Parenting in the modern world means worrying about how much time your child spends in front of a screen. Pediatricians may recommend only two hours of screen time a day, but kids actually spend as much as seven hours a day looking at TVs, computer monitors, video games, tablets, and cell phones. Study after study has linked those sedentary hours to the skyrocketing rate of childhood obesity in the U.S.
I realize that it’s not realistic in today’s high tech world to restrict screen time to two hours, especially for teenagers. So here’s an alternative: How about harnessing some of that technology to make our children healthier? The need couldn’t be more dire. One in three children in America is overweight or obese, and obesity remains one of the biggest threats to the health of our children, both now and as they grow into adults. That’s why the Robert Wood Johnson Foundation announced that it will pledge $500 million over the next 10 years to expand efforts to ensure that all children in the U.S. — no matter who they are or where they live — can grow up at a healthy weight.
Building on a $500 million commitment made in 2007, this brings our funding of this issue to $1 billion. To get the biggest impact for those dollars, we need to come up with fresh ideas, creative approaches, and new tools that will help us build a culture of health for our children, and their children. What better tool than the digital devices our children have already mastered?
And adults can lead by example, because many of us have already embraced digital health tools. There are currently 17,000 mobile apps designed to improve our health; according to industry estimates, half of the world’s 500 million smartphone owners will have a health app on their device this year. Plus, some 70 million wearable fitness trackers were sold in 2014, and people are expected to buy another 160 million by 2016.
Of course, having health apps and using them is not always the same thing. And getting kids to use digital technology and social media for health is yet another challenge. But it’s not that big of a leap from Snapchatting with friends, or searching YouTube and Vine, to sharing stats and photos about how many days you walked to school, vegetables you ate or miles you rode on your bike. Almost 95% of 12- to 17-year-olds in the U.S. have Internet access at home or school. Why not meet them in their online world?
We already know it can work. Zamzee, a children’s online activity meter and motivational website designed by HopeLab, with feedback from actual kids (and funding from RWJF) is meant to get kids moving more. Research shows that Zamzee increased physical activity in kids by 59% on average over a six-month study period.
There is a growing number of such digital health tools designed with kids in mind. The Weigh2Rock.com website, founded by a pediatrician, allows overweight teens, pre-teens and their parents to form support groups, share tips and track their personal fitness goals online. It also allows healthcare providers to follow the progress and interact with their patients online. Leapfrog’s Leapband, introduced in August, is a personal fitness tracker for children. Worn like a watch, it uses games to get kids moving and allows them to rack up points as they progress though the challenges. FoodnMe.com, a site that promotes healthy eating, has a fun SmashYourFood mobile app that lets kids smash or explode a variety of foods (virtually, of course) while learning about their fat, sugar, and salt content. Actually, this one is fun for adults, too
I’d like to see a lot more of these digital health tools for children. My hope is that developers, parents, health professionals and coaches will start thinking more like kids. Or, better yet, ask some kids what technologies and apps would most entice them to embrace healthier choices. I’ll bet they’d come up with some pretty creative ideas. Let’s start now. If you have some ideas about how to harness personal data, digital technologies and social media in ways that can help kids, and their families, get and stay healthy, please share in the comments. Because even $1 billion won’t solve this problem without lots of help.
As a user of computing resources for almost 50 years, I have seen changes that were unimaginable in prospect and are still dramatic in retrospect. Nevertheless, throughout my career I have always felt I could rely on one iron-clad proposition, namely, “Computers are never fast enough.” It seemed clear to me that the human imagination would always run well ahead of the ability of computers to keep pace. In effect, we were operating in a world of computational scarcity, and always would be.
At some level, I feel sure this Law of Computational Scarcity will continue to apply. Nevertheless, within my limited focus on the domain of information systems for economics, finance, accounting and risk management, I have become convinced that I must surrender the conviction of a lifetime. In this domain, I believe we are entering an Era of Computational Abundance.
A recent straw in the wind was Google’s announcement that it is abandoning the use of Captchas – distorted text that is used online to distinguish humans from web robots. It seems the robots can decipher even the most difficult Captchas 99.8% of the time.
While growth in the Internet of Things – devices that are connected to the web, such as driverless cars – will likely be constrained by limited computing capacity, the resources produced to make this a reality at all will swamp traditional computing domains such as financial risk management. A relevant recent example of this phenomenon is the revolution in international voice communications. Fifteen years ago, international phone calls were notably expensive; today, they are practically free on Skype, Apple FaceTime, Vonage and other alternatives. How did this happen? In effect, we built a huge global communication capacity geared to support the new market of streaming video. In this context, voice became almost a rounding error. It could be a virtual giveaway relative to the massive expansion in global communication capacity.
As global computing capacity expands exponentially, driven by things talking to each other rather than to people, traditional business computing will start to take on a role similar to voice communications over the past 15 years. It will be swimming in an ocean of computational abundance. This raises important technological and sociological difficulties.
Virtually all existing business computing systems have been built around an architecture rooted in the mentality of computational scarcity. Minimizing storage requirements and CPU cycles has always been a key goal for system architects and developers. This has a serious downside. A crucial technique for achieving computational parsimony is to embed information in formal structures – the schemas that underlie relational database designs are pervasive examples of this. Such schemas economize on storage and CPU requirements but, because of multiple, inconsistent schemas, effectively mask important metadata needed to consolidate the underlying information across databases.
An architecture based on computational abundance will look very different and can only be implemented incrementally. During the transition, these two architectures will have to operate in tandem. One way this can work is to build enterprise data stores on the basis of the new realities. This would employ traditional extract, transform and load tools to access data from source systems but store the results in transparent, self-describing documents rather than in a complex and inflexible relational data warehouse.
At least as big a problem will be the sociological one. Hardly any IT professional under 50 years of age has stored data in any fashion other than in relational databases. This deeply ingrained bias will be hard to overcome. In the 1960s, it was accepted wisdom that, “No one is ever fired for buying IBM.” Today, it is accepted wisdom that, “No one is ever fired for buying Oracle database licences.” The effectiveness of relational databases within narrow applications for which they are designed reinforces this bias.
Top management needs to impress the importance of enterprise- wide data transparency on its IT staff. Those that do not will risk being dangerously slow in reaping the benefits of computational abundance.
Two thirds of employees in industrialized countries use a computer on a daily basis. One in five interact with a computer at least 3/4 of the total work-time1. This usage of the technology ushered in an epidemic of work related ailments known as musculoskeletal disorders (MSDs). They are also known as repetitive motion disorder (RMD), repetitive motion injury (RMI), repetitive strain injury (RSI), ergonomic related disorder (ERD) and cumulative trauma disorder (CTD).
Though these disorders may as yet not be household terms, the patent effects of substantial computer use reveal themselves in terms of increased morbidity and declining productivity. In short, in the absence of ergonomic practices, employee efficiency in the American workplace takes a substantial hit.
In fact, according to the United States Bureau of Labor and Statistics (Chart 1), the prevalence rates for these types of disorders increased 1200% from 1982 to 1994 for all standard industry codes; however, those who employed good ergonomic safety management strategies enjoyed a 27% decline through 2000. Even though the rate reached a plateau for office or knowledge workers (computer workers) the wane may have occurred as a result of skewed interventions (e.g., training, workspace design and layout, equipment and accessories, work organization, etc.)2.
In addition, according to the Liberty Mutual Workplace Safety Index, injuries due to repetitive motion disorders from using computers were the #4 cause of work injuries in 2001 and 2002. The bottom line? A $2.8 billion price tag in 2002 for haphazard ergonomics3.
The Good News
According to OSHA, work related musculoskeletal disorders are the most prevalent, most expensive, and most preventable injuries in the American workplace today 4. The Center for Disease Control and Prevention's Injury Control Division reveals that injuries follow the same principles as infectious diseases and are just as predictable and therefore, just as preventable5.
Historical Sketch Of Computer Usage
Twenty years ago, computer workstations typically adjusted easily; however, they were relatively uncomfortable. Over time, they have morphed into rather complex devices with myriad levers and buttons that allow an uneducated user too many options for damage. Position (user may sit or stand), chair interfaces that move in multiple directions, numerous viewing angles of the monitor and fancy keyboard constructions that are split in half and look like accordions supply bells and whistles that may end up delivering harm unless organizations provide training. For those in the know, today's desktop computer were not necessarily designed to cooperate with the body; the user's natural alignment and paths of motion need not become contorted or required to engage in movements that never were designed to become repetitive nor prolonged. Modern fixed computer workstations beg accommodation to the body's motion flow.
Unfortunately, just when we are getting accustomed to our cubicles and other workstation environments, and are making gains in users' ergonomic awareness, some large computer companies have stopped making these computers and amazingly, are forecasting the death of the personal computer. Over the last 10 years, advances in technology have brought us a smorgasbord of new miniaturized devices or gadgets that provide us with faster communication — in essence what amounts to a handheld mobile computer workstation. Ironically, with this enhanced portability comes additional risk exposure for injury, particularly for the hands and neck.
These smaller devices foster awkward postures such as hands twisted into claws, and unnatural neck and shoulder angles — in short, resulting in increased discomfort and less than-efficient performance6. The root cause appears to be poor design — keyboarding areas, pointing devices (mouse) and a monitor-to eye interface that work together to produce a non-accommodating interactive work station. In particular, laptops (notebooks), tablets, I-phones and various PDAs unwittingly draw an unaware user into muscular and skeletal distortions.
Are the gadgets themselves to blame? Arguably, what is most important is the method by which we interact with them: the duration of exposure (how much is too much?), work organization and flow-process stress that occurs at less-than-optimal locations for usage. For example, many users must often conduct business in places such as coffee shops, airport waiting areas, planes, trains, and automobiles — places not designed for anyone to remain effectively postured.
Several primary physical risk and causation factors come into play between the computer user and all computer workstation environments, whether large or small. Three interfaces must be negotiated: the support interface (chair and floor), the manual interface (keyboard and mouse) and the monitor interface (distance from user, luminance, height). In addition to physical risk factors, behavioral variables commonly emerge: individual keyboarding and mousing techniques and style, excessive work pace without a break, prolonged sitting, and awkward forward head and wrist postures complicate the risk. What should be done about this trend?
The Spectrum Of Prevention
Fortunately, there are several easy-to-use methods to implement an effective ergonomics program. Once incorporated, they have prevention potential. A good ergonomics program can minimize computer-related musculoskeletal disorders by utilizing a more proactive and comprehensive approach to the potentially disabling conditions computer users in various workplace settings encounter. The answer lies in numbers.
It has been well documented that an integrated model of ergonomics safety management is critical for developing a healthy, effective workforce provided the company emphasizes a grassroots participatory approach in order to maximize collaboration and communication. The first step is to dedicate an ergonomic team. A successful group should comprise: an ergonomist, risk manager or loss control specialist, health service provider, company management representative (e.g., human resources, CFO, general manager, etc.), and a pre-designated employee ergonomics team trainer (leader)7.
This model efficiently capitalizes company resources and makes the best use of opportunities for surveillance and behavior change. It has been particularly effective in various organizations where the majority of employees consist of office and biotechnical workers typically tethered to their desktops 4-16 hours; all the while engaging in forceful/repetitive/awkward keyboarding and mousing whether interacting with desktop computers or hand-held devices. This extended risk exposure without appropriate rest cycles invites subsequent unwieldy neck and constrained back postures. The inevitable result? Discomfort at best or an actual recordable MSD at worst.
Nevertheless, these disorders have been shown to respond significantly to surveillance and behavioral change interventions such as job-task-specific ergonomics team training that provides information about strategies to maintain neutral work postures and movements when interacting with computers (Table 1).
Table 1: Team Intervention Recommendations
Have A Seat
While adjusting your chair, make sure that you are sitting on the seatpan.
Maneuver the backrest so it supports the low back curve and the shoulder blades at a 90 -105 degree angle (upright and lever should be located at very back of chair on the right or ratcheting it up and down for the Office Masters).
When keyboarding, recline to 120 degrees for surfing the net or telephoning and decline at 60 – 90 degrees for writing.
Use sit-to-stand options (available now for alternating 30 minutes standing and 30 minutes for sitting).
Watch Your Hands
While keyboarding/mousing, keep your arms, wrists and hands in a neutral work posture, as if playing a piano.
Avoid flexing wrists downward, sideways or extending upwards.
Place hands on lap or armrest when paused or resting.
Wrist rests are to be used when resting only!
Feast Your Eyes
Rest your eyes by placing hands in your lap for 30 seconds while looking away from your screen at another object 20 feet away. Repeat every ten minutes, as you really do deserve a break today … a small one now will give your body a big one later!
Ring A Bell
Consider installing software that reminds you to take short breaks every 10 -15 minutes. While seated, stretch hands, neck and shoulders using helps such as the ForgetMeNot Online Reminders that can be found at the following link www.remedyinteractive.com> (microbreaks).
Stretch Your Day
Get up from your desk or table and walk to the water cooler or perform some simple stretches near your workstation at least once every 50 minutes or so (macrobreaks) that can be found at the following link www.netergonomics.net (wallet-sized stretching cards).
Pay close attention to head posture. Draw an imaginary line so that it begins at the top of your head, extends over your ear to the shoulder, ending at the hip.
Head posture should be maintained suspended, like a puppet, with an imaginary line drawn from the top of head, over the ear, aligned directly over the shoulder and hip as viewed from the side. This avoids forward head posture or craning (for every inch the head moves over the shoulder, the neck bears 30 additional pounds of pressure per square inch … yikes!
No Foot Faults
Plant feet firmly on the floor at a 90-degree angle to the knees.
Avoid resting feet on the pedestals of the chair.
Order a footrest if you are less than 5'2″ or have a medical condition that elicits edema (swelling) in the legs/feet. See www.ergoanywhere.com.
Place your computer monitor/monitors directly in front of you at an arm's length away or 18 – 28 inches with the top of the screen or tool bar at your eye level.
Tilt the screen back 15 degrees, much like you would hold a book you are reading (unless you use bifocals/trifocals-then lower it slightly).
Make sure you have had an eye exam within the last year.
There are specialized accommodation products for mobile computer laptops, tablets, e-readers and smart phones found at www.ergovue.com that will make life a little easier while on the go!
Make It Happen
Communicate with clients in easy-to-understand messages.
Underscore the benefit to both the worker and the company that employs these practices.
Emphasize the long term effects of increased production, increased efficiency, and improved personal health.
Utilize specific and customized approaches such as the OccuCom Ergonomic Team Training Program package that is available at www.netergonomics.net, which also provides Cal-OSHA and Fed-OSHA compliance.
If your employees are experiencing any discomfort, have them contact their supervisor or designated ergonomics-team leader for a possible ergonomic evaluation of their workstations. Also, these same principles and practices will apply to employees with material-handling tasks of transferring mail, printed materials, folders, bins, etc. in the office area. Any employee whose tasks include lifting should be trained to use correct lifting postures, personal protective equipment, and employ stretching and strengthening recommendations for maintaining neutral work postures, especially in the wrists, shoulders, and low back.
Moreover, as ergonomists, health and safety professionals, human resources personnel, loss control and risk managers, and managers of various workplace settings, we must provide a solution to the question of how much exposure for those workers interacting with various computer devices is too much. Employees who must use a workstation are ever exposed to potential harm through extra strain or forces from the repetitive motions and awkward postures while keyboarding mousing, or staring at a monitor screen for hours on end. Further, we must be on the lookout for the important question in terms of what is good ergonomics vs. voodoo ergonomics. We must be adept at identifying the potential smokescreens of unsuccessful products and advice given to companies with real problems in their workplace. White collar environments are especially at risk for unqualified vendors … be careful out there when selecting an intervention program8.
1 Brandt, LP. Neck and shoulder symptoms and disorders among Danish computer workers. Scand J Work Environ Health 2004, 30:399-409.
2 Sherrod, C. Johnson, D. The modulation of upper extremity musculoskeletal disorders in a knowledge worker population with chiropractic care and ergonomics. ACC-RAC Washington, DC. Journal of Chiropractic Education, 58;2007.
3 Liberty Mutual Safety Index of 2002. Liberty Mutual Insurance Company Seminar. 2003.
4 Sherrod, C. The relationship between an ergonomics team training program and the compression of repetitive motion injuries in a bus operator population. ErgoCon Conference Proceedings, 4; 2000.
5 Cotton, P. Preventive medicine extends to injuries, too. Journal of American Medical Association 1990, 263:19-2097.
6 Korkki, P. So many gadgets, so many aches. New York Times. 2011; 12.
7 Sherrod, C. The relationship between an ergonomics team training program and the compression of repetitive motion injuries in a bus operator population. ErgoCon Conference Proceedings, 4; 2000.
8 Chong, I. Prioritize office workstation goals and watch out for voodoo ergonomics. Occupational Health and Safety. 1993, pg. 55-57.