Enabling Technology

BetheaNotes

Keith’s notes on T. Carter Bethea’s talk.

  • T. Carter Bethea, MD
    • Clinical Fellow, Division of Child Psychiatry
    • ASPIRE Research Program
    • Terrence_Bethea@med.unc.edu
    • Schizophrenia, Bipolar, Autism, Obesity, etc.
  • Some Basics of Psychiatry
    • Psychiatry: Treatment with Medicine
    • Psychology: Treatment without Medicine
    • The medical field is not very good with regular medicine, so in psychiatry the bar is even lower.
      • Cycling through the best 3–5 treatment meds (one at a time) yields improvements for 75% of the patients
      • Improvement does not equal cure
      • There are serious side effects, mainly weight gain
        • A quarter to a half a kilo is alot for a 30 kilo kid
        • Essentially double their weight in 6 months
        • Kids are fat, more likely to get diabetes and glucose increase
        • Unknown if change is behavioral, chemical or both

  • Slides: Using Technology to Undo the Incidental Harms Caused by Using New Technologies
    • National obesity trends
      • Normal BMI (body mass index): 18–25
      • Obese BMI (non-athletes): > 25
      • One-fifth of US population is obese (need to lose 20–40 lbs)
      • Obese is worse than merely overweight (need to lose 10 lbs)
    • Why the pandemic?
      • Hypotheses include fast food, tv/video, less xercise, car culture/urban sprawl, erroneous social trends (i.e. parents are scared for kids safety even though schools & streets are actually safer)

    • TV Watching Trends
      • 3 yr olds are playing less!
      • Obesity has increased for 12–17 year olds from 5% in early 980’s to 11% in mid 1980’s to 16% current day
      • Similar numbers for 8–12 year olds
      • Even 2–4 year old are getting obese; only 2 of 30 states had significant number of obese children in 1989, but 28 of those 30 reported obese children in 1999.
      • Changes are environmental since it affects all ages
      • If kids are fat when they are young, they are usually still fat when they are 12 years old
    • TV’s competition
      • TV time is actually down
      • Reasons are mainly video games, the computer, and taped TV (DVR)
      • Kids increased calorie intake not offset by parallel exercise increase
    • Video Game Penetrance, 1999
      • 52% of 2–7 year olds have a console
      • 83% of 8–13 year olds have a console
      • More consoles options
    • DDR (Dance-Dance Revolution)
      • Easy to learn, hard to master
      • Good for any social paradigm
      • Antisocial people can play by themself
      • Social people can invite the whole neighborhood over to play
      • Since need TV for DDR, not watching TV food commercials
      • Lesson mode (learn on your own)

    • Dancer
      • Joint program between Dr Maloney of UNC and Gatorade
      • Sixty 7–8 year olds
      • Randomized Control Trial (RCT)
        • Control: no DDR for ten weeks, intro lesson to DDR @ 11th week
        • Basic: initial lesson to DDR @ week 1
        • Enhanced: physical trainer gives DDR lessons every few weeks
      • No change in PA, BMI, vitals
        • Kids from RTP already healthy and active
        • High income ($85k), high education (college grad) households
        • Basic group saw TV watching decrease of 3.76 hours/week
        • Enhanced group saw slightly better TV watching decrease of 4.01 hours/week
      • Next step: how get low interest kids interested?
    • Dancer Andrews
      • After school program & home use of DDR
      • Twenty eight 9–11 year olds (2/3 black, 1/3 hispanic)
      • Naturalistic (as opposed to RCT)
      • No change in PA, BMI
      • Improvement in physical fitness test (20 meter shuttle run)
        • Improvement in fitness precedes weight loss
      • Used parents to track DDR home usage
      • Look at memory card to see playing times and songs
    • State Programs
      • Oregon – In The Groove
      • Maine – Dr Maloney
      • West Virginia – DDR

    • Other Games & What’s Next? (Research Ideas)
      • EyeToy, AntiGrav: commercial games
      • Stepmania: open source, less commercial
      • Convenient game: Mac, PC, Linux
      • End-user modifiable game
        • Change music & steps
        • Computer engine generates stepfle for music (less licensing problems)
      • Special Needs Considerations
        • Sensory (deaf, blind)
        • Physical (wheelchair, amputee)
        • Developmental (MR/DD)
      • Cotrol difficulty (number of steps, especially for developmental patients)
      • Change rules; steps can be color or number, not just shape
    • Pydance
      • Developed by Brendon Becker in Python
      • Open-source (code is ugly)
      • Re-engineerd by Michael Stewart
      • Win, Mac, Linux compatible game
      • Team game
        • Multiple player pads
        • Best score counts
        • Don’t know who did the best score
        • Good for competitive and non-competitive players

    • It’s never too young to get kids started!