AATP Interactive

Compulsive Gamers - Not Addicts

According to the Smith & Jones Centre in Amsterdam, Europe's first and only clinic to treat gaming addiction, ninety per cent of the young people who seek treatment for compulsive computer gaming are not addicted. The clinic opened in 2006 and initially approached treatment for compulsive computer gaming as an addiction. It has recently revised its approach as it realized that compulsive gaming is more often a social rather than a psychological problem.

Keith Baker, the clinic director points out that "these kids come in showing some kind of symptoms that are similar to other addictions and chemical dependencies, but the more we work with these kids the less I believe we can call this addiction. What many of these kids need is their parents and their school teachers - this is a social problem."

The clinic has had very high success rates treating people who also show other addictive behaviours such as drug taking and excessive drinking using traditional abstinence-based treatment models. But Mr Bakker believes that this kind of cross-addiction affects only 10% of gamers. For the other 90% who may spend four hours a day or more playing games such as World of Warcraft, he no longer thinks addiction counselling is the way to treat these people.

By offering compulsive gamers a place where they feel accepted and where their voice will be heard, the clinic has found that the vast majority have been able to leave gaming behind and rebuild their lives. The clinic staff believe that the root cause of the huge growth in excessive gaming lies with parents who have failed in their duty of care. But it is important to note that 87% of online gamers are over the age of 18 - and once they cross that line, help is something they need to seek for themselves because parents no longer have the legal right to intervene.

For younger gamers, intervention may be the only way to break the cycle. That means stepping in and sometimes literally taking a child away from a computer, removing them from the game for a period of time until they become aware of their habits and begin to see there are other choices.

"It's a choice," says Baker. "These kids know exactly what they are doing and they just don't want to change. If no one is there to help them, then nothing will ever happen."

Research at Smith & Jones has found that feelings of anger and powerlessness often pre-exist a compulsion to play violent games. In some cases these people find each other in the gaming world and form a bond based on those feelings of alienation and anger. It is believed that if there was more commitment from parents and other care givers to listen to what their children are saying then these issues of isolation and frustration could be dealt with at the source and bring many young people out of the virtual world and back into real life.

Resources
Smith and Jones Clinic

BBC News Story

Previous AATP Weblog Posts on Internet/Gaming Addiction

PubMed Search on Gaming Addiction

American Journal of Psychiatry Editorial - Jerald Block, MD
Internet Addiction

Next Generation Internet

In the early days of the Internet, communication was limited to the US Defense Department and select academic institutions. Information exchange took place through simple computer terminals using unix-style commands. It was unfriendly until the world wide web placed a graphic front end on the Net.

What is next? A World Wide Grid. Where the Internet is a communications channel between computers, the Grid goes beyond this by not just using the Internet for communications but also as a means of sharing computing resources. Every computer and user can access and make use of the combined resources of the grid. The goal is to have the WWGrid running on top of the Internet and just as its predecessor, it is starting to take shape between academic and scientific institutions. Until recently, also like the Net, it was difficult to use, requiring knowledge of specialised computer languages and coding skills.

A European group, the Eclipse Project, as been developing an easy-to-use, graphical interface which allows access to grid resources with a few mouse clicks. It is called g-Eclipse and can be best described as a browser for what will become the World Wide Grid. It searches for and displays the resources that are available, and allows the user to access them. Complicated computing jobs which need more processing or storage than are available on the user’s system can be sent to the grid. Data can be transferred from the local computer to the grid and workflows can be managed. The project is making use of the Eclipse open-source ecosystem, which has thousands of developers and a very large user base and is host to numerous application development projects from around the world. Eclipse allows us to create a user base and it also means anybody in the world can contribute. Eclipse projects are really transparent and open, more so even than Linux, and source code can simply be reused between Eclipse programs.

The system is active with many individuals and organizations already sending their daily jobs to the grid. They have created a framework that can be used for other developers to build their applications. The system has also been configured for use with computing clouds, and specifically Amazon.com’s Elastic Compute Cloud. Cloud computing allows firms which have installed computer capacity to cope with peak periods, such as the holidays, to hire the excess capacity out. Site administrators expecting unusually heavy traffic can lease tens, hundreds or even thousands of virtual servers from firms like Amazon, for minutes, hours or days at a time as and when the extra capacity is required.

It is the hope that the Eclipse community, having seen the value of the work to date, will continue to push back the boundaries with other developers plugging g-Eclipse into all the grids and clouds which connect to the Internet. It is predicted that a few years down the road g-Eclipse could be a part of everybody’s desktop. Perhaps there will be a layer in computer operating systems which allows applications to be executed on the grid rather than the local desktop. If and when that happens, every PC user could well have access to all of the computing power and speed they could possibly require.

Sources and Links:
Eclipse Project
gEclipse Tools for Grid and Cloud Computing Project
Migrating Desktop Tools
GridBench
Amazon Elastic Compute Cloud

New Neuroscience Information Framework

A special issue of the journal Neuroinformatics describes a new Neuroscience Information Framework. (NIF) It is a dynamic inventory of web-based neurosciences data, resources and tools that scientists and students can access via any computer connected to the Internet. An initiative of the National Institutes of Health Blueprint for Neuroscience Research, the NIF will advance neuroscience research by enabling discovery and access to public research data and tools worldwide through an open source, networked environment.

The Neuroscience Information Framework is designed to serve a broad set of neuroscience investigators working on many problems, using many techniques and preparations. It enables users to discover global neuroscience web resources that cut across traditional boundaries - from experimental, clinical and translational neuroscience databases to knowledge bases, atlases, and genetic and genomic resources. Unlike general search engines, the NIF provides deeper access to a more focused set of resources that are relevant to neuroscience, search strategies tailored to neuroscience, and access to content that is traditionally 'hidden' from web search engines. All components of the NIF are available Open Source to encourage multiple community, institution and publisher development of NIF-compatible portals and web resources.

Neuroinformatics Special Issue
(free online)

NIH Neuroscience Information Framework

Over 60 Million US Adults Using Health 2.0 Tools

A study of consumer use of social media for health information from Manhattan Research reports that over 60 million U.S. adults are Health 2.0 consumers – using health blogs, online support groups, prescription rating sites, and other health-related social media applications. According to the Cybercitizen Health™ consumer study, the number of Health 2.0 consumers has doubled over the past year. The study also found that a consumer’s condition, as opposed to just age or gender, is an important factor in his or her likeliness to engage in health-related social media.

Health 2.0 consumers are defined as consumers who have conducted one of the following activities in the past 12 months: read health-related blogs, message boards or participated in health-related chatrooms; contributed or posted health content online such as: writing or commenting on a health-related blog, adding or responding to a topic in a forum or group, or creating health related web pages, videos or audio content; used online patient support groups, message boards, chatrooms, or blogs.

According to Manhattan Research Vice President of Research Meredith Abreu Ressi, “social media is changing the way that consumers gather health information from the Internet. Patients and caregivers are no longer limited to static resources but are now sharing advice and treatment experiences online. And it’s not just younger audiences connecting online – consumers with conditions such as cancer, fibromyalgia, and depression are also avid users of these types of resources. Health 2.0 is happening, and it’s changing the way things are done in the healthcare industry.”

Source: PharmaLive

Manhattan Research

Cybercitizen White Paper (free with registration)

Manhattan Research eHealth Trends podcast
from the Health 2.0 Conference in San Francisco

Sometimes We Learn From Robots

Researchers from RIKEN Brain Science Institute, Japan, have created a new type of neural network model that changes how we understand neural activity. Current literature focuses on the spatial structure of a series of actions. For example, an animal's motor control system contains a functional hierarchy, whereby small, reusable parts of movements are flexibly integrated to create various action sequences. Thus, the action of drinking a cup of coffee can be broken down into a combination of small movements including the motions of reaching for a cup, grasping the cup, and bringing it to one's mouth.

Earlier studies suggested that this functional hierarchy results from an explicit spatial hierarchical structure, but this has not been seen in anatomical studies of the brain. The underlying neural mechanisms for functional hierarchy, thus, had not yet been definitively determined.

Humanoid robots have been used to show that that functional hierarchy in the brain is linked to time as well as space. In a study published November 7 in the open-access journal PLoS Computational Biology, Yuichi Yamashita and Jun Tani demonstrate that even without explicit spatial hierarchical structure, a functional hierarchy can self-organize through multiple timescales in neural activity. Their model was proven viable when tested with the physical body of a humanoid robot. Results suggest that it is not only the spatial connections between neurons, but also the timescales of neural activity, that act as important mechanisms in neural systems.

Emergence of Functional Hierarchy in a Multiple Timescale Neural Network Model: A Humanoid Robot Experiment.
Yamashita Y, Tani J (2008) PLoS Comput Biol 4(11): e1000220. doi:10.1371/journal.pcbi.1000220

Source: Medical News Today

A Scholarly Review of EHR Regulation

In the first scholarly study on EHR regulation, faculty from Case Western University assess the need for federal regulation of electronic health record systems. The authors of this study point out that most Americans would argue against an increase in government regulation, but their research suggests that more regulation in an area like health care record systems is needed.

One of the authors, Sharona Hoffman, professor of law and bioethics at the School of Law, states that "we regulate drugs, transportation, communication, food, and many other goods and services, a safe and effective transition to computerized medical records cannot be achieved without federal regulation."

The study points out that electronic health records systems offer great promise to truly improve health care in the US and globally but "their complexities generate many risks of software and hardware failures and adverse patient outcomes, and thus they require rigorous regulation. "This is an exciting time for health information technology, but it must be approached cautiously and thoughtfully."

The authors state that currently, the Certification Commission for Healthcare Information Technology (CCHIT), a private organization, conducts one-day testing of EHR systems. They believe that CCHIT's certification process is not sufficiently thorough and has several important shortcomings. It is suggested that CCHIT oversight be replaced by governmental oversight and that an extensive testing and approval process be established. Without this testing, new EHR systems should not be marketed, just as drugs and devices cannot be sold if they have not been approved by the Food and Drug Administration (FDA). In addition, EHR systems must be subject to monitoring throughout their operational lifetimes to ensure that technical problems are detected and resolved.

Another important factor that contributes to the future success of EHR systems is financial support.

* It is estimated that the cost of purchasing an EHR system is $33,000 for each physician, with an additional cost of $1,500 per doctor per month for maintenance. This expense has cost challenges for many providers, especially those in small practices. Some estimate that the long-term cost-savings produced by a national health information network could reach $77.8 billion a year from a reduction in medical errors, diagnostic test duplication, and administrative expenses.

* Currently, however, only 17% of physicians in ambulatory care settings use them to any extent, and only 11% of hospitals have fully implemented them. The slow pace of EHR system adoption may reflect a misalignment of incentives. While cost savings will be enjoyed primarily by insurers and the government, the expense of purchasing and implementing EHR systems must be absorbed by health care providers.

* Several Congressional bills, including the Health Information Technology Act of 2007 and the Wired for Health Care Quality Act of 2007, were designed to provide financial incentives such as tax credits and grants, but have not passed due to other health care priorities.

* Some clinicians may resist computerization for more than just monetary reasons. There is concern that patients may suffer from less face to face time with their physicians if it becomes more time consuming for doctors to input information into a computer than it is to dictate notes. Others believe that EHR systems require time-consuming documentation of irrelevant facts, are difficult to navigate, and do not organize clinical information in a way that enhances the delivery of treatment.

The authors describe that many of these problems can be solved through careful attention to system usability and user interface design. They suggest that federal regulations include a "best practices" standard and guidance as to how optimal usability is to be achieved. They also emphasize the importance of interoperability, which will allow EHRs to be transmitted electronically from one provider to another so that work does not have to be duplicated each time a patient sees a new clinician.

The goal of this study is the hope that it will reach policy-makers and be influential as the country continues to transition to EHR systems.

References/resources

"Finding a Cure: The Case for Regulation and Oversight of Electronic Health Record Systems" (Harvard Journal of Law and Technology, forthcoming 2009)

Source: American Association for the Advancement of Science Press Release