The Nintendo Wii and BMI

May 29, 2008

Nintendo Apologizes for Wii Fit BMI Offenses


– Backlash continues against the fitness game

By: Andrei Dumitrescu, Games Editor

Last week, we reported on the girl who was offended by the fact that the Wii Fit game considered her to be… a little above the recommended weight as it was constructed based on her other physical attributes. The story itself seems a bit on the fishy side but, nevertheless, the parents of other kids,

presumably overweight themselves, expressed outrage at the fact that a game would dare to imply that their kids were fat.

If you ask me, this is snowballing into something newsworthy just because it’s about the Wii Fit, which is a clear success as far as videogames go. The sole purpose of the game is to get people back into exercising and it’s only natural that it would make an evaluation of the Body Mass Index of the person so that it can recommend the best exercises. It’s absurd to ask from a game not to hurt someone’s feelings. It’s only numbers that the game shows and it’s up to you to draw the appropriate conclusions from them.

Nevertheless, Nintendo has released a statement in which it apologizes for any sensibilities hurt. The statement reads: “Nintendo would like to apologize to any customers offended by the in-game terminology used to classify a player’s current BMI status, as part of the BMI measurement system integrated into Wii Fit. Wii Fit is still capable of measuring the BMI for people aged between two and 20 but the resulting figures may not be entirely accurate for younger age groups due to varying levels of development”.

Despite this, the backlash against Nintendo and its Body Mass Index continues. Tam Fry, who represents the United Kingdom’s National Obesity Forum, stated that “I’m absolute aghast that children are being told they are fat. BMI is far from perfect, but with children it simply should not be used. A child’s BMI can change every month and it is perfectly possible for a child to be stocky, yet still very fit”.

Nintendo has announced that it does not plan to change the way the game displays BMI, since it is clear in the fact that it does not judge anyone, but only offers accurate data on the fitness level of the player.


Google Health

May 29, 2008

Article at the Hastings Center’s Bioethics Forum:

Thursday, May 22, 2008
Google Health: Organizing Your Medical Information


The press and blogs have been talking about it for a while, but on May 19, Google finally launched Google Health, a service that allows those who sign up for it to create their own personal electronic medical record system. Users will be able to enter their health information, manage it, and access it anywhere they


Personal electronic health records: MySpace or HealthSpace? (BMJ

May 13, 2008

BMJ, doi:10.1136/bmj.39567.550301.80 (published 6 May 2008)

The NHS, through Connecting for Health, is introducing two types of online health record for everybody in England—the summary care record and HealthSpace.1 2 The summary care record is being introduced in five “early adopter” pilot sites. An independent evaluation of this implementation was released this week.3 Delays in deployment, with summary care records in only two sites to date, mean that the evaluation cannot provide the concrete answers that many people were hoping to see regarding consent, patient acceptance, and clinical benefits.

The summary care record is a centrally stored summary of health information created initially from general practitioner records. It contains information on current medications, adverse reactions, and allergies. Proponents of the summary care record expect to see improved patient safety, with reductions in preventable errors, improved access to vital information, and better informed patients.1

HealthSpace is a separate initiative that allows patients to record selected data in their . . . [Full text of this article]


Tim Berners Lee on the Medicalization of Cyberspace

March 17, 2008

Well, more or less. He recently invoked an example of concern about online surveillence:


Sir Tim said he did not want his ISP to track which websites he visited.

“I want to know if I look up a whole lot of books about some form of cancer that that’s not going to get to my insurance company and I’m going to find my insurance premium is going to go up by 5% because they’ve figured I’m looking at those books,” he said.

This speaks to Chapters 4 and 7 in our book!.


Medicine 2.0 (un)conference (Toronto, 2008, Sept 4-5)

March 5, 2008

Medicine 2.0 (un)conference – How Social Networking and Web 2.0 Changes
Health, Health Care, and Biomedical Research

Toronto/Canada, MaRS Discovery District, Sept 4-5th

(to blog about this event use banners provided at

Medicine 2.0 (http://www.medicine20congress.com/) is an international
conference on Web 2.0 applications in health and medicine, organized and
co-sponsored by the Journal of Medical Internet Research, the International
Medical Informatics Association, the Centre for Global eHealth Innovation,
CHIRAD, and a number of other sponsoring organizations. It takes place at
the MaRS Discovery District in Toronto/Canada, Sept 4th-5th, 2008.

Pre-register now to get on our mailing list:

Conference Abstract / Panel Proposal Submission Deadline: May 2nd, 2008
Abstract Decisions emailed to Presenters: June 16th, 2008
Early Bird Registration Deadline & Speaker Registration Deadline: June
30th, 2008
Hotel Reservation Deadline: July 25th, 2008
Medicine 2.0 Conference: September 4-5th, 2008

(see http://www.medicine20congress.com/ocs/callforpapers.php)

The Medicine 2.0 Congress on Sept 4-5th in Toronto is now accepting
abstracts, speaker and panel proposals.

The conference invites academic and international contributions, and also
covers areas such as social networking for consumers and health
professionals, Science 2.0, Peer-Review 2.0, and others.

The conference will be accompanied by a JMIR Theme Issue on Medicine 2.0,
containing invited and contributed full papers (selected abstract/panel
presenters may be invited to submit a full paper).

Medicine 2.0 will contain a mix of traditional academic/research, practice
and business presentations, keynote presentations, and panel discussions to
discuss emerging issues. We strive for an interdisciplinary mix of
presenters from different disciplines (e.g. health care, social sciences,
computer sciences, engineering, business) and with a different angle
(research, practice, and business).
Participants are invited to either submit a 500 word abstract to propose a
15 minute single-presenter talk, or can submit a a 500 word panel proposal
to present or discuss a topic in a 45-60 min session with 3-4 colleagues
from other organizations/institutions (panel proposals with all authors
from the same institution are discouraged). Panel presentations are the
preferred format for non-research presentations.

Possible Topics
• Blogs

• Building virtual communities and social networking applications for
health professionals

• Building virtual communities and social networking applications for
patients and consumers

• Business models in a Web 2.0 environment

• Collaborative biomedical research, academic / scholarly communication,
publishing and peer review

• Consumer empowerment, patient-physician relationship, and
sociotechnical issues

• Ethical & legal issues, confidentiality and privacy

• Health information on the web: Supply and Demand

• Innovative RSS/XML applications

• Personal health records and Patient portals

• Public (e-)health, population health technologies, surveillance

• Search, Collaborative Filtering and Recommender Technologies

• Semantic Web (“Web 3.0”) applications

• The nature and dynamics of social networks in health

• Usability and human factors on the web

• Virtual (3D) environments, Second Life

• Web 2.0 approaches for behaviour change, public health and

• Web 2.0 approaches for clinical practice, clinical research, quality

• Web2.0-based medical education and learning

• Wikis

• Youth and Digital Learning

• other

General Submission Instructions

Note that all abstracts and panel proposals must be submitted on this site
(http://www.medicine20congress.com/ocs/submit.php) only. Submissions by
email will be ignored.
After submission you can edit or change your abstract by returning to the
conference site at http://www.medicine20congress.com/ocs/submit.php before
the abstract submission deadline.

Note that before you can submit you have to pre-register! You will need to
enter your preregistration username and password when you submit you paper.
If you have already preregistered and you forgot your password, go to help.

Please also note that for all submissions you will be asked to nominate two
peer-reviewers (who should not be working with you or have any other
conflicts of interests). In order to identify peer-reviewers, go to
pubmed.gov, search for published articles that are in the broadest sense
similar to your abstract/proposal, and make a note of the name and email
address of the corresponding author. You will need the email address, which
is listed in some (but not all) publications in PubMed (affiliation field).
If you have a name/affiliation but not an email address, you may try to
Google it.

Policy on simultaneous or previous publications/other conferences. Results
presented at the Medicine 2.0 congress should preferably be new results,
but overlaps with prior publications or prior/simultaneous submissions to
other conferences is not a problem.

The conference language is English. No simultaneous translation will be
provided. All abstracts and proposals must be submitted in English.

For all tracks and presentation formats
Do not use any HTML or attempt to hyperlink to websites.
References. You can cite up to 5 bibliographic or webreferences (note that
cited URLs are treated as reference). The in-text citation must be a number
in square brackets like this [1]. IMPORTANT: Cited webpages (URLs) which are
not journal articles must be archived with WebCite [2].
The References section at the end of the abstract should start with the
word “References”, followed by a line break, and a numbered (1. , 2., …)
list of references in JMIR format (but you do not have to include Medline
links or DOIs, as specified in these instructions). Put each reference on a
new line. See the following example:

1. JMIR Instructions for Authors.
WebCite: http://www.webcitation.org/query?id=95905 [cached 29.12.2005)
2. Eysenbach G, Trudel M. Going, Going, Still There: Using the WebCite
Service to Permanently Archive Cited Web Pages. J Med Internet Res
2005;7(5):e60 [URL: http://www.jmir.org/2005/5/e60/%5D

On submission, authors can select one of the following presentation

• Oral presentation only
• Oral or poster presentation (let organizers decide)
• Poster presentation

Call for Panel Proposals
Submit panel proposals at http://www.medicine20congress.com/ocs/submit.php
(select “single paper presentation”).
Panels are 45-60 min presentations or debate sessions of a group of leaders
in a field discussing a broad issue of general interest from various
perspectives. Panels are the preferred format for non-research
presentations. If you have an idea for a panel topic, please approach 3-4
colleagues from other organizations/institutions/companies and make sure
that all potential speakers are available (please also ask your fellow
panelists to preregister). Then draft a short panel proposal, and submit

Panel titles should preferably have the word “panel” in the title, e.g.
“PHR 2.0 Panel”, “Accelerating Research with Web 2.0 Panel”, “Consumer
Empowerment Panel”, “Venture Capitalists and Entrepreneurs Panel”, etc.
Please note that normally we will not be able to cover the registration
fee, travel and accommodation for any of the panelists.
A complete panel proposal should be submitted as “single paper submission”.
Each panelist should be added as presenting coauthors (add an asterisk in
front of each name to indicate that they are presenting). The abstract
should contain up to 500 words, containing a short overview of the common
issues and 1-2 sentences per presenter about the contribution of each
Please note that research abstracts are better suited to be submitted in
the research track as “single abstract/paper submission”, not as panel
contribution. We will not accept panels consisting of coauthors or
collaborators of a single research project. Each panelists must come from
different organizations. Panel topics should be broad and appeal to a wide

Call for Single-Presenter Abstracts

Submit abstracts at http://www.medicine20congress.com/ocs/submit.php to
propose a single-presenter 15 min talk.
All abstracts have a word limit of 500 words, plus up to 5 references.
Abstracts will have to be pasted into an online abstract form and should
NOT contain any special formatting (bold, italics), special characters (eg.
Greek characters), tables, or figures. DO NOT USE ALL-CAPS FOR THE TITLE OR
ANY PART OF THE ABSTRACT. The Title Should be in “Title Case”, Meaning That
All Words Except Articles and Prepositions Should Be Capitalized Like in
This Sentence.

Abstracts are invited in 3 tracks: research, practice, and business.

Abstracts in the research track have higher acceptance standards and must
be structured into Background, Objective, Methods, Results, and
Conclusions, and References. Each section (except References) should start
with the respective heading in the same line (e.g. “Background: The
Internet has become…”), with a new section starting on a new line. DO NOT
“Background:”). In the results section, make sure to include relevant
statistics, such as sample sizes, response rates, P-values or Confidence

References (citing previous and related work) are good scholarly tradition
and mandatory for Research abstracts. Submissions in the research track
which do not cite references may be rejected or moved to the practice
track. See below on how references should be cited.

Interested in sponsoring this event?
Please contact us by filling in the
Journal of Medical Internet Research – The leading peer-reviewed ehealth
journal – Open Access – Fast Review – High Impact – http://www.jmir.org


Pro-Ana on Facebook

February 26, 2008

A news story broke this week that there is a clinic in Cheadle, UK, campaigning to get the pro-ana (Pro-Anorexia) groups out of Facebook. It feels like 2001 all over again. Check out the Sky News story along with some of our quotes for journos below and then take our poll below:

Should Facebook remove Pro-Ana groups?

1) Yes
2) No
3) This is the wrong question
4) Let’s ask the users
5) Phone a friend

View Results

Make your own poll

We have a few chapters on this subject in our new book, The Medicalization of Cyberspace (Feb, 2008) and Emma Rich has been focusing her recent years on these aspects of eating disorders and new media.

Our quotes for journalists:

“While we have no wish to promote eating disorders, we must be cautious not to respond to pro-ana sites as wholly dangerous. Calling for the removal of pro-ana spaces from Facebook will only obscure such communities even further.

As things stand, anyone can join these groups and the identities of users is much clearer than it is for other web spaces. So, if medics are concerned about the users within these communities, they stand a much better chance of offering support than they will by these groups existing in a lower profile webspace.

Rather than remove of these sites, we should be concerned more with the relationship between healthcare professionals and users of such environments. They offer spaces for intervention and support, which allow the concomitant avoidance of the traditional models of monitoring and regulation.

“It would be naïve to assume that people, especially young women, can be swayed into anorexia through social networking sites like facebook. All this does is further pathologise those experiencing the condition. If nothing else, these sites emerge from the desperate need for understanding and social support that these people seek. The content of these pro-ana networks varies greatly, in many instances one can find support from others experiencing an eating disorder.

We should also remember that these same arguments for their removal were used in 2001, when Google was urged to remove Pro-Ana sites from its search engine. What difference did it make, other than ensure that these communities were now out of our view? The users of these environments are far more capable of finding other spaces than regulators are at shutting them down.

Eating disorders are incredibly complex, damaging and isolating conditions, but often remain grossly unreported by those experiencing it. Many of the pro-ana users may not have sought help or reported their condition and facebook may be the only context in which they might be exposed to possible support. .

These spaces are also often the only context in which sufferers will talk about so openly about their experiences. There are few, other social spaces in their everyday lives where people experiencing anorexia can do this, without some form of censorship. Pro-ana sites may therefore offer us a greater insight in terms of helping us to better understand the condition. Anorexia is after all, experienced not simply as an illness, but as an identity, in this sense it is not surprising that communities are formed around it.

The sharing of stories through such environments is an integral part of the condition and so to call for a removal is simplistic and, potentially, more dangerous than their existence. The other point is about whether organizations like Facebook should be empowered to decide what goes on within its space and this level of censorship control extends their role considerably and makes them vulnerable to any high profile media campaign, which has been launched in this case.”

The New story from Sky
Social Sites Push Pro-Ana Beliefs

Site users seek starving advice

Site users seek starving advice

There is nothing new about so-called pro-ana websites that offer ‘thinspiration’ and suggest ways of hiding your problem from friends and family, but the advent of sites like Facebook has allowed groups to be set up very quickly and easily.

On one Facebook group, a user asks: “How can I convince myself not to be hungry?! I want to be thinner, a lot thinner!!”

On the discussion wall of another a member is looking for a ‘thin pal’.

“Anyone up for being weight loss penpals, sharing tips, that sort of thing?” she writes.

But this is not about a pound here or there. It is about fasting, starving, disappearing.


Internet gene tests provoke alarm

February 11, 2008

Story from Robin McKie in the Guardian last week…
Internet gene tests provoke alarm


Biotechnology checks for bipolar depression and schizophrenia will soon be sold over the web, despite warnings from leading psychologists

This article appeared in the Observer on Sunday February 03 2008 on p15 of the News section. It was last updated at 00:08 on February 03 2008.

Plans to sell genetic tests over the internet so people can find out if they are at risk of developing mental illnesses have been denounced by leading UK psychiatrists. They say the technology is still primitive and is only likely to worsen individuals’ emotional and mental problems.

The tests, which biotechnology companies will begin selling in a few months, will allow people to find out, by sending off a spittle sample, if they possess gene variants that increase their chances of suffering bipolar depression or schizophrenia. The information will help both patients and doctors, it is claimed.

But scientists argue that selling these tests on the internet is dangerous. The technology is still in its infancy and cannot yet help make helpful diagnoses.

‘These tests will only worry, confuse and mislead the public and patients,’ said psychiatrist Professor Nick Craddock, of Cardiff University. ‘There is a long way to go before we have genetic tests that may be helpful to patients. Using tests at the moment is only likely to cause harm.’

This point was backed by Professor David Collier, of the Institute of Psychiatry, London. ‘At best, these tests are clinically useless. At worst, their results could cause serious worries for patients.’

The tests are based on recent discoveries of gene variants that can increase a person’s chance of succumbing to depression or schizophrenia. Each variant raises a person’s risks by only a slight margin but if tests for several variants are combined, this creates a useful risk assessment for an individual, firms say.

As a result, several – including NeuroMark in Colorado, Psynomics in California, and SureGene in Kentucky – have developed tests based on these variants and are preparing to sell them for several hundred pounds a test on the internet.

For example, Psynomics has developed a test for pinpointing individuals at risk of depression. ‘This is going to be initially driven by patients,’ John Kelsoe, chief executive, told Science magazine last week.

But the usefulness of such tests was disputed by Dr Cathryn Lewis, also of the Institute of Psychiatry. ‘The general risk of developing bipolar depression is around one per cent. If you possess the worst set of gene variants, then your risk rises to three per cent. That means you are three times more likely than average to get bipolar depression. That may seem worrying but it is still a very low risk. It is still 97 per cent likely that you won’t get depression. People are not likely to realise that, however.’

Another test – to be marketed by NeuroMark, first in the US and later this year in Europe – is based on genes that predispose people to react badly to stress. If a person inherits this gene section from both parents, he or she has an increased chance of suffering from severe depression after stressful situations. ‘About 20 per cent of people have this combination,’ said Kim Bechthold, chief executive of the biotechnology company. ‘It is useful information to know.’

But if a person proves positive, what action can they take to avoid risk and counter the risk they face? ‘We suggest joining a choir, eating chocolate or buying a puppy,’ said Bechthold.

These ideas were dismissed by Craddock. ‘Life is stressful. You cannot avoid it. It is extremely unhelpful to tell people that they face a risk like that.’

In addition, scientists have found only a small number of risk gene variants for psychiatric disorders. Many more await detection, it is thought. ‘The trouble is that if someone takes a test which suggests they face no risk, they could easily think they can then do what they want,’ added Craddock. ‘They might start taking recreational drugs again, which would pose problems if they are prone to depression. Other risk gene variants might later be discovered and new tests developed. Then we will find these people actually have an inherent proneness to depression after all. It will be too late by then, however.'”