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Ann Fudge: “We Are Losing Civility and Openness”

Topic: Democracy’s future

Ann Fudge: I think one of the interesting challenges for democracy in our time is the fact that we have so many opportunities for people to express their points of view, whether it’s on the internet and express their points of view not always looking at the facts. So it’s almost like the person who can go and stand up on a soap box and express their feelings, but maybe not really have all the facts. And the interesting dynamic I think which I’m sure we’re going to be studying for awhile and it’s been my career, marketing and communications, is how is communications helping or hurting democracy and how is the spread of the internet and how is the fact that there is so many blog sites, what we would call micro marketing back in the day, to target a lot of different audiences. How does that influence the conversation and the discourse? And I think one of the challenges that we have is sometimes we’re losing the very civility and the openness and the listening to other points of view.

I try to read a vast array of newspapers even if and particularly if I don’t believe or necessarily concur with everything that is in their editorials. But I find that there is always something that makes me pause and think about my view on something because I look at it. Because I look at these two things opposed to one another and say, “You know what? It’s not really black and white.” We really don’t live in a black and white world. There are so many shades of grey and there are elements of that that you know what, I agree with and I surprise myself and I think sometimes we lose that. People don’t allow themselves to be open to people who have different points of view. One of the things that I think is really important and exciting about the global world we live in is that we are so different. I love traveling and learning about new cultures because I think it helps me to open my mind more in the day-to-day living and work that I get involved with.

Question: Do global conversations like the World Economic Forum help?

Ann Fudge: I think they’ve helped to a degree because it starts a conversation and then those people go back. Still, when you think about it, it’s still a very small segment of the population. It’s only been what, maybe three or four years that NGOs have been actively included in the discussions, whereas they weren’t before. I think that inclusion back to listening to perspectives that may be different from yours has been helpful. I think we’ve got to do more of that. We tend to look at Davos, but sometimes the little mini Davos conversation that people can start in their own communities are extremely helpful and looking at things and listening to other perspectives.

Recorded on September 3, 2009

Young and Rubicam’s former CEO finds herself constantly in search of an answer to the question: What is the future of the democracy?

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Duke University researchers might have solved a half-century old problem.

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  • Duke University researchers created a hydrogel that appears to be as strong and flexible as human cartilage.
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Predicting PTSD symptoms becomes possible with a new test

An algorithm may allow doctors to assess PTSD candidates for early intervention after traumatic ER visits.

Image source: camillo jimenez/Unsplash
Technology & Innovation
  • 10-15% of people visiting emergency rooms eventually develop symptoms of long-lasting PTSD.
  • Early treatment is available but there's been no way to tell who needs it.
  • Using clinical data already being collected, machine learning can identify who's at risk.

The psychological scars a traumatic experience can leave behind may have a more profound effect on a person than the original traumatic experience. Long after an acute emergency is resolved, victims of post-traumatic stress disorder (PTSD) continue to suffer its consequences.

In the U.S. some 30 million patients are annually treated in emergency departments (EDs) for a range of traumatic injuries. Add to that urgent admissions to the ED with the onset of COVID-19 symptoms. Health experts predict that some 10 percent to 15 percent of these people will develop long-lasting PTSD within a year of the initial incident. While there are interventions that can help individuals avoid PTSD, there's been no reliable way to identify those most likely to need it.

That may now have changed. A multi-disciplinary team of researchers has developed a method for predicting who is most likely to develop PTSD after a traumatic emergency-room experience. Their study is published in the journal Nature Medicine.

70 data points and machine learning

nurse wrapping patient's arm

Image source: Creators Collective/Unsplash

Study lead author Katharina Schultebraucks of Columbia University's Department Vagelos College of Physicians and Surgeons says:

"For many trauma patients, the ED visit is often their sole contact with the health care system. The time immediately after a traumatic injury is a critical window for identifying people at risk for PTSD and arranging appropriate follow-up treatment. The earlier we can treat those at risk, the better the likely outcomes."

The new PTSD test uses machine learning and 70 clinical data points plus a clinical stress-level assessment to develop a PTSD score for an individual that identifies their risk of acquiring the condition.

Among the 70 data points are stress hormone levels, inflammatory signals, high blood pressure, and an anxiety-level assessment. Says Schultebraucks, "We selected measures that are routinely collected in the ED and logged in the electronic medical record, plus answers to a few short questions about the psychological stress response. The idea was to create a tool that would be universally available and would add little burden to ED personnel."

Researchers used data from adult trauma survivors in Atlanta, Georgia (377 individuals) and New York City (221 individuals) to test their system.

Of this cohort, 90 percent of those predicted to be at high risk developed long-lasting PTSD symptoms within a year of the initial traumatic event — just 5 percent of people who never developed PTSD symptoms had been erroneously identified as being at risk.

On the other side of the coin, 29 percent of individuals were 'false negatives," tagged by the algorithm as not being at risk of PTSD, but then developing symptoms.

Going forward

person leaning their head on another's shoulder

Image source: Külli Kittus/Unsplash

Schultebraucks looks forward to more testing as the researchers continue to refine their algorithm and to instill confidence in the approach among ED clinicians: "Because previous models for predicting PTSD risk have not been validated in independent samples like our model, they haven't been adopted in clinical practice." She expects that, "Testing and validation of our model in larger samples will be necessary for the algorithm to be ready-to-use in the general population."

"Currently only 7% of level-1 trauma centers routinely screen for PTSD," notes Schultebraucks. "We hope that the algorithm will provide ED clinicians with a rapid, automatic readout that they could use for discharge planning and the prevention of PTSD." She envisions the algorithm being implemented in the future as a feature of electronic medical records.

The researchers also plan to test their algorithm at predicting PTSD in people whose traumatic experiences come in the form of health events such as heart attacks and strokes, as opposed to visits to the emergency department.

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