Smartphone app may help older adults manage serious mental illness and chronic health conditions

The use of new technologies in geriatric psychiatry shows promise for advancing personalised medicine and improving patient care. A new study in The American Journal of Geriatric Psychiatry describes the successful adaptation of an integrated medical and psychiatric self-management intervention to a smartphone application for middle-aged and older adults with serious mental illness.

Care of middle-aged and older patients with serious mental illness can be difficult. Often these patients suffer from other medical conditions and are at increased risk of premature death. In order to help patients cope with their illness, researchers from Dartmouth developed a smartphone-based intervention using adaptive systems engineering framework and principles of user-centred design.

“The use of mobile health interventions by adults with serious mental illness is a promising approach that has been shown to be highly feasible and acceptable,” explained lead investigator Karen L. Fortuna, PhD, of the Dartmouth Centers for Health and Aging and the Geisel School of Medicine at Dartmouth.

They found that even patients with limited technical abilities could use this app successfully. The app and intervention protocol were developed using commercially available products from Wellframe.

Following multiple design iterations, investigators tested the app’s usability and found Ten participants with serious mental illness and other chronic health conditions reported a high level of usability and satisfaction with the smartphone application.

The app takes patients through 10 sessions over a period of around three months, covering topics such as stress vulnerability and illness, medication adherence and strategies, and substance and medication abuse. Physicians can remotely monitor app use, and intervene when problems are detected, facilitating telemedicine for less accessible populations.

This study is part of a special issue of The American Journal of Geriatric Psychiatry that captures an important moment in the evolving relationship between technology and the clinical care of

 

Vitamin B3 could prevent miscarriages and birth defects

An extra dose of vitamin B3 might help prevent certain kinds of complex birth defects, according to a new study. It is thought the vitamin can help compensate for defects in the body’s ability to make a molecule, nicotinamide adenine dinucleotide (NAD), which researchers have now linked for the first time to healthy fetal development in humans.

Every year 7.9 million babies are born with a birth defect worldwide. The discovery suggests the possibility that boosting levels of B3 in pregnant women’s diets might help lower overall rates of birth defects.

Researchers from the Victor Chang Institute in Sydney called it ‘a double breakthrough’ as they found both a cause and a preventative solution. The researchers analysed the DNA of four families where the mothers had suffered multiple miscarriages or their babies were born with multiple birth defects, such as heart, kidney, vertebrae and cleft palate problems.

They found mutations in two genes that caused the child to be deficient in a vital molecule known as Nicotinamide adenine dinucleotide (NAD), which allows cells to generate energy and organs to develop normally. Lead researcher Prof Sally Dunwoodie replicated these mutations in mice and found they could be corrected if the pregnant mother took niacin (vitamin B3).

“You can boost your levels of NAD and completely prevent the miscarriages and birth defects. It bypasses the genetic problem,” she said. “It’s rare that you find a cause and a prevention in the same study. And the prevention is so simple, it’s a vitamin,” she said.

 

Back In 2005, Dunwoodie’s team dealt with a particularly severe case, a baby who had major defects in the heart, backbone, and ribs; the rib problems being so bad that the child’s lungs couldn’t fully inflate. The team found that the family carried a mutation in a gene related to the production of NAD, a molecule crucial for energy storage and DNA synthesis in cells. Both parents carried a mutation in one of their copies of the gene, and the affected baby had inherited two defective copies.

No one had reported any role for NAD in heart or bone development, Dunwoodie says. “We didn’t know what to do with it.”

To confirm the role of the mutations in organ and bone development, the researchers knocked out the two genes in mice to see whether similar birth defects appeared. At first all the pups were normal. But then the researchers realised that standard mouse chow is rich in niacin and that cells can use either niacin or nicotinamide—both known together as vitamin B3—to make NAD by an alternate pathway.

The work opens a potentially exciting new area of research for developmental biologists: Trying to understand how cell metabolism affects development

 

 

Exploragen launches new sleep app

DNA lifestyle company Exploragen last week launched their first iOS app, which is available on Helix.com. The online marketplace of DNA-powered products offers insights on nutrition, fitness, health, ancestry, family and entertainment. The new app, which is named SlumberType, is a lifestyle app providing insights on the genetics of sleep, enabling people to understand the way sleep can be influenced by DNA.

By analysing four key sleep measurements – Chronotype, Sleep Quality, Sleep Onset Latency and Sleep Duration – the app helps users conclude whether they are a morning or night person, how long it may take them to fall asleep, the duration and quality of their sleep, and how these factors may affect other areas of their lives. SlumberType also features tools and trackers which monitor everyday behaviour that potentially affects sleep.

“Our bodies function at their best when we get the right amount of sleep. SlumberType will allow people to understand how their unique biology, combined with their daily habits and activities, affects their sleep patterns, so they can optimise their lifestyle for better sleep”, said Exploragen co-founder and Head of Science Sara Riordan.

The app was recently launched on 24^th July and is available now on Helix.com.

The future of diagnostic wearables?

 

The University of Tokyo has recently started to develop a new generation of wearable diagnostics. The hypoallergenic electronic sensor wearables are designed to monitor health indicators without being invasive or causing any discomfort.

The electronic sensors are made up of breathable nanoscale meshes that attach directly to the skin to produce accurate and precise readings of heart rate and other health indicators. Japanese scientists believe the new wearables can be worn for up to one week, without causing any irritation. However, if devices are worn over a longer period it is thought they may be deemed unsafe, as they prevent breathability and block airflow causing irritation and inflammation.

“We learned that devices that can be worn for a week or longer for continuous monitoring were needed for practical use in medical and sports applications” says Professor Takao Someya at the University of Tokyo’s Graduate School of Engineering.

The device can be applied by spraying a small amount of water, which dissolves PVA nanofibres to allow it to stick to the skin. It is designed to fit curvilinear surfaces of skin making it ideal to apply to sweat pores and index fingers.

Scientists are hopeful this is the beginning of a new chapter for wearable diagnostics and hope that it will be possible to measure health indicators without causing stress or discomfort to the user. The device is thought to not only be the future for medical diagnostics, but also have applications for sports technology.

 

 

FDA takes steps to improve hearing aid accessibility

The U.S. Food and Drug Administration (FDA) have announced important steps to better support consumer access to hearing aids. The FDA will consider creating a category of OTC hearing aids that could deliver new, innovative and lower-cost products to millions of consumers.

The agency also announced important steps to better support consumer access to hearing aids. In a guidance document, the agency explains that it does not intend to enforce the requirement that people aged 18+ years receive a medical evaluation or sign a waiver prior to purchasing most hearing aids. Under the new guidance, the FDA will continue to enforce the medical evaluation required for people under 18 years of age.

The agency also requires that consumers are provided with information and instructions about hearing aids before any purchase from a licensed hearing aid dispenser. This guidance is effective immediately.

FDA Commissioner Robert Califf, M.D commented “Today’s actions are an example of the FDA considering flexible approaches to regulation that encourage innovation in areas of rapid scientific progress,”Califf continued “The guidance will support consumer access to most hearing aids while the FDA takes the steps necessary to propose to modify our regulations to create a category of OTC hearing aids that could help many Americans improve their quality of life through better hearing.”

The FDA has cited that hearing loss affects some 30 million people in the United States and can have a significant impact on communication, social participation and overall health and quality of life.

AOMRC release list of 40 treatments that bring little or no benefit to patients

The Academy of Medical Royal Colleges has released a list of over 40 treatments that bring little or no benefit to patients. The list is part of a campaign to reduce the number of unnecessary medical treatments.

Medical experts from 11 different specialties were asked to identify five treatments or procedures commonly used in their field that were not always necessary or valuable.

These have been used as part of the Choose Wisely campaign to highlight the need for patients and doctors to talk frankly about how health issues should be treated.

The advice suggests:

• Tap water is just as good for cleaning cuts and grazes as saline solution
• Small wrist fractures in children do not normally need a plaster cast, and will heal just as quickly with a removable splint
• Children with bronchiolitis, or breathing problems, usually get better without treatment
• Electronic monitoring of a baby’s heart is only needed during labour if the mother has a higher-than-normal risk of complications
• Chemotherapy may be used to relieve symptoms of terminal cancer but it cannot cure the disease and may well bring further distress in the final months of life
• Routine screening for prostate conditions using a test known as a Prostate Specific Antigen, or PSA test, does not lead to longer life and can bring unnecessary anxiety

The Academy says there is evidence that patients often pressure doctors into prescribing or carrying out unnecessary treatments and the NHS is also coming under increasing pressure to reduce over-medicalisation – in other words the medicines and treatments it prescribes.

Alongside this list, for some time now, GPs have also been advised to cut back on prescribing antibiotics to patients. This will surely be a driver in the OTC market as patients may turn to self-medication if they are unable to get what they require under prescription.