Does feedback from activity trackers influence physical activity? Evidence from a randomized controlled trial (Preprint)

BACKGROUND Despite their popularity of Physical Activity (PA) tracking devices, studies rigorously examining the efficacy of wearables and feedback effect independent of other behavioral and educational interventions in promoting PA have been limited. OBJECTIVE To estimate the causal and independent effect of feedback provided by a commercial activity tracker. METHODS We designed an experimental longitudinal study in which we asked our study participants to wear: (1) a device that provided feedback for 7-consecutive days; (2) a device that provided no feedback for 7 consecutive day; (3) both devices for 2 consecutive days. We randomized half the sample to either wear the feedback device or the non-feedback device for the first 7 days. At the end of each study day, participants also completed a short survey online where they shared and reported their own experience participating in the study. RESULTS We find that participants accumulated an additional 530 steps in a given day when they wore Fitbit, which provided feedback, compared to a day when they wore GENEActiv, which didn’t provide feedback (P < .001). Given that study participants accumulated 7,560 steps/day on average, the increase in PA due to feedback represented a 7% increase in daily PA. CONCLUSIONS The use of wrist-worn PA trackers providing feedback as a standalone intervention tool is effective in increasing daily PA of older US adults aged 50 and above. Wearables-measured PA together with self-reports of PA offer the best approach to diagnosing population PA and sedentary behavior. CLINICALTRIAL Name of the registry: https://www.socialscienceregistry.org Registration number: AEARCTR-0007831 (Please note that our experiment was not a typical medical trial)

Novel endoscopic optical diagnostic technologies in medical trial research: recent advancements and future prospects

Novel endoscopic biophotonic diagnostic technologies have the potential to non-invasively detect the interior of a hollow organ or cavity of the human body with subcellular resolution or to obtain biochemical information about tissue in real time. With the capability to visualize or analyze the diagnostic target in vivo, these techniques gradually developed as potential candidates to challenge histopathology which remains the gold standard for diagnosis. Consequently, many innovative endoscopic diagnostic techniques have succeeded in detection, characterization, and confirmation: the three critical steps for routine endoscopic diagnosis. In this review, we mainly summarize researches on emerging endoscopic optical diagnostic techniques, with emphasis on recent advances. We also introduce the fundamental principles and the development of those techniques and compare their characteristics. Especially, we shed light on the merit of novel endoscopic imaging technologies in medical research. For example, hyperspectral imaging and Raman spectroscopy provide direct molecular information, while optical coherence tomography and multi-photo endomicroscopy offer a more extensive detection range and excellent spatial–temporal resolution. Furthermore, we summarize the unexplored application fields of these endoscopic optical techniques in major hospital departments for biomedical researchers. Finally, we provide a brief overview of the future perspectives, as well as bottlenecks of those endoscopic optical diagnostic technologies. We believe all these efforts will enrich the diagnostic toolbox for endoscopists, enhance diagnostic efficiency, and reduce the rate of missed diagnosis and misdiagnosis.

Hans Wolfgang Sachs (1912–2000)

During the Second World War, the German Wehrmacht and the SS tested various chemical warfare agents on prisoners of concentration camps. The SS needed a pathologist to do this. Therefore, Reichsarzt SS Ernst-Robert Grawitz recruited the 32-year-old Hans Wolfgang Sachs. Despite his position as senior pathologist at the office of the Reichsarzt SS, Sachs was spared interrogation and prosecution after 1945, although the prosecution presented a document about chemical warfare and human experiments during the Nuremberg medical trial. In this, Sachs was named as a participant in so-called “N-Stoff” (chlorine trifluoride) experiments. Little is known about Sachs to this day. This article is intended to close this gap. Of particular interest are the motives and reasons why Sachs joined the party and the SS, as well as his career after 1945.

“Washing the black sheep white again”

The first postwar period (1945–50) consisted, importantly, of the Nuremberg Medical Trial and formation of the Nuremberg Code for medical ethics. During the initial period most collaborator neuroscientists, even those involved in patient selection for euthanasia, escaped largely unscathed. The latter faced temporary career setbacks but re-emerged in the next decade professionally. The second period (1950–70) included a seminal event, the Hallervorden Affair, which pertained to the 1953 International Neuropathology Conference in Lisbon. Former Dutch neuroscientist resistor Rademaker and the Dutch delegation withdrew when they found out Hallervorden was presenting, leading to Hallervorden and Spatz’s withdrawal but only after fiery correspondence on both sides of the argument. Some collaborator neuroscientists continued to support sterilization, and even spoke against victims’ rights. Overall, only three of 25 (12%) of collaborators ever publicly repented for their involvement in Nazi programs, suggesting against an ability to rehabilitate for this directly involved group.

Design and pre-study assessment of a dashboard for presenting self-collected health data from patients with diabetes to clinicians (Preprint)

BACKGROUND Introducing self-collected health data from patients with diabetes into consultation can be beneficial for both patients and clinicians. Patients can be more proactive in their disease management and clinicians can provide more tailored medical services. In the best situation, EHRs should be able to receive self-collected health data in a medical data standard representation such as FHIR from patients systems such as mHealth apps and to display it directly to their users, the clinicians. However, while Norwegian EHRs are working on implementing FHIR, no solution or graphical interface is available today to display self-collected health data. OBJECTIVE The objective of this study was to design and assess a dashboard for displaying relevant self-collected health data from patients with diabetes to clinicians. METHODS The design relied on 1) consulting scientific literature dealing with health data presentation in combination with existing system providing self-collected health data to clinicians, and 2) workshops involving patients, clinicians and researchers to define which in-formation should be available and how it should be displayed. The assessment relied on presenting an instance of the dashboard populated with the data collected from one patient with diabetes type 1 (in-house researcher) face to face with six clinicians. We per-formed a qualitative analysis based on usability, functionality and expectation using responses to questionnaires distributed to the six clinicians at the end of the workshops and collected before the participants left. RESULTS We showed a dashboard permitting clinicians to 1) assess the reliability of self-collected health data, 2) list all collected data among medical calculations and 3) point out medical situations to investigate for improving the situation of the patients. The system uses a combination of tables, graphs and other visual representations to display the relevant information. The assessment showed that the clinicians think that this type of solution will be useful during consultations every day, especially for patients living in remote areas or the ones being technologically interested. CONCLUSIONS Displaying self-collected health data along with their reliability and extracted information can ease the introduction of self-collected health data during consultations with clinicians. The pre-study assessment showed that the system has been very well received by the participants and they were eager to start using it during consultations. The system is currently being tested in a medical trial since No-vember 2018 and the first results concerning its assessment in a real-life situation are expected in the beginning of next year (2020).

When money talks: Judging risk and coercion in high-paying clinical trials

Millions of volunteers take part in clinical trials every year. This is unsurprising, given that clinical trials are often much more lucrative than other types of unskilled work. When clinical trials offer very high pay, however, some people consider them repugnant. To understand why, we asked 1,428 respondents to evaluate a hypothetical medical trial for a new Ebola vaccine offering three different payment amounts. Some respondents (27%) used very high pay (£10,000) as a cue to infer the potential risks the clinical trial posed. These respondents were also concerned that offering £10,000 was coercive—simply too profitable to pass up. Both perceived risk and coercion in high-paying clinical trials shape how people evaluate these trials. This result was robust within and between respondents. The link between risk and repugnance may generalize to other markets in which parties are partially remunerated for the risk they take and contributes to a more complete understanding of why some market transactions appear repugnant.

Bibliotherapy

This article discusses the historical development of bibliotherapy and how books can be used in the treatment of a range of minor mental health conditions. The article provides a brief historical account of how books have been used in institutions through the centuries and how the bibliotherapuetic process works through the use of texts from which the reader gains an insight into their personal situation by identifying with a character experiencing similar problems. Bibliotherapy as both clinical and community-based treatment is discussed through a number of case studies from the critical literature, in particular the Ayrshire Read Yourself Well scheme and the Reading Well/Books on Prescription scheme. The results of a medical trial on the benefits of reading a novel based on MRI (magnetic resonance imaging) scans of readers are then discussed.