Category Archives: meaning

healthy habits, meaning, musings, nutrition, policy, politics

Katz on attitudes to wealth vs health

Lots of quotable quotes…

https://www.linkedin.com/today/post/article/20140330140626-23027997-health-wealth-and-wisdom-be-serious

Health, Wealth, and Wisdom? Be Serious!

March 30, 2014(Note: some content adapted for use in this column originally appeared on the Huffington Post on 3/9/12.)

As my newly published review article, “Can We Say What Diet is Best for Health?” makes the media rounds, some questions arise more commonly than others- and some are just more interesting than others. One that stands out in both categories is: what’s the problem? Why, if we really do (and yes, we really do!) have knowledge of the basic theme of eating that could do so much to promote health- adding years to life, and life to years– don’t we embrace it and put it to that excellent use for ourselves and those we love?

There are a number of answers, and different ones received particular emphasis in different interviews. But several of the most important start along distinct trajectories only to wind up at exactly the same place: money.

One such trajectory has to do with those entities – Big Food, Big Publishing, Big Pharma, Madison Avenue, Big Weight Loss industry- that profit enormously from the status quo. Many in this space would be well within the bounds of reason, if not propriety, to wish fervently for our dietary pseudo-confusion and related health travails to last forever. Maybe they do- but I won’t presume to say. I will say: it’s much about the money being made.

But it’s about our hard-earned, carefully tended money as well, and that’s the more interesting part of the story. Because if most of us in our culture treated our money and wealth in any manner vaguely comparable to how we treat our health we would be, in a word, morons. Or, at best, suckers. That’s the problem, right there. Fix this, and a world of opportunity would open up before us.

What’s the case?

Over nearly 25 years of patient care, I have seen — far too many times, painful to recall — people reach retirement age with nicely gilded nest eggs, and disastrously scrambled health. I have never met anyone seriously willing to trade their capacity to get out of bed for a large bundle of cash. I have known many people who would gladly give up large fortunes for the chance to get out of bed one more time, or get out of a wheelchair or be free of weekly dialysis.

But now we enter the Twilight Zone, where what’s real and important, and how we behave, part company. We value money (i.e., wealth) before we have it, while we have it and if ever we had it. We want it if we can’t get it. It’s a crime when someone takes it from us. We fight to keep it.

Health is more important, but most of us — and our society at large — value it only after it’s lost.

Consider that one of the more significant trends in health promotion is providing some financial incentive for people to get healthy. This strategy is populating more and more programs in both real space and cyberspace, and is incorporated into many worksite wellness initiatives.

I have no real problem with it — whatever gets us to the prize is okay with me. But it is… bizarre. We have to be paid to care about getting healthy.

Consider if it were the other way around. You could do a job, and you would get money for doing the job, but then you demanded an “incentive.” Money is not an incentive? No! We insist on being provided “health” to incentivize us to work for the sake of wealth. Unless you, my employer, can guarantee that working for you will help make me healthy, you can take this job and paycheck and…

Ludicrous, right? It doesn’t even sound rational to insist on getting paid in health to accept benefits in wealth. And yet, we all accept that it’s perfectly rational to require payment in wealth to accept benefits in health. We all accept it, that is, until health is gone, we realize what really mattered all along, and we say: What the %#^$ was I thinking? Too late.

I have a real problem with this, not because I want to be in charge of anyone else’s life, but because I know that people want to be in charge of their own lives. Once health is gone, so is control. Your life is governed by medications, procedures, doctor visits and emergencies. You are the very opposite of in charge.

Our society makes it quite clear that responsible adults take care of their money. They don’t spend it as they earn it — they put some into savings. They anticipate the needs of their children, and their own needs in retirement. Wealth — or at least solvency — is cultivated. If you neglect to take care of your budget and your savings, you are, in the judgment of our culture, irresponsible.

But our culture renders no such guidance for those who routinely neglect their health. Those who don’t have time today to eat well, but will have time tomorrow for cardiac bypass. Those who don’t have time today to exercise, but will have time tomorrow to visit the endocrinologist. Those who get, and apply, mutually exclusive recommendations dosed almost daily by daytime television. Prevailing neglect of health costs us dearly, individually and collectively, and it costs us both health and wealth. Being sick is very expensive — in every currency that matters: time, effort, opportunity cost, legacy and yes, dollars.

What if health were more like wealth?

  • If health were like wealth, we would value it while gaining it — not just after we’d lost it.
  • If health were like wealth, we would make getting to it a priority.
  • If health were like wealth, we would invest in it to secure a better future.
  • If health were like wealth, we would work hard to make sure we could pass it on to our children.
  • If health were like wealth, we would accept that it may take extra time and effort today, but that’s worth it because of the return on that investment tomorrow.
  • If health were like wealth, society would respect those who are experts at it- and not substitute the guidance from those who are not.
  • If health were like wealth, young people would aspire to it.
  • If health were like wealth, we would be serious about it.

But health is not like wealth. We venerate wealth, and all too often, denigrate health. People are routinely willing to lose weight fast on some cockamamie diet to look good for a special event. It’s not healthy, but what the heck? Well, it would be like cashing out your 401(k) to show up at the special event in a flashy car you can’t really afford. It would feel good for a day, and bad for the rest of your life. We know this, and responsible people don’t treat wealth this way. But we mortgage health to the point of foreclosure as a matter of routine.

Health is not like wealth. It is vastly MORE important. Just ask anyone who has one but not the other.

We are raised to aspire to wealth, while health is often left to languish in that space where stuff just happens. Wealth is its own prize; we need an incentive in another currency to recognize health as such. We watch sitcoms to laugh at get-rich-quick gullibility, then apply that very delusion ourselves to promises of get-thin-quick, get-healthy-quick, or stay-young-forever. We look to genuine experts for advice in almost any field, and certainly when it comes to managing our money- but if some Hollywood celebrity tells the world “I lost weight by eating only pencil erasers while being thrashed about the elbows with wilted artichoke leaves”- we get in line and reach for our credit cards.

To the extent we own wisdom or at least common sense, we are encouraged at every turn to apply them to our careers, and our bank accounts. But they lapse into a coma with every weight loss infomercial.

The result is an endless appetite for an unending parade of “my diet can beat your diet” contestants, rather than a sensible devotion to applying the fundamentals of healthful eating. It’s exactly analogous to frittering away all of our money on a comparable parade of get-rich-quick schemes, while ignoring the readily available, reliable information about sound investing. Or, if you prefer: it’s shopping for fiddles while Rome burns.

Wise is wonderful, but probably sets the bar too high. We could be both healthy and wealthy- or at least exercise comparable control over both- if we were just comparably sensible about both. We don’t even need to be wise to be healthy- we just need to be serious about it, rather than silly. What’s the problem? When it comes to eating well and being healthy, we are not serious people. Silly prevails.

-fin

Dr. David L. Katz has authored three editions of a nutrition textbook for health care professionals. He is editor-in-chief of the peer-reviewed journal, Childhood Obesity, and President of the American College of Lifestyle Medicine. He was commissioned by Annual Review in Public Health to write the review article, Can We Say What Diet is Best for Health? He is the author, most recently, of Disease Proof.

www.davidkatzmd.com
www.turnthetidefoundation.org

http://www.facebook.com/pages/Dr-David-L-Katz/114690721876253
http://twitter.com/DrDavidKatz
http://www.linkedin.com/pub/david-l-katz-md-mph/7/866/479/

Photo: Stefan Holm/Shutterstock.com

complex adaptive systems, cool, data saving lives, entrepreneurship, file note, healthcare, healthy habits, management and leadership, meaning, musings, nutrition, policy, politics, quantified self, rapid learning health systems, research methodology, startup, storytelling, technology

an idea of earth shattering significance

ok.

been looking for alignment between a significant industry sector and human health. it’s a surprisingly difficult alignment to find… go figure?

but I had lunch with joran laird from nab health today, and something amazing dawned on me, on the back of the AIA Vitality launch.

Life (not health) insurance is the vehicle. The longer you pay premiums, the more money they make.

AMAZING… AN ALIGNMENT!!!

This puts the pressure on prevention advocates to put their money where their mouth is.

If they can extend healthy life by a second, how many billions of dollars does that make for life insurers?

imagine, a health intervention that doesn’t actually involve the blundering health system!!?? PERFECT!!!

And Australia’s the perfect test bed given the opt out status of life insurance and superannuation.

Joran wants to introduce me to the MLC guys.

What could possibly go wrong??????

cool, meaning, music

Vale Frankie Knuckles: “On a scale of 1 to 10, it’s 12.”

“How hot is house music now?” an interviewer asks Knuckles in the video.

“On a scale of 1 to 10, it’s 12.”

http://www.huffingtonpost.com/2014/04/02/godfather-of-house-music-video_n_5078764.html?utm_hp_ref=chicago&ir=Chicago

Rare Video Footage Proves The ‘Godfather’ Of House Music Will Live On Forever

The Huffington Post  | by  Joseph Erbentraut

Consider yourself warned: This clip will probably bum you out that time travel still isn’t a thing.

On the heels of the passing of Grammy-winning house music pioneer Frankie Knuckles, the Media Burn video archive shared a previously unseen mini-documentary of the Oct. 25, 1986 opening of the Power House club in Chicago on Wednesday. The documentary was produced by filmmaker Phil Ranstrom.

The clip features a brief interview with Knuckles, plus footage of patrons dancing to what Knuckles coined as “disco’s revenge” and a performance from the Steve “Silk” Hurley-led J.M. Silk. These were the glory days of Chicago house.

“House music to me represents yet another form of black music that has broken from the street into peoples’ homes,” Simon Low, then an executive with RCA Records, says in the clip. “House music is intrinsically a Chicago phenomenon. You can hear it. I mean, all this music they’re playing tonight has come out of Chicago.”

Knuckles had his own Chicago club, the Power Plant, from 1982 to 1987. He then began the residency at Power House, but according to Tim Lawrence, author of “Love Saves the Day: A History of American Dance Music Culture, 1970-79,” Knuckles left Chicago for New York after Power House closed and was renamed the Music Box in 1988.

“How hot is house music now?” an interviewer asks Knuckles in the video.

“On a scale of 1 to 10, it’s 12.”

(h/t Gapers Block)

healthy habits, meaning

Raising successful children…

Interesting insights into what helps children succeed… it’s about developing grit and character, not just smarts.

Author calls for focus on character over homework for kids

Friday 28 March 2014 6:31PM

Many self-help parenting books seem to do little to reduce either the anxiety or fear that many feel about the important job of raising children to become successful members of society.

In contrast, American author Paul Tough argues that the way to happiness and success in children is not to be found through an increased focus on homework or after-school tutoring.

Instead, Tough’s new book How Children Succeed talks up the need for a greater focus on building character traits like like grit, social intelligence and gratitude.

Guests

Paul Tough
Author of How Children Succeed

Credits

Producer
Ali Benton
data saving lives, entrepreneurship, healthcare, healthy habits, meaning, nutrition, policy, politics, quantified self, quotes & aphorisms, rapid learning health systems

Ornish on Digital Health

The limitations of high-tech medicine are becoming clearer—e.g., angioplasty, stents, and bypass surgery don’t prolong life or prevent heart attacks in stable patient; only one out of 49 men treated for prostate cancer benefit from the treatment, and the other 48 often become impotent, incontinent or both; and drug treatments of type 2 diabetes don’t work nearly as well as lifestyle changes in preventing the horrible complications.

http://www.forbes.com/sites/johnnosta/2014/03/17/the-stat-ten-dean-ornish-on-digital-health-wisdom-and-the-value-of-meaningful-connections/

3/17/2014 @ 11:09AM |1,095 views

The STAT Ten: Dean Ornish On Digital Health, Wisdom And The Value Of Meaningful Connections

STAT Ten is intended to give a voice to those in digital health. From those resonant voices in the headlines to quiet innovators and thinkers behind the scenes, it’s my intent to feature those individuals who are driving innovation–in both thought and deed. And while it’s not an exhaustive interview, STAT Ten asks 10 quick questions to give this individual a chance to be heard.  

Dean Ornish, MD is a fascinating and important leader in healthcare.  His vision has dared to question convention and look at health and wellness from a comprehensive and unique perspective.  He is a Clinical Professor of Medicine, UCSF Founder & President, nonprofit Preventive Medicine Research Institute.

Dr. Ornish’s pioneering research was the first to prove that lifestyle changes may stop or even reverse the progression of heart disease and early-stage prostate cancer and even change gene expression, “turning on” disease-preventing genes and “turning off” genes that promote cancer, heart disease and premature aging. Recently, Medicare agreed to provide coverage for his program, the first time that Medicare has covered an integrative medicine program. He is the author of six bestselling books and was recently appointed by President Obama to the White House Advisory Group on Prevention, Health Promotion, and Integrative and Public Health. He is a member of the boards of directors of the San Francisco Food Bank and the J. Craig Venter Institute. The Ornish diet was rated #1 for heart health by U.S. News & World Report in 2011 and 2012. He was selected as one of the “TIME 100” in integrative medicine, honored as “one of the 125 most extraordinary University of Texas alumni in the past 125 years,” recognized by LIFE magazine as “one of the 50 most influential members of his generation” and by Forbes magazine as “one of the 7 most powerful teachers in the world.”

The lexicon of his career is filled with words that include innovator, teacher and game-changer.  And with this impressive career and his well-established ability to look at health and medicine in a new light, I thought i would be fun–and informative–to ask Dr. Ornish some questions about digital health.

Dean Ornish, MD

Dean Ornish, MD

 1. Digital health—many definitions and misconceptions.  How would describe this health movement in a sentence or two?

“Digital health” usually refers to the idea that having more quantitative information about your health from various devices will improve your health by changing your behaviors.  Information is important but it’s not usually sufficient to motivate most people to make meaningful and lasting changes in healthful behaviors.  If it were, no one would smoke cigarettes.

2. You’ve spoken of building deep and authentic connection among  patients as key element of your wellness programs.  Can digital health foster that connection or drive more “techno-disconnection”?

Both.  What matters most is the quality and meaning of the interaction, not whether it’s digital or analog (in person).  Study after study have shown that people who are lonely, depressed, and isolated are three to ten times more likely to get sick and die prematurely compared to those who have a strong sense of love and community.  Intimacy is healing.  In our support groups, we create a safe environment in which people can let down their emotional defenses and communicate openly and authentically about what’s really going on in their lives without fear they’ll be rejected, abandoned, or betrayed.  The quality and meaning of this sense of community is often life-transforming.  It can be done digitally, but it’s more effective in person.  A digital hug is not quite as fulfilling, but it’s much better than being alone and feeling lonely.

3. How can we connect clinical validation to the current pop culture trends of “fitness gadgets”?

Awareness is the first step in healing.  In that context, information can raise awareness, but it’s only the first step.

 4. Can digital health help link mind and body wellness?

Yes.  Nicholas Christakis’ research found that if your friends are obese, your risk of obesity if 45% higher.  If your friends’ friends are obese, your risk of obesity if 25% higher.  If your friends’ friends’ friends are obese, your risk is 10% higher—even if you’ve never met them.  That’s how interconnected we are.  Their study also showed that social distance is more important than geographic distance.  Long distance is the next best thing to being there (and in some families, even better…).

5. Are there any particular area of medicine and wellness that might best fit in the context of digital health (diet, exercise, compliance, etc.)?

They all do.

6. There is much talk on the empowerment of the individual and the “democratization of data”.  From your perspective are patients becoming more engaged and involved in their care?

Patients are becoming more empowered in all areas of life, not just with their health care.  Having access to one’s clinical data can be useful, but even more empowering is access to tools and programs that enable people to use the experience of suffering as a catalyst and doorway for transforming their lives for the better.  That’s what our lifestyle program provides.

 7. Is digital health “sticking” in the medical community?  Or are advances being driven more by patients?

Electronic medical records are finally being embraced, in part due to financial incentives.  Also, telemedicine is about to take off, as it allows both health care professionals and patients to leverage their time and resources more efficiently and effectively.  But most doctors are not prescribing digital health devices for their patients.  Not yet.

 8. Do you personally use any devices?  Any success (or failure) stories?

I weigh myself every day, and I work out regularly using weight machines and a treadmill desk.  I feel overloaded by information much of the day, so I haven’t found devices such as FitBit, Nike Plus, and others to be useful.  These days, I find wisdom to be a more precious commodity than information.

 9. What are some of the exciting areas of digital health that you see on the horizon?

The capacity for intimacy using digital platforms is virtually unlimited, but, so far, we’ve only scratched the surface of what’s possible.  It’s a testimony to how primal our need is for love and intimacy that even the rather superficial intimacy of Facebook (or, before that, the chat rooms in AOL, or the lounges in Starbucks) created multi-billion-dollar businesses.

My wife, Anne, is a multidimensional genius who is developing ways of creating intimate and meaningful relationships using the interface of digital technologies and real-world healing environments.  She also designed our web site (www.ornish.com) and created and appears in the guided meditations there; Anne has a unique gift of making everyone and everything around her beautiful.

 10. Medicare is now covering Dr. Dean Ornish’s Program for Reversing Heart Disease as a branded program–a landmark event–and you recently formed a partnership with Healthways to train health care professionals, hospitals, and clinics nationwide.  Why now?

We’re creating a new paradigm of health care—Lifestyle Medicine—instead of sick care, based on lifestyle changes astreatment, not just as prevention.  Lifestyle changes often work better than drugs and surgery at a fraction of the cost—and the only side-effects are good ones.  Like an electric car or an iPhone, this is a disruptive innovation.  After 37 years of doing work in this area, this is the right idea at the right time.

The limitations of high-tech medicine are becoming clearer—e.g., angioplasty, stents, and bypass surgery don’t prolong life or prevent heart attacks in stable patient; only one out of 49 men treated for prostate cancer benefit from the treatment, and the other 48 often become impotent, incontinent or both; and drug treatments of type 2 diabetes don’t work nearly as well as lifestyle changes in preventing the horrible complications.

At the same time, the power of comprehensive lifestyle changes is becoming more well-documented.  In our studies, we proved, for the first time, that intensive lifestyle changes can reverse the progression of coronary heart disease and slow, stop, or reverse the progression of early-stage prostate cancer.  Also, we found that changing your lifestyle changes your genes—turning on hundreds of good genes that protect you while downregulating hundreds of genes that promote heart disease, cancer, and other chronic diseases.  Our most recent research found that these lifestyle changes may begin to reverse aging at a cellular level by lengthening our telomeres, the ends of our chromosomes that control how long we live.

Finally, Obamacare turns economic incentives on their ear, so it becomes economically sustainable for physicians to offer training in comprehensive lifestyle changes to their patients, especially now that CMS is providing Medicare reimbursement and insurance companies such as WellPoint are also doing so.  Ben Leedle, CEO of Healthways, is a visionary leader who has the experience, resources, and infrastructure for us to quickly scale our program to those who most need it.  Recently, we trained UCLA, The Cleveland Clinic, and the Beth Israel Medical Center in New York in our program, and many more are on the way.

 

complex adaptive systems, cool, meaning, musings, rapid learning health systems

Machines put half of US work at risk

Great tip from Michael Griffith on the back of last night’s dinner terrific conversation at the Nicholas Gruen organised feast at Hellenic Republic…

http://www.bloomberg.com/news/2014-03-12/your-job-taught-to-machines-puts-half-u-s-work-at-risk.html

Paper (PDF): The_Future_of_Employment

Your Job Taught to Machines Puts Half U.S. Work at Risk

By Aki Ito  Mar 12, 2014 3:01 PM ET
Photographer: Javier Pierini/Getty Images

Who needs an army of lawyers when you have a computer?

When Minneapolis attorney William Greene faced the task of combing through 1.3 million electronic documents in a recent case, he turned to a so-called smart computer program. Three associates selected relevant documents from a smaller sample, “teaching” their reasoning to the computer. The software’s algorithms then sorted the remaining material by importance.

“We were able to get the information we needed after reviewing only 2.3 percent of the documents,” said Greene, a Minneapolis-based partner at law firm Stinson Leonard Street LLP.

Full Coverage: Technology and the Economy

Artificial intelligence has arrived in the American workplace, spawning tools that replicate human judgments that were too complicated and subtle to distill into instructions for a computer. Algorithms that “learn” from past examples relieve engineers of the need to write out every command.

The advances, coupled with mobile robots wired with this intelligence, make it likely that occupations employing almost half of today’s U.S. workers, ranging from loan officers to cab drivers and real estate agents, become possible to automate in the next decade or two, according to a study done at the University of Oxford in the U.K.

Source: Aethon Inc. via Bloomberg

Aethon Inc.’s self-navigating TUG robot transports soiled linens, drugs and meals in…Read More

“These transitions have happened before,” said Carl Benedikt Frey, co-author of the study and a research fellow at the Oxford Martin Programme on the Impacts of Future Technology. “What’s different this time is that technological change is happening even faster, and it may affect a greater variety of jobs.”

Profound Imprint

It’s a transition on the heels of an information-technology revolution that’s already left a profound imprint on employment across the globe. For both physical andmental labor, computers and robots replaced tasks that could be specified in step-by-step instructions — jobs that involved routine responsibilities that were fully understood.

That eliminated work for typists, travel agents and a whole array of middle-class earners over a single generation.

Yet even increasingly powerful computers faced a mammoth obstacle: they could execute only what they’re explicitly told. It was a nightmare for engineers trying to anticipate every command necessary to get software to operate vehicles or accurately recognize speech. That kept many jobs in the exclusive province of human labor — until recently.

Oxford’s Frey is convinced of the broader reach of technology now because of advances in machine learning, a branch of artificial intelligence that has software “learn” how to make decisions by detecting patterns in those humans have made.

Source: Aethon Inc. via Bloomberg

Artificial intelligence has arrived in the American workplace, spawning tools that… Read More

702 Occupations

The approach has powered leapfrog improvements in making self-driving cars and voice search a reality in the past few years. To estimate the impact that will have on 702 U.S. occupations, Frey and colleague Michael Osborne applied some of their own machine learning.

They first looked at detailed descriptions for 70 of those jobs and classified them as either possible or impossible to computerize. Frey and Osborne then fed that data to an algorithm that analyzed what kind of jobs make themselves to automation and predicted probabilities for the remaining 632 professions.

The higher that percentage, the sooner computers and robots will be capable of stepping in for human workers. Occupations that employed about 47 percent of Americans in 2010 scored high enough to rank in the risky category, meaning they could be possible to automate “perhaps over the next decade or two,” their analysis, released in September, showed.

Safe Havens

“My initial reaction was, wow, can this really be accurate?” said Frey, who’s a Ph.D. economist. “Some of these occupations that used to be safe havens for human labor are disappearing one by one.”

Loan officers are among the most susceptible professions, at a 98 percent probability, according to Frey’s estimates. Inroads are already being made by Daric Inc., an online peer-to-peer lender partially funded by former Wells Fargo & Co. Chairman Richard Kovacevich. Begun in November, it doesn’t employ a single loan officer. It probably never will.

The startup’s weapon: an algorithm that not only learned what kind of person made for a safe borrower in the past, but is also constantly updating its understanding of who is creditworthy as more customers repay or default on their debt.

It’s this computerized “experience,” not a loan officer or a committee, that calls the shots, dictating which small businesses and individuals get financing and at what interest rate. It doesn’t need teams of analysts devising hypotheses and running calculations because the software does that on massive streams of data on its own.

Lower Rates

The result: An interest rate that’s typically 8.8 percentage points lower than from a credit card, according to Daric. “The algorithm is the loan officer,” said Greg Ryan, the 29-year-old chief executive officer of the Redwood City, California, company that consists of him and five programmers. “We don’t have overhead, and that means we can pass the savings on to our customers.”

Similar technology is transforming what is often the most expensive part of litigation, during which attorneys pore over e-mails, spreadsheets, social media posts and other records to build their arguments.

Each lawsuit was too nuanced for a standard set of sorting rules, and the string of keywords lawyers suggested before every case still missed too many smoking guns. The reading got so costly that many law firms farmed out the initial sorting to lower-paid contractors.

Training Software

The key to automate some of this was the old adage to show not tell — to have trained attorneys illustrate to the software the kind of documents that make for gold. Programs developed by companies such as San Francisco-based Recommind Inc. then run massive statistics to predict which files expensive lawyers shouldn’t waste their time reading. It took Greene’s team of lawyers 600 hours to get through the 1.3 million documents with the help of Recommind’s software. That task, assuming a speed of 100 documents per hour, could take 13,000 hours if humans had to read all of them.

“It doesn’t mean you need zero people, but it’s fewer people than you used to need,” said Daniel Martin Katz, a professor at Michigan State University’s College of Law in East Lansing who teaches legal analytics. “It’s definitely a transformation for getting people that first job while they’re trying to gain additional skills as lawyers.”

Robot Transporters

Smart software is transforming the world of manual labor as well, propelling improvements in autonomous cars that make it likely machines can replace taxi drivers and heavy truck drivers in the next two decades, according to Frey’s study.

One application already here: Aethon Inc.’s self-navigating TUG robots that transport soiled linens, drugs and meals in now more than 140 hospitals predominantly in the U.S. When Pittsburgh-based Aethon first installs its robots in new facilities, humans walk the machines around. It would have been impossible to have engineers pre-program all the necessary steps, according to Chief Executive Officer Aldo Zini.

“Every building we encounter is different,” said Zini. “It’s an infinite number” of potential contingencies and “you could never ahead of time try to program everything in. That would be a massive effort. We had to be able to adapt and learn as we go.”

Human-level Cognition

To be sure, employers won’t necessarily replace their staff with computers just because it becomes technically feasible to do so, Frey said. It could remain cheaper for some time to employ low-wage workers than invest in expensive robots. Consumers may prefer interacting with people than with self-service kiosks, while government regulators could choose to require human supervision of high-stakes decisions.

Even more, recent advances still don’t mean computers are nearing human-level cognition that would enable them to replicate most jobs. That’s at least “many decades” away, according to Andrew Ng, director of the Stanford Artificial Intelligence Laboratory near Palo Alto, California.

Machine-learning programs are best at specific routines with lots of data to train on and whose answers can be gleaned from the past. Try getting a computer to do something that’s unlike anything it’s seen before, and it just can’t improvise. Neither can machines come up with novel and creative solutions or learn from a couple examples the way people can, said Ng.

Employment Impact

“This stuff works best on fairly structured problems,” said Frank Levy, a professor emeritus at the Massachusetts Institute of Technology in Cambridge who has extensively researched technology’s impact on employment. “Where there’s more flexibility needed and you don’t have all the information in advance, it’s a problem.”

That means the positions of Greene and other senior attorneys, whose responsibilities range from synthesizing persuasive narratives to earning the trust of their clients, won’t disappear for some time. Less certain are prospects for those specializing in lower-paid legal work like document reading, or in jobs that involve other relatively repetitive tasks.

As more of the world gets digitized and the cost to store and process that information continues to decline, artificial intelligence will become even more pervasive in everyday life, says Stanford’s Ng.

“There will always be work for people who can synthesize information, think critically, and be flexible in how they act in different situations,” said Ng, also co-founder of online education provider Coursera Inc. Still, he said, “the jobs of yesterday won’t the same as the jobs of tomorrow.”

Workers will likely need to find vocations involving more cognitively complex tasks that machines can’t touch. Those positions also typically require more schooling, said Frey. “It’s a race between technology and education.”

To contact the reporter on this story: Aki Ito in San Francisco at aito16@bloomberg.net

To contact the editors responsible for this story: Chris Wellisz at cwellisz@bloomberg.net Gail DeGeorge, Mark Rohner

meaning, quantified self

Reflections on trackers…

It’s about healthy living, not quantifying oneself…

http://www.medgadget.com/2014/03/an-interview-with-the-monitored-man-albert-sun.html

An Interview with “The Monitored Man”: Albert Sun

Posted: 13 Mar 2014 12:04 PM PDT

Albert Sun, a young journalist at the New York Times, recently authored an article entitled “The Monitored Man” chronicling his experience using a multitude of health fitness trackers over the last few months. I wanted to ask him about his fitness tracking adventure and gain further insight into this booming sector from a “super user” who at times was simultaneously wearing up to four fitness tracking devices.

Tom Fowler, Medgadget: Albert, tell me about why you decided to put fitness tracking devices to the test.

Albert Sun An Interview with The Monitored Man: Albert SunAlbert Sun: I think it started with a really simple graphic that my colleague Alastair put together last year listing a few interesting wearable health monitors and what things they measured. For that he put together this google spreadsheet and we sort of tried to keep it up to date with all the different gadgets as we heard about them. I was constantly adding things to it and at a point felt that if I was having this much trouble keeping track of all of them that probably other people were as well. My original idea was actually to put them all to the test in accuracy and be able to chart which ones were the most accurate. I had plans to reverse engineer their drivers and access the raw data they were recording. But once I actually started wearing them I realized that, yes there was a lot of data, but it was actually this idea of motivation and behavior change and how you understand the data that was much more interesting.

 

Medgadget: You mentioned that many trackers were lacking in detecting exertion and activities like biking and fidgeting. Are the device makers missing the point, or are these merely due to current technical limitations?

Albert Sun: It’s definitely due to current technical limitations. If companies could make devices that could track everything perfectly, I think they absolutely would. And I think a lot of people see that kind of tracking as a kind of holy grail and are trying very hard to make it to that goal. I’m not so sure that’s a good idea. No tracker is going to be able to fully track everything about you and we’ve all already got a perfectly good “tracker” that’s wired in to every part of our body: our brain. My colleague Gretchen Reynolds writes about that in her article on why she decides to remain a “tech nudie.”

Yes an objective measure of your activity level is useful, but it’s just one view, and it has to be integrated into the broader subjective view of how you feel.

 

Medgadget: If every fitness tracking device producing company CEO was reading this interview, what tips would you like to give them?

Albert Sun: I think many of these CEO’s are already thinking about the things and experiences I wrote about. From talking to their users they know what experiences people are having and they’re definitely improving rapidly. Just in the time I’ve been using them they’ve improved a lot.

There are two things that I think they could do that would improve people’s experiences though. First is they could be a little more upfront in their marketing of these devices about what they can and can’t do instead of presenting them as magic.

The other thing that I think would be really helpful would be for them to put some error bars on the data they show and indicate that they are estimates and the true values lie somewhere in a range. I think that would go a long way towards helping people interpret their data in the proper context.

I might be sounding overly pessimistic about activity tracking, but I actually really like these devices and think they’re very cool and useful. But to be very cool and useful I think people have to approach them the right way and that means having realistic expectations of how they work. Otherwise people will be disappointed.

 

Medgadget: Would you say your conclusion “I don’t need a monitor anymore. I’m tracking me.” is a reflection of a large part of the market, in that many will initially use but then no longer have a need for trackers?

Albert Sun: Yes, absolutely. It’s maybe not a permanent thing, but it could be a now and again thing. I mean, are we really expecting people to start now and wear something that tracks their movement continually until they’re in the grave?

The goal here is to be healthier and happier — to live well — not to be perfectly quantified. Once an activity tracker has helped you do that it should ideally fade to the background to the point where you can almost forget about it. I obviously haven’t been able to do that while I’ve been working on this story, I’ve been juggling a lot of different gadgets and apps and chargers trying to keep everything straight. It’s quite taxing and it takes a toll on all the other things that life is about.

complex adaptive systems, cool, healthcare, meaning, policy, politics, quotes & aphorisms, rapid learning health systems, research methodology

A clear head shot from Jeffrey…

Not one stakeholder group left untrashed…

Great Einstein quote – the original definition of insanity presumably:

‘The significant problems we face cannot be solved at the same level of thinking we were at when we created them’

PDF: Braithwaite Delusions of health care JRSM 2014

The medical miracles delusion

Army ants subscribe to a simple rule: follow the ant
in front. If the group gets lost each ant tracks
another, eventually forming a circle. According to
crowd theorist James Surowiecki, one circle 400m
in circumference marched for two days until they
all died.1
Humans are not ants, but we often trudge together
along the same trail, neglecting to look around for
alternatives. Mass delusions involve large groups
holding false or exaggerated beliefs for sustained periods.
Humanity has a long, sorry list of these shadowthe-
leader epidemics of collective consciousness which
appear obviously wrong only in hindsight. Some last
for centuries: early alchemists intent on transmuting
base metals into gold and the Christian Crusades of
Europe’s middle ages, for example. Others have correlates
which resurface decades or centuries later:
McCarthy’s persecution of alleged communists in
the 1950s harked back to the Salem Witch hunts of
16th century America just as the 2008 Global
Financial Crisis had much in common with the
‘South Sea Bubble’ which slashed 17th century
Britain’s GDP.
In the educated 21st century, too, we blithely trust
in economic and political systems which are stripping
the earth’s resources, altering the climate and facilitating
wars. Are we then similarly mistaken, en masse,
about the capabilities of the health system?
Most of us believe in the miracles of modern medicine.
We like to think that the health system is
increasingly effective, that we are implementing
better treatments and cures with rapid diffusion of
new practices and pharmaceuticals and that there is
always another scientific or technological breakthrough
just around the corner promising to save
even more lives; all at an affordable price.
We maintain the faith despite multiple contraindications.
Modern health systems consistently deliver
at least 10% iatrogenic harm.2 Despite very large
investments and intermittent but important interventional
successes, such as checklists in theatres3 and
clinical bundles in ICU,4 there is no study showing
a step-change reduction in this rate, systems-wide.

Only half of care delivered is in line with guidelines,5
one-third is thought to be waste,6 and much is not
evidence-based,7 notwithstanding concerted efforts to
optimise that evidence and incorporate it into routine
practice.8
The reality is that progress is slowing, and medicine
seems to be reaching the limits of its capacities.
The potentially disastrous problems of antibiotic
resistance, for example, are yet to play out. This is
only one point among many. New technologies such
as the enormously expensive human genome project
have provided only marginal benefits to date. We still
do not have the answers to fundamental questions
about the causes of common diseases and how to
cure them. Many doctors are dissatisfied and increasingly
pessimistic.9,10 It must also be remembered that
although death is no longer seen as natural in the
modern era, everyone must die. Yet, we inflict most
of our medical ‘miracles’ on people during their last
six months of life. Le Fanu describes this levelling off
and now falling away of health care progress in The
Rise and Fall of Modern Medicine.11
Every major group of stakeholders has its own
specific delusion which acts to augment the metalevel
medical miracles delusion. Thus, the overarching
delusion is buttressed by a set of related ‘viruses
of the mind’, to borrow Richard Dawkins’ evocative
phrase.12
Although politicians think and act as if they are
running things, modern health systems are so complex
and encompass so many competing interests that no
one is actually in charge. Then, bureaucrats – acting
under their own brand of ‘groupthink’ – assume their
rules and pronouncements provide top-down stimulus
for medical progress and improved clinical performance
on the ground. Yet coalface clinicians are relatively
autonomous agents, so there can only ever be
modest policy trickle down.13,14
Researchers, too, support the medical miracles
industrial complex. The electronic database
PubMed holds some 23 million articles and is growing
rapidly. Every author hopes it will be his or her
results that will make a difference, yet there is far less

take up than imagined and comparatively little
investment in the science of implementation8 – translating
evidence into real life enhancements.
Nor are clinicians or the patients they serve
immune. While frontline clinicians strive to provide
good care, many myopically assume their practice is
above average; the so-called Dunning-Kruger
effect.15,16 Of course, statistically, half of all care clinicians
provide is below average. And notwithstanding
decades of public awareness, patients believe modern
medicine can repair them after decades of alcohol,
drugs, sedentary lives and dietary-excesses, despite
evidence to the contrary.
Meanwhile, the media’s unremitting propensity to
lend credibility to controversial views and to hone in
on ‘gee whiz’ breakthroughs – while ignoring the
incremental and the routine – fuels unrealistic expectations
of what modern medicine can deliver.
Throughout history, mass delusions have been
aligned with mass desires for favourable outcomes.
In the pursuit of medical miracles all of our interests
line up in a perfect circle. We seem more like army
ants than we think.
Just as the Global Financial Crisis was a wake-up
call for the serious consequences of blind fiscal faith
we must begin to manage our expectations of the
health system. Progress is always in jeopardy when
the real problems are obscured.
The challenge is to harness the tough-minded
scepticism needed to tackle this widely held ‘received
wisdom’. One realistic way forward is to encourage
stakeholders – politicians, policymakers, journalists,
researchers, clinicians, patients – to first consider
that their own and others’ perspectives are simply not
logically sustainable. This may be achieved through
genuine inter-group discourse about the health
system, where it is at, and its limitations.
As is so often the case, Albert Einstein said it best,
in a typically neat aphorism: ‘The significant problems
we face cannot be solved at the same level of
thinking we were at when we created them’.17 If we
can humbly accept that we need new perspectives
for healthcare – and radically different ways of
thinking – we will be better placed to free ourselves
from the hold of these peculiar viruses of the mind.