Once tested, they could be sent off to schools for these individuals. Was this for their benefit or that of society, and were the initial tests by Binet genuinely valid? The test had 30 questions.

Translated and revised to become an American test by Herbert Goddard, this original Binet-Simon test and a puzzle test provided a way to separate immigrants at Ellis Island and direct the “feeble-minded” to low-level jobs. One of the reasons? Racism and bias ran rampant.

Italian and Irish immigrants had little to no schooling, and many couldn’t read and were, therefore, of low intellect as rated by those in charge. How many of us could pass an I.Q. test administered in Russian and printed out in the Cyrillic alphabet? Could we even know what to do with a puzzle if the directions were spoken in a language we were unfamiliar with?

One current, widely used I.Q. test for kids displayed (maybe still?) a lack of cultural understanding and rated against some children. The test of judgment was one where a specific problem existed, and the child was scored on what they said they’d do in that situation.

When I read the question, I knew what a child in a poor neighborhood would do, and I wouldn’t have scored against them for what I saw as a smart action. To my mind, that portion of the test is culturally biased. Remember that call for “culture-free testing” or “culture-fair testing?” Who missed this one? Schools all over the U.S. use this test and others for school placement.

The question of intelligence has been one where many psychologists have attempted to devise one test to measure everything. Howard Gardner believed there wasn’t a singular intelligence, but multiple intelligences (Linguistic, Logical/Mathematical, Spatial, Bodily-Kinesthetic, Musical, Interpersonal, Intrapersonal, and Naturalist), and each should be measured. Gardner outlined these intelligences in his book Frames of Mind. Some forms of intelligence, he noted, could be enhanced by exposure to learning and culture.

Other psychologists, for example, Alexander Luria, studied neurologic aspects of psychology with his Luria-Nebraska battery of tests. One caveat most psychologists never hear is that Luria cautioned that it would take several years to become proficient in administering the test.

I do not know if the battery was normed on a diverse cultural sample. However, today we may turn to neurologic imaging for answers to individual deficits/difficulties.

I.Q. tests aren’t the only ones that are not sensitive to cultural considerations. Tests to assess depression have come under the research microscope, and we find them wanting, especially with Black women, an understudied group. An analysis of depressive symptoms in Black mothers found: In this sample of A.A. women with increased cardiometabolic burden, increased stress was associated with depressive symptoms that standard screening tools may not capture.

One reason depression may not be adequately assessed is the stereotype of the “strong black woman” (SBW), where self-silencing is one of the cardinal features. Seeking out or admitting to a need for mental health services does not mesh well with this image. The question for researchers is how to best devise tests of emotion for groups other than the usual white samples.

Any medical or psychological test must acknowledge the inherent factors of discrimination, culture, and bias. As in artificial intelligence algorithms, psychological test construction can have bias unacknowledged and unstudied by those who create and validate the tests.

Much work remains for everyone involved in providing care for all who come to them, and reliable, valid tests are a mandate for everyone.

The post Depression Scales and IQ Measures Fail Some Who Need Help the Most appeared first on Medika Life.

Of course, it says that beauty is the be-all and end-all of our lives, and we should be rocketing toward that goal our entire life. Forget about education or career plans because beauty takes care of everything. How wrong can a tale be? Some research indicates that taller, more attractive people have advantages in career achievement.

What of those who aren’t beautiful as their culture demands of them? They are sentenced to life as vengeful witches or evil women with nothing but mean intentions and wickedness in their lives. Old crones are anathema to us, and that’s where the old, the “ugly,” and the wrinkled belong. What should we do since that wrecks our self-esteem and career goals?

When the women’s movement began in the 60s with the publication of books like Betty Friedan’s “Feminine Mystique,” the question of moralizing children’s stories, books, and the all-important bedtime fairy tale came under a new microscope. Most parents never suspected that the tales were derived from ancient rape, kidnapping, and child sacrifice stories. These were supposed to be tales of good-over-evil and a pleasant means to instill moral standards in children.

Bruno Bettelheim explained it in his allegedly plagiarized book, The Uses of Enchantment. He outlined that Sleeping Beauty had been a prostitute in the original Italian tale, and Little Red Riding Hood was murdered for her naivete.

But the “mirror” sentence stands out because none of the other tales have such a memorable line. I wonder what standard the new children’s books and bedtime stories convey. Marlo Thomas sang “You’ve Got to Be Carefully Taught,” and the question of beauty remains as kids learn to accept each other.

Should the old, the wrinkled, and the misshapen be banished? TV ads keep hammering away at the battle for “beauty” against wrinkles, so the unconscious message is that being old and wrinkled is unacceptable. We need to fight to plump up our skin, laser off those age spots, and build that core. The only good advice is related to keeping our core muscles in shape for better health and maintaining our ability to pursue our lives actively.

And, in the beauty biz, men are now one of the last areas of marketing pursuit with skin lotions, body washes, laser hair removal (chest, of course), and even subtle makeup to achieve that glow of the great outdoors. They are being pursued to use facial fillers and wrinkle-removing products to retain a youthful appearance and advance their careers. Think about the Neil Young lyrics for “Old Man.”

One of the best things I saw coming out of Tinseltown lately was that women and producers seek meaningful roles for women over 45. Yeah, that’s a female actor’s sell-by date for getting roles. After that, she can head for the food pantries and forget her health benefits. I believe Angela Lansbury helped with the latter by employing older actors on her TV show, Murder, She Wrote.

Is beauty always skin without wrinkles, or is it so much more?

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“It seems that the stars are aligned.  These glimmers of facts, figures, innovation and needs are converging on the year 2013. And the result promises to be an inflection point for digital health. The curve of innovation will shift and place us all on a new course for managing disease and wellness.”

#1—2013.  Explosive new technology

Think about the smart phone and how far it’s come in just a few short years.  Today, technology is the new intellectual playground that connects vision with application.  And the players are both big, well-funded companies as well as smart, adroit and nimble startups.

#2—2013. The pressing need to advance healthcare and the Affordable Care Act

There’s almost no scientific, political or sociological discussion that doesn’t find its way to health and healthcare.  The costs, access and resources are a key driver to seeking solutions to the health dilemma that exists right now and is projected to only get worse.  Technology has always been part of the answer in other areas.  Today, innovation and technology are poised to advance care in new directions that can drive new efficiencies and lead a course to self-care and wellness.

#3—2013. The caldron of connectivity

Ideas are promiscuous.  The profound interconnectedness of thinkers and ideas create a “neural-network” that powers our imaginations. Another important driver to the digital health revolution is the  increasing level of patient / caregiver connectivity.  The role of telemedicine will foster new connections for care and become essential, proving ground for new “tricorder-type” technology that makes the interaction more clinically robust.

#4—2013.  The power of cool

The advantage of the digital health movement is that carries “the stamp of cool” and takes clinical / social utility to a place beyond the practical—the emotional.  It’s not about taking a pill but living the life of innovation that is validated by science and medicine.

#5—2013. The empowerment of the “quantified self” in health

Our lives are quantified in many ways…tools to measure key clinical parameters (serum glucose, blood oxygen, etc.) will combine with mainstream devices used by joggers and athletes.  The result will become “full circle” data that will proactively inform us of issues and concerns. And all this data and knowledge will become less of burden and more of reassurance that all systems are go!

 #6—2013.  Pharma’s search for new meaning

The evolution of pharmaceutical science will move therapy to include preventative care, gene therapy and other innovations.  The pill, as it conventionally exists today, will have a role, but innovation (and digital health) will make conventional therapies a bit harder to swallow.

#7—2013. Big Data and the electronic medical record

New technology and the vast amounts of generated data come a rich source of information.  Research protocols, family history, medical records and large-scale epidemiological studies are a significant aspect of digital health.  These data may become the single biggest aspect of this new area.

#8—2013.  Money

Money is a key driver to innovation.  The increasing role of venture capital in digital health sends a clarion call of validation that this initiative is here to stay.  

#9—2013. The voices of brilliance

Science, medicine, genomics, electronics, analytics, etc.  The list of contributors to digital health is vast and smart as heck.  And the very nature of the mixed and varied voices coming together will result in a “critical mass” of brilliance rarely seen in the conventional business model.

#10—2013.  The moral imperative

There’s another simple, yet powerful driver at work here.  It’s the right thing to do.  The application of digital health to global health issues and the practice of medicine in developing countries can play a tremendous role in changing the very nature and quality of care that directly translates into life-changing and life-saving treatments.

So, there you have it.  Ten powerful reasons why 2013 was the “year of digital health” and it would reach its proverbial inflection point.  It didn’t.  But the interesting thing here is that we can just change the date from 2013 to 2022 and these predictions feel about right for this year.  Maybe I’m too good of a futurist.  But my sense is that there’s something more fundamental about this “failure” and why technological innovation have been stuck at the starting line.

The reason is both simple and complex: innovation is tough.  But the diffusion of innovation can be even more difficult.  The idea of just building a great solution that will simply be embraced and adopted is false. “Build it and they will come” isn’t a market-driven strategy, but a wish.

Prominent tech, consumer goods and pharmaceutical companies have failed to drive adoption of  new products hailed as big ideas and game changers. The same may be true for technology and digital health and how 2013 offers up many of the  same opportunities and challenges as 2022.

In many ways, medical innovation is part technology and part humanity. And driving adoption along one path can get many heads nodding, but few feet moving in the right direction. The healthcare system is driven by complex vectors of inertia.  From financial gain (companies and providers) to cognitive rigidity to the essential cautions that must be applied to clinical care, advances are often defined as “that same, but better” with concern for the status quo and even self-preservation.

Perhaps an essential fix to this dilemma is to take a page from the “patient centricity” play book that has captured the minds of many in 2022. Innovation, startups, accelerators, and incubators need to think past the big idea and consider the process of adoption as integral to success. Otherwise, we’re stuck in the quagmire of complacency.

My look back to almost a decade ago to the advances of technology and medicine was an eye-opener. Interestingly, it seems like the future is here now and has been for a while. And a key path, in many instances, is to focus on implementation of the brilliant ideas at hand today. Innovation is disruptive, but adoption is gradual. And recognizing this simple truth might just get things moving!

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