Dr. Nusheen Ameenuddin is a Mayo Clinic pediatrician and a member of the American Academy of Pediatrics. While there are many benefits to technology, she says it also can affect children and teens in negative ways, including some behavioral changes.

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Is your teen always texting? Or gaming? Or you just don't know?

"We've always told parents to try to monitor their children's online content, to try to limit it, to make sure that it's not affecting their sleep or their schoolwork or their mood," says Dr. Ameenuddin.

And she says that's a huge job. Kids can get online, literally, from the palms of their hands.

"For parents, I would recommend that they check in with their kid and try to find out what kids are doing when they're online," she says. "Are they spending time playing games with friends? Or are they searching for things? Are they using it for schoolwork?"

Excessive use of social media can be related to how it affects your child, she says.

"Anything that is affecting your child's sleep, anything that's affecting their mood, anything that is affecting their academic performance would be considered excessive use," says Dr. Ameenuddin.

She says that parents and adult caregivers know their children best and are likely in the best position to know what is or isn't excessive. If you are concerned, she says talk with your child's pediatrician or health care team for advice. 

Screen time tips

Screen time can refer to time spent on smartphones, tablets, TVs or gaming devices. That could mean texting friends, watching videos or movies, playing games, doing homework, and browsing the internet. 

Here are some ways to help establish healthy screen time habits.

• Communicate: Talk openly with your children about the video games and content they engage with online.
• Set "no screen" times: Designate periods without screens, like mealtime and one hour before bed.
• Bedroom charging: Encourage charging devices outside the bedroom for better sleep.
• Lead by example: Demonstrate healthy screen habits, such as putting your phone on "do not disturb" during family time and during dinner. 

Related posts:

• Mayo Clinic Minute: How staring at screens can affect your vision
• Mayo Clinic Q and A: Balancing screen time and creating a healthy home for children

The post Mayo Clinic Minute: How much screen time is too much time for your kids? appeared first on Mayo Clinic News Network.

Social media describes internet-based self-publishing platforms allowing anyone with an internet connection to interact with others and share their ideas. Social media connects people well beyond the geographical and socioeconomic boundaries of the 20^th century. According to the Pew Research Center, more than 70% of American adults use social media today, leading to instant access to both complementary and conflicting ideas. 

Not surprisingly, social media sites are playing a large and growing role in where people get their news and information. They contribute to how people develop their worldview, including their understanding of health and health care.

This ease of exchange connects sources of evidence-based medicine directly with potential patients and their families. However, it also connects patients to a bombardment of unverifiable information, delivered through extended social networks. Some of this information may be well meaning, but anecdotal or no longer true to the original source. Other information may be deliberately false or misleading, with intent to benefit from the false information or simply to cause harm.

"Our findings and discussion can add value not only for clinicians, but for patients and other consumers of health care," says Ryan D'Souza, M.D., an anesthesiologist and pain management physician at Mayo Clinic, and the series' first author. "We have provided a framework with which to appraise health information presented on social media networks."

Is this trustworthy information?

First, Dr. D'Souza says, is determining the trustworthiness of the content, including:

• Is the source of the content clear, including the name, credentials and affiliation of the author?
• Is the content comprehensive and up to date?
• Are areas of uncertainty presented, with different views discussed, as relevant?
• Is content independent of conflicts of interest?

In the first paper, the authors describe scenarios of real-world social media content examined for trustworthiness. In the scenarios, they identify and compare several items, providing a simple path to understanding the level of trust that one could assign to each particular piece of information.

Is this information usable?

The authors separate information into two categories — that intended for direct patient use, and that intended for clinicians. They discuss what constitutes usable for patients, as opposed to clinicians.

Patient information should be arranged and presented to meet health literacy standards. In other words, the content should be able to be read and understood by a typical middle school student in their primary language.

"This is not to say that content is not useful if the reading levels are higher than about sixth grade," says M. Hassan Murad, M.D., medical director of the Knowledge Synthesis Program in the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, and the series' senior author. "However, if, for example the Facebook site of an academic medical center posts content directed at peer researchers, their patient audience will be less likely to understand or find it usable."

Meanwhile, although information for clinicians may be presented with more complexity, for ease of understanding, the authors suggest that minimizing technical jargon and statistics increases usability.

"For any audience," continues Dr. Murad, "if the content does not promote self-care, a healthy lifestyle or a collaboration between patient and physician, it is not particularly usable."

Accessibility and privacy

The intended audience must be able to easily obtain the health information from the social media post. Special technical expertise or extra log-in requirements for patient-focused content make it difficult to appraise credibility. These also can block access to those who could most benefit from the content.

"We assign less weight to the importance of privacy and the confidentiality of personal data when accessing social media platforms and content," says Dr. D'Souza. "After all, one of the benefits of social media platforms is their ability to link together people and content based on personal characteristics and interests. However, if a platform is collecting information, it should disclose how that information will be used."

In the paper, the authors reason that widest reach will occur when the intended audience can access the information anonymously.

Deeper dive for clinicians

In the second part of the series, the authors explore the use of data derived from social media.

"We are fortunate that patients tend to trust their doctors above all other sources of information," says Dr. D'Souza. "However, more and more of those patients come armed with information they collected online."

Dr. D'Souza acknowledges that the volume of peer-reviewed literature has been growing faster than many physicians can keep up with. Along with this comes growth in the number of poorly conducted studies, and studies with low quality evidence.

To assist in a broad-reaching manner, the series' authors developed a framework for the appraisal of studies using data collected from social media platforms — a rapidly growing genre.

They recommend considering questions similar to those used when conducting a systematic review, including:

• Did the study address a question that makes sense in the social media environment?
• Did the search include the appropriate platforms and search terms?
• Is the study process reproducible?
• Did the study use appropriate narrative, qualitative or quantitative methods?
• How certain are the study findings?

The authors delved deeper into questions to consider whether a social media-based study makes sense. They provided several examples of studies that appropriately used data derived from a single or multiple social media platforms.

"We would prefer to see a formal study protocol developed for answering research questions with social media derived data," says Dr. Murad. "At a minimum, investigators should have an a priori plan for the search and analysis, one that is logically developed from available knowledge."

To assist clinicians and researchers in understanding and applying their methodology, the authors appraise a real-world study from 2007 assessing YouTube video content about immunization, or vaccination.

The research team also included:

• Lubna Daraz, Ph.D., University of Montreal, Quebec, Canada. Previously Dr. Daraz held a research fellowship at Mayo Clinic.
• Gordon Guyatt, M.D., McMaster University, Hamilton, Ontario, Canada.
• W. Michael Hooten, M.D., Mayo Clinic.

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Related resources

• Mayo Clinic — Evidence-Based Practice Research Program.
• Common Sense Education — Everything you Need to Teach Digital Citizenship.
• Pew Research Center — Internet & Technology.

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Computers, laptops, smartphones all play an important role in the lives of our teens. Dr. Mattke says teens are "using [technology] to learn in the classroom and out of the classroom. They're using it to collaborate and connect on projects."

But it's outside the classroom where too much social media may lead to social problems. Dr. Mattke says kids learn to become passive engagers.

"They're watching everyone else's Instagram, but they’re not engaging and, so, they're losing out on that social connection."

Electronic screens also can disrupt sleep. And a lack of good sleep can result in a depressed mood, moodiness and irritability.

"If they are spending a lot of time on their cellphones or screens, it can affect the hormones in their brain via the blue light that comes off of these screens."

Dr. Mattke offers a few tips:

• Limit recreational screen time to two hours a day.
• Encourage shutting screens down at least an hour before bedtime.
• Set a rule of no screens in the bedroom.

"If they are getting texts or messages that are coming through all night long, that's going to be interrupting their sleep and you're not going to know how late they're up."

Related posts:

• Mayo Clinic Minute: How to tell if your teen is moody versus depressed
• Mayo Clinic Minute: 5 signs of depression in teens
• Mayo Clinic Minute: How much sleep do kids need?

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"When I see your social media feed, I am going to see all that is wonderful happening in your life, and ... I'm going to feel unworthy because my life is so boring compared to yours," Dr. Sood says, explaining how many people feel when scrolling through their social media feeds.

But Dr. Sood says most people don't post the negative things in their lives, so we tend to compare our worst with other people's best. That, he says, can be misleading.

On the other hands, many people seek out social media popularity to feel good about themselves.

"People are paying attention to what I am doing," Dr. Sood says, explaining why some people seek out social media fame. "And if I have, you know, 20 million followers, I feel good about myself, too."

He offers two recommendations to stop you from basing your self-worth on social media. First, limit your time online.

"Just visit there and come back to your real life," he says. "So decrease your dose and duration, and keep it optimal."

Second, use social media for information – not emotional investment.

"So it's like a handshake – not a hug," Dr. Sood says. "Don't use it for emotional fulfillment. It can't provide that."

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ROCHESTER, Minn. — Physicians who receive negative reviews online do not receive similar responses in rigorous patient satisfaction surveys, according to new Mayo Clinic research in Mayo Clinic Proceedings. Yet, compared with colleagues without negative reviews, they score lower on factors that go beyond patient interactions and are beyond their immediate control.

“Our study highlights the disconnection between industry-vetted patient satisfaction scores and online review comments,” says Sandhya Pruthi, M.D., an internal medicine physician at Mayo Clinic, who is the senior author. “Patients need to be aware of these distinctions as they make decisions about their health. Physicians also need to be aware, as they manage their online reputations.”

Online physician reviews have become a popular resource for patients seeking information about medical options, with 1 in 6 physicians being rated. This is the first study to compare data of physicians who had negative online reviews and physicians who did not have negative reviews.

In a pilot between September and December 2014, researchers used Google searches and alerts to track negative online reviews of physicians at Mayo Clinic’s Rochester campus. Of 2,148 physicians, 113 had negative online reviews. The physicians represented 28 departments and divisions.

Researchers then compared these physicians’ scores in a formal patient satisfaction survey with the scores of other Mayo Clinic physicians in similar fields who had no negative online reviews. Researchers found no statistical differences in the overall scores, or in the scores for patient communication and interaction.

However, the group with negative reviews scored much lower on factors beyond patient-physician interactions. Those variables include interaction with desk staff, nursing, physical environment, appointment access, waiting time, problem resolution, billing and parking. The data did not indicate the specific instances or patient experiences that led to negative reviews.

Researchers acknowledge the study’s limitations. The physician groups were small. The time period to collect data, which used a single search engine, was limited. The online reviews reflected single experiences of patients.

In an editorial published in the same issue of Mayo Clinic Proceedings, Bradley Leibovich, M.D., a Mayo Clinic urologist, says this research offers timely messages for patients with complaints, patients searching for information, providers and, ultimately, health care organizations.

“These findings … underscore the totality and integrity of processes, elements and encounters – and not just the patient-provider interaction – that all need to be effectively and cohesively in place to ensure optimal patient experience and welfare,” Dr. Leibovich writes.

In addition to Dr. Pruthi, Robert (R Jay) Widmer, M.D., Ph.D, an interventional cardiology resident at Mayo Clinic, is the first author. The researchers report no financial support or conflicts of interest.

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About Mayo Clinic Proceedings
Mayo Clinic Proceedings is a monthly peer-reviewed medical journal that publishes original articles and reviews dealing with clinical and laboratory medicine, clinical research, basic science research, and clinical epidemiology. Mayo Clinic Proceedings is sponsored by the Mayo Foundation for Medical Education and Research as part of its commitment to physician education. It publishes submissions from authors worldwide. The journal has been published for more than 80 years and has a circulation of 130,000. Articles are available on the Mayo Clinic Proceedings website.

About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to clinical practice, education and research, providing expert, comprehensive care to everyone who needs healing. Learn more about Mayo Clinic. Visit the Mayo Clinic News Network.

Media contact:

• Rhoda Madson, Mayo Clinic Public Affairs, 507-284 5005, newsbureau@mayo.edu

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I got the news early yesterday in an email from the Cowans’ daughter, DeDe Shour:

One of the last questions a week ago my Dad asked me was, "Do you think there will be a piano in heaven I can play?" (Of course our Dad could never pass up a piano without playing it). I told him I was certain there was something similar to a piano but much more glorious and that I was sure he would be joining with the angels playing it for the Lord.

So if you happen to hear some rag-time music floating through the air, smile....cause it's just our dad playing the piano as he brings joy to those who have gone before him.

Mr. Cowan certainly brought joy to millions while he was here. So with DeDe’s permission, I want to share some memories of Marlow and also let you remember (or see for the first time) for yourself. 

Marlow and Frances Cowan are most widely known for this video captured and uploaded to YouTube in September 2008 by Jodi Hume, the daughter of another Mayo Clinic patient:

Seven years years ago last month, we saw Jodi's video and included it here on Sharing Mayo Clinic, and also posted the link to Facebook and Twitter. The video's view count at the time was just over 1,000.

Within a month, it had over a half-million views, leading Good Morning America to fly DeDe and her parents to New York for a live studio performance on the morning their YouTube view count reached 2 million.

The Cowans also were interviewed (via something akin to Skype) for a story on the Japanese TV network, NHK, and were featured in many other news stories.

We've stayed in touch since then, as I had opportunities to visit with them in Ankeny, Iowa, and as they also have returned to Rochester for some medical appointments and even a couple of concerts.

We're honored that the Cowans chose to do their last major public performance at Mayo Clinic, an after-hours concert in connection with a health care social media conference we hosted in 2011. In the video below you'll see Marlow's wit, as well as his love for music and for Frances:

For Marlow Cowan, music was a ministry. Through it he brought joy to millions (more than 11 million on YouTube as of this morning, as well as countless others through live performances.) I have been blessed to know Marlow and his family.

This video from the first time I met the Cowans at their home in Iowa captures well who Marlow was, and why so many of us will miss him:

Editor's Note: Lee Aase is a communications director at Mayo Clinic.

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Mayo Clinic will host an interactive webinar on stem cells and growth factors Wednesday, March 23, at noon CDT.

Dr. Jonathan Finnoff, Medical Director for Sports Medicine – Minneapolis and Head Team Physician for the Minnesota Timberwolves & Lynx, will participate in the webinar. Physical Medicine & Rehabilitation expert Dr. Jacob Sellon will also join the conversation to discuss the hope and hype around this newly emerging and game-changing area called regenerative medicine.

A live Q & A session will follow the presentation. Sign up for the webinar now to receive email reminders and post questions for the doctors. Read more on Mayo Clinic Connect.

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#Glaucoma Twitterchat TODAY at #ABCDrBchat 1-2  p.m. ET 

@ArthurSitMD @NatEyeInstitute will join ABC’s Dr. Richard Besser

Glaucoma is a challenge for Baby Boomers, but how early in life can glaucoma appear? The answer may surprise you. Mayo Clinic expert Arthur Sit, M.D., is a nationally regarded ophthalmologist and researcher on glaucoma, and he'll join the chat along with experts from the NEI National Eye Health Education Program. Click here to learn more about Dr. Sit’s research.

Read more about symptoms of glaucoma.

The post How to Save Your Sight – Treat Glaucoma – Live with Declining Vision appeared first on Mayo Clinic News Network.

Mayo Clinic Cancer Center and the American Association for Cancer Research host Twitter Chat  

Mayo Clinic Cancer Center and the American Association for Cancer Research (AACR) will partner with TIME magazine for a Twitter chat titled, “The Role of Proton Beam Therapy in Cancer Care.”

Tuesday, Sept. 23, 1-2 p.m. ET.
Follow #ProtonBeam

The chat will be moderated by TIME’s senior health reporter @AlicePark.

Mayo Clinic Radiation oncologists Sameer Keole, M.D., Nadia Laack, M.D. and Samir Patel, M.D. will join Dennis Hallahan, M.D., from the AACR’s Radiation Oncology Task Force.  Dr. Hallahan is chairman of the Radiation Oncology Department and the Elizabeth H. and James S. McDonnell III distinguished professor in medicine at Washington University School of Medicine in St. Louis.

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Our next Mayo Clinic Radio program, Saturday, August 16 at 9 a.m. CT, will highlight the influence and power of social media in health care. Medical director for the Mayo Clinic Center for Social Media Farris Timimi, M.D., will join us to discuss the impact of social networks on health care. Hope you'll tune in!

Myth or Fact: The main reason many physicians and hospitals give for not participating in social media is they have legal concerns.

Follow #MayoClinicRadio and tweet your questions.

To listen to the program on Saturday, click here.

Mayo Clinic Radio is available on iHeart Radio.

Listen to this week’s Medical News Headlines: News Segment August 16, 2014 (right click MP3) 

Mayo Clinic Radio is a weekly one-hour radio program highlighting health and medical information from Mayo Clinic. The show is taped for rebroadcast by some affiliates.

For future topics, click on Upcoming Programs.
To listen to archived shows, click on Episodes.
If there is a topic you would like us to address, drop us a note. Click here to create a guest account.

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