A decade into Facebook: where is psychiatry in the digital age?

Social networking sites are a part of everyday life for over a billion people worldwide. They show no sign of declining popularity, with social media use increasing at 3 times the rate of other Internet use. Despite this proliferation, mental healthcare has yet to embrace this unprecedented resource. We argue that social networking site data should become a high priority for psychiatry research and mental healthcare delivery. We illustrate our views using the world’s largest social networking site, Facebook, which currently has over 1 billion daily users (1 in 7 people worldwide). Facebook users can create personal profiles, socialize, express feelings, and share content, which Facebook stores as time-stamped digital records dating back to when the user first joined. Evidence suggests that 92% of adolescents go online daily and disclose considerably more about themselves online than offline. Thus, working with Facebook data could further our understanding of the onset and early years of mental illness, a crucial period of interpersonal development. Furthermore, a diminishing ‘digital divide’ has allowed for a broader sociodemographic to access Facebook, including homeless youth, young veterans, immigrants, patients with mental health problems, and seniors, enabling greater contact with traditionally harder-to-reach populations

Online Social Networking Sites and Mental Health Research

Socializing and networking was transformed in the technological era by the introduction of social networking sites (SNSs). These online sites contain an abundance of information about individual preferences, interests, types, and frequency of social interactions, etc. However, scientific studies that have utilized SNS activity data to aid our understanding of mental health disorders are scarce. This is partly due to the practicalities of accessing SNS data and methodological issues of large-scale data collection, but also because the construct validity of SNS measures is unknown. By and large, the literature to date has attempted to link various SNSs measures to various mental health symptomologies, mostly collected using self-report measures rather than data generated by SNSs. Although such research has demonstrated some preliminary and putative associations between SNS activity and mental health measures, the current literature is still in its infancy and arguably lacks rigor in design, offering limited insights into its theoretical significance and plausibility. In this review, we will provide an account of the theoretical importance of using data generated from SNSs in mental health research and provide a brief overview of the literature published in this area to date

Beyond mobile apps: a survey of technologies for mental well-being

Mental health problems are on the rise globally and strain national health systems worldwide. Mental disorders are closely associated with fear of stigma, structural barriers such as financial burden, and lack of available services and resources which often prohibit the delivery of frequent clinical advice and monitoring. Technologies for mental well-being exhibit a range of attractive properties, which facilitate the delivery of state-of-the-art clinical monitoring. This review article provides an overview of traditional techniques followed by their technological alternatives, sensing devices, behaviour changing tools, and feedback interfaces. The challenges presented by these technologies are then discussed with data collection, privacy, and battery life being some of the key issues which need to be carefully considered for the successful deployment of mental health toolkits. Finally, the opportunities this growing research area presents are discussed including the use of portable tangible interfaces combining sensing and feedback technologies. Capitalising on the data these ubiquitous devices can record, state of the art machine learning algorithms can lead to the development of robust clinical decision support tools towards diagnosis and improvement of mental well-being delivery in real-time

Characterizing problematic hypoglycaemia: iterative design and preliminary psychometric validation of the Hypoglycaemia Awareness Questionnaire (HypoA-Q)

AIMS: To design and conduct preliminary validation of a measure of hypoglycaemia awareness and problematic hypoglycaemia, the Hypoglycaemia Awareness Questionnaire. METHODS: Exploratory and cognitive debriefing interviews were conducted with 17 adults (nine of whom were women) with Type 1 diabetes (mean &plusmn; sd age 48&plusmn;10 years). Questionnaire items were modified in consultation with diabetologists/psychologists. Psychometric validation was undertaken using data from 120 adults (53 women) with Type 1 diabetes (mean &plusmn; sd age 44&plusmn;16 years; 50% with clinically diagnosed impaired awareness of hypoglycaemia), who completed the following questionnaires: the Hypoglycaemia Awareness Questionnaire, the Gold score, the Clarke questionnaire and the Problem Areas in Diabetes questionnaire. RESULTS: Iterative design resulted in 33 items eliciting answers on awareness of hypoglycaemia when awake/asleep and hypoglycaemia frequency, severity and impact (healthcare utilization). Psychometric analysis identified three subscales reflecting \u27impaired awareness\u27, \u27symptom level\u27 and \u27symptom frequency\u27. Convergent validity was indicated by strong correlations between the impaired awareness subscale and existing measures of awareness: (Gold: rs =0.75, P&lt;0.01; Clarke: rs =0.76, P&lt;0.01). Divergent validity was indicated by weaker correlations with diabetes-related distress (Problem Areas in Diabetes: rs =0.25, P&lt;0.01) and HbA1c (rs =-0.05, non-significant). The impaired awareness subscale and other items discriminated between those with impaired and intact awareness (Gold score). The impaired awareness subscale and other items contributed significantly to models explaining the occurrence of severe hypoglycaemia and hypoglycaemia when asleep. CONCLUSIONS: This preliminary validation shows the Hypoglycaemia Awareness Questionnaire has robust face and content validity; satisfactory structure; internal reliability; convergent, divergent and known groups validity. The impaired awareness subscale and other items contribute significantly to models explaining recall of severe and nocturnal hypoglycaemia. Prospective validation, including determination of a threshold to identify impaired awareness, is now warranted.<br /

Cohort profile: The NSPN 2400 Cohort: a developmental sample supporting the Wellcome Trust NeuroScience in Psychiatry Network

Mental and substance use disorders are the leading cause of years lived with disability, worldwide. Other than childhood developmental disorders and neurodegenerative dementias of the elderly, most mental health disorders are first manifest in the second and third decades of life during which the highest proportion of total disability adjusted life years occurs due to their enormous impact on normal, adolescent and young adult functioning; non-syndromal abnormalities can be identified far earlier in life.This study was supported by the Neuroscience in Psychiatry Network, a strategic award from the Wellcome Trust to the University of Cambridge and University College London (095844/Z/11/Z). Additional support was provided by the National Institute for Health (NIHR) Research Cambridge Biomedical Research Centre, the NIHR Collaboration for Leadership in Applied Health Research & Care East of England, and the Medical Research Council (MRC)/Wellcome Trust Behavioural and Clinical Neuroscience Institute

Adolescence is associated with genomically patterned consolidation of the hubs of the human brain connectome.

How does human brain structure mature during adolescence? We used MRI to measure cortical thickness and intracortical myelination in 297 population volunteers aged 14-24 y old. We found and replicated that association cortical areas were thicker and less myelinated than primary cortical areas at 14 y. However, association cortex had faster rates of shrinkage and myelination over the course of adolescence. Age-related increases in cortical myelination were maximized approximately at the internal layer of projection neurons. Adolescent cortical myelination and shrinkage were coupled and specifically associated with a dorsoventrally patterned gene expression profile enriched for synaptic, oligodendroglial- and schizophrenia-related genes. Topologically efficient and biologically expensive hubs of the brain anatomical network had greater rates of shrinkage/myelination and were associated with overexpression of the same transcriptional profile as cortical consolidation. We conclude that normative human brain maturation involves a genetically patterned process of consolidating anatomical network hubs. We argue that developmental variation of this consolidation process may be relevant both to normal cognitive and behavioral changes and the high incidence of schizophrenia during human brain adolescence.This study was supported by the Neuroscience in Psychiatry Network, a strategic award by the Wellcome Trust to the University of Cambridge and University College London. Additional support was provided by the NIHR Cambridge Biomedical Research Centre and the MRC/Wellcome Trust Behavioural & Clinical Neuroscience Institute. PEV is supported by the MRC (MR/K020706/1). We used the Darwin Supercomputer of the University of Cambridge High Performance Computing Service provided by Dell Inc. using Strategic Research Infrastructure Funding from the Higher Education Funding Council for England and funding from the Science and Technology Facilities Council.This is the author accepted manuscript. This is the author accepted manuscript. The final version is available from the National Academy of Sciences via https://doi.org/10.1073/pnas.160174511

Internet use, needs and expectations of web-based information and communication in childbearing women with type 1 diabetes

<p>Abstract</p> <p>Background</p> <p>In the childbearing period women use the internet both to seek information and as an important source of communication. For women with type 1 diabetes, pregnancy and early motherhood constitute a more complex situation than for women in general. This implies need for support from various professionals and a way of bridging any discontinuity in care would be to develop a website providing complementary social support and information. The objective of this study was to explore internet use, needs, and expectations regarding web-based information and communication in childbearing women with type 1 diabetes.</p> <p>Methods</p> <p>Data were collected via a web-based survey with an explorative and descriptive design, in which 105 of 139 eligible mothers with type 1 diabetes and recent childbearing experience participated. The data were analyzed with descriptive and analytical statistics, and open answers with a directed content analysis.</p> <p>Results</p> <p>Of the 105 women, 22% never used the internet to search for information concerning pregnancy, childbirth, and parenthood. 12% searched for information every day, 29% one or more times a week, and 38% one or more times a month. Of the women 44% declared themselves to be passive participants on social websites, and 45% to be active participants. 45% had specific expectations of web-based support directed towards childbearing, especially those with higher educational level (<it>P </it>= .01). Expectations of instrumental and informational support included an expert-controlled website with reliable, updated, and information focused on childbearing and diabetes, improved access to diabetes care professionals and alternative ways to communicate and to receive childbearing-related support. The women also asked for online technical devices to manage the frequent monitoring of blood glucose during pregnancy. Informal, emotional, and appraisal support from women in similar situations was suggested as a way to provide an arena for belonging instead of creating feelings of alienation.</p> <p>Conclusions</p> <p>Our results add important knowledge about the web-based needs of women with type 1 diabetes in relation to childbearing. This user directed study indicates specific areas of development for the provision of effective web-based support that includes facilities for reliable information, interactive support and social networking in this population.</p

The impact of the Great Exhibition of 1851 on the development of technical education during the second half of the nineteenth century

This paper examines the contribution made by the mechanics’ institute movement in Britain just prior to, and following, the opening of the Great Exhibition of 1851 in London. It argues that far from making little contribution to education, as often portrayed by historians, the movement was ideally positioned to respond to the findings of the Exhibition, which were that foreign goods on display were often more advanced than those produced in Britain. The paper highlights, through a regional study, how well suited mechanics’ institutes were in organising their own exhibitions, providing the idea of this first international exhibition. Subsequently, many offered nationally recognised technical subject examinations through relevant education as well as informing government commissions, prior to the passing of the Technical Instruction Acts in 1889 and the Local Taxation Act of 1890. These acts effectively put mechanics’ institutes into state ownership as the first step in developing further education for all in Britai

Poor glycated haemoglobin control and adverse pregnancy outcomes in type 1 and type 2 diabetes mellitus: Systematic review of observational studies

BACKGROUND: Glycaemic control in women with diabetes is critical to satisfactory pregnancy outcome. A systematic review of two randomised trials concluded that there was no clear evidence of benefit from very tight versus tight glycaemic control for pregnant women with diabetes. METHODS: A systematic review of observational studies addressing miscarriage, congenital malformations and perinatal mortality among pregnant women with type 1 and type 2 diabetes was carried out. Literature searches were performed in MEDLINE, EMBASE, CINAHL and Cochrane Library. Observational studies with data on glycated haemoglobin (HbA(1c)) levels categorised into poor and optimal control (as defined by the study investigators) were selected. Relative risks and odds ratios were calculated for HbA(1c )and pregnancy outcomes. Adjusted relative risk estimates per 1-percent decrease in HbA(1c )were calculated for studies which contained information on mean and standard deviations of HbA(1c). RESULTS: The review identified thirteen studies which compared poor versus optimal glycaemic control in relation to maternal, fetal and neonatal outcomes. Twelve of these studies reported the outcome of congenital malformations and showed an increased risk with poor glycaemic control, pooled odds ratio 3.44 (95%CI, 2.30 to 5.15). For four of the twelve studies, it was also possible to calculate a relative risk reduction of congenital malformation for each 1-percent decrease in HbA(1c), these varied from 0.39 to 0.59. The risk of miscarriage was reported in four studies and was associated with poor glycaemic control, pooled odds ratio 3.23 (95%CI, 1.64 to 6.36). Increased perinatal mortality was also associated with poor glycaemic control, pooled odds ratio 3.03 (95%CI, 1.87 to 4.92) from four studies. CONCLUSION: This analysis quantifies the increase in adverse pregnancy outcomes in women with diabetes who have poor glycaemic control. Relating percentage risk reduction in HbA(1c )to relative risk of adverse pregnancy events may be useful in motivating women to achieve optimal control prior to conception