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)
- National obesity trends
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- 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
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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)
- TV Watching Trends
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- 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
- Dancer
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- 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
- Other Games & What’s Next? (Research Ideas)
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- It’s never too young to get kids started!