This can be achieved with efficient office ergonomics. Making sure that all objects that will be needed are situated close by reduces excessive stretching.

When sitting in front of a computer, the body should be positioned centrally to the monitor and keyboard. You should sit up straight with feet rested flat on the floor. If this is not possible, a footrest should be used. Thighs should ideally be horizontal with the knees and level with the hips.

The forearms should also be level or tilted up slightly. When typing, wrists should be in a straight and natural position. Using a wrist rest can reduce stress on the wrists and help prevent specific awkward positioning.

There are a number of common posture mistakes that can be made when sitting and can easily become part of a routine if not addressed:

• Slouching - this position places a lot of pressure on the lower back, damaging the ligaments, joints and soft tissue in this area and can lead to hunching
• Sitting cross-legged - this position tucks in the hip, making it difficult to sit up straight and leading to slouching. Sitting cross-legged can also lead to muscle imbalances in the hips that cause pain and stiffness
• Hunching forward - can lead to a tight chest and weak upper back, potentially leading to the development of a rounded upper back that is susceptible to pain and stiffness
• Poking the chin forward - sometimes a symptom of a hunched back or sitting too low as an attempt to compensate for excess downward pressure, this can lead to muscle weakness around the neck
• Phone cradling - employees that have to use a phone frequently may hold their phone handset between their ear and shoulder in order to leave their hands free to operate a computer or write. This can weaken the neck muscles and lead to muscle imbalances that cause headaches.

Office workers are advised to get up and move around whenever they can. The nature of many office jobs, however, usually results in long periods of sitting down. If you are going to be sitting down at a desk for any length of time, it is a good idea to get the basics right.

"The number one thing that gets people into trouble as far as a downgrade in their health is their posture," says Luis Feigenbaum, a director of sports physical therapy at the University of Miami's Miller School of Medicine, in conversation with ABC News.

Computers: one-eyed monsters of the office

These days, most people sitting at a desk will have a computer sitting right in front of them. Although they make a lot of jobs easier, they also make keeping healthy in the office a lot harder.

Many office workers will be familiar with computers, and using them properly is important for keeping healthy.

Firstly, where a computer and its related hardware are positioned can drastically influence posture. The height of a computer monitor will affect the height of an office chair - a monitor should be positioned directly in front of the user, about an arm's length away, with the top of the screen just below eye level.

As well as posture, using a computer can wear down other parts of the body that are directly using it, namely the eyes and the wrists.

To avoid eye strain, both the computer monitor and the office lighting need to be addressed. The screen should be adjusted so that its brightness and contrast levels suit the lighting conditions in the room, which should not be too bright.

Screen glare is a major cause of eyestrain and can be reduced by ensuring that monitors are not positioned opposite windows where possible. If situated close to a window, use shades and blinds to reduce the amount of light that falls on the monitor.

If the font size of text being read on a computer is too small it can lead to eyestrain as well as harming posture, as a worker may be inclined to hunch forward to read text more closely. Increasing font size or zooming in on a page that is being read protects employees from this risk.

Typing is a repetitive action that puts the hands and wrists under great pressure. If performed forcefully enough and for long enough periods of time, it can lead to disabling pain. In office workers, it can lead to repetitive strain injuries, whereby the tissue surrounding the joints becomes inflamed or stress fractures develop.

Wrist injuries through typing can be prevented or at least reduced by maintaining a good typing posture. As mentioned earlier, wrists should be kept in a relaxed, natural position. Foam or gel wrist supports can provide extra protection.

One of the key messages when it comes to using computers in the office is how important it is to take regular breaks. The US Occupational Safety and Health Administration (OSHA) recommend that workers take a 10 minute break for every hour spent on a computer, allowing the body to recover and reducing the risk of strain.

These breaks can include working on other tasks that do not involve using a computer. They also represent an opportunity for employees to get out of the sitting position. Alternatively, if employees have the freedom to do so, breaks could involve seeking sustenance to refuel their bodies.

Here be vending machines

The office environment is often full of temptation when it comes to eating healthily. Many offices are home to vending machines filled with sugary drinks and fatty snacks that sing out to workers eager to get a quick energy boost.

Bringing a packed lunch from home is good for both your health and your wallet.

A desire for this kind of unhealthy food is increased if an individual hasn't eaten properly in the morning or obtained enough sleep the night before. Finding time for both sleep and breakfast helps reduce the lure of unhealthy food throughout the working day.

Bringing a lunch and snacks to work also helps keep office workers away from vending machines and restaurants, as well as saving them money. Snacking is fine if it is done healthily, and while vending machines are unlikely to stock fruit, vegetables, hummus and seeds, workers can bring these in themselves.

"It's really important to eat at least every four hours," Beth Thayer tells ABC. "You need to make sure you're setting some time aside to make sure you're getting food in."

Thayer, a registered dietitian and spokesperson for the American Dietetic Association, recommends packaging and preparing your own meals. "Small bags of nuts or snack mix you make yourself, or a small bag of fruit like apples or grapes," she suggested. "Fruit works well for people who drive a lot."

Eating is a great opportunity for workers to escape from their workstations, but few take advantage of it. According to a survey conducted by the American Dietetic Association in 2011, 62% of Americans eat lunch at their desks.

As well as preventing workers from getting away from work and keeping them sitting down in the same place, eating at the desk can lead to a build-up of bacteria if the correct hygiene precautions are not taken.

"We need to wash our hands and clean up the area after we eat at our desks," Thayer warns. "Don't let desks become places for bacterial growth."

Leaving the desk for a break allows workers to regroup and collect themselves away from their work. Doing this can be particularly important in mentally demanding roles. Taking a proper break can help reduce stress levels that can be responsible for a wide range of health problems.

How to improve your fitness at work

Although the office can often be a comfortable place to work, it is important that workers do not allow unhealthy practices to become comfortable and routine. Remaining sedentary, using office equipment incorrectly and eating unhealthily can eventually lead to debilitating health problems that could stop individuals from working altogether.

Thankfully, office work also provides a number of options for keeping fit, and if these are incorporated into a working routine then there is no reason why working in an office should condemn employees to a life of ill health.

• Travel to work by walking or biking. Get off public transport a stop earlier than normal or park your car further away from the office
• Stand instead of sitting when working as much as possible. Find as many excuses to get out of your chair as possible
• Spend time during breaks to go for a brisk walk or do some stretching to keep the muscles loose and strong.

On the surface, working in an office appears to be a simple form of employment. While that may be true in comparison with some other jobs, it is important that office workers do not get complacent and sit idly as their health runs away from them.

Dr. Timothy Church, from the Preventive Medicine Laboratory at Pennington Biomedical Research Center, Louisiana State University, told that the biggest risk to the health of office workers is the sedentary lifestyle.

"The answer is getting active," he said. "Get up at least every 45 minutes and obtain at least 7,000 steps per day."

Continue to Read more ...

IBM Supercomputer "Watson" To Help In Cancer Treatment

Oncologists hope that IBM's Watson supercomputer can help them improve the speed and efficacy of cancer treatments, IBM announced.

Two years ago, "Watson" beat all-time Jeopardy! champions. Dr. Larry Norton, Deputy Physician-in-Chief for Breast Cancer Programs at Memorial Sloan-Kettering Cancer Center had wondered then whether the IBM Watson system might be harnessed to improve cancer care and research. Mark Kris, MD, Chief, Thoracic Oncology Service at Sloan-Kettering, heard Dr. Norton's comment and became interested too.

The two doctors felt that combining Watson's ability to process huge amounts of data and use natural language processing might accomplish much more than winning Jeopardy! "Might it not also revolutionize cancer care and research and speed up progress for patients?" they wondered.

A year ago, a team at Memorial Sloan-Kettering started working with an IBM and a WellPoint team to train Watson to help doctors choose therapies for breast and lung cancer patients. They continue to share their knowledge and expertise in oncology and information technology, beginning with hundreds of lung cancers, the aim being to help Watson learn as much as possible about cancer care and how oncologists use medical data, as well as their experiences in personalized cancer therapies.

During this period, doctors and technology experts have spent thousands of hours helping Watson learn how to process, analyze and interpret the meaning of sophisticated clinical data using natural language processing; the aim being to achieve better health care quality and efficiency.

An opportunity to improve how medicine is taught, practiced and paid for

According to the American cancer Society, approximately 1.6 million new cancers will be diagnosed in the United States in 2013 alone. The studies have shown that about 20% of patients have received either an incomplete or wrong diagnosis.

In a communiqué, IBM wrote "These statistics, coupled with a data explosion of medical information that is doubling every five years, represents an unprecedented opportunity for the health care industry and next generation cognitive computing systems, to combine forces in new ways to improve how medicine is taught, practiced and paid for."

Manoj Saxena, IBM General Manager, Watson Solutions, said:

"IBM's work with WellPoint and Memorial Sloan-Kettering Cancer Center represents a landmark collaboration in how technology and evidence based medicine can transform the way in which health care is practiced. breakthrough capabilities bring forward the first in a series of Watson-based technologies, which exemplifies the value of applying big data and analytics and cognitive computing to tackle the industry's most pressing challenges."

Using evidence-based medicine to advance oncology

So far, Watson has ingested:

• Over 600,000 pieces of medical evidence


• 2,000,000 pages of text from 42 academic journals and human studies (clinical trials) based on oncology research


• A huge number of patients' records spanning decades of cancer treatment history, including medical records and patient outcomes. Watson can sift through 1.5 million pieces of such records and provide doctors with evidence-based treatment options within seconds

In less than 12 months "Memorial Sloan-Kettering has immersed Watson in the complexities of cancer and the explosion of genetic research which has set the stage for changing care practices for many cancer patients with highly specialized treatments based on their personal genetic tumor type," says an IBM communiqué.

Watson has started off learning about 1,500 cancer cases. Memorial Sloan-Kettering doctors and analysts are training Watson to retrieve and interpret laboratory results, clinical research and physician notes, and using data on hundreds of thousands of cancer patients to put forward treatment suggestions and possible diagnostic observations.

Craig B.Thompson, M.D., President of Memorial Sloan-Kettering Cancer Center, said:

"It can take years for the latest developments in oncology to reach all practice settings. The combination of transformational technologies found in Watson with our cancer analytics and decision-making process has the potential to revolutionize the accessibility of information for the treatment of cancer in communities across the country and around the world. Ultimately, we expect this comprehensive, evidence-based approach will profoundly enhance cancer care by accelerating the dissemination of practice-changing research at an unprecedented pace."

The first adopters of this capability include the Maine Center for Cancer Medicine and WESTMED Medical Group. Their cancer specialists will start testing the product and providing valuable feedback to IBM, WellPoint and Memorial Sloan-Kettering.

Improving patient care by speeding utilization management

According to WellPoint Inc., during its utilization management pilot, Watson ingested over 25,000 test case scenarios and 1,500 real life cases "and gained the ability to interpret the meaning and analyze queries in the context of complex medical data and human and natural language, including doctors' notes, patient records, medical annotations and clinical feedback. In addition, more than 14,700 hours of hands-on training were spent by nurses who meticulously trained Watson."

Even now, while on the job Watson continues to learn as if it were a medical resident, while working side-by-side with the WellPoint nurses.

In December, Watson started processing common, medical procedure requests by providers for members in WellPoint affiliated health plans; this was later expanded to include another five provider offices in the Midwest.

Watson will help speed up the review process between the patient's doctor and their health plan.

Lori Beer, WellPoint's executive vice president of Specialty Businesses and Information Technology, said:

"The health care industry must drive transformation through innovation, including harnessing the latest technology that will ultimately benefit the health care consumer. We believe that WellPoint's data, knowledge and extensive provider network, combined with the IBM Watson technology and Memorial Sloan-Kettering's oncological expertise can drive this transformation."

IBM, Memorial Sloan-Kettering and WellPoint are now introducing the first viable products based on Watson. The three teams say that these innovations represent a breakthrough in how doctors may apply advances in analytics and natural language processing to "big data", together with the clinical knowledge base, including genomic data, so that evidence-based decision support systems are created.

These Watson-based systems have been created to help scientists, medical centers, insurance carriers, and doctors - the ultimate aim being to improve the quality and speed of care.

The creators of the Watson system have not disclosed the price. Hospitals and health care networks that sign up can buy or rent Watson's advice either from their own server or from cloud.

Two years ago, Watson occupied the area of a master bedroom, now it fits into a server the size of a pizza carton.

Over the past 24 months, Watson's processing speed has increased by over 240%. What was once a bit of IT fun, has become a real business for WellPoint and IBM. WellPoint is currently the exclusive seller of the technology.

What does Watson do?

Watson does not tell the physician what to do. Rather, the system provides a number of options for each case, backed up with supporting evidence, which the doctor can use to come to a faster and hopefully more beneficial decision for the patient.

The physician can write something into an iPad in simple speech, for example "my patient has blood in her urine". Within 30 seconds Watson comes back with a series of well considered treatment options.

According to IBM, over 90% of the nurses who have worked with Watson follow the guidance the system gives to them.

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Healthcare's Mobile Revolution - What Do We Know About Its Effectiveness?

Two systematic reviews by Caroline Free and colleagues from the London School of Hygiene & Tropical Medicine are published in PLOS Medicine this week and examine the evidence on whether mobile technology can help improve health behaviors, improve disease self-management, or help health care delivery processes. The researchers report that while mobile technology-based interventions have shown moderate benefits in a few specific contexts, not all outcomes are beneficial. Moreover, rigorous studies in low- and middle-income settings - where experts agree that mobile health has tremendous potential--largely do not exist.

In the first article, the scientists systematically searched for and analyzed all reported controlled trials of mobile technology interventions for health-care consumers with the aim to change health behavior or improve disease management. They identified 75 trials, of which 72 had been conducted in high-income countries. Three trials with low risk of bias showed clear benefits: two trials tested interventions developed to help smokers quit (both conducted in the UK), and one trial in Kenya examined an intervention that helped HIV-positive patients to take their medications accurately, which in turn improved their HIV viral load. The other trials showed modest or no benefits.

In the second publication, the researchers systematically reviewed trials that evaluated the effectiveness of mobile technology-based interventions for health care providers or services. They identified 32 trials of interventions designed to support communication among health care providers and 10 trials of interventions targeting communication between health services and health care consumers (appointment reminders and information regarding test results). None of those trials were conducted in low-income countries (though a recent update of the search identified one recently published trial from Kenya). The researchers found that while some interventions designed to provide support for health care providers modestly improved aspects of clinical diagnosis and management, other interventions were less successful. Most notably, the use of mobile technology-based photos for diagnosis sometimes resulted in incorrect diagnoses compared with face-to-face-diagnosis. SMS-based appointment reminders were better than no reminders but not better than reminders by phone or mail.

Given the much-heralded potential benefits of mobile health and the limited evidence available to date, the authors stress that additional rigorous tests of mobile health interventions are needed, especially tests in low- and middle-income settings, where the control group of "standard care" might be very different from the standard care available in high-income countries.

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