12 Burst results for "Dr Linden"
"dr linden" Discussed on John Bartolo Show
"And there's two more in the pipeline. You know i i. I got sponsors. I just got a Email today. I gotta read it about a tequila company. That wants to be the brand ambassador. So i just read that. I'm working with a cb company got to tell you about this. Because i think it's it's volume two cd in it. But they j him contacted me. You've got to companies. Contact me all the time and i always ask them to. Question is which approves source so jake j. Tim says that they created a cream for cuts for the healing process. And they contacted me. And i asked what what proves source do. You have well. That's why we contacted you right so ours aright well look i work the bare knuckle fights and let's go you take your stuff. And they saw him up in the dressing because they all get cut five percent of them get cut so they saw him up in the dressing room. Jay will give them the cream. Take a picture of And a week later they respond back with a picture and the results have been tremendous ahead like stem cell and cbd and vitamin e. and collagen so So it's the stitch premium cut And it's made at the cbd in it Dot com. And so i. I'm using that now. Like pf. L. that professional league rates and all that they bought some for their fighters song gonna talk to of course the bare knuckle. Everybody should have that for their fighters just for the the healing process. I i gotta tell you dr linden over a ufc. She swears by the cd. it's I think the cbd and we'd thing is stupid. i think it should be legalized. i know. cpa's but i think it should all be legalize. It doesn't make any sense to me. I i don't get it. Because i understand the recovery properties. Of course you know. Nature's is at its finest You know you can't knock. Nature has been here a lot longer us. You know it's so true. Talking about cameras cannabis now. Here's i was thinking. Here's how i could find out whether i should do this or not. And we'll do it on the john bartolo show so i got contacted by a cannabis company right and they wanna do.
"dr linden" Discussed on Chicago Tonight
"Dangers. Variant continue to merge is now the most common variant an american here and unvaccinated. People are incredibly vulnerable. This is a serious concern with what experts called. The delta vary in here now to help us understand the delta variant. Is dr emily landon executive medical director for infection prevention and control at you chicago medicine. Welcome back dr linden so we know that. This delta variant exploding globally isn't just infecting people who are unvaccinated or is it breaking through the vaccine will anyone who's been vaccinated could still got a mild case of covid wild type alpha variant delta variant doesn't matter about five percent of the time people are catching covid when it comes to the battery and even nate individuals maybe up to twelve percent of the time a mild case but the good news is the vaccine is preventing most of those cases and it is certainly keeping those people out of the hospital so as covid nineteen mutates. How does that. Impact infection rates and hospitalizations. Well it certainly at this particular. Variant is pretty nasty. It's extremely contagious. And the jury is still a bit out as to whether or not it causes more severe disease in younger people that said it is able to sort of spread through unvaccinated communities much much better than the old grown virus was spreading and so these things that people if you're unvaccinated. The things that you were doing before to help protect you from covid would probably be enough needed to take additional precaution. Masking all the time staying out of crowds staying home. And if you're not doing that than it looks like you're gonna find yourself homemade and you might end up hospitalized. But a large proportion of individuals with long term symptoms and long so there are a lot of concerns out there to do this marriage now the delta covert nineteen variants symptoms. They differ slightly from the original virus. Symptoms include stomach pain loss of appetite nausea and vomiting joint pain and hearing. Loss dr landon. Why so different. Well these are symptoms that we actually saw in a minority of cases of code from the very beginning and in fact the younger individuals are more likely to have these unusual symptoms or less common symptoms the gi tract have nausea vomiting and diarrhea has been with us a long and then they hearing loss actually kind of similar to the loss of smell very sensitive nerve solve when we know that it has a way of dealing with that so this is not terribly surprising to me and since younger people are actually getting this variant because most older people and most people at high risk have already been vaccinated so the only people available to delta variant spread around or younger people. Not surprising that we're seeing sort of send a more broad presentation of symptoms and so you really have to think any sort of illness that you might come down with you. Need to get tested proven vaccine. Now we know that israel has reinstated the mask requirement there. The united kingdom is under lockdown. Could either be reinstated back in the united states. Well i think in the united states it is not very popular to have lockdowns and they are damaging for the economy. Now that said i think masking endorsed spaces is something that we may need to go back to in the future. I think anyone who throws out. All of their masks at this point is being overly optimistic. Certainly the world health organization came out with a recommendation this weekend saying that individuals were fully vaccinated. May need to wear indoors in order to help. Keep the spread of delta virus in the delta variant and check. I'm especially because vaccines don't work quite as well. Although i really think the main issue the unvaccinated now the variant itself has already mutated into a new strain called delta. Plus we'll vaccine booster shots. Be able to keep up with these mutations. Well it depends on how many people get vaccine so the faster we get vaccinated. The fewer people are going to have cuban the less mutations we're going to see and that's not just for the united states it's everywhere we really need to get vaccines out to every single country. We need to step it up. Entry it the same way that we treated in the beginning of the vaccine roll out here in the united states and there are still a lot of americans who have skipped their second. Joe's that i chose is not going to enough to protect you from this various really mean doses and if you haven't been vaccinated yet the current plans are basically beauty. Either get covid or get the vaccine. I would choose the vaccine. And i think the faster we can all adopt that then the less likely we are to need to many new versions of the vaccines combat. Lots and lots of variants and as covid. Nineteen mutates the mutations mutate. What does that mean for people who are immunocompromised about that is compromise like other people and i am sort of in a middle category of of a level of a sort of compromise status. You really need to talk to. Your doctor is data coming in fast and furious that have more and more details about who's really not responding to the shot. He's responding pretty well and what sorts of precaution that you need to take so definitely reach out to your doctor. Whoever's managing your ns oppressed condition and make sure you get good advice about how to proceed based on the newest data and keep checking back to keep in. Mind as always. Dr emily landon. Thanks so much for joining us up next a visit to a photo exhibit that honors women blues legends across the country. Stay with us.
"dr linden" Discussed on Dishing Up Nutrition
"Yeah i've tried that too based and now it tastes a lot like the bio side and just not as strong. Yeah that's got a really lovely lovely flavor. Okay feel very clean. This feel very perfect. You heard it folks the one and only theresa so yeah well great. Because i had never tried it before so. I'm glad you had some experience with that so before we went to break. We're starting to dive into the sugar story. And how dr lynn was saying. You know dentist over the years. They know to talk to their patients. About reducing shuker but oftentimes. You know it's hard as we know is dieticians. It's hard for people to practise that day in and day out and many people who say they don't eat a lot of sugar actually consume far more than they really think so. Dr linden goes on to say the connection between tooth decay. Sugar and bacteria has been established in the scientific literature for a long time and yet the occurrence of twos decay does little to dampen our sugar addiction. Nearly everyone knows that sugar as so many people cannot stay away from it. Sugar is one of the most consumed products on the planet to address that point. Dr lynn wrote quote. One hundred seventy million tonnes of sugar is produced each year. Sugar is cheap. tasty and addictive. Most people cannot get enough of it. Which is why seventy. Four percent of packaged foods contains added sugar and quote. He went on to say that it is also why one of our biggest health challenges is to lose. Loosen the vice like grip on. Perhaps sugar has on our lives. That is the reason why we talk about the harmful effects of sugar on nearly every dishing up nutrition radio show and podcast Yeah so we all have to be on the same page with this method because like you just said it's it is a vice-like grip that is so hard to break for so people and went dr. Lynn wrote about how and what to feed kids for good dental health. He says and this is what i think. The most important points in his book is have kids. Eat food that requires chewing. So we'll explain that in just a second. He recommends to eat meat and veggies and also nuts. You know if you're if you're kit is of age to have nuts which is i think it's after four four years old you can start giving kids like whole nuts and stuff so contrast that to the soft easy to foods like goldfish mac and cheese or peanut butter and jelly sandwiches and also we pay attention to what our kids.
"dr linden" Discussed on The Carlat Psychiatry Podcast
"Reminds me of critical incident. Debriefing this therapy was developed to help. People who recently went through a traumatic event like burns car accidents like in the study you just quoted. They would talk about the trauma in this day briefing session. The problem is that in studies. The people who get this. Debriefing had more ptsd and anxiety when they were followed up down the road yes. This doesn't mean that. Debriefing is bad. Therapy it just has this negative side effect in people who were recently. Traumatized focusing on the trauma at that point only causes the memory to set in deeper but a few months later and someone with real. Ptsd it's a different story. And that's when careful exposure to the traumatic memory can be curative. What people need in the immediate aftermath of a trauma is support and help getting back into their lives community housing food necessities and reassurance stuff like that another place was psychotherapy. Ken backfire is in psycho. Education taught to linden found that out in a study he conducted that compared to forms of b. t. one was conducted as regular. Cbt therapy with a therapist and patient in the other therapists was encouraged to add written educational materials into the therapy. It was a large study of three hundred seventy seven patients in a hospital unit berries disorders mainly depression and anxiety. After five to six weeks the ones who got the additional written materials were more knowledgeable about their health but list satisfied with therapy and had worse outcomes on mini psychological measures. They had poor self esteem. Wellbeing family relationships. There'd be thought that the could support a patient education by giving the leaflets stood patients where he can read it and the therapist has been more climb for friedman. Crossing the result was basis of rent. What begin gave the bengals to the therapist and wanted explanations it even less come to the point get treatment and also. The patient had so much information was insecure. The end informed them. You give me information information intonation and in the end Overkill and the patient is irritated even more than before. These was standard. Cbt materials about scheme is cognition and coping skills over written at a level of an easy to read newspaper. The idea was that these leaflets would support the therapy and allow more time for other discussions in session but had the opposite effect. Patients read the materials and then spent the session asking questions about what they read. Instead of doing the treatment it was more information than the patients could absorb in. It ended up making them feel overwhelmed and insecure and we'll close with one more example of psychotherapy side effects particularly important one in the two thousand and one study from edinburgh scotland. They tested whether a video education program could help people with schizophrenia. There are one hundred and fourteen patients and half a randomized to watch. This video about schizophrenia. Has left the hospital when the followed up a few months later the ones who sold the video with four times more likely to have suicidal thoughts. That's a profound result. But it doesn't mean that you shouldn't teach people with schizophrenia. About their condition. It just means that it has to be done carefully and with a human touch in other studies. Suicide -ality actually goes down in schizophrenia. When the same type of psycho education is delivered as part of a therapy program that teaches skills to cope with the illness rather than through an impersonal video. It's good to know that there can't be side. Effects is better when you know which specific side effects can occur miss which technique for example exposure treatment every therapist should be aware that exposure treatment can result in anxiety learning so he has to monitor that and maybe intervene every third his should know that psycho education can result in terrible misunderstandings. The have to check what the patient has on the stove. So there is a scientific guide. The treatment side effects are negative effects of good treatment. And now for the word of the day cutie until one of the most important measurements solo electrocardiogram or ec. Gene is the distance between the start of the q wave and the end of the t wave the q t interval. It represents the time that it takes for the ventricles of the heart diplo rise and re polarize or to contract and relax. The qt interval is longer when the heart rate is and shorter when the heart rate is faster. So you'll usually see corrected for the heart rate. In which case it's called a t c. c. For corrected along q t interval can cause a potentially fatal ventricular arrhythmia called torsos deployment. Many psychiatric medications can prolong the q t including antidepressants anti psychotics and stimulants. But a lot of other medications prolong it as well so can electrolyte disturbances including those caused by bulimia and anorexia. A long queue t can also be hereditary. Some patients are just born with it. Although that's very rare all of these risk factors can stack up in an additive way. So a psych med. That prolongs the q t just a little could be the straw that broke the camel's back if there are enough other risk factors going on in the background so how long is too long any q ti above four fifty is long anything above five hundred milliseconds is potentially dangerous and probably worthy of medical or cardiology console. Join us next week for a really special child. Psychiatry addition to the podcast. You can read the full interview with dr linden which includes a table of common psychotherapy side effects at the car. Report dot com where we have a special offer for podcast listeners. You can get thirty dollars off your first year subscription with the promo code. Podcast subscriptions include. Sammy credits so long on a knockout a dozen before twenty. Twenty s over an wall though celebrate thanksgiving. We wish it was siphon happy one..
"dr linden" Discussed on The Carlat Psychiatry Podcast
"So we need to think of anxiety as a side effect rather than a good part of the therapy. But how does that change things. You're just calling it by a different name in practice. It shifts us more toward the patient's experience because it forces us to recognize aspects of therapy that are negative for the patient so in that way. It's more compassionate like i've said as professionals. We tend to venerate some of these side effects. Imbuing them with hidden therapeutic mechanisms as though they are necessary for recovery but patients don't see it that way and we also tend to be blind problems were causing in our patients whether a primary care physician or a psychotherapist. It's easier to see the good. You're doing than the harm. So dr linens idea here is that we need to intentionally watch for side effects in psychotherapy and even engage the patient in looking out for them. He believes in informed consent in warning patients that they may experience negative effects during therapy in that way. He's helping them to make rational decisions about their treatment which is ultimately what they need to do in their life. Few of the choices. We have available to us in life or perfect. They do some good. They do some harm and we try to follow the path that works best on balance why should psychotherapy be any different. So i'm guessing linden wouldn't agree with the idea that everyone should be in psychotherapy. He at least want them to consider the risks and the benefits one thing. He said that it's changed. My practice is that even the act of gathering a history has side effects. Let's start at the beginning. You'd see a psychotherapist. The first thing is he'll start fifty an nieces soviets the history and then he starts asking you how you feel about your mother and your father and your spouse and sewing so force and just because talking about all negative events featuring appearance in your life this may already start to have negative impact on you because you get the feeling. Your life has been possibly a whole mess. I think of a few patients. I've seen who literally refused to let me take psychiatric history. They weren't paranoid they just didn't want to talk about the past the depressions and psychiatric hospitalizations. It was all too painful to talk about and from my point of view is a doctor. I thought this was irrational. How can i help them without taking a history but after talking with dr linden is more compassionately. Essentially these patients were telling me. Yes i know. Your treatment can help and taking a history as part of that treatment but it causes side effects. That i don't want to experience right now and i need to be in charge of my own experience. Said did you get that history not entirely. I had to piece it together. You know over time talking to the family and gathering records but the patient never went through it with me. And i've come to appreciate their honesty as well. A lot of patients aren't assertive enough to tell us that they don't wanna go through their history so instead they give us a history that's vague and inaccurate and we may end up believing that they've never had a suicide attempt or a manic episode when they have these patients were at least a learning to fact that there was something big in their psychiatric history.
"dr linden" Discussed on The Carlat Psychiatry Podcast
"I was excited to see that. The carl report shows psychotherapy this month. Focus but i have to say a found this interview on psychotherapy side effects rather challenging. Also one thing that patients struggle with in psychotherapy is that they avoid pain so when i practice psychotherapy. I'm often trying to get them to move towards that pain instead of away from it could be an exposure therapies like when i work with trauma phobias with depression. Depressed patients will often stay in bed and avoid doing anything because it makes them uncomfortable or anxious. So the way i see it. Psychotherapy is difficult and it ought to be difficult. Because that's what makes it work. So why is delta. Linden calling that a side effect. You're not alone in that kelly. Judging from the reader feedback a lot of people were challenged by dr linden's ideas. Here's what i think is going on. We have a bias in our field about psychotherapy and perhaps about life. And dr linden is coming at this work without that particular bias. Which is unsettling the biased. Goes something like what you just said. It's the idea that the only way to grow in life is through difficulty. And it's embedded in a lot of our idioms like no pain no gain every rose has its thorn. What doesn't kill you makes you stronger. And it even comes from our own empirical research like about years ago. There was a study finding that people can the most gains in psychotherapy when they went through difficulties in the therapeutic relationship and then worked it out in the therapy so delta linda leaves. You don't need to suffer to get better. Well he's a realist. And he sees side effects as somewhat inevitable third inevitable consequence of psychotherapy in fact of any medical treatment. Dr linden is just trying to call it what it is because for many years we've been glorifying them as the royal road to recovery in other fields of medicine. We don't do that when patients have memory loss on. Abc t. we don't say this is part of the cure. You need to forget the pain. That's been making you depressed. I have heard saidan. Psychopharmacology like with mood stabilisers. Some doctors warn patients that they may feel flood dull on the mood stabiliser but that this is an inevitable part of treating the extreme highs of mania or with sri's sometimes patients feel emotionally numb on them. Daughter will tell them. This is because the alternative is to fill anxious and overly reactive yet. I guess you're right. We do say that sometimes. And perhaps we shouldn't. I think what's happened here is that we've been so busy trying to get patients to stick with treatment whether it's psychotherapy or medication that we've created this mythology around the negative aspects of treatment. The side affects as though they were an inevitable. Sometimes necessary for the cure but really we can treat anxiety neurosis without causing apathy. Like the essa is to. There's beaupre lawn. Bruce sperone even m sam sam e. these don't tend to make people emotionally numb and sedation and affect of flattening are not inevitable. Consequences of mood stabiliser treatment. If they were then anything that made you feel tired out of it would treat bi polar disorder. These are side effect. They are not part of the cure. Pharmacotherapy the assessment of side effects has a long tradition. Meanwhile in the early days Think about konta gone. Didn't have a tradition also of them the learnt that especially regulators forced to have closer look on side effects and since then side effects from therapy are a maitre aspect of other accompanied villa marketed. Luck for example. I'm a trip to linda. Mold until the present is still available with nowadays never be marketed. So threats y you have a little bit tight on the topic from therapy widened. Psychotherapy up to now. There's no such tradition dissolve. Everybody who has thought grades new psychotherapy. And whether that's helpful not say interesting question okay so back to psychotherapy. Let's talk about exposure therapy. I understand out to lend. It is himself a cbt therapist and has done a lot of exposure work now. I thought it was necessary for phobic patients to experience anxiety. An order overcome their phobias exposure. Therapy does this and so did. The third wave behavior therapies like mindfulness and acceptance and commitment. Therapy these all encourage the patient to be with the anxious feeling instead of running away from it. You're right all of those psycho therapy's is causing anxiety and on the other side they all work to improve anxiety disorders so i can understand height. Come to believe that as you put it. We have to go if you have to go through the anxiety to get to the other side of it. We'll dr linden suggesting we stop calling this unnecessary step in therapy and call it what it is anxiety. It's a side effect. Well that makes it sound like there's something wrong like exposure is a pet therapy. No is another part of his work where it helps to put our biases aside to understand what he sang. Dr linden defines side effects as unwanted effects of good therapy. These aren't therapeutic. Mistakes like a violation and they aren't the result of bad therapy either again is just like with medications when search aline causes nausea or sweating. We don't say that it's a bad medicine or that. I'm a bad doctor for prescribing it. It's a side effect okay. Maybe i'm starting to understand it. Exposure therapy is a valid therapy. It's one of the best. We have slow became zaidi but it causes the side effect particularly in the beginning in that it makes the patient feel worse if they feel more anxiety the very thing they've come to us to overcome and if they get more anxious during the therapy there are several ways it could turn out one. They might get better if therapy works and come out with less anxiety than ever before but exposure. Therapy doesn't always work. It could cause flooding where it makes them anxious beyond the point that they can tolerate and they give up on therapy or there's a third possibility they might go through all the hard work of exposure therapy and not get any better or even worse they might go through exposure therapy with all the anxiety that entails and come out feeling worse in other words their condition could get worse during therapy now. It's hard to prove that any of those results are caused by therapy. Just like it's hard to prove that any given side effect is caused by a medication. But we at least need to think about these possibilities p treating scientists. They do exposure treatment. Want to have the patient confront anxiety in or the band to Out of culpas. In if it's really good treatment condemned be able for example to go up way without any anxiety anymore to get to that end. You have to expose the patient tool zip relations which are frightening for the patient if everything comes out fine baseman losing somebody but i've seen dozens of patients who asked the that.
"dr linden" Discussed on 860AM The Answer
"Back to the show. We're speaking with Dr Linden have Lynn. She is a distinguished scholar of the CUNY School of Public Health and Health Policy. And Dr Havilland Jonathan Height who is a social psychologist probably know the name of founder of Federal Tax Academy. A gentleman academic who described himself is definitely center left. Hey was a co author of this book in the last couple of years, called the coddling of the American Mind. And in there, he talked about three untruth ce that were embracing as a culture increasingly woven into American childhood in education one. What doesn't kill you makes you weaker to always trust your feelings. Three. Life is a battle between good people and evil people. Thes three untruth ce the great UN truths as their termed in the book interferes with young people, social, emotional and intellectual development. It makes it harder for them to become autonomous adults who are able to navigate the road of life height and his co author argue, Do You agree with that? And if you do, How does that this culture of safety is, um, that they describe How does that fit with the policy approach? We're taking to covert 19. Well, I confess. I have not read Jonathan's book. But what I would say is what we know right now is that indeed we are trying to follow the science to understand what is the best policy and what is the best approach in the midst of a pandemic to keep our kids safe and help them? To grow and thrive. What I would say is, it's a really important opportunity to talk about. How do we build the most resilient kids possible? How do we create the learning situations where they can have a positive self image where they can develop problems helping skills? Or they learned to self regulate their emotions learned to be adaptable. I think the challenge for many parents and kids Has been moved from the abrupt end of the semester last spring, and then the uncertainty on the inability to really understand what is the science of the pandemic, as it has been shifting on as we've been learning about transmission rage, and as we've been learning about what are the best policy and frankly when we've had a 50 state Kind of experimentation where every governor is taking a different approach because we are lacking. In a singular narrative about the pandemic, I think for kids Building. Connections and empathy and resilience are the most important things we could be doing for our kids today. So with respect of resilience, um it's interesting concept is sort of this is the whole sort of dichotomy between Preparing the road for your kid or preparing your kid for the road and that that matters. And so I wonder. Are we by protecting them from being resilient were how do we engender resilience, right? I think there are some very clear guides on how do we build resilience? I mean, as we all know, when you fall down, you have to stand up again. Right, and so by helping kids problem self and to set goals and measure progress against those goals and to understand that indeed they have the emotional wherewithal and the intellectual wherewithal to succeed is a really important thing. I think when we look at Classroom. You don't get every answer right every time, but what we want to do is help them build the skills necessary to unpack a problem and to respond appropriately. That's how we build resilience. Do you think it's helpful? I mean, you write in your piece in the hell about the fear and anxiety that is gripping. A lot of America's Children is certainly more so than in a normal year as a percentage. And I wonder if some of the suggestions the way this is covered, which could lead one to believe that somebody who is under the age of 21 is justice likely to die or suffer serious illnesses. Somebody over the age of 70. One. Of course, we know that the data suggests those two things are wildly different. Those two cohorts are wildly different in terms of their experience with covert 19. I wonder if sort of the blurring of the distinctions. If that helps, or if that creates anxiety where somebody say this is weird, and it doesn't treat kids as sort of self actualized beings or trying to get them to be self actually things. Look, this is dangerous. But I want you to understand what the risk is here. And I want to understand what the risk is for other people, cause I want you to be considered other people. I mean, you know, treat them as people who can process information and help them start to develop their ability to make risk assessments. Well, I think you're making a very important point. I think we need to give them information and then we need to help them get the tools necessary. I think you know when we talked about asking people to wear facial coverings and wear a mask. You can ask a young person to do that as well and explain why it's important and have them understand that they're protecting themselves and their protecting others, and it's a really important I think the other issue is we don't as we're learning about the pandemic, and as we're learning about Kobe's 19, we are also learning about what are the long term impacts on our whole body as well as on our mental health of exposure to code. It means so, yes, indeed many young people if they are exposed to covet. Perhaps they get a mild case. But we don't know what the long term impact is on their cardiovascular system on their kind of respiratory system, and even on their brains, So I would say it's really important that we That would give young people information to make good decisions. Help them understand the data, and we need to be consistent about that. And as adults, we also need a model good behavior. And what? Ah what would you suggest we understand or need to understand about the long term impacts on mental health, intellectual development, socialize socialization of being locked down being in this place. We're at now, in so many parts of the country for, say, the foreseeable future for the next for the second half of the school year, maybe into The next school year next fall, right to the long term impact of that on young people can be quite devastating for some of the best studies that we've seen say that this increased anxiety, and this increase in stress will have a long tail that it could last as long as nine years. So it's really important that we help nine years the best studies that we've seen. So the question becomes. What can we do? One is that we can help young people have a sense of hopefulness and optimism about the future. We can help them build skills around resilience. We can help them like he have good and positive connections with their peers or even with their parents. You know, it is very important for young people to feel a sense of connectedness as opposed to social isolation and one of the ways we can do that you have a plan. Have people have young people reaching out to their peers by a zoom or social media, even a phone call to positive things with their family enjoy a family dinner. Don't just sit with your device on the dinner table. Have the parents think about what are the skills they can be building and have young people see their parents also being hopeful and optimistic. She is Dr Linden have Elin distinguished scholar at the CUNY School of Public Health and Health Policy, Doctor, have Lynne Thanks so much for joining us. Thank.
"dr linden" Discussed on 860AM The Answer
"Show and bouncing back to Kobe 19 from our discussion of health insurance policy with Shias. Tucker. Charlie Baker is Thie governor Massachusetts. He recently had this to say about kids in school, the kids in schools or not spreaders of covert. I mean, there's no better example of that right now than the parochial schools in Massachusetts. They have 20,000 kids and 4000 employees who've been back in person learning since the middle of August. They have a handful of cases, so that's coming up on three months. Right Governor Baker also added that hundreds of thousands of other school students have also return to the classroom under the hybrid model that have only been about 150 to 160 covert cases in Massachusetts, in those classrooms are resulting from that interaction, so they believe if you're to believe Contact tracing as effective sourcing, which seems to be someone in doubt my home state governor Pritzker, who is instituting the on ly as I understand it, Ah, lock down of in person dining in restaurants and bars around the country. As of the end of this week, the first said the basis was thes air environments. The wear transmission occurs based on contact racing, then saying yesterday contract tracing doesn't really tell us where the transmission occurs. It just sort of gives us a general sense of transmission along with e obviously positive cases. Positive tests, huh? You know the the transmit the contact tracing that was supposed to be such a feature of flattening slowing stopping is now to be discarded altogether. OK, getting back to Governor Baker. Talking about schools, both Catholic and private and the public in short, RIA life experience, and the research shows that classrooms are not a major source of transmission. Oh, by the way. Against that backdrop, the National Assessment of Educational Progress Test scores came out on Wednesday. 37% of high school seniors are proficient or above and reading only 24% in math. Virtually unchanged from 2015 those air Ah, depressing enough for the lowest performers. There was a decline in both subjects so again, disproportionately the poor. Getting hit the hardest by these lock down policies, which include Distance learning rather than in person learning. This makes sense. Does this make sense what we're doing for more on that? We're pleased to be joined by Dr Lyndon Havilland. She's a distinguished scholar at the CUNY School of Public Health and Health Policy. Doctor Havel in thanks for joining us appreciate it. Thanks for having me so why don't we just start with the school? Since? Of course, this is where parents are. Most concerned parents with kids are most concerned about their kid's education and by extension. Intellectual social development, the academic record they're able to put together. I mean, with what Governor Baker's saying in Massachusetts, that does that. Does that make sense that we're not Still having kids in schools and somebody big urban school district. Well, I think every every state is different. Governor Baker has actually been fantastic on getting out ahead of the curve with coded and actually his contact tracing. He was one of the first to really invest in extensive contact tracing, so I think it makes a lot of sense. To follow the science to look at the data. They're doing a great job in Massachusetts, and I love the statistics from both the parochial schools and the public schools. But that means that they are listening to the science. They're testing. They're following up when there are positive cases, so it makes a lot of sense. We As adults. We know that school is a really important place for Children to develop and learn and your point. I think it's also really important, which is not the hybrid model or, you know, doing school by remote learning isn't helping kids very much right on DH. So these are and this is not just a exclusive to Massachusetts. Of course, as we know from some of the research, and we we know this from the Yale study it Ah. In daycare centers. 57,000 daycare centers across all 50 states that Z very low transmission environment, So I I mean, you know, out of an abundance of caution. Should we be out in abundance of caution, no positive cases, Or should we be out of an abundance of caution, concerned about Children's mental health, And as I said at the outset, social and intellectual development, I think we should always be concerned with There's Both their mental health and their physical health. I think in schools where they have indeed put in place policies for testing for contact, tracing for appropriate precautions and responding appropriately, I think it's great. Have kids back in school. I have a nephew who's back in school at a university that has zero positive cases. And why, because they have been doing aggressive testing their doing appropriate social distancing, and they're really following the best in public health recommendations, but for Kids this abrupt end of the school year last spring, followed by the uncertainty that they perceived about the world. It is indeed causing Children, additional anxiety and stress and social isolation. We know it's not great for their mental health. So what we really need to be thinking about is how do we help kids? Well, the more resilient attitude towards the future. And how do we give them the skills necessary? Just drive in the current situation when we come back with Dr Linden, Haven't I wantto talk a little bit about this?.
"dr linden" Discussed on Cardionerds
"Acute my podcast so that means for an acute hip results in patients that are we doubt a previous East story of heart failure or known category but the of course death me said the oldest patient etta scene. Tom's within one mile then there is another kind of consideration that is related to time. So when as the Of the scene terms so we can divide the patient with inflammatory myopathy steal form of myocarditis comparing with patients with acute my stand on have a defense based on the killer and so we have the most common form. The induced by viruses by another common format is our at that is that are associated with immune disorders or associated with drugs in particular for instance. Today the new immune checkpoint set in meters but and then we can have all solder form. Sir Footing allegic forms then. Finally we have. If if we perform an indoor cat biopsy or we have a postmortem examination than we can divide the myocarditis based on the die of inflammatory cells. So we have a giant sound myocarditis. The also the form. So we did. The worst prognosis is Felix myocarditis. Lymphocytic myocarditis Day The the most common form that is typically associated with a virus infection or with immune checkpoint inhibitors and then finally wherever gun rheumatoid myocarditis and. Typical example is associated with conduct. Suck widows thank you so much for that and the the classification schemes are really helpful. So we have a clinical classification his logical classification and then classification based on ideology. I echo the sentiments. This is Dan binder here. We are so humbled to have you on his show and just so appreciative for reach for helping. Coordinate this so for you. Dr Linden fell taking it back to the bare basics. How'd you clinically diagnosed myocarditis? And this could be before the CO Dara. The diagnosis is Is a little bit difficult? Only because all of the signs and symptoms are very non specific but I think in general clinical suspicion would be in one of four major syndromes in the best description of this is I think in the European Society of Cardiology review in two thousand thirteen. The White Paper about this. But if you suspect Mark Addison then have a biopsy confirmed by positive biopsy which used to be considered by the Dallas criteria douse criteria published in nineteen eighty five for used for a long time and they require evidence of inflammatory infiltrates within the myocardium but also evidence of Maya Cardio Disruption necrosis which is not typically schemic or contraction band necrosis but recently people they added a number of other immuno history chemical criteria and the European society proposed a number of things that there'd be at least fourteen white cells per meter squared or four monocytes and three CD three positive lymphocytes. Those are all still suggestions that definite but they seem to enhance the Dallas criteria. Which will get back to later. So if you suspect. Clinical micronized is based on science and symptoms and they've also described in that nice paper for clinical syndromes and I think it's interesting really mirrors the four patients at least three or four patients just published in circulation last week by the Columbia Group in that is the clinical presentations are acute chest. Pain particularly with features appear itis sort of not a schemic chest pain. It can be a schemic though. However or new onset. Evidence of heart failure worsening Disney A- or fatigue or other signs of heart failure the sub acute or more chronic presentation and then palpitations or other arrhythmias. Syncope or precinct. Be or her block or unexplained Cardi Genyk Shock. So one of those presentations should suggest my medicine if you have any of those things then what they have suggested is it. We'll talk about when Bob if it's not confirmed by BOPs than suspected myocarditis suggested that you have one of these clinical syndromes plus one diagnostic criteria. That's abnormal and the diagnostic criteria. Suggestion would be things such as. Ekg changes in a rid. Mia's markers satellites such opponent elevation in a functional or structural abnormalities on cardiac imaging such as primarily echo in Resonance Imaging and now more recently tissue characteristics of cardiac magnetic resonance imaging such as delayed Gabon in contrast enhancement. And not to waiting that demonstrates Dima Indoor inflammation so you should have one of each of those for suspected myocarditis. If at all possible I in the absence of symptoms. If for some reason you suspect markered itis then you should have at least one or more both those in in addition to some other features such as fever so that would probably be right now. The single most altogether way to make the diagnosis. That's a great summary out of all of the things that you mentioned. Are there certain tests that we do? That really confirmed the diagnosis or doing these tests to confirm the diagnosis of myocarditis. Dr Mosley He. Maybe you could take that question. Yes Oh thank you very much so i WanNa Echo everything. Dr Leonard fell just mentioned. Just also give you a perspective from where I come from which is in the cardio oncology world. We have cancer patients who getting no therapies where there may be the possibility of Mike Where confirming the diagnosis would be particularly imperative in these patients because a you may withhold lifesaving therapy in these patients and or give them fairly potent their east to potentially attenuate that character. Samah micronized so in that scenario. WanNa be sure that the patient does have my card. Itis some collaboration with Dr Monaco who is now at the University of Colorado. We last year we kind of created at least some propose definitions of Mike Arthritis that may be especially relevant in the clinical trial population or large database population and. This is a paper that was ocean circulation last year. So in all cases given that the manifestations clinical manifestations of Mike or may be fairly nonspecific and associated with other cardiac issues such as acute coronary syndrome. I think we have developed a hierarchy. He'll definition accounting for different levels of evidence for all diagnoses. It's important I think to excludes things like acute corey and rule in addition with for definite coach Mike I think we have to take a multi pronged approach. Where either you have the syndrome. Clinical characteristics potential. Ekg changes but also other things that includes possibly pathology which is what we consider gold standard diagnostic our cardiac MRI witchdoctor Linden focused went over as was potentially other imaging modalities if the other two cannot obtain to feel confident that the patient has Mike. Alright so I think if I could say one thing. It's important to rule out other causes of my car us. But it's also important to take a multi pronged approach and not just use one technique yet imaging or authority to speak At that makes a Lotta sense so if I could sort of summarize what you said so in. Certain types of my curtis biopsy plays a huge role in making sure that you know. We're not calling curtis something else. For instance another mimic like a two coronary syndrome or some sort of other cardio toxicity. That's mimicking the myocarditis. And it seems that the pathology can really dictate therapy so biopsy seems to be really important and then like you said just multi-modality diagnosis using imaging to cardiac MRI in the whole syndrome. One question that a lot of people have is. Why don't we do a biopsy on everybody? Dr Linda felt. Do you have any thoughts on that? You know who who do we really reserve it for to Echo? What Dr Mostly he just said one is that we want to do a biopsy to determine if that we've excluded other things but is there something that we can treat number one and also want to do a biopsy if we think it might provide prognostic information. The classic case would be giant cell myocarditis where we think if if you had that diagnosis. You'RE GONNA probably on certainly need a transplant. So those are important issues and does the patient have of course that suggests. They're not likely to improve the reason we don't do those. And everyone has many cases of Margaret. Either much more mild than appears if the patient is improving and so we. We don't think we need to take the risk. While there is a small risk to biopsy and I would point out. We always worry about CARDIAC TAMPA as a risk for these biopsies and that happens probably in the range of one or two percent. We have to be careful. We're not lulled a little bit. That the risk of biopsies seems to be less than the average transplant patient. Which is where most of us do the majority of our biopsies than it is in the cardiomyopathy patients so there there is a risk of this but we also can't forget the risk of damaging the tricuspid valve which could be a really pretty big risk several years down the line if we create severe Regurgitation so that's number one number two is that the biopsies themselves are not very sensitive even when we get three or four pieces of tissue good pieces of tissue the sensitivity of that is poor any given disease so the the biopsies are often not positive so when you take fairly low risk group may not be helpful to do biopsies in those patients so those would be the major reasons. They may add a comment. We have exactly we. Perform are quite a large number of Biopsy with the the patients that we the left ventricle diction fraction between fifty to forty percents. And we'd Ositive Carter the community corrections but at the end in this patient we have a right Approach to biopsy Batta. The proportion of positive case is quite low so there is no real improvement and also the fact that that we can find. Osama macrophages shoe lymphocytes that we don't really know if it's a specific specific enough to say that the disease specific subtype of Or if it can really guide the The therapy at the end the probably this group of patients Arizona's stealing more useful because we have a full overview altay and involvement of the heart. But when you have seen heart. Failure seem to Or Very USA ejection fraction. I believe that the underwear category biopsy is very important to end can be by far more accurate and more sensitive Impatient to without Meyde the Levin. Three calera systolic dysfunction completely agree and I think the one other issue is that we know from democratised treatment. Trial that across a broad spectrum of pathologists there's variation in reading these biopsies in all the criteria for the biopsies. There's a pretty big variation even giant cell biopsies. There was a fairly good variation. So that's another issue with cardio biopsy fully agree as I prefer the US perspective comparing with the European perspective. That in my view it simplifies. Osama some issues saying Gazzara adding a summit immune so chemistry can include secure AC- butter at the end in my view you can increase it sensitivity. But you can lose specificity as we can have cut to myopathy or even dilated cardiomyopathy with presence Macrophages and at the end. You're not sure that is our mild trauma to Myopathy aretha calm on findings that you can have that case of dated cardiomyopathy cynically. I say so from what I'm hearing. It sounds like MRI can kind of give you a global assessment of inflammation and we can sort of use the league criteria to say whether or not myocarditis is present..
"dr linden" Discussed on Biz Talk Radio
"Talk radio. Lauber t- London. He's a well known psychiatrist educator writer. He's been a practitioner for over forty years. And he is the founder and former head of the short term psychotherapy unit NYU's Langone medical center in a pioneer in consumer healthcare radio and TV programming. We've been reading his articles. For years and newspapers and magazines and leading medical journals, and we're so thrilled. He's with us today with talking about his new book, find freedom fast short term therapy that works and it's a pleasure. Welcome Dr London. Thank you so much for having made this morning on your show. So Dr Linden. This is a different concept because a lot of people that have anxiety and my goodness. There are many people who suffer, you know, anxiety, and depression. And reliving. Traumatic experiences that they just cannot get over and they just can't so you having Zayed's you have people that have PTSD. It causes all kinds of issues, including insomnia. So and you know, and I know that medications are not, not, not always the answer. In many cases, most of the medications aren't really effective. Many times, people don't want to take medication. That's really important when I when I finished medical school. I did my residents who training Kaya tweets at NYU Bellevue in New York City, my father was a surgeon was to on goals, and interesting that when I picked. My father, who was so Jin insurgents, have a career discipline of knowing how to circumscribe the problem and treat it in their way. And my father said that great big wisdom that he offered me with on with learn something specific that the other folks, don't know, time will accept exceedingly long hospital stays, and the talks that are unfortunately, still the same ten go on forever with, with a beginning, very well, Sherwin possibly no end today. Of course, hostels phase, too short in my opinion. So I decided to work in that model of circumscribing particular set of problems, they probably two or three problems. And I went up to my training to New York material Columbia, University, and studied for four or five years, under a great mentor. Dr herb Spiegel was an expert in yet, on name. Therapies. He'd be to behavior therapy has not become popular, and he was an expert in this and hypnosis relaxation behavior modification. And then I took that information that to my home base, and the University Medical Center Bellevue and establish a short term psychotherapy unit starting with smoking cessation, weight control. Those were done usually in one one visit and. Translated into my private practice. And then we expanded to hang Ziobro phobias civilian aspects of PTSD. I'm not familiar with I do work in the military and insomnia. And we found the whole program was very successful when I ran for about twenty years and, and at the same time I thought over thirty years ago, leading newspaper combs about various methods to shorten of psychotherapy. And in the process, I developed my own learning philosophizing and action spin on cognitive behavioral therapy cvt causing the behavior therapy, it's people to understand what that's about. But if you're in terms of what did you learn how, how do they philosophize about it? And how if you learn some stuff that doesn't work for you. How does it affect your life, and what kind of actions can you take to get? A mill perspective on set of problems, and much of the stuff when you're circumscribe it. You're just addressing one or two problems. Not the whole existence of man, or woman kind. And it's just basically learning how to get a new perspective on the old set of problems. What you learn how you philosophize about it. And you action and I put this together in the book fun fast, which is available on Amazon, of course. And I tried to sell readers that, that many times, you can improve your situation and short-term model, that also allows the person could take some of the stigma out of mental health care, which is this because of you is just going to go on forever. And I'll never get any help absolutely forty million Americans forty million American adults suffer from as -iety disorder every year. That's a huge. I mean, that's a huge number doc. That's a huge number I would say what is on Potomac? But, you know, unlike a bacterial at the oftentimes don't recognize an emotional evidently, and that includes a lot of civilian PTSD much of which in my opinion, doesn't get nose. And because you wouldn't you mean by that. Right. Post traumatic stress disorder is something that occurs from a massive trauma, natural disasters manmade disasters, obviously war. Torture in cost elation, and you're, you're facing death or someone around you is facing a real separation of from life. But in my experience, there's a lot of sub clinical PTSD in terms of how the brain processes of the sort of for example, I've seen so much so much of, of divorce bankruptcy job loss. Where person sees this as almost the end of their existence almost the end of their life. And to me, it's not so much the event. It's how the person classes and that's seen a lot of that. And it's very treatable, once you can identify it. Now, I and depression, concerning the pot of post traumatic stress disorder PTSD, but. But if you just treat the just depression, you'll going to miss the traumatic event that this particular person that's processes, someone who's going to go through a divorce it lose a job. And see life as being improved. But also many, many people who have ability to this, and they will go to the symptoms of post, which can be treated in many, many cases. And oftentimes, it can be treated in the short term model. But, but the point about inside being an epidemic across the nation is, is well taken because it is it is there and people get anxious they get phobic. They they're living a will living in a very high stress environment where, you know, the usual nine to five job, doesn't occur any more. Because if you've manager, your boss texts you eight thirty at night for something. You're ending up texting them back and send me an hour and a half on by you're still working and the downtime is as limited things goes on over and over. We're inundated with thirty six forty eight hours new cycle, and how bad, the weather is going to be in the rain and the wind them sometimes ran in the wind. Never shows up. And this is all producing anxiety, and certainly and people who would, you know, we have different vulnerabilities people go pick up the heavy box, and one person's fly, another person has back out the same thing as with emotional issues, someone get stressed out, and it means nothing to them, and they move on and someone else is affected by it. And I think those folks accepted by it. They should be able to as a consumer pick mental health as a short term solution before they go into a long open ended a procedure. You know, if the will is leaking you fix the truth. You don't have to burn down the whole house. To those who read the book besides seeing the techniques and seeing the definitions, Zion phobias and PSE and a composite vignettes. It also should teach the reader to be a good consumer, and ask, what kind of they're getting into, and they might want to assure model obviously, there assist psychiatric kid that request meditation. And there were some illnesses, that need that I'm okay with that, because the medications starting in the fifties and moving forward. Successively help people live productive lives, just like it infectious disease, heart disease. But the whole the whole point is the consumer ask, and nothing safe with newer, denial or resistance because you're trying to go she ate your own type of therapy. You know, we go into grocery store, and we have no problem, asking how long the tuna fish is been sitting out there. Well, we can do the same with the same model for getting medical care, including mental healthcare. Absolutely. Absolutely. This is really very important work.
"dr linden" Discussed on Biz Talk Radio
"London is a well known psychiatrist educator writer. He's been a practitioner for over forty years. And he is the founder and former head of the short term psychotherapy unit NYU's Langone medical center in pioneer and consumer healthcare radio and TV programming, we've been reading his articles for years and newspapers and magazines and leading medical journals, and we're so thrilled. He's with us today with talking about his new book following freedom fast short term therapy that works and it's a pleasure. Welcome. Dr london. Hi, thank you so much for having made this morning on your show. So Dr Linden. This is a different concept because a lot of people that have in and my goodness. There are many people who suffer, you know, anxiety, and depression. And reliving traumatic experiences that they just cannot get over and they just can't so you having Zayed's you have people that have PTSD. It causes all kinds of issues, including insomnia. So and you know, and I know that medications are not, not, not always the answer. In many cases, most of the medications aren't really effective. Many times, people don't want to take medication. That's really important when I when I finished medical school. I did my residency training at NYU Bellevue in New York City, my father was a was a two on goals, and it's interesting that when I picked the clients rate. My father who was associated insurgents, have a career discipline of knowing how to circumscribe problem and treat it in the way. And my father said that great big wisdom that he often was on be with learn something specific that the other folks, don't know that's time excess exceedingly long hospital stays and the talks that beat. Unfortunately, still the same can go on forever with, with a beginning very wall shirt, possibly no end today. Of course, the hostels phase, too short in my opinion. So I decided to work in that model of circumscribing particular set of problems. They problem two or three problems and I went up to my training to New York material Columbia, University and studied for four or five years, under a great mentor. Dr herb Spiegel was an expert in yet, on name of. Therapies. CB to talking to behavior therapy has become popular. And he was an expert in this, and hypnosis relaxation hid modification. And then I took that information back to my home base, and the University Medical Center Bellevue and establish a short term psychotherapy UNICEF starting with smoking cessation way control. And those were usually in one one visit and translated into my private practice, and then we expanded to exile phobias civilian aspects of PTSD. I'm not familiar with I don't do work in the military and, and some and we found the whole program was very successful when I ran for about twenty years and, and at the same time I thought over thirty years ago, leading newspaper columns about various methods to shorten psychotherapy. And in the process, I developed my own learning philosophizing and action spin on cognitive behavior therapy in that seeming to cognitive behavior therapy, it's homeless people understand what that's about. But if you're in terms of what did you learn how, how philosophize about? And how if you learn some stuff that doesn't work for you. How does it affect your life, and what kind of actions can you take to get a new perspective on set of problems, and much of the stuff when you circumscribe it, you're just addressing one or two problems, not the whole existence of man or woman kind. And it's just basically learning how to get a new perspective on the old set of problems. What you learn how you philosophize about it. And you action and I put this together in the book, find freedom fast, which is available in Amazon. Of course, and I try to show readers that, that many times, you can improve your situation and short-term model, that also allows person to take some of the stigma out of mental health care, which still is this, because the view is just going to go on for ever. And I'll never get better. Absolutely forty million Americans forty million American adults suffer from disorder every year. That's a huge. I mean, that's a huge number doc. That's a number I would say what is on FM IQ? But, you know, unlike a bacterial epidemic oftentimes, we don't recognize an emotional damage, and that includes a lot of civilian PTSD much of which in, my opinion, doesn't get by nose. And because you wouldn't you mean by that depression, telling me example. Post traumatic stress disorder is something that occurs from a massive trauma, natural disasters manmade disasters, obviously war torture in cost relation, and it's your, your faces death or someone around you is facing Dennis a real separation of you from life. But in my experience, there's a lot of sub clinical PTSD in terms of how the brain processes of the sort of, for example, I, I've seen so much so much of, of divorce bankruptcy job loss where a person sees this as almost the end of their existence almost the end of their life. And to me, it's not so much the event. It's how the person process that. And that's seen a lot of that. And it's very treatable once you can identify it now, I eighty and depression, concerning the pot of post traumatic stress disorder PTSD, but. If you just treat the exile, just depression, you'll going to miss the traumatic event that this particular person has processes someone who's going to go through a divorce lose a job and see life as being improved. But there are also many, many people who have ability to this, and they will. That go to the symptoms of post traumatic stress disorder which can be treated in many, many cases. And oftentimes, it can be treated in any short-term model. But, but your point about inside being an epidemic across the nation is, is well taken because it is it is there and people get anxious, they get folded. They they're living a will living in a very high stress environment where, you know, the usual nine to five job, doesn't occur any more. Because if your manager your boss texts, you eight thirty at night or something. You ending up texting them back and send me an hour and a half is gone by, and you're still working and the downtime is limited things I goes on over and over. We're inundated with thirty six or forty eight hours new cycle, and how bad the weather is going to be in the rain and the wind and sometimes ran in the window shows up. And this is all producing anxiety, and certainly in people who would, you know, we have different vulnerabilities people go pick up the heavy box, and one person's fine. Another person has their back out the same thing as with emotional issues, someone get stressed out, and it means nothing to them. And I move on and someone else is affected by it. And I think those folks accepted by it. They should be able to as a consumer pick mental health as a short term solution before they go into a long open ended a procedure. You know wolf is leaking you fix the roof? You don't have to burn down the whole house. And I like to. Those who read the book besides seeing the techniques and seeing the destinations exile in phobias and PBS and a composite of vignettes. It also should teach the reader to be a good consumer, and ask, what kind of he, they're getting into, and they might want to flow a short-term model obviously, there assist psychiatric kit that request meditation and there was some illnesses, that need that I'm okay with that. Because the medications starting in the fifties and moving forward. Have successfully help people live productive lives, just like infectious disease, heart disease. But the whole the whole point is. Good, consumer, and ask and not faced with new denial or resistance because you're trying to go. She ate your own type of, you know, we're going to restore and have no problem, asking how long the tuna fishing, but sitting out there, well, we can do the same with the same model for getting medical care, including mental health care. Absolutely. Absolutely. This is really very important work that you're doing, Dr Robert London, find freedom..
"dr linden" Discussed on WNYC 93.9 FM
"Called them writer. Message or did you just follow the just going to go and meet him understand that fake news can cause? We shouldn't let something dangerous rate. She convinced FU fudgy to leave that. And then it was time for these be like, shed joy, not rumors. What's remarkable though is that despite all those fake news stories Indians continue to trust WhatsApp as a source of information. So why is that ready ago is Hindi editor at the online news site the print in Delhi? It is one of the main ways of how people get the new specially now that data being very cheap in India and smartphones have become very cheap. So VR country is sort of leapfrogged into the mobile generation. There have been lots of people who didn't have a landline would never seen a phone before in their lives. But the move straight away to mobile because the technology has become cheaper and daytime India's incredibly cheap. I think one of the cheapest rates in the world is in India. And when it comes to the Indian elections is this proliferation of what's happened information distribution through WhatsApp is going to help into voters. It will help the. Political parties. But I'm not sure whether it will help the voters because what's happened. India has had a bad history in the sense of a lot of fake news fake, videos, traveling across the country. Thanks to what's up. But because it's a tool which reaches a large number of people political parties have been using it, and there's a mushrooming so to say of these political messages, which are reaching out to people. So what to political parties and politicians make of these moves by what's up to limit the spread of information via their innovative creative. So whatever put in numbers said yet, you can't have a group larger than two fifty six and you can't have forward more than five at one goals you call forward. A message more than five times five India. They've limited it to five times. So the politicians know how to deal with it. They've created many subgroups they've kind of now created groups which are sort of specific to fail grow Fitch does skaters to eighty. Into five years old young voters overboard, there's a facial gator to a certain cost, and they're leveraging the messaging, according to the cost according to the Israel their catering to so they're smartly using this app, despite the limitations all the parties of realized that it's a tool in their hands in twenty fourteen the last election. It was the right thing. BJP the ruling party which made good use of it which also made good use of all kinds of technology. They were the leaders in sorta exploiting everything that was available around them. They won with a huge margin. But that also became a lesson benchmark for the other parties to follow. Now. Everybody is doing the same, and they're disseminating whatever they feel will help their election prospects. I don't think they're thinking of right or wrong in that sense thinking all self interest in what's of them best. And I suppose it matters in India because elections are one on very narrow margin. So a small swing as. As a result of a what message can matter we find an India other just before polling happens, and the campaigning is coming to an end. You would have politicians saying things are outlandish. But as you're saying a small thing involves can make the difference. It's a first-past-the-post system. But there are there also have civic groups trying to counter this. There are people who set themselves up to counter fake news. Are they affective to the not that much because see what's being used by a lot of young people is being used even by rural folk because even the cheap phones now can have a free app. Download and by the time a company like old news or hawks lead were working on disseminating sort of correcting out. What is forgetting what is and what is not fake by the time that reaches out to people. The damage is already done the news authority spread. Is there? A lot of worry in the moment. If you if you look at the mainstream media in. In what people are saying amongst themselves that family and friends are people worried about the effect of WhatsApp on the Indian elections. Quite frankly, it has affected journalism matters is done in India, it it it's a close up very it has been misused. And there's enough data valuable to show that it's is being misused Dennis continuing to be misused. But as long as politicians stand to gain from that misuse, in whatever way, then there's unlikely to be any break relation as the I think no political party will want to change too much because just exploited Felicien media as something that they can do because everything else is expensive. They advertisement in newspapers is very expensive diamond television is expensive. So this is the cheapest way to reach out to people renting wacko in Delhi. All this comes only weeks after Facebook's founder, Mark Zuckerberg, cooled on governments to play a more active role in controlling what get said on social media. He said the responsibility for monitoring harmful content is too great for companies alone. And as we heard really say that. By the time. Fact checking services get involved, it's often too late. But what's up which is owned by Facebook is looking at alternative ways to stop the spread of fake stories? And it's enlisted outside help we work with what's app as an independent sort of academic institution to try to look into you know, how to solve some of their problems Dr to Sunday from the Linden is director of the university of Cambridge's social decision making lab. So some of the research we're doing is looking into motivations as to why people use WhatsApp and how they use it for news. It turns out in a lot of countries like Africa Latin America internet's very expensive. And so a lot of people actually get their news from messaging, apps and social media platforms. That's where most of the online activity takes place. People are part of many, many, many groups what happens is that political actors. They set up hundreds of groups to try to spread fake content about political candidates. And so on it's very difficult because unlike Twitter and Facebook what's happening is that. People receive content from other people they trust in their network, which is a bit different from other forms of misinformation on social media. And so we're trying to look into that to what can you do them? Well, one intervention that we've come up with is based on a principle known as psychological inoculation just as regular vaccines when you inject yourself with the weekend dose of virus triggers antibodies in the immune system to help confer resistance to future infection, and we found you can do the same with information by exposing people to weaken doses of strategies that are used to deceive you you can actually build mental antibodies and help people gain resistance against misinformation. That's very elaborate with saying you just educating people not really I would say that educating people, and the sort of media literacy and debunking is exactly what we're not trying to do to some extent because we know that that doesn't work as effectively I mean, I don't dislike the word education. But what we're doing rather than educate people about facts or tell people what they need to believe. Or gift people media literacy training, where we're trying to do is preemptively expose people to very specific strategies that are used to deceive people, and we can doses of those strategies. Well, I had a go at one of those strategies that comes in the form of an online game which doctor under Linden's team devised in collaboration with the media literacy organization called bad news. Basically, it involves setting up an online persona on a website called get bad. News dot com. You then use tools such as impersonation trolling fuelling of conspiracy theories and for mentoring of dissent to increase your number of followers all in a fictional setting. Of course, the aim is to get more followers. Because the move follows. You have the Moyal credibility goes up in the game. Whatever disinformation your spouting. And I'm glad to report. I wasn't very good at it. But back to Dr Linden, the idea really is that once you step into the shoes of someone who is trying to deceive you. That's really how you come to understand how it works. And then when you're exposed to it yourself, you're more resistant to it. I tend to use a magician metaphor, you know, the first time you see magic trick easily duped. But once you know, you know, how to trick works. You won't be full the next time around. But there's two ways of doing that. I could tell you what the trick is which is traditional education using that analogy or I could try to walk you through and let you do the trick on your own. And that's really what we're trying to do here. And that I think is what sets it apart from all other approaches, but you still have to get the people who use WhatsApp to actually play the game in the first place. How'd you get people to do that? Yeah. That's a great question. So what we're doing for WhatsApp is creating a new version of this game that we've already designed and tested and know that that works, and we've we do that in many different countries. But what's up is different? So we've created a special version for what's up that's about setting up your own WhatsApp group attracting people to the group spreading misinformation through that platform getting messages from people you trust. And so it's tailored to that specific situation. And what we do for what's up is we try this. The countries that are most targeted, and then we recruit people through professional organizations. So we can prescreen for people who use what's up. So we tracked people to come play the game in control settings that we know are users of what's happened other messaging platform, so that's how we can get those people to come in and play the game and test them before. And after playing the game. There are so many people almost let me talking billions you'd need to sort of get all of them to be involved somehow really to make a really big difference. Wouldn't you? I think you needed to get enough critical mass inoculated to use a metaphor in order for the informational virus sort of speak to stop. Spreading the reason why we use the game is because it's scalable, it's fun. It's a new way for people to try to familiarize themselves with this issue. And we're trying to do the same for what's up possibly make it available in many languages around the world get lots of people playing the what's up version is still in development. So we're hoping to try to launch that under this year how it's working. So we started with. The most straightforward way to do it. Which during the launch of the game was the test people before they played by subjecting them to a wide variety of misleading tweets and headlines and see how reliable they think these headlines are have people play the game and show them different examples to see if people could really use the strategies that they've learned in the game and use them to discern. What's real and fake when confronted with new information to hadn't seen before? So we found that that worked quite well, but that doesn't follow the traditional sort of randomized control group design. So what we did next was to actually recruit people either to play our game or maybe tetris or some other game right control for a variety of factors that we were able to control before we found that works in exactly the same way there the effects were even somewhat stronger, then in a third trial. We decided to look at how long does this inoculation affect really last? And so then we follow up with people after they played a game weeks later, we subject them to sort of same battery of fake headlines in tweets many weeks later, and we found that the effect. Was still there one week later five weeks later. So there was quite promising in terms of still being inaugurated, we've been to see what's up the company is the concern that if this continues that they're going to end up being banned in some countries..