Journal articles on the topic 'Best Apple Watch for Seniors'

Abstract Introduction Consumer wearables use accelerometry and heart rate to predict sleep, the same data signals used by research-grade devices to classify sleep/wake patterns. However, metrics predicted by consumer wearables are based on black box algorithms limiting their use in research. The objective of this study was to develop algorithms for predicting sleep in children based on the raw accelerometry and heart rate data from a popular consumer wearable device, therefore bypassing the onboard black box algorithms. Methods 38 children (M=8.5 years, SD=2.4, 42% black, 61% male) underwent overnight laboratory-based polysomnography (PSG) while wearing an Apple Watch Series 7. Heart rate and accelerometry data were collected via the Apple Watch application program interface. Features extracted included (1) age, (2) heart rate, (3) y-axis offset angle, (4) y-axis angle relative to x-axis (y-angle), (5) x-axis fast Fourier transformation (FFT) 4Hz, (6) x-axis FFT 9Hz, (7) vector magnitude (VM) FFT 9Hz, (8) VM FFT 14Hz, (9) mean power dispersion (MPD), (10) bandpass filter followed by Euclidean norm/vector magnitude (BFEN), (11) dominant signal power at 0.6–2.5Hz (PMAXBAND), and (12) activity counts. Four machine learning models: logistic regression (LR), K-nearest neighbor (KNN), random forest (RF), and neural network (NN) predicted sleep or wake. Model performance was evaluated by F1 score, precision, sensitivity, and specificity. Feature importance was evaluated using the RF model. Results LR achieved the best performance according to F1 score (RF: 85.04, LR: 86.50, KNN: 82.52, NN: 85.13). LR also had the highest precision (RF:88.33, LR:88.94, KNN: 86.77, NN:87.95), and nearly the highest sensitivity (RF:84.52, LR:86.11, KNN:84.73, NN:86.55) and specificity (RF:75.72, LR:75.00, KNN:54.01, NN:60.57). BFEN was the most important feature, followed by MPD, age, PMAXBAND, VM FFT 14Hz, x-axis FFT 9Hz, heart rate, y-axis offset angle, y-angle, activity count, VM FFT 9Hz, x-axis FFT 4Hz. Conclusion Raw accelerometry data combined with heart rate data from the Apple Watch Series 7 was able to detect sleep and wake in children. Leveraging the raw accelerometry data is a viable alternative to relying on black-box algorithms for sleep classification in consumer wearable devices. Support (if any)

Background: Sickle cell disease (SCD) is an inherited blood disorder that impacts the structure of red blood cells. The most common complication of SCD are vaso-occlusive crises (VOCs), commonly called pain crisis. Frequency and intensity of VOCs can differ among individuals. The unpredictable nature of VOCs increases risk of further complications, limits daily activities, affects mental well-being, and decreases health related quality of life. The use of mHealth and wearables for those living with SCD allows the opportunity to better understand pain and general wellbeing through real time data and analysis. Objectives: We aimed to: 1) Establish a comprehensive baseline health profile for individuals with SCD; and 2) determine potential relationships between patient reported symptoms and biometric data. Methods: Following IRB approval, patients entering the SCD clinic or the SCD Day Hospital at Duke University were approached, consented, and provided with the Nanbar Health app. Participants were instructed to make entries at least once daily and wear an Apple Watch throughout the day for 6 months. If a participant did not have Apple devices, an iOS Apple smartphone and/or Apple Watch series SE were provided. Self-reported general symptoms were recorded in the Nanbar Health app on scales from 0 (none) to 10 (most severe). General wellbeing was rated on an emoji scale, converted to 1 (worst/'frowny face') to 5 (best/'smiley face'). The biometric data from wearable collected included heart rate, step count, heart rate variability (HRV), resting heart rate (RHR), respiratory rate, and O2 saturation. For participants that had their own Apple Watch, 3 months of retroactive data was acquired. Statistical and network analysis was performed to analyze the correlations between symptoms, biometric data, and the general wellbeing of the participant. Results: Over 3 months, 18 participants were enrolled in the study. Median age of participant was 25 (IQR 21-33), 10 females, all Black/African American, and most either HgbSS (72%) or HgbSC (16%). Participants logged symptoms in the app 597 times over 93 days with a median of 0.33 entries/day/patient (IQR 0.22-0.44). The average pain score participants reported was 5.9 (SD 2.4, n=220). The three most reported symptoms, besides pain, were tiredness (22.1%), headache (5.2%), and priapism (5%). The patient-reported general feeling average was 3.3 (n=597, SD 1.6). Heart rate (n=74646), HRV (n=1277), and step count (n=1566) were the most recorded biometrics from the wearables. The average heart rate, HRV, and step count were 105.1 bpm (SD 26.8), 31.9 ms (SD 13.3), and 4100 steps/day (SD 5960), respectively. Significant expected correlations include between pain and priapism (r=0.85, p<0.01), aching and pain (r=0.78, p<0.01), and feeling bad and aching (r= -0.74, p<0.01). We also found feeling well correlated positively to back pain and tired correlated negatively with aching (see Table 1). Using network analysis of biometrics, RHR and HRV had a higher expected influence on patient feeling compared to the other biometrics collected. Conclusion: Baseline biometric characteristics for patients were similar to other diseases with chronic pain and as expected, pain is the most common symptom reported. Our data reflected lower HRV compared to healthy individuals and consistent with other disorders characterized by chronic pain. However, compared to other chronic pain disorders, patients with SCD appeared to have lower HRV values. There was no strong correlation (>0.7) between biometrics obtained by the watch and SCD patient-reported pain scores. Our study found a strong significant correlation between priapism and feeling cold. The strongest correlation was between feeling tired and feeling cold, however, tired/fatigue was also significantly correlated with priapism and feeling cold, although negatively correlated with aching. Limitations to conducting comprehensive analyses and making direct comparisons with other conditions include discrepancies in biometrics due to high variability and participant adherence. These limitations underscore the need to enroll more patients and improve patient adherence to improve the reliability of biometric data in future studies. Future efforts will compare the use of other mHealth devices besides the Apple Watch and expand to patients outside our institution.

BACKGROUND: Manual interpretation of single-lead ECGs (SL-ECGs) is often required to confirm a diagnosis of atrial fibrillation. However accuracy in detecting atrial fibrillation via SL-ECGs may vary according to clinical expertise and choice of smart device. AIMS: To compare the accuracy of cardiologists, internal medicine residents and medical students in detecting atrial fibrillation via SL-ECGs from five different smart devices (Apple Watch, Fitbit Sense, KardiaMobile, Samsung Galaxy Watch, Withings ScanWatch). Participants were also asked to assess the quality and readability of SL-ECGs. METHODS: In this prospective study (BaselWearableStudy, NCT04809922), electronic invitations to participate in an online survey were sent to physicians at major Swiss hospitals and to medical students at Swiss universities. Participants were asked to classify up to 50 SL-ECGs (from ten patients and five devices) into three categories: sinus rhythm, atrial fibrillation or inconclusive. This classification was compared to the diagnosis via a near-simultaneous 12-lead ECG recording interpreted by two independent cardiologists. In addition, participants were asked their preference of each manufacturer’s SL-ECG. RESULTS: Overall, 450 participants interpreted 10,865 SL-ECGs. Sensitivity and specificity for the detection of atrial fibrillation via SL-ECG were 72% and 92% for cardiologists, 68% and 86% for internal medicine residents, 54% and 65% for medical students in year 4–6 and 44% and 58% for medical students in year 1–3; p <0.001. Participants who stated prior experience in interpreting SL-ECGs demonstrated a sensitivity and specificity of 63% and 81% compared to a sensitivity and specificity of 54% and 67% for participants with no prior experience in interpreting SL-ECGs (p <0.001). Of all participants, 107 interpreted all 50 SL-ECGs. Diagnostic accuracy for the first five interpreted SL-ECGs was 60% (IQR 40–80%) and diagnostic accuracy for the last five interpreted SL-ECGs was 80% (IQR 60–90%); p <0.001. No significant difference in the accuracy of atrial fibrillation detection was seen between the five smart devices; p = 0.33. SL-ECGs from the Apple Watch were considered as having the best quality and readability by 203 (45%) and 226 (50%) participants, respectively. CONCLUSION: SL-ECGs can be challenging to interpret. Accuracy in correctly identifying atrial fibrillation depends on clinical expertise, while the choice of smart device seems to have no impact.

Heart rate variability (HRV) has been studied for decades in clinical environments. Currently, the exponential growth of wearable devices in health monitoring is leading to new challenges that need to be solved. These devices have relatively poor signal quality and are affected by numerous motion artifacts, with data loss being the main stumbling block for their use in HRV analysis. In the present paper, it is shown how data loss affects HRV metrics in the time domain and frequency domain and Poincaré plots. A gap-filling method is proposed and compared to other existing approaches to alleviate these effects, both with simulated (16 subjects) and real (20 subjects) missing data. Two different data loss scenarios have been simulated: (i) scattered missing beats, related to a low signal to noise ratio; and (ii) bursts of missing beats, with the most common due to motion artifacts. In addition, a real database of photoplethysmography-derived pulse detection series provided by Apple Watch during a protocol including relax and stress stages is analyzed. The best correction method and maximum acceptable missing beats are given. Results suggest that correction without gap filling is the best option for the standard deviation of the normal-to-normal intervals (SDNN), root mean square of successive differences (RMSSD) and Poincaré plot metrics in datasets with bursts of missing beats predominance (p<0.05), whereas they benefit from gap-filling approaches in the case of scattered missing beats (p<0.05). Gap-filling approaches are also the best for frequency-domain metrics (p<0.05). The findings of this work are useful for the design of robust HRV applications depending on missing data tolerance and the desired HRV metrics.

Sleep is a fundamental physiological process that is essential for sustaining a healthy body and mind. The gold standard for clinical sleep monitoring is polysomnography(PSG), based on which sleep can be categorized into five stages, including wake/rapid eye movement sleep (REM sleep)/Non-REM sleep 1 (N1)/Non-REM sleep 2 (N2)/Non-REM sleep 3 (N3). However, PSG is expensive, burdensome and not suitable for daily use. For long-term sleep monitoring, ubiquitous sensing may be a solution. Most recently, cardiac and movement sensing has become popular in classifying three-stage sleep, since both modalities can be easily acquired from research-grade or consumer-grade devices (e.g., Apple Watch). However, how best to fuse the data for greatest accuracy remains an open question. In this work, we comprehensively studied deep learning (DL)-based advanced fusion techniques consisting of three fusion strategies alongside three fusion methods for three-stage sleep classification based on two publicly available datasets. Experimental results demonstrate important evidences that three-stage sleep can be reliably classified by fusing cardiac/movement sensing modalities, which may potentially become a practical tool to conduct large-scale sleep stage assessment studies or long-term self-tracking on sleep. To accelerate the progression of sleep research in the ubiquitous/wearable computing community, we made this project open source, and the code can be found at: https://github.com/bzhai/Ubi-SleepNet.

Background Individuals of all ages are becoming more health conscious, and wearable technology devices (eg, Fitbit and Apple Watch) are becoming increasingly popular in encouraging healthy lifestyles. Objective The aim of this paper was to explore how consumers use wearable devices. Methods A retrospective review was done on the top-rated verified purchase reviews of the Fitbit One posted on Amazon.com between January 2014 and August 2018. Relevant themes were identified by qualitatively analyzing open-ended reviews. Results On retrieval, there were 9369 reviews with 7706 positive reviews and 1663 critical reviews. The top 100 positive and top 100 critical comments were subsequently analyzed. Four major themes were identified: sleep hygiene (“charts when you actually fall asleep, when you wake up during the night, when you're restless--and gives you a cumulative time of “actual sleep” as well as weekly averages.”), motivation (“25 lbs lost after 8 months – best motivator ever!”), accountability (“platform to connect with people you know and set little competitions or group…fun accountability if you set a goal with a friend/family.”), and discretion (“able to be clipped to my bra without being seen.”). Alternatively, negative reviewers felt that the wearable device’s various tracking functions, specifically steps and sleep, were inaccurate. Conclusions Wearable technology devices are an affordable, user-friendly application that can support all individuals throughout their everyday lives and potentially be implemented into medical surveillance, noninvasive medical care, and mobile health and wellness monitoring. This study is the first to explore wearable technology device use among consumers, and further studies are needed to examine the limitless possibilities of wearable devices in health care.

AIMS: Validate the application for iPad (Apple, California, USA) “Teste seu Cérebro” as well as establish cutoff point between normal seniors and Mild Neurocognitive Impairment.METHODS: In a prospective cross-sectional study, elderly subjects who attended the neuropsychology clinic of a tertiary health hospital in the southern region of Brazil and the community in general underwent cognitive assessment using two instruments: the Montreal Cognitive Assessment (Gold Standard Test) and the “Teste seu Cérebro”. These results served as a parameter to validate the said application from a diagnostic test and to establish the cutoff point between normal elderly and mild cognitive impairment; the following statistical measures were determined: sensitivity and specificity, internal consistency and reliability reached by the McDonald’s Omega coefficient and Pearson’s correlation coefficient, respectively. The average “Teste seu Cérebro” cutoff point to detect cases classified as mild neurocognitive impairment by the Montreal Cognitive Assessment was obtained through the ROC curve. Evaluations include functions such as memory, attention / orientation, fluency, language, and visuospatial skills. RESULTS: The sample consisted of 104 participants with mean age of 70.3 (standard deviation = 6.6), with a minimum age of 60 and a maximum of 87 years. An acceptable reliability was achieved for the “Teste seu Cérebro” application by analyzing the internal consistency. In the comparison between the general scores of the two instruments (Teste seu Cérebro and Montreal Cognitive Assessment), where the result showed a statistically significant correlation, positive and classified as moderate. The cutoff point of the “Teste seu Cérebro” scores that best discriminated patients with mild neurocognitive impairment diagnosed by the Montreal Cognitive Assessment was 89.5%, that is, scores below or equal to that percentage reached higher sensitivity and specificity for the instrument. No influence of sociodemographic variables such as sex, age and schooling were identified on the linearity relationship between the “Teste seu Cérebro” and Montreal Cognitive Assessment instruments. CONCLUSIONS: The results suggest that the “Teste seu Cérebro” instrument can be safely used to identify early and accurately the presence of Mild Neurocognitive Impairment in the elderly population. New studies will be directed to the validation of the instrument “Teste seu Cérebro” in the identification of other types of cognitive disorders, in addition to Mild Neurocognitive Impairment.

Background Sickle cell disease (SCD) is an inherited disorder of red blood cells affecting millions of people worldwide. SCD is characterized by recurrent episodes of severe pain attacks, also called vaso-occlusive crisis (VOC), and are the most common reason for hospitalization. Approximately 90% of the hospital admissions are for pain treatment and the hospital readmission rate is alarmingly high, as 30-50% are re-admitted within 30 days. We previously were successful in developing machine learning models to predict pain using inpatient vital signs data as well as Apple Watch data in patients with SCD hospitalized for VOC. We now aimed to predict reutilization of care within 30 days in patients with SCD treated for a VOC. Methods Patients with SCD aged 18 years and above, who were admitted for a VOC to the day hospital or Duke University Hospital between April and June 2022, were eligible for this study. Following informed consent, demographics, SCD genotype, details from the hospitalization such as length of stay, pain scores, as well as vital signs measured per standard of care were collected from the electronic medical records including blood pressure, pulse rate, respiratory rate, oxygen saturation and temperature. Baseline vital signs during regular visits were collected 6 months before and after the hospitalization. We used the values of nearest neighbors to fill in the empty entries. The vital signs over the whole hospital stay were averaged and those numbers were used as the predictor values for the model. The primary outcome was reutilization of care defined as readmission within 30 days to the day hospital and/or hospital. The predictors were used to fit 3 different machine learning classification models for the prediction of reutilization of care: random forest, logistic regression, gradient boosting. By fitting random forest model on the whole dataset, we were able to rank all the features using mean decrease in impurities. To avoid overfitting, we only used the best four predictors which were diastolic blood pressure, pulse rate, respiratory rate and pain score.The performance of the machine learning models was evaluated using the following metrics: accuracy, precision, recall, F1 score and area under the receiver-operating-curve (AUC). Results Eighteen participants with SCD were included in this study. The median age at inclusion was 30 years (IQR 22-34). The majority of the participants had SCD genotype HbSS (68%), and all were Black of African-American. There were 10 participants treated at day hospital (56%), while the other 8 participants were admitted to the hospital with a median length of stay of 7.5 days (IQR 2.5-10). After discharge, 15 participants sought medical care at least once within 30 days (83%); 8 were hospitalized (44%), and 13 were readmitted to the day hospital (72%). This pilot study consisted of 88 vital sign data points across the 18 patients. The metrics of our best-performing machine learning model, the random forest model, were: accuracy 70%, precision 0.94, recall 0.71, F1 score 0.81 and AUC 0.61 (Figure 1 and 2). The difference in precisions and recalls for all the models reflects the class imbalance in the dataset. To test how the model will perform for independent data sets, we used 5-fold cross-validation, and the cross-validation accuracy was 66% with a standard deviation of 7.7%. Conclusion In this pilot study, our machine learning model was able to accurately predict health care reutilization within 30 days following discharge, with real-time vital signs data collected during clinic visits and hospital admissions in participants with SCD. Prediction of reutilization may help healthcare providers identify those at high risk and allow considerations for inpatient and outpatient strategies for patient management. Our next efforts include prediction of re-utilization from data collected from consumer wearables and in a larger number of participants.

Abstract Introduction With the recent developments in wearable technology, detecting arrhythmias has become much easier. Although smartwatches are commonly used to detect patients with atrial fibrillation, there is no consensus on their efficiency in detecting supraventricular tachycardias (SVT). Methods & Results Electrophysiological procedures were performed on 47 patients that have been previously documented to have SVT by a 12-lead ECG. All patients had sinus rhythm before the procedure. A narrow complex SVT which patients had at least once was induced by electrophysiological methods. Induced SVTs were recorded with a 6th-generation Apple Watch as one rhythm strip. Among the induced tachycardias, 27 typical AVNRT, 11 AVRT and 9 AT/AFLwere diagnosed. These records obtained from the smartwatch were evaluated by 3 cardiology residents and 3 attending cardiologists. Evaluated records were predicted among attending physicians with a minimum sensitivity of 66.0% and maximum sensitivity of 76.6%. Among residents, minimum and maximum sensitivity rates were 68.1% and 74.5%, respectively. The reliability between residents and attendings was assessed separately using Fleiss’s kappa method. The interrater reliability was found to be Kappa=0.465 (p&lt;0.001), 95% CI (0.30-0.63) within the group of residents and Kappa=0.519, (p&lt;0.001), 95% CI (0.35-0.68) within the group of attendings. Overall Kappa value was 0.417 (p&lt;0.001), 95% CI (0.34-0.49), indicating a significantly important moderate level of agreement (p&lt;0.001). Conclusion To the best of our knowledge, this is the first study showing how accurately clinicians can interpret the recording of SVTs with wearable devices such as smart watches, whose definitive diagnosis was made invasively by electrophysiological study. As presented in our study, induced, and subsequently recorded SVTs were predicted with high sensitivity and a moderate reliability rate. Adoption of smartwatches could significantly limit the delays in diagnosis and treatment of patients admitted to the hospitals with complaints of palpitations that cannot be documented.Statistics

This case study analyses the dilemma and strategic decision choices faced by Titan Watches (TW) regarding its growth aspirations and competitive challenges in the Indian context. The case reflects in detail the global watch industry and the competitive landscape from the company’s standpoint and highlights the journey covering more than three decades of its history. The case analysis is conducted based on secondary data gathered from various sources. The period considered to study the company and its competitive landscape is over three decades, that is, from its inception in 1984 to 2020. The financial data and other related data used in this case study were collected from different databases, that is, Euromonitor passport, Ace Knowledge Portal, CRISIL Research and ProQuest databases. It is found that the company is planning to achieve profitable growth in its revenue but faces tough competition from both analogue watchmakers (e.g. Seiko Holdings Corporation, Citizen Watch Co. Ltd and Swatch Group) and digital watch makers (e.g. Apple Inc., Fossil Group Inc., Samsung Electronics, Garmin Ltd. and Fitbit Inc.). To the best of our knowledge, there is no case study on TW highlighting the dilemma and strategic challenges the chief managing director faced in 2019. These include the challenges of capturing market share, achieving profitable growth and balancing the image of TW between a mass-market brand and a premium brand, etc. Furthermore, it discusses how TW needs to compete with global smartwatch companies like Apple and Samsung.

Abstract Wearable, multisensor, consumer devices that estimate sleep are now commonplace, but the algorithms used by these devices to score sleep are not open source, and the raw sensor data is rarely accessible for external use. As a result, these devices are limited in their usefulness for clinical and research applications, despite holding much promise. We used a mobile application of our own creation to collect raw acceleration data and heart rate from the Apple Watch worn by participants undergoing polysomnography, as well as during the ambulatory period preceding in lab testing. Using this data, we compared the contributions of multiple features (motion, local standard deviation in heart rate, and “clock proxy”) to performance across several classifiers. Best performance was achieved using neural nets, though the differences across classifiers were generally small. For sleep-wake classification, our method scored 90% of epochs correctly, with 59.6% of true wake epochs (specificity) and 93% of true sleep epochs (sensitivity) scored correctly. Accuracy for differentiating wake, NREM sleep, and REM sleep was approximately 72% when all features were used. We generalized our results by testing the models trained on Apple Watch data using data from the Multi-ethnic Study of Atherosclerosis (MESA), and found that we were able to predict sleep with performance comparable to testing on our own dataset. This study demonstrates, for the first time, the ability to analyze raw acceleration and heart rate data from a ubiquitous wearable device with accepted, disclosed mathematical methods to improve accuracy of sleep and sleep stage prediction.

Abstract Funding Acknowledgements Type of funding sources: None. Background Manual interpretation of single-lead ECGs (SL-ECG) is often required to confirm a diagnosis of atrial fibrillation (AF). However, accuracy to detect AF via SL-ECGs may vary according to clinical expertise and choice of the wearable device. Aims To compare the accuracy to detect AF via single-lead ECG from five different wearable devices (Apple Watch, Fitbit Sense, KardiaMobile, Samsung Galaxy Watch, Withings ScanWatch) between cardiologists, internal medicine (IM) residents, and medical students. Methods In this prospective study, invitations to an online survey were distributed via digital invitations among physicians from major Swiss hospitals and medical students from Swiss universities. Participants needed to classify 50 SL-ECGs (from 10 patients and 5 different devices) into three categories: sinus rhythm, AF, or inconclusive. This classification was compared to the diagnosis from an almost simultaneously recorded 12-lead ECG interpreted by two independent cardiologists. In addition, participants were asked to choose the best/worst quality/readability of each manufacturer’s SL-ECG. (Figure A) Results Overall 450 participants rated 10’865 SL-ECGs. Sensitivity and specificity for the detection of AF via SL-ECG was 75% and 92% for cardiologists, 70% and 86% for IM residents, 55% and 65% for master medical students (year 4-6) and 45% and 58% for bachelor medical students (year 1-3), p&lt;0.001, (Figure A). Participants which stated prior experience in interpreting SL-ECGs demonstrated a sensitivity and specificity of 65% and 81% compared to a sensitivity and specificity of 56% and 67% for participants with no prior experience in interpreting SL-ECGs, p&lt;0.001. Of all participants, 107 rated all 50 ECGs. Diagnostic accuracy of the first five interpreted SL-ECGs was 60% (IQR 40-80%) and diagnostic accuracy of the last five interpreted SL- ECGs was 80% (IQR 60-90%), p&lt;0.001. No significant difference in the accuracy of AF detection was seen between the 5 different wearable devices, p=0.58. 203 participants (45%) and 226 participants (50 %) ranked SL- ECGs from the Apple Watch as the best quality and readability, respectively. Conclusion SL-ECG can be difficult to interpret. Accuracy to correctly identify AF depends on clinical expertise, while the choice of the wearable device seems to have no impact.

AbstractWearables are being increasingly used to monitor heart rate (HR). However, their usefulness for analyzing continuous HR in research or at clinical level is questionable. The aim of this study is to analyze the level of agreement between different wearables in the measurement of HR based on photoplethysmography, according to different body positions and physical activity levels, and compared to a gold-standard ECG. The proposed method measures agreement among several time scales since different wearables obtain HR at different sampling rates. Eighteen university students (10 men, 8 women; 22 ± 2.45 years old) participated in a laboratory study. Participants simultaneously wore an Apple Watch and a Polar Vantage watch. ECG was measured using a BIOPAC system. HR was recorded continuously and simultaneously by the three devices, for consecutive 5-min periods in 4 different situations: lying supine, sitting, standing and walking at 4 km/h on a treadmill. HR estimations were obtained with the maximum precision offered by the software of each device and compared by averaging in several time scales, since the wearables obtained HR at different sampling rates, although results are more detailed for 5 s and 30 s epochs. Bland–Altman (B-A) plots show that there is no noticeable difference between data from the ECG and any of the smartwatches while participants were lying down. In this position, the bias is low when averaging in both 5 s and 30 s. Differently, B-A plots show that there are differences when the situation involves some level of physical activity, especially for shorter epochs. That is, the discrepancy between devices and the ECG was greater when walking on the treadmill and during short time scales. The device showing the biggest discrepancy was the Polar Watch, and the one with the best results was the Apple Watch. We conclude that photoplethysmography-based wearable devices are suitable for monitoring HR averages at regular intervals, especially at rest, but their feasibility is debatable for a continuous analysis of HR for research or clinical purposes, especially when involving some level of physical activity. An important contribution of this work is a new methodology to synchronize and measure the agreement against a gold standard of two or more devices measuring HR at different and not necessarily even paces.

Abstract Objective To assess whether an individual’s degree of psychological resilience can be determined from physiological metrics passively collected from a wearable device. Materials and Methods Data were analyzed in this secondary analysis of the Warrior Watch Study dataset, a prospective cohort of healthcare workers enrolled across 7 hospitals in New York City. Subjects wore an Apple Watch for the duration of their participation. Surveys were collected measuring resilience, optimism, and emotional support at baseline. Results We evaluated data from 329 subjects (mean age 37.4 years, 37.1% male). Across all testing sets, gradient-boosting machines (GBM) and extreme gradient-boosting models performed best for high- versus low-resilience prediction, stratified on a median Connor-Davidson Resilience Scale-2 score of 6 (interquartile range = 5–7), with an AUC of 0.60. When predicting resilience as a continuous variable, multivariate linear models had a correlation of 0.24 (P = .029) and RMSE of 1.37 in the testing data. A positive psychological construct, comprised of resilience, optimism, and emotional support was also evaluated. The oblique random forest method performed best in estimating high- versus low-composite scores stratified on a median of 32.5, with an AUC of 0.65, a sensitivity of 0.60, and a specificity of 0.70. Discussion In a post hoc analysis, machine learning models applied to physiological metrics collected from wearable devices had some predictive ability in identifying resilience states and a positive psychological construct. Conclusions These findings support the further assessment of psychological characteristics from passively collected wearable data in dedicated studies.

Background: Apple Watch (AW) for the detection of silent atrial fibrillation (AF) has shown encouraging results due to its photoplethysmogram (PPG) sensors. However, clinical accuracy studies show varying results. To the best of our knowledge, this is the first meta-analysis conducted to ascertain the pooled sensitivity, and specificity in AF detection using the AW. Methods: PubMed, Google Scholar, and Scopus were queried till May 2023 for studies examining the accuracy of AW in AF detection. The outcomes of interest were the sensitivity and specificity of AW for the detection of AF. Sensitivities and specificities were calculated using true positives, true negatives, false positives, and false negatives wherever applicable. A random-effects meta-analysis was conducted using the generic inverse variance method to pool sensitivities and specificities. Further, sensitivity analysis was performed excluding studies using KardiaBand. Results: A total of 12 studies with a patient population of 421,156 were included with a mean age of 63 years. 6/12 studies used AW series 4 or higher while 3/12 studies evaluated the use of KardiaBand on top of the AW. AF was detected in 3,184 patients from a total of 420,312 patients. Following pooled analysis, an overall point estimate of sensitivity was observed to be [0.87 (0.76, 0.98); Figure 1A]. Ten studies evaluated specificity, with the pooled estimate being [0.91 (0.87, 0.95); Figure 1B]. After excluding studies using KardiaBand, the sensitivity was reported as 0.84 [0.68, 1.00] and specificity was observed to be 0.94 [0.91, 0.98]. Conclusion: AW proved to be effective in detecting AF in our analysis owing to high overall sensitivity and specificity with and without the addition of KardiaBand. However, cardiologists should still exercise caution before undertaking action based on the electrocardiographic diagnosis generated by this wrist-worn monitor.

BackgroundIn sickle cell disease (SCD), unpredictable episodes of acute severe pain, known as vaso-occlusive crises (VOC), disrupt school, work activities and family life and ultimately lead to multiple hospitalizations. The ability to predict VOCs would allow a timely and adequate intervention. The first step towards this ultimate goal is to use patient-friendly and accessible technology to collect relevant data that helps infer a patient's pain experience during VOC. This study aims to: (1) determine the feasibility of remotely monitoring with a consumer wearable during hospitalization for VOC and up to 30 days after discharge, and (2) evaluate the accuracy of pain prediction using machine learning models based on physiological parameters measured by a consumer wearable.MethodsPatients with SCD (≥18 years) who were admitted for a vaso-occlusive crisis were enrolled at a single academic center. Participants were instructed to report daily pain scores (0–10) in a mobile app (Nanbar) and to continuously wear an Apple Watch up to 30 days after discharge. Data included heart rate (in rest, average and variability) and step count. Demographics, SCD genotype, and details of hospitalization including pain scores reported to nurses, were extracted from electronic medical records. Physiological data from the wearable were associated with pain scores to fit 3 different machine learning classification models. The performance of the machine learning models was evaluated using: accuracy, F1, root-mean-square error and area under the receiver-operating curve.ResultsBetween April and June 2022, 19 patients (74% HbSS genotype) were included in this study and followed for a median time of 28 days [IQR 22–34], yielding a dataset of 2,395 pain data points. Ten participants were enrolled while hospitalized for VOC. The metrics of the best performing model, the random forest model, were micro-averaged accuracy of 92%, micro-averaged F1-score of 0.63, root-mean-square error of 1.1, and area under the receiving operating characteristic curve of 0.9.ConclusionOur random forest model accurately predicts high pain scores during admission for VOC and after discharge. The Apple Watch was a feasible method to collect physiologic data and provided accuracy in prediction of pain scores.

Wearable Technology is such advice which can be worn by people and they can help to measure certain important parameters of human body such as heart beat, rhythm, quality of sleep per day and also they can identify some disease like heart disease, diabetes and cancer. Smart shirts are used for the purpose of monitoring the health and wellbeing of patients and feedback the obtained information to hub station at real-time. These are quite sensitive to pick up and record electro-signals like heart beats and movements of muscles and finally sent to healthcare providers which can monitor the vitals of the users remotely for necessary actions to be taken by the appropriate body. It can create through devices better understanding of daily activities. Piezo resistive and ferroelectric sensors have been studied for various types of wearable and flexible electronics sensors. With controlled setting wearable technologies are very useful tools for assessment of individuals. Digital inter activity can interact by smart glasses delivery system as close as the wearer’s nose. The peculiarity of the technology is that the system based on hard-free gadgets with practical uses, powered by microprocessors for enhancing the ability to send and receive data through internet. Smart phone is best known wearable has emerged and continue to emerge today as proposed by APPLE watch. For humanity wearable devices with electronics present a unique interface of technology.

Introduction: While mHealth platforms can enable rapid participant recruitment, the first 5 ResearchKit apps retained less than 10% of daily participants after the first 90 days, whereas well-optimized consumer mobile apps like Instagram and Twitter retain 31% and 48%, respectively. We proposed to apply design principles from the world of consumer internet to achieve high engagement and retention in a mHealth study. Methods: We enrolled 14,011 users of Cardiogram for Apple Watch app into the Health eHeart Study, an IRB-approved study at UCSF. We applied 3 key design principles to drive engagement and retention. First, give valuable insights back to user—e.g., notify users of abnormal heart rate spikes, and show when exercise caused a lower resting heart rate trend—using Gottman’s ratio: for every negative insight, give 5 positive ones. Second, minimize latency so users’ data updates many times per day. Third, use simple user interfaces that easily visualize trends and provide insights in small digestible formats. Results: Mean age was 42.3 ± 12.1, 31% were women. Seven days after app install, 64% of participants were active; 63% were active after 30 days, and 54% after 90 days. Retention was consistent across age groups—day 90 retention was 52% for 20-40 y.o., 55% for 40-60, and 49% for above 60. Refreshing data as frequently as possible had the highest impact on user engagement—in A/B testing, where heart rate visualizations were updated less frequently, we saw 20.9% drop in daily active users (51951 to 41094) within 7 days. The ratio of daily to monthly active users, a key measure of engagement, is 69.8% in our study, while average mHealth app is 8%. Conclusions: By applying design techniques from consumer mobile apps, we achieved day 90 retention 5x higher than the best ResearchKit app, showing that mHealth studies can retain large cohorts of participants and collect unique ambulatory health data with high engagement, improving the impact of mobile health interventions.

Abstract Background Standardized validation indices (i.e., accuracy, bias, and precision) provide a comprehensive comparison of step counting wearable technologies. Purpose To expand a previously published child/youth catalog of validity indices to include adults (21–40, 41–60 and 61–85 years of age) assessed across a range of treadmill speeds (slow [0.8–3.2 km/h], normal [4.0–6.4 km/h], fast [7.2–8.0 km/h]) and device wear locations (ankle, thigh, waist, and wrist). Methods Two hundred fifty-eight adults (52.5 ± 18.7 years, 49.6% female) participated in this laboratory-based study and performed a series of 5-min treadmill bouts while wearing multiple devices; 21 devices in total were evaluated over the course of this multi-year cross-sectional study (2015–2019). The criterion measure was directly observed steps. Computed validity indices included accuracy (mean absolute percentage error, MAPE), bias (mean percentage error, MPE), and precision (correlation coefficient, r; standard deviation, SD; coefficient of variation, CoV). Results Over the range of normal speeds, 15 devices (Actical, waist-worn ActiGraph GT9X, activPAL, Apple Watch Series 1, Fitbit Ionic, Fitbit One, Fitbit Zip, Garmin vivoactive 3, Garmin vivofit 3, waist-worn GENEActiv, NL-1000, PiezoRx, Samsung Gear Fit2, Samsung Gear Fit2 Pro, and StepWatch) performed at < 5% MAPE. The wrist-worn ActiGraph GT9X displayed the worst accuracy across normal speeds (MAPE = 52%). On average, accuracy was compromised across slow walking speeds for all wearable technologies (MAPE = 40%) while all performed best across normal speeds (MAPE = 7%). When analyzing the data by wear locations, the ankle and thigh demonstrated the best accuracy (both MAPE = 1%), followed by the waist (3%) and the wrist (15%) across normal speeds. There were significant effects of speed, wear location, and age group on accuracy and bias (both p < 0.001) and precision (p ≤ 0.045). Conclusions Standardized validation indices cataloged by speed, wear location, and age group across the adult lifespan facilitate selecting, evaluating, or comparing performance of step counting wearable technologies. Speed, wear location, and age displayed a significant effect on accuracy, bias, and precision. Overall, reduced performance was associated with very slow walking speeds (0.8 to 3.2 km/h). Ankle- and thigh-located devices logged the highest accuracy, while those located at the wrist reported the worst accuracy. Trial registration Clinicaltrials.gov NCT02650258. Registered 24 December 2015.

In many ways, computers are becoming invisible and will continue to do so. When we reach into our pockets and pull out our cell phones to find a place to eat or message a friend on Facebook, we are no longer consciously aware that we are interacting with a user experience that has been consciously designed for our computer or device screen—but we are.— Andy Pratt and Jason Nunes, Interactive Design In theory, cell phones and other information and communication technologies (ICTs) are just a means for us to interact with people, businesses, and data sources. They have interfaces and, in a larger sense, are interfaces between their users and the networked world. Every day, people spend more time using them to perform more different tasks and find them more indispensable (Smith). As the epigraph above suggests, however, their omnipresence makes them practically invisible and has all but erased any feelings of awe or mystery that their power once generated. There is both a historical and functional dimension to this situation. In the historical advance of technology, it is part of what Kevin Kelly calls the “technium,” the ever-more complex interactions between advancing technology, our cognitive processes, and the cultural forces in which they are enmeshed; ICTs are measurably getting more powerful as time goes on and are, in this sense, worthy of our admiration (Kelly 11-17). In the functional dimension, on the other hand, many scholars and designers have observed how hard it is to hold on to this feeling of enchantment in our digital devices (Nye 185-226; McCarthy and Wright 192-97). As one study of human-computer interfaces observes “when people let the enchanting object [ICTs] do the emotional work of experience for them . . . what could be enchanting interactivity becomes a paradoxically detached interpassivity” (McCarthy et al. 377). ICTs can be ever more powerful, then, but this power will not necessarily be appreciated by their users. This paper analyzes recent narrative representations of ICT use in spy thrillers, with a particular focus on the canon of James Bond films (a sub-genre with a long-standing and overt fascination with advanced technology, especially ICTs), in order to explore how the banality of ICT technology has become the inescapable accompaniment of its power (Willis; Britton 99-123; 195-219). Among many possible recent examples: recall how Bond uses his ordinary cell phone camera to reveal the membership of the sinister Quantum group at an opera performance in Quantum of Solace; how world-wide video surveillance is depicted as inescapable (and amoral) in The Bourne Legacy; and how the anonymous protagonist of Roman Polanski’s Ghost Writer discovers the vital piece of top secret information that explains the entire film—by searching for it on his laptop via Google. In each of these cases, ICTs are represented as both incredibly powerful and tediously quotidian. More precisely, in each case human users are represented as interfaces between ICTs and their stored knowledge, rather than the reverse. Beginning with an account of how the naturalization of ICTs has changed the perceived relations between technology and its users, this essay argues that the promotional rhetoric of human empowerment and augmentation surrounding ICTs is opposed by a persistent cinematic theme of human subordination to technological needs. The question it seeks to open is why—why do the mainstream cinematic narratives of our culture depict the ICTs that enhance our capacities to know and communicate as something that diminishes rather than augments us? One answer (which can only be provisionally sketched here) is the loss of pleasure. It does not matter whether or not technology augments our capacities if it cannot sustain the fantasy of pleasure and/or enhancement at the same time. Without this fantasy, ICTs are represented as usurping position as the knowing subject and users, in turn, become the media connecting them– even when that user is James Bond. The Rhetoric of Augmentation Until the past five years or so, the technologization of the human mind was almost always represented in popular culture as a threat to humanity—whether it be Ira Levin’s robotic Stepford Wives as the debased expression of male wish-fulfillment (Levin), or Jonathan Demme’s brainwashed assassins with computer chip implants in his remake of The Manchurian Candidate. When Captain Picard, the leader and moral centre of the television series Star Trek: The Next Generation, is taken over by the Borg (an alien machine race that seeks to absorb other species into its technologized collective mind) in an episode from 1990, it is described as “assimilation” rather than an augmentation. The Borg version of Picard says to his former comrades that “we only wish to raise quality of life, for all species,” and it is a chilling, completely unemotional threat to the survival of our species (“Best of Both Worlds”). By 2012, on the other hand, the very same imagery is being used to sell smart phones by celebrating the technological enhancements that allegedly make us better human beings. In Verizon’s Droid DNA phone promotions, the product is depicted as an artificial heart for its user, one that enhances memory, “neural speed,” and “predictive intelligence” (thanks to Google Now). The tagline for the Verizon ad claims that “It’s not an upgrade to your phone; it’s an upgrade to yourself”, echoing Borg-Picard’s threat but this time as an aspirational promise (“Verizon Commercial”). The same technologization of the mind that was anathema just a few years ago, is now presented as both a desirable consumer goal and a professional necessity—the final close-up of the Verizon artificial heart shows that this 21st century cyborg has to be at his job in 26 minutes; the omnipresence of work in a networked world is here literally taken to heart. There is, notably, no promise of pleasure or liberation anywhere in this advertisement. We are meant to desire this product very much, but solely because it allows us to do more and better work. Not coincidentally, the period that witnessed this inversion in popular culture also saw an exponential increase in the quantity and variety of digitally networked devices in our lives (“Mobile Cellular”) and the emergence of serious cultural, scientific, and philosophical movements exploring the idea of “enhanced” human beings, whether through digital tool use, biomedical prostheses, drugs, or genetic modifications (Buchanan; Savulescu and Bostrom; “Humanity +”). As the material boundaries of the “human” have become more permeable and malleable, and as the technologies that make this possible become everyday objects, our resistance to this possibility has receded. The discourse of the transhuman and extropian is now firmly established as a philosophical possibility (Lilley). Personal augmentation with the promise of pleasure is still, of course, very much present in the presentation of ICTs. Launching the iPad 2 in 2011, the late Steve Jobs described his new product as a “magical and revolutionary device” with an “incredible magical user interface on a much larger canvas with more resources” and gushing that “it's technology married with liberal arts, married with the humanities, that yields us the result that makes our hearts sing” (“Apple Special Event”). This is the rhetoric of augmentation through technology and, as in the Verizon ad, it is very careful to position the consumer/user at the centre of the experience. The technology is described as wonderful not just in itself, but also precisely because it gives users “a larger canvas” with which to create. Likewise, the lifelogging movement (which encourages people to use small cameras to record every event of daily life) is at great pains to stress that “you, not your desktop’s hard drive, are the hub of your digital belongings” (Bell and Gemmell 10). But do users experience life with these devices as augmented? Is either the Verizon work cyborg or the iPad user’s singing heart representative of how these devices make us feel? It depends upon the context in which the question is asked. Extensive survey data on cell phone use shows that we are more attached than ever to our phones, that they allow us to be “productive” in otherwise dead times (such as while waiting in queues), and that only a minority of users worry about the negative effects of being “permanently connected” (Smith 9-10). Representations of technological augmentation in 21st century popular cinema, however, offer a very different perspective. Even in James Bond films, which (since Goldfinger in 1964) have been enraptured with technological devices as augmentations for its protagonists and as lures for audiences, digital devices have (in the three most recent films) lost their magic and become banal in the same way as they have in the lives of audience members (Nitins 2010; Nitins 2011; “List of James Bond Gadgets”). Rather than focusing on technological empowerment, the post 2006 Bond films emphasize (1) that ICTs “know” things and that human agents are just the media that connect them together; and (2) that the reciprocal nature of networked ICTs means that we are always visible when we use them; like Verizon phone users, our on-screen heroes have to learn that the same technology that empowers them simultaneously empowers others to know and/or control them. Using examples from the James Bond franchise, the remainder of this paper discusses the simultaneous disenchantment and power of ICT technology in the films as a representative sample of the cultural status of ICTs as a whole. “We don’t go in for that sort of thing any more...” From Goldfinger until the end of Pierce Brosnan’s tenure in 2002, technological devices were an important part of the audience’s pleasure in a Bond film (Willis; Nitins 2011). James Bond’s jetpack in Thunderball, to give one of many examples, is a quasi-magical aid for the hero with literary precursors going back to Aeneas’s golden bough; it is utterly enchanting and, equally importantly, fun. In the most recent Bond film, Skyfall, however, Q, the character who has historically made Bond’s technology, reappears after a two-film hiatus, but in the guise of a computer nerd who openly disdains the pleasures and possibilities of technological augmentation. When Bond complains about receiving only a gun and a radio from him, Q replies: “What did you expect? An exploding pen? We don’t really go in for that sort of thing any more.” Technology is henceforth to be banal and invisible albeit (as the film’s computer hacker villain Silva demonstrates) still incredibly powerful. The film’s pleasures must come from elsewhere. The post-credit sequence in Casino Royale, which involves the pursuit and eventual death of a terrorist bomb-maker, perfectly embodies the diminished importance of human agents as bearers of knowledge. It is bracketed at the beginning by the bomber looking at a text message while under surveillance by Bond and a colleague and at the end by Bond looking at the same message after having killed him. Significantly, the camera angle and setup of both shots make it impossible to distinguish between Bond’s hand and the bomber’s as they see the same piece of information on the same phone. The ideological, legal, racial, and other differences between the two men are erased in pursuit of the data (the name “Ellipsis” and a phone number) that they both covet. As digitally-transmitted data, it is there for anyone, completely unaffected by the moral or legal value attached to its users. Cell phones in these films are, in many ways, better sources of information than their owners—after killing a phone’s owner, his or her network traces can show exactly where s/he has been and to whom s/he has been talking, and this is how Bond proceeds. The bomber’s phone contacts lead Bond to the Bahamas, to the next villain in the chain, whom Bond kills and from whom he obtains another cell phone, which allows the next narrative location to be established (Miami Airport) and the next villain to be located (by calling his cell phone in a crowded room and seeing who answers) (Demetrios). There are no conventional interrogations needed here, because it is the digital devices that are the locus of knowledge rather than people. Even Bond’s lover Vesper Lynd sends her most important message to him (the name and cell phone number of the film’s arch villain) in a posthumous text, rather than in an actual conversation. Cell phones do not enable communication between people; people connect the important information that cell phones hold together. The second manifestation of the disenchantment of ICT technology is the disempowering omnipresence of surveillance. Bond and his colleague are noticed by the bomber when the colleague touches his supposedly invisible communication earpiece. With the audience’s point of view conflated with that of the secret agent, the technology of concealment becomes precisely what reveals the secret agent’s identity in the midst of a chaotic scene in which staying anonymous should be the easiest thing in the world; other villains identify Bond by the same means in a hotel hallway later in the film. While chasing the bomber, Bond is recorded by a surveillance camera in the act of killing him on the grounds of a foreign embassy. The secret agent is, as a result, made into an object of knowledge for the international media, prompting M (Bond’s boss) to exclaim that their political masters “don’t care what we do, they care what we get photographed doing.” Bond is henceforth part of the mediascape, so well known as a spy that he refuses to use the alias that MI6 provides for his climactic encounter with the main villain LeChiffre on the grounds that any well-connected master criminal will know who he is anyway. This can, of course, go both ways: Bond uses the omnipresence of surveillance to find another of his targets by using the security cameras of a casino. This one image contains many layers of reference—Bond the character has found his man; he has also found an iconic image from his own cultural past (the Aston Martin DB V car that is the only clearly delineated object in the frame) that he cannot understand as such because Casino Royale is a “reboot” and he has only just become 007. But the audience knows what it means and can insert this incarnation of James Bond in its historical sequence and enjoy the allusion to a past of which Bond is oblivious. The point is that surveillance is omnipresent, anonymity is impossible, and we are always being watched and interpreted by someone. This is true in the film’s narrative and also in the cultural/historical contexts in which the Bond films operate. It may be better to be the watcher rather than the watched, but we are always already both. By the end of the film, Bond is literally being framed by technological devices and becomes the organic connection between different pieces of technology. The literal centrality of the human agent in these images is not, in this disenchanted landscape, an indication of his importance. The cell phones to which Bond listens in these images connect him (and us) to the past, the back story or context provided by his masters that permits the audience to understand the complex plot that is unfolding before them. The devices at which he looks represent the future, the next situation or person that he must contain. He does not fully understand what is happening, but he is not there to understand – he is there to join the information held in the various devices together, which (in this film) usually means to kill someone. The third image in this sequence is from the final scene of the film, and the assault rifle marks this end—the chain of cell phone messages (direct and indirect) that has driven Casino Royale from its outset has been stopped. The narrative stops with it. Bond’s centrality amid these ICTS and their messages is simultaneously what allows him to complete his mission and what subjects him to their needs. This kind of technological power can be so banal precisely because it has been stripped of pleasure and of any kind of mystique. The conclusion of Skyfall reinforces this by inverting all of the norms that Bond films have created about their climaxes: instead of the technologically-empowered villain’s lair being destroyed, it is Bond’s childhood home that is blown up. Rather than beating the computer hacker at his own game, Bond kills him with a knife in a medieval Scottish church. It could hardly be less hi-tech if it tried, which is precisely the point. What the Bond franchise and the other films mentioned above have shown us, is that we do not rely on ICTs for enchantment any more because they are so powerfully connected to the everyday reality of work and to the loss of privacy that our digital devices exact as the price of their use. The advertising materials that sell them to us have to rely on the rhetoric of augmentation, but these films are signs that we do not experience them as empowering devices any more. The deeper irony is that (for once) the ICT consumer products being advertised to us today really do what their promotional materials claim: they are faster, more powerful, and more widely applicable in our lives than ever before. Without the user fantasy of augmentation, however, this truth has very little power to move us. We depict ourselves as the medium, and it is our digital devices that bear the message.References“Apple Special Event. March 2, 2011.” Apple Events. 21 Sep. 2013 ‹http://events.apple.com.edgesuite.net/1103pijanbdvaaj/event/index.html›. Bell, Gordon, and Jim Gemmell. Total Recall: How the E-Memory Revolution Will Change Everything. New York: Dutton, 2009.“The Best of Both Worlds: Part Two.” Star Trek: The Next Generation. Dir. Cliff Bole. Paramount, 2013. The Bourne Legacy. Dir. Tony Gilroy. Universal Pictures, 2012. Britton, Wesley. Beyond Bond: Spies in Fiction and Film. Westport, CT: Praeger, 2005. Buchanan, Allen. Beyond Humanity: The Ethics of Biomedical Enhancement. Uehiro Series in Practical Ethics. New York: Oxford University Press, 2011. Casino Royale. Dir. Martin Campbell. Columbia Pictures, 2006. “Data’s Day.” Star Trek: The Next Generation. Dir. Robert Wiemer. Burbank, CA: Paramount, 2013. The Ghost Writer. Dir. Roman Polanski. R.P. Productions/France 2 Cinéma, 2010. “Humanity +”. 25 Aug. 2013 ‹http://humanityplus.org›. Kelly, Kevin. What Technology Wants. New York: Viking, 2010. Levin, Ira. The Stepford Wives. Introd. Peter Straub. New York: William Morrow, 2002. Lilley, Stephen. Transhumanism and Society: The Social Debate over Human Enhancement. New York: Springer, 2013. “List of James Bond Gadgets.” Wikipedia. 11 Nov. 2013 ‹http://en.wikipedia.org/wiki/List_of_James_Bond_gadgets›. The Manchurian Candidate. Dir. Jonathan Demme. Paramount, 2004. McCarthy, John, and Peter Wright. Technology as Experience. Cambridge, Mass.: MIT Press, 2004. McCarthy, John, et al. “The Experience of Enchantment in Human–Computer Interaction.” Journal of Personal and Ubiquitous Computing 10 (2006): 369-78. “Mobile Cellular Subscriptions (per 100 People).” The World Bank. 25 March 2013 ‹http://data.worldbank.org/indicator/IT.CEL.SETS.P2›. Nitins, Tanya L. “A Boy and His Toys: Technology and Gadgetry in the James Bond Films.” James Bond in World and Popular Culture: The Films Are Not Enough. Eds. Rob Weiner, B. Lynn Whitfield, and Jack Becker. Newcastle upon Tyne: Cambridge Scholars Publishing, 2010. 445-58. ———. Selling James Bond: Product Placement in the James Bond Films. Newcastle upon Tyne: Cambridge Scholars Publishing, 2011. Nye, David E. Technology Matters—Questions to Live With. Cambridge, MA: MIT Press, 2006. Pratt, Andy, and Jason Nunes Interactive Design: An Introduction to the Theory and Application of User-Centered Design. Beverly, MA: Rockport, 2012. Quantum of Solace. Dir: Marc Foster, Eon Productions, 2008. DVD. Savulescu, Julian, and Nick Bostrom, eds. Human Enhancement. Oxford: Oxford University Press, 2009. Skyfall. Dir. Sam Mendes. Eon Productions, 2012. Smith, Aaron. The Best and Worst of Mobile Connectivity. Pew Internet & American Life Project. Pew Research Center. 25 Aug. 2013 ‹http://pewinternet.org/Reports/2012/Best-Worst-Mobile.aspx›. Thunderball. Dir. Terence Young. Eon Productions, 1965. “Verizon Commercial – Droid DNA ‘Hyper Intelligence’.” 11 April 2013 ‹http://www.youtube.com/watch?v=IYIAaBOb5Bo›. Willis, Martin. “Hard-Wear: The Millenium, Technology, and Brosnan’s Bond.” The James Bond Phenomenon: A Critical Reader. Ed. Christoph Linder. Manchester: Manchester University Press, 2001. 151-65.

Things would never be the same again. As sales went through the roof, with some breathless estimates in the region of a 200% increase overnight, marketers practically wet their pants at the phenomenal success of the chocolate bar seen by millions in ET: the Extraterrestrial. That was back in 1982. Though not the first instance of product placement ‘at the movies’, the strategic placement of Reese’s Pieces in ET is often hailed as the triumphant marketing moment heralding the onset of the era of embedded advertising in popular media. Today, much media consumption is characterised by aggressive branding strategies. We’ve all seen ostentatious product wrangling – the unnatural handling of items (especially chocolate bars and bottled drinks) to best display their logo (regardless of considerations of verisimilitude, or even common sense), and ungainly product mentions in dialogue (who can forget the early Jude Law shocker Shopping?) that have passed into the realm of satire. In television and feature filmmaking, props bearing corporate trademarks not only supplement, but often sustain production budgets. Some programs appear to be entirely contrived around such sponsors. Australian commercial television makes no secret of the increasingly non-existent line between ‘entertainment’ and ‘advertising’, though it still purports to describe ‘lifestyle’ shows as ‘reality’ television. With the introduction of technologies like TiVO which enable consumers to skip over ads, the move is from ‘interruptive’ style advertising between programs or segments, to products insinuated in the décor – and increasingly scripts – of programs themselves, with correspondent online shopping opportunities for digital consumers. An entire industry of middle-people – sometimes euphemistically self-described as ‘prop houses’ – has sprung up to service the lucrative product placement industry, orchestrating the insertion of branded products into television and films. The industry has grown to such an extent that it holds an annual backpatting event, the Product Placement Awards, “to commemorate and celebrate product placement” in movies, television shows, music etc. But ‘advertising by stealth’ is not necessarily passively accepted by media consumers – nor media makers. The shoe-horning of brands and their logos into the products of popular culture not only defines the culture industry today, but also characterises much of the resistance to it. ‘Logo-backlash’ is seen as an inevitable response to the incursion of brands into public life, an explicit rejection of the practice of securing consumer mindshare, and subvertisements and billboard liberation activities have been mainstays of culture jamming for decades now. However, criticism of product placement remains highly problematic: when the Center for the Study of Commercialism argued that movies have become “dangerously” saturated with products and suggested that full disclosure in the form of a list, in a film’s credits, of paid product appearances, many noted the counterproductivity of such an approach, arguing that it would only result in further registration – and hence promotion – of the brand. Not everyone subscribes to advertising’s ‘any news is good news’ thesis, however. Peter Conheim and Steve Seidler decided to respond to the behemoth of product placement with a ‘catalogue of sins’. Their new documentary Value Added Cinema meticulously chronicles the appearance of placed products in Hollywood cinema. Here they discuss the film, which is continuing to receive rave reviews in the US and Europe. Danni Zuvela: Can you tell me a little about yourselves? Peter: I’m a musician and filmmaker living in the San Francisco Bay Area who wears too many hats. I play in three performing and recording groups (Mono Pause, Wet Gate, Negativland) and somehow found the time to sit in front of a Mac for six weeks to edit and mix VALUE-ADDED CINEMA. Because Steve is a persuasive salesperson. Steve: I’ve been a curator for the past decade and a half, showing experimental works week after week, month after month, year after year, at the Pacific Film Archive. It was about time to make a tape of my own and Peter was crazy enough to indulge me. DZ: Why product placement? Why do you think it’s important? Where did this documentary come from? S: Steven Spielberg released Minority Report last year and it just raised my hackles. The film actually encourages the world it seems to critique by stressing the inter-relationship of his alleged art with consumerism in the present day and then extending that into a vision of the future within the film itself. In other words, he has already realized the by-product of an alarming dystopia of surveillance, monolithic policing, and capital. That by-product is his film. The rumor mill says that he was reimbursed to the tune of $25 million for the placements. So not only can he not see a constructive path out of dystopia, a path leading toward a more liberating future, he makes millions from his exhausted imagination. What could be more cynical? But Spielberg isn’t alone within the accelerating subsumption of mainstream cinema into the spectacle of pure consumption. He’s just more visible than most. But to consider product placements more directly for a moment: during the past few years, mainstream cinema has been little more than an empty exercise in consumerist viewership. The market-driven incentives that shape films, determining story-lines, exaggerating cultural norms, striving toward particular demographics, whatever, have nothing to do with art or social change and everything to do with profit, pandering, and promulgation. Movies are product placements, the product is a world view of limitless consumption. Value-Added Cinema is about the product-that-announces-itself, the one we recognize as a crystallization of the more encompassing worldview, the sole commodity, spot-lit, adored, assimilated. So why Value-Added Cinema? You’ve got to start somewhere. DZ: Can you tell me a bit about the production process – how did you go about getting the examples you use in the film? Were there any copyright hassles? P: Steve did nearly all of the legwork in that he spent weeks and weeks researching the subject, both on-line and in speaking to people about their recollections of product placement sequences in films they’d seen. He then suffered through close to a hundred films on VHS and DVD, using the fast-forward and cue controls as often as possible, to locate said sequences. We then sat down and started cutting, based at first on groupings Steve had made (a bunch of fast food references, etc.). Using these as a springboard, we quickly realized the narrative potential inherent in all these “narrative film” clips , and before long we were linking sequences and making them refer to one another, sort of allowing a “plot” to evolve. And copyright hassles? Not yet! I say... bring ‘em on! I would be more than happy to fight for the existence of this project, and one of the groups I am in, Negativland, has a rather colourful history of “fair use” battles in the music arena (the most nefarious case, where the band was sued by U2 and their big-label music lawyers over a parody we made happened before I came on board, but there’s been some skirmishes since). We have folks who would be happy to help defend this sort of work in a court of law should the occasion arise. DZ: Can you talk to me about the cultural shift that’s occurred, where the old ‘Acme’ propmaster has been replaced by ‘product peddler’? What is this symptomatic of, and what’s its significance now? S: In the past, privacy existed because there were areas of experience and information that were considered off limits to exploitation. A kind of tacit social contract assumed certain boundaries were in place to keep corporate (and State) meddling at bay and to allow an uncontaminated space for disengaging from culture. Nowadays the violation of boundaries is so egregious it’s hard to be sure that those boundaries in fact exist. Part of that violation has been the encroachment, at every conceivable level, of daily experience by all manner of corporate messages—urinal strainers with logos, coffee jackets with adverts, decals on supermarket floors, temporary tattoos on random pedestrians. Engagement with corporate predation is now foisted on us 24 hours a day. It’s the GPS generation. The corporations want to know where we “are” at all times. Again: in the past there was a certain level of decorum about the sales pitch. That decorum has vanished and in its place is the inter-penetration of all our waking moments by the foghorn of capital. If that foghorn gets loud enough, we’ll never get any sleep. DZ: How do you think product placement affects the integrity of the film? P: Well, that’s definitely a question of the moment, as far as audience reactions to our screenings have been thus far. It really depends on the work itself, doesn’t it? I think we would be highly judgmental, and perhaps quite out of line, if we dismissed out of hand the idea of using actual products in films as some sort of rule. The value of using an actual product to the narrative of a film can’t be discounted automatically because we all know that there are stories to be told in actual, marketed products. Characterizations can develop. If a flustered James Cagney had held up a bottle of Fred’s Cola instead of Pepsi in the climactic shot of One, Two, Three (Billy Wilder’s 1963 Coke-executive comedy), it wouldn’t have resonated very well. And it’s an incredibly memorable moment (and, some might say, a little dig at both cola companies). But when you get into something like i am sam, where Sean Penn’s character not only works inside a Starbucks, and is shown on the job, in uniform and reading their various actual coffee product names aloud, over and over again, but also rides a bus with a huge Nike ad on the side (and the camera tracks along on the ad instead of the bus itself), plus the fact that he got onto that bus underneath an enormous Apple billboard (not shown in our work, actually), or that his lawyer has a can of Tab sitting on an entirely austere, empty table in front of a blank wall and the camera tracks downward for no other discernable purpose than to highlight the Tab can… you can see where I’m going with this. The battle lines are drawn in my mind. PROVE to me the value of any of those product plugs on Penn’s character, or Michelle Pfeiffer’s (his lawyer). DZ: What do you make of the arguments for product placement as necessary to, even enhancing, the verisimilitude of films? Is there a case to be made for brands appearing in a production design because they’re what a character would choose? S: It’s who makes the argument for product placements that’s troublesome. Art that I value is a sort of problem solving machine. It assumes that the culture we currently find ourselves strapped with is flawed and should be altered. Within that context, the “verisimilitude” you speak of would be erected only as a means for critique--not to endorse, venerate, or fortify the status quo. Most Hollywood features are little more than moving catalogs. P: And in the case of Jurassic Park that couldn’t be more explicit – the “fake” products shown in the amusement park gift shop in the film are the actual tie-in products available in stores and in Burger King at that time! Another film I could mention for a totally different reason is The Dark Backward (1991). Apparently due to a particular obsession of the director, the film is riddled with placements, but of totally fake and hilarious products (i.e. Blump’s Squeezable Bacon). Everyone who has seen the film remembers the absurdist products… couldn’t Josie and the Pussycats have followed this format, instead of loading the film with “funny” references to literally every megacorporation imaginable, and have been memorable for it? DZ: What do you think of the retroactive insertion of products into syndicated reruns of programs and films (using digital editing techniques)? Is this a troubling precedent? P: Again, to me the line is totally crossed. There’s no longer any justification to be made because the time and space of the original television show is lost at that point, so any possibility of “commentary” on the times, or development of the character, goes right out the window. Of course I find it a troubling precedent. It’s perhaps somewhat less troubling, but still distressing, to know that billboards on the walls of sports stadiums are being digitally altered, live, during broadcast, so that the products can be subtly switched around. And perhaps most disturbingly, at least here in the states, certain networks and programs have begun cross-dissolving to advertisements from program content, and vice-versa. In other words, since the advertisers are aware that the long-established “blackout” which precedes the start of advertising breaks on TV causes people to tune out, or turn the volume off, or have their newfangled sensing devices “zap” the commercial… so they’re literally integrating the start of the ad with the final frames of the program instead of going black, literally becoming part of the program. And we have heard about more reliance of products WITHIN the programs, but this just takes us right back to TV’s past, where game show contestants sat behind enormous “Pepsodent” adverts pasted right there on the set. History will eat itself… DZ: Could you imagine a way advertisers could work product placement into films where modern products just don’t fit, like set in the past or in alternate universes (Star Wars, LOTR etc)? P: Can’t you? In fact, it’s already happening. Someone told us about the use of products in a recent set-in-the-past epic… but the name of the film is escaping me. S: And if you can’t find a way to insert a product placement in a film than maybe the film won’t get made. The problem is completely solved with films like Star Wars and Lord of the Rings—most of the characters are available in the store as action figures making them de facto placements. In Small Soldiers just about every toy-sized character was, in fact, nicely packaged by Hasbro. DZ: What is the role of the logo in product placement? S: There are the stars, and there are the many supporting roles—the logo is just one of them. We’re hoping to see this category at the next Oscars. P: And categories like “Best Song” are essentially product placement categories already… DZ: I’ve heard about the future of product placement being branding in computer games, interactive shop-at-home television – what other visions of the (branded) future can you imagine? P: The future is now. If you can’t watch a documentary on so-called public television in this country without having text boxes pop up on screen to suggest “related” web sites which “might be of interest” to the viewer, you’re already well on the way to being part of a branded environment. Computer games already have ads built-in, and shop-at-home already seems plenty interactive (and isn’t internet shopping, also?). I think if the various mega-corporations can not only convince people to wear clothing emblazoned with their logo and product name, but so successfully convince us to pay for the privilege of advertising them, then we are already living in a totally branded future. Where else can it go? It may seem a trite statement but, to my mind, wearing an entire Nike outfit is the ultimate. At least the British ad company called Cunning Stunts actually PAYS their human billboards… but those folks have to agree to have the company logo temporarily tattooed onto their foreheads for three hours as they mingle in public. I’m not joking about this. DZ: Is there any response to product placement? How can audiences manage their interactions with these texts? S: Films have been boycotted for culturally heinous content, such as racist and homophobic characters. Why not boycott films because of their commodity content? Or better yet boycott the product for colluding with the filmmakers to invade your peace of mind? What I hope Value-Added Cinema does is sensitize us to the insinuation of the products, so that we critically detect them, rather than passively allow them to pass before us. When that happens, when we’re just insensate recipients of those advertising ploys, we’re lost. DZ: Do you have anything to add to contemporary debates on culture jamming, especially the charge that culture jamming’s political power is limited by its use of logos and signs? Anne Moore has written that detourning ads ends up just re-iterating the logo - “because corporate lifeblood is profit, and profit comes from name recognition”, culture jammers are “trafficking in the same currency as the corporations” – what do you think of this? P: It’s an interesting assertion. But the best culture jams I’ve seen make total mincemeat of the product being parodied; just as you can’t simply discount the use of actual products in films in the context of a narrative, you can’t NOT try to reclaim the use of a brand-name. Maybe it’s a dangerous comparison because “reclaiming” use of the word Coke is not like reclaiming the use of the word “queer”, but there’s something to it, I think. Also, I wear t-shirts with the names of bands I like sometimes (almost always my friends’ bands, but I suppose that’s beside the point). Am I buying into the advertising concept? Yes, to a certain extent, I am. I guess to me it’s about just what you choose to advertise. Or what you choose to parody. DZ: Do you have any other points you’d like to make about product placement, advertising by stealth, branding, mindshare or logos? P: I think what Steve said, that above all we hope with our video to help make people aware of how much they are advertised to, beyond accepting it as a mere annoyance, sums it up. So far, we’ve had some comments at screenings which indicate a willingness of people to want to combat this in their lives, to want to “do something” about the onslaught of product placement surrounding them, in films and elsewhere. Works Cited ET: The Extraterrestrial. Dir. Steven Spielberg. Prod. Kathleen Kennedy & Steven Spielberg, M. Universal Pictures 1982. Shopping. Dir. Paul Anderson. Prod. Jeremy Bolt , M. Concorde Pictures,1993. http://www.cspinet.org/ http://www.productplacementawards.com/ Links http://www.cspinet.org/ http://www.productplacementawards.com/ Citation reference for this article Substitute your date of access for Dn Month Year etc... MLA Style Zuvela, Danni. "An Interview with the Makers of Value-Added Cinema" M/C: A Journal of Media and Culture< http://www.media-culture.org.au/0306/03-valueadded.php>. APA Style Zuvela, D. (2003, Jun 19). An Interview with the Makers of Value-Added Cinema. M/C: A Journal of Media and Culture, 6,< http://www.media-culture.org.au/0306/03-valueadded.php>

Introduction I think the Privacy Act is a huge edifice to protect the minority of things that could go wrong. I’ve got a good example for you, I’m just trying to think … yeah the worst one I’ve ever seen was the Balga Youth Program where we took these students on a reward excursion all the way to Fremantle and suddenly this very alienated kid started to jump under a bus, a moving bus so the kid had to be restrained. The cops from Fremantle arrived because all the very good people in Fremantle were alarmed at these grown-ups manhandling a kid and what had happened is that DCD [Department of Community Development] had dropped him into the program but hadn’t told us that this kid had suicide tendencies. No, it’s just chronically bad. And there were caseworkers involved and … there is some information that we have to have that doesn’t get handed down. Rather than a blanket rule that everything’s confidential coming from them to us, and that was a real live situation, and you imagine how we’re trying to handle it, we had taxis going from Balga to Fremantle to get staff involved and we only had to know what to watch out for and we probably could have … well what you would have done is not gone on the excursion I suppose (School Principal, quoted in Balnaves and Luca 49). These comments are from a school principal in Perth, Western Australia in a school that is concerned with “at-risk” students, and in a context where the Commonwealth Privacy Act 1988 has imposed limitations on their work. Under this Act it is illegal to pass health, personal or sensitive information concerning an individual on to other people. In the story cited above the Department of Community Development personnel were apparently protecting the student’s “negative right”, that is, “freedom from” interference by others. On the other hand, the principal’s assertion that such information should be shared is potentially a “positive right” because it could cause something to be done in that person’s or society’s interests. Balnaves and Luca noted that positive and negative rights have complex philosophical underpinnings, and they inform much of how we operate in everyday life and of the dilemmas that arise (49). For example, a ban on euthanasia or the “assisted suicide” of a terminally ill person can be a “positive right” because it is considered to be in the best interests of society in general. However, physicians who tacitly approve a patient’s right to end their lives with a lethal dose by legally prescribed dose of medication could be perceived as protecting the patient’s “negative right” as a “freedom from” interference by others. While acknowledging the merits of collaboration between people who are working to improve the wellbeing of students “at-risk”, this paper examines some of the barriers to collaboration. Based on both primary and secondary sources, and particularly on oral testimonies, the paper highlights the tension between privacy as a negative right and collaborative helping as a positive right. It also points to other difficulties and dilemmas within and between the institutions engaged in this joint undertaking. The authors acknowledge Michel Foucault’s contention that discourse is power. The discourse on privacy and the sharing of information in modern societies suggests that privacy is a negative right that gives freedom from bureaucratic interference and protects the individual. However, arguably, collaboration between agencies that are working to support individuals “at-risk” requires a measured relaxation of the requirements of this negative right. Children and young people “at-risk” are a case in point. Towards Collaboration From a series of interviews conducted in 2004, the school authorities at Balga Senior High School and Midvale Primary School, people working for the Western Australian departments of Community Development, Justice, and Education and Training in Western Australia, and academics at the Edith Cowan and Curtin universities, who are working to improve the wellbeing of students “at-risk” as part of an Australian Research Council (ARC) project called Smart Communities, have identified students “at-risk” as individuals who have behavioural problems and little motivation, who are alienated and possibly violent or angry, who under-perform in the classroom and have begun to truant. They noted also that students “at-risk” often suffer from poor health, lack of food and medication, are victims of unwanted pregnancies, and are engaged in antisocial and illegal behaviour such as stealing cars and substance abuse. These students are also often subject to domestic violence (parents on drugs or alcohol), family separation, and homelessness. Some are depressed or suicidal. Sometimes cultural factors contribute to students being regarded as “at-risk”. For example, a social worker in the Smart Communities project stated: Cultural factors sometimes come into that as well … like with some Muslim families … they can flog their daughter or their son, usually the daughter … so cultural factors can create a risk. Research elsewhere has revealed that those children between the ages of 11-17 who have been subjected to bullying at school or physical or sexual abuse at home and who have threatened and/or harmed another person or suicidal are “high-risk” youths (Farmer 4). In an attempt to bring about a positive change in these alienated or “at-risk” adolescents, Balga Senior High School has developed several programs such as the Youth Parents Program, Swan Nyunger Sports Education program, Intensive English Centre, and lower secondary mainstream program. The Midvale Primary School has provided services such as counsellors, Aboriginal child protection workers, and Aboriginal police liaison officers for these “at-risk” students. On the other hand, the Department of Community Development (DCD) has provided services to parents and caregivers for children up to 18 years. Academics from Edith Cowan and Curtin universities are engaged in gathering the life stories of these “at-risk” students. One aspect of this research entails the students writing their life stories in a secured web portal that the universities have developed. The researchers believe that by engaging the students in these self-exploration activities, they (the students) would develop a more hopeful outlook on life. Though all agencies and educational institutions involved in this collaborative project are working for the well-being of the children “at-risk”, the Privacy Act forbids the authorities from sharing information about them. A school psychologist expressed concern over the Privacy Act: When the Juvenile Justice Department want to reintroduce a student into a school, we can’t find out anything about this student so we can’t do any preplanning. They want to give the student a fresh start, so there’s always that tension … eventually everyone overcomes [this] because you realise that the student has to come to the school and has to be engaged. Of course, the manner and consequences of a student’s engagement in school cannot be predicted. In the scenario described above students may have been given a fair chance to reform themselves, which is their positive right but if they turn out to be at “high risk” it would appear that the Juvenile Department protected the negative right of the students by supporting “freedom from” interference by others. Likewise, a school health nurse in the project considered confidentiality or the Privacy Act an important factor in the security of the student “at-risk”: I was trying to think about this kid who’s one of the children who has been sexually abused, who’s a client of DCD, and I guess if police got involved there and wanted to know details and DCD didn’t want to give that information out then I’d guess I’d say to the police “Well no, you’ll have to talk to the parents about getting further information.” I guess that way, recognising these students are minor and that they are very vulnerable, their information … where it’s going, where is it leading? Who wants to know? Where will it be stored? What will be the outcomes in the future for this kid? As a 14 year old, if they’re reckless and get into things, you know, do they get a black record against them by the time they’re 19? What will that information be used for if it’s disclosed? So I guess I become an advocate for the student in that way? Thus the nurse considers a sexually abused child should not be identified. It is a positive right in the interest of the person. Once again, though, if the student turns out to be at “high risk” or suicidal, then it would appear that the nurse was protecting the youth’s negative right—“freedom from” interference by others. Since collaboration is a positive right and aims at the students’ welfare, the workable solution to prevent the students from suicide would be to develop inter-agency trust and to share vital information about “high-risk” students. Dilemmas of Collaboration Some recent cases of the deaths of young non-Caucasian girls in Western countries, either because of the implications of the Privacy Act or due to a lack of efficient and effective communication and coordination amongst agencies, have raised debates on effective child protection. For example, the British Laming report (2003) found that Victoria Climbié, a young African girl, was sent by her parents to her aunt in Britain in order to obtain a good education and was murdered by her aunt and aunt’s boyfriend. However, the risk that she could be harmed was widely known. The girl’s problems were known to 6 local authorities, 3 housing authorities, 4 social services, 2 child protection teams, and the police, the local church, and the hospital, but not to the education authorities. According to the Laming Report, her death could have been prevented if there had been inter-agency sharing of information and appropriate evaluation (Balnaves and Luca 49). The agencies had supported the negative rights of the young girl’s “freedom from” interference by others, but at the cost of her life. Perhaps Victoria’s racial background may have contributed to the concealment of information and added to her disadvantaged position. Similarly, in Western Australia, the Gordon Inquiry into the death of Susan Taylor, a 15 year old girl Aboriginal girl at the Swan Nyungah Community, found that in her short life this girl had encountered sexual violation, violence, and the ravages of alcohol and substance abuse. The Gordon Inquiry reported: Although up to thirteen different agencies were involved in providing services to Susan Taylor and her family, the D[epartment] of C[ommunity] D[evelopment] stated they were unaware of “all the services being provided by each agency” and there was a lack of clarity as to a “lead coordinating agency” (Gordon et al. quoted in Scott 45). In this case too, multiple factors—domestic, racial, and the Privacy Act—may have led to Susan Taylor’s tragic end. In the United Kingdom, Harry Ferguson noted that when a child is reported to be “at-risk” from domestic incidents, they can suffer further harm because of their family’s concealment (204). Ferguson’s study showed that in 11 per cent of the 319 case sample, children were known to be re-harmed within a year of initial referral. Sometimes, the parents apply a veil of secrecy around themselves and their children by resisting or avoiding services. In such cases the collaborative efforts of the agencies and education may be thwarted. Lack of cultural education among teachers, youth workers, and agencies could also put the “at-risk” cultural minorities into a high risk category. For example, an “at-risk” Muslim student may not be willing to share personal experiences with the school or agencies because of religious sensitivities. This happened in the UK when Khadji Rouf was abused by her father, a Bangladeshi. Rouf’s mother, a white woman, and her female cousin from Bangladesh, both supported Rouf when she finally disclosed that she had been sexually abused for over eight years. After group therapy, Rouf stated that she was able to accept her identity and to call herself proudly “mixed race”, whereas she rejected the Asian part of herself because it represented her father. Other Asian girls and young women in this study reported that they could not disclose their abuse to white teachers or social workers because of the feeling that they would be “letting down their race or their Muslim culture” (Rouf 113). The marginalisation of many Muslim Australians both in the job market and in society is long standing. For example, in 1996 and again in 2001 the Muslim unemployment rate was three times higher than the national total (Australian Bureau of Statistics). But since the 9/11 tragedy and Bali bombings visible Muslims, such as women wearing hijabs (headscarves), have sometimes been verbally and physically abused and called ‘terrorists’ by some members of the wider community (Dreher 13). The Howard government’s new anti-terrorism legislation and the surveillance hotline ‘Be alert not alarmed’ has further marginalised some Muslims. Some politicians have also linked Muslim asylum seekers with terrorists (Kabir 303), which inevitably has led Muslim “at-risk” refugee students to withdraw from school support such as counselling. Under these circumstances, Muslim “at-risk” students and their parents may prefer to maintain a low profile rather than engage with agencies. In this case, arguably, federal government politics have exacerbated the barriers to collaboration. It appears that unfamiliarity with Muslim culture is not confined to mainstream Australians. For example, an Aboriginal liaison police officer engaged in the Smart Communities project in Western Australia had this to say about Muslim youths “at-risk”: Different laws and stuff from different countries and they’re coming in and sort of thinking that they can bring their own laws and religions and stuff … and when I say religions there’s laws within their religions as well that they don’t seem to understand that with Australia and our laws. Such generalised misperceptions of Muslim youths “at-risk” would further alienate them, thus causing a major hindrance to collaboration. The “at-risk” factors associated with Aboriginal youths have historical connections. Research findings have revealed that indigenous youths aged between 10-16 years constitute a vast majority in all Australian States’ juvenile detention centres. This over-representation is widely recognised as associated with the nature of European colonisation, and is inter-related with poverty, marginalisation and racial discrimination (Watson et al. 404). Like the Muslims, their unemployment rate was three times higher than the national total in 2001 (ABS). However, in 1998 it was estimated that suicide rates among Indigenous peoples were at least 40 per cent higher than national average (National Advisory Council for Youth Suicide Prevention, quoted in Elliot-Farrelly 2). Although the wider community’s unemployment rate is much lower than the Aboriginals and the Muslims, the “at-risk” factors of mainstream Australian youths are often associated with dysfunctional families, high conflict, low-cohesive families, high levels of harsh parental discipline, high levels of victimisation by peers, and high behavioural inhibition (Watson et al. 404). The Macquarie Fields riots in 2005 revealed the existence of “White” underclass and “at-risk” people in Sydney. Macquarie Fields’ unemployment rate was more than twice the national average. Children growing up in this suburb are at greater risk of being involved in crime (The Age). Thus small pockets of mainstream underclass youngsters also require collaborative attention. In Western Australia people working on the Smart Communities project identified that lack of resources can be a hindrance to collaboration for all sectors. As one social worker commented: “government agencies are hierarchical systems and lack resources”. They went on to say that in their department they can not give “at-risk” youngsters financial assistance in times of crisis: We had a petty cash box which has got about 40 bucks in it and sometimes in an emergency we might give a customer a couple of dollars but that’s all we can do, we can’t give them any larger amount. We have bus/metro rail passes, that’s the only thing that we’ve actually got. A youth worker in Smart Communities commented that a lot of uncertainty is involved with young people “at-risk”. They said that there are only a few paid workers in their field who are supported and assisted by “a pool of volunteers”. Because the latter give their time voluntarily they are under no obligation to be constant in their attendance, so the number of available helpers can easily fluctuate. Another youth worker identified a particularly important barrier to collaboration: because of workers’ relatively low remuneration and high levels of work stress, the turnover rates are high. The consequence of this is as follows: The other barrier from my point is that you’re talking to somebody about a student “at-risk”, and within 14 months or 18 months a new person comes in [to that position] then you’ve got to start again. This way you miss a lot of information [which could be beneficial for the youth]. Conclusion The Privacy Act creates a dilemma in that it can be either beneficial or counter-productive for a student’s security. To be blunt, a youth who has suicided might have had their privacy protected, but not their life. Lack of funding can also be a constraint on collaboration by undermining stability and autonomy in the workforce, and blocking inter-agency initiatives. Lack of awareness about cultural differences can also affect unity of action. The deepening inequality between the “haves” and “have-nots” in the Australian society, and the Howard government’s harshness on national security issues, can also pose barriers to collaboration on youth issues. Despite these exigencies and dilemmas, it would seem that collaboration is “the only game” when it comes to helping students “at-risk”. To enhance this collaboration, there needs to be a sensible modification of legal restrictions to information sharing, an increase in government funding and support for inter-agency cooperation and informal information sharing, and an increased awareness about the cultural needs of minority groups and knowledge of the mainstream underclass. Acknowledgments The research is part of a major Australian Research Council (ARC) funded project, Smart Communities. The authors very gratefully acknowledge the contribution of the interviewees, and thank *Donald E. Scott for conducting the interviews. References Australian Bureau of Statistics. 1996 and 2001. Balnaves, Mark, and Joe Luca. “The Impact of Digital Persona on the Future of Learning: A Case Study on Digital Repositories and the Sharing of Information about Children At-Risk in Western Australia”, paper presented at Ascilite, Brisbane (2005): 49-56. 10 April 2006. http://www.ascilite.org.au/conferences/brisbane05/blogs/proceedings/ 06_Balnaves.pdf>. Dreher, Tanya. ‘Targeted’: Experiences of Racism in NSW after September 11, 2001. Sydney: University of Technology, 2005. Elliot-Farrelly, Terri. “Australian Aboriginal Suicide: The Need for an Aboriginal Suicidology”? Australian e-Journal for the Advancement of Mental Health, 3.3 (2004): 1-8. 15 April 2006 http://www.auseinet.com/journal/vol3iss3/elliottfarrelly.pdf>. Farmer, James. A. High-Risk Teenagers: Real Cases and Interception Strategies with Resistant Adolescents. Springfield, Ill.: C.C. Thomas, 1990. Ferguson, Harry. Protecting Children in Time: Child Abuse, Child Protection and the Consequences of Modernity. London: Palgrave Macmillan, 2004. Foucault, Michel. Power/Knowledge: Selected Interviews and Other Writings, 1972-1977. Ed. Colin Gordon, trans. Colin Gordon et al. New York: Pantheon, 1980. Kabir, Nahid. Muslims in Australia: Immigration, Race Relations and Cultural History. London: Kegan Paul, 2005. Rouf, Khadji. “Myself in Echoes. My Voice in Song.” Ed. A. Bannister, et al. Listening to Children. London: Longman, 1990. Scott E. Donald. “Exploring Communication Patterns within and across a School and Associated Agencies to Increase the Effectiveness of Service to At-Risk Individuals.” MS Thesis, Curtin University of Technology, August 2005. The Age. “Investing in People Means Investing in the Future.” The Age 5 March, 2005. 15 April 2006 http://www.theage.com.au>. Watson, Malcolm, et al. “Pathways to Aggression in Children and Adolescents.” Harvard Educational Review, 74.4 (Winter 2004): 404-428. Citation reference for this article MLA Style Kabir, Nahid, and Mark Balnaves. "Students “at Risk”: Dilemmas of Collaboration." M/C Journal 9.2 (2006). echo date('d M. Y'); ?> <http://journal.media-culture.org.au/0605/04-kabirbalnaves.php>. APA Style Kabir, N., and M. Balnaves. (May 2006) "Students “at Risk”: Dilemmas of Collaboration," M/C Journal, 9(2). Retrieved echo date('d M. Y'); ?> from <http://journal.media-culture.org.au/0605/04-kabirbalnaves.php>.

In the contemporary era, media spectacle organizes and mobilizes economic life, political conflict, social interactions, culture, and everyday life. My recently published book Media Spectacle explores a profusion of developments in hi-tech culture, media-driven society, and spectacle politics. Spectacle culture involves everything from film and broadcasting to Internet cyberculture and encompasses phenomena ranging from elections to terrorism and to the media dramas of the moment. For ‘Logo’, I am accordingly sketching out briefly a terrain I probe in detail in the book from which these examples are taken.1 During the past decades, every form of culture and significant forms of social life have become permeated by the logic of the spectacle. Movies are bigger and more spectacular than ever, with high-tech special effects expanding the range of cinematic spectacle. Television channels proliferate endlessly with all-day movies, news, sports, specialty niches, re-runs of the history of television, and whatever else can gain an audience. The rock spectacle reverberates through radio, television, CDs, computers networks, and extravagant concerts. The Internet encircles the world in the spectacle of an interactive and multimedia cyberculture. Media culture excels in creating megaspectacles of sports championships, political conflicts, entertainment, "breaking news" and media events, such as the O.J. Simpson trial, the Death of Princess Diana, or the sex or murder scandal of the moment. Megaspectacle comes as well to dominate party politics, as the political battles of the day, such as the Clinton sex scandals and impeachment, the 36 Day Battle for the White House after Election 2000, and the September 11 terrorist attacks and subsequent Terror War. These dramatic media passion plays define the politics of the time, and attract mass audiences to their programming, hour after hour, day after day. The concept of "spectacle" derives from French Situationist theorist Guy Debord's 1972 book Society of the Spectacle. "Spectacle," in Debord's terms, "unifies and explains a great diversity of apparent phenomena" (Debord 1970: #10). In one sense, it refers to a media and consumer society, organized around the consumption of images, commodities, and spectacles. Spectacles are those phenomena of media culture which embody contemporary society's basic values, and dreams and nightmares, putting on display dominant hopes and fears. They serve to enculturate individuals into its way of life, and dramatize its conflicts and modes of conflict resolution. They include sports events, political campaigns and elections, and media extravaganzas like sensational murder trials, or the Bill Clinton sex scandals and impeachment spectacle (1998-1999). As we enter a new millennium, the media are becoming ever more technologically dazzling and are playing an increasingly central role in everyday life. Under the influence of a postmodern image culture, seductive spectacles fascinate the denizens of the media and consumer society and involve them in the semiotics of a new world of entertainment, information, a semiotics of a new world of entertainment, information, and drama, which deeply influence thought and action. For Debord: "When the real world changes into simple images, simple images become real beings and effective motivations of a hypnotic behavior. The spectacle as a tendency to make one see the world by means of various specialized mediations (it can no longer be grasped directly), naturally finds vision to be the privileged human sense which the sense of touch was for other epochs; the most abstract, the most mystifiable sense corresponds to the generalized abstraction of present day society" (#18). Today, however, I would maintain it is the multimedia spectacle of sight, sound, touch, and, coming to you soon, smell that constitutes the multidimensional sense experience of the new interactive spectacle. For Debord, the spectacle is a tool of pacification and depoliticization; it is a "permanent opium war" (#44) which stupefies social subjects and distracts them from the most urgent task of real life -- recovering the full range of their human powers through creative praxis. The concept of the spectacle is integrally connected to the concept of separation and passivity, for in passively consuming spectacles, one is separated from actively producing one's life. Capitalist society separates workers from the products of their labor, art from life, and consumption from human needs and self-directing activity, as individuals passively observe the spectacles of social life from within the privacy of their homes (#25 and #26). The situationist project by contrast involved an overcoming of all forms of separation, in which individuals would directly produce their own life and modes of self-activity and collective practice. Since Debord's theorization of the society of the spectacle in the 1960s and 1970s, spectacle culture has expanded in every area of life. In the culture of the spectacle, commercial enterprises have to be entertaining to prosper and as Michael J. Wolf (1999) argues, in an "entertainment economy," business and fun fuse, so that the E-factor is becoming major aspect of business.2 Via the "entertainmentization" of the economy, television, film, theme parks, video games, casinos, and so forth become major sectors of the national economy. In the U.S., the entertainment industry is now a $480 billion industry, and consumers spend more on having fun than on clothes or health care (Wolf 1999: 4).3 In a competitive business world, the "fun factor" can give one business the edge over another. Hence, corporations seek to be more entertaining in their commercials, their business environment, their commercial spaces, and their web sites. Budweiser ads, for instance, feature talking frogs who tell us nothing about the beer, but who catch the viewers' attention, while Taco Bell deploys a talking dog, and Pepsi uses Star Wars characters. Buying, shopping, and dining out are coded as an "experience," as businesses adopt a theme-park style. Places like the Hard Rock Cafe and the House of Blues are not renowned for their food, after all; people go there for the ambience, to buy clothing, and to view music and media memorabilia. It is no longer good enough just to have a web site, it has to be an interactive spectacle, featuring not only products to buy, but music and videos to download, games to play, prizes to win, travel information, and "links to other cool sites." To succeed in the ultracompetitive global marketplace, corporations need to circulate their image and brand name so business and advertising combine in the promotion of corporations as media spectacles. Endless promotion circulates the McDonald’s Golden Arches, Nike’s Swoosh, or the logos of Apple, Intel, or Microsoft. In the brand wars between commodities, corporations need to make their logos or “trademarks” a familiar signpost in contemporary culture. Corporations place their logos on their products, in ads, in the spaces of everyday life, and in the midst of media spectacles like important sports events, TV shows, movie product placement, and wherever they can catch consumer eyeballs, to impress their brand name on a potential buyer. Consequently, advertising, marketing, public relations and promotion are an essential part of commodity spectacle in the global marketplace. Celebrity too is manufactured and managed in the world of media spectacle. Celebrities are the icons of media culture, the gods and goddesses of everyday life. To become a celebrity requires recognition as a star player in the field of media spectacle, be it sports, entertainment, or politics. Celebrities have their handlers and image managers to make sure that their celebrities continue to be seen and positively perceived by publics. Just as with corporate brand names, celebrities become brands to sell their Madonna, Michael Jordan, Tom Cruise, or Jennifer Lopez product and image. In a media culture, however, celebrities are always prey to scandal and thus must have at their disposal an entire public relations apparatus to manage their spectacle fortunes, to make sure their clients not only maintain high visibility but keep projecting a positive image. Of course, within limits, “bad” and transgressions can also sell and so media spectacle contains celebrity dramas that attract public attention and can even define an entire period, as when the O.J. Simpson murder trials and Bill Clinton sex scandals dominated the media in the mid and late 1990s. Entertainment has always been a prime field of the spectacle, but in today's infotainment society, entertainment and spectacle have entered into the domains of the economy, politics, society, and everyday life in important new ways. Building on the tradition of spectacle, contemporary forms of entertainment from television to the stage are incorporating spectacle culture into their enterprises, transforming film, television, music, drama, and other domains of culture, as well as producing spectacular new forms of culture such as cyberspace, multimedia, and virtual reality. For Neil Gabler, in an era of media spectacle, life itself is becoming like a movie and we create our own lives as a genre like film, or television, in which we become "at once performance artists in and audiences for a grand, ongoing show" (1998: 4). On Gabler’s view, we star in our own "lifies," making our lives into entertainment acted out for audiences of our peers, following the scripts of media culture, adopting its role models and fashion types, its style and look. Seeing our lives in cinematic terms, entertainment becomes for Gabler "arguably the most pervasive, powerful and ineluctable force of our time--a force so overwhelming that it has metastasized into life" to such an extent that it is impossible to distinguish between the two (1998: 9). As Gabler sees it, Ralph Lauren is our fashion expert; Martha Stewart designs our sets; Jane Fonda models our shaping of our bodies; and Oprah Winfrey advises us on our personal problems.4 Media spectacle is indeed a culture of celebrity who provide dominant role models and icons of fashion, look, and personality. In the world of spectacle, celebrity encompasses every major social domain from entertainment to politics to sports to business. An ever-expanding public relations industry hypes certain figures, elevating them to celebrity status, and protects their positive image in the never-ending image wars and dangers that a celebrity will fall prey to the machinations of negative-image and thus lose celebrity status, and/or become figures of scandal and approbation, as will some of the players and institutions that I examine in Media Spectacle (Kellner 2003). Sports has long been a domain of the spectacle with events like the Olympics, World Series, Super Bowl, World Soccer Cup, and NBA championships attracting massive audiences, while generating sky-high advertising rates. These cultural rituals celebrate society's deepest values (i.e. competition, winning, success, and money), and corporations are willing to pay top dollar to get their products associated with such events. Indeed, it appears that the logic of the commodity spectacle is inexorably permeating professional sports which can no longer be played without the accompaniment of cheerleaders, giant mascots who clown with players and spectators, and raffles, promotions, and contests that feature the products of various sponsors. Sports stadiums themselves contain electronic reproduction of the action, as well as giant advertisements for various products that rotate for maximum saturation -- previewing environmental advertising in which entire urban sites are becoming scenes to boost consumption spectacles. Arenas, like the United Center in Chicago, America West Arena in Phoenix, on Enron Field in Houston are named after corporate sponsors. Of course, after major corporate scandals or collapse, like the Enron spectacle, the ballparks must be renamed! The Texas Ranger Ballpark in Arlington, Texas supplements its sports arena with a shopping mall, office buildings, and a restaurant in which for a hefty price one can watch the athletic events while eating and drinking.5 The architecture of the Texas Rangers stadium is an example of the implosion of sports and entertainment and postmodern spectacle. A man-made lake surrounds the stadium, the corridor inside is modeled after Chartes Cathedral, and the structure is made of local stone that provides the look of the Texas Capitol in Austin. Inside there are Texas longhorn cattle carvings, panels of Texas and baseball history, and other iconic signifiers of sports and Texas. The merging of sports, entertainment, and local spectacle is now typical in sports palaces. Tropicana Field in Tampa Bay, Florida, for instance, "has a three-level mall that includes places where 'fans can get a trim at the barber shop, do their banking and then grab a cold one at the Budweiser brew pub, whose copper kettles rise three stories. There is even a climbing wall for kids and showroom space for car dealerships'" (Ritzer 1998: 229). Film has long been a fertile field of the spectacle, with "Hollywood" connoting a world of glamour, publicity, fashion, and excess. Hollywood film has exhibited grand movie palaces, spectacular openings with searchlights and camera-popping paparazzi, glamorous Oscars, and stylish hi-tech film. While epic spectacle became a dominant genre of Hollywood film from early versions of The Ten Commandments through Cleopatra and 2001 in the 1960s, contemporary film has incorporated the mechanics of spectacle into its form, style, and special effects. Films are hyped into spectacle through advertising and trailers which are ever louder, more glitzy, and razzle-dazzle. Some of the most popular films of the late 1990s were spectacle films, including Titanic, Star Wars -- Phantom Menace, Three Kings, and Austin Powers, a spoof of spectacle, which became one of the most successful films of summer 1999. During Fall 1999, there was a cycle of spectacles, including Topsy Turvy, Titus, Cradle Will Rock, Sleepy Hollow, The Insider, and Magnolia, with the latter featuring the biblical spectacle of the raining of frogs in the San Fernando Valley, in an allegory of the decadence of the entertainment industry and deserved punishment for its excesses. The 2000 Academy Awards were dominated by the spectacle Gladiator, a mediocre film that captured best picture award and best acting award for Russell Crowe, thus demonstrating the extent to which the logic of the spectacle now dominates Hollywood film. Some of the most critically acclaimed and popular films of 2001 are also hi-tech spectacle, such as Moulin Rouge, a film spectacle that itself is a delirious ode to spectacle, from cabaret and the brothel to can-can dancing, opera, musical comedy, dance, theater, popular music, and film. A postmodern pastiche of popular music styles and hits, the film used songs and music ranging from Madonna and the Beatles to Dolly Parton and Kiss. Other 2001 film spectacles include Pearl Harbor, which re-enacts the Japanese attack on the U.S. that propelled the country to enter World War II, and that provided a ready metaphor for the September 11 terror attacks. Major 2001 film spectacles range from David Lynch’s postmodern surrealism in Mulholland Drive to Steven Spielberg’s blending of his typically sentimental spectacle of the family with the formalist rigor of Stanley Kubrick in A.I. And the popular 2001 military film Black-Hawk Down provided a spectacle of American military heroism which some critics believed sugar-coated the actual problems with the U.S. military intervention in Somalia, causing worries that a future U.S. adventure by the Bush administration and Pentagon would meet similar problems. There were reports, however, that in Somalian cinemas there were loud cheers as the Somalians in the film shot down the U.S. helicopter, and pursued and killed American soldiers, attesting to growing anti-American sentiment in the Muslim world against Bush administration policies. Television has been from its introduction in the 1940s a promoter of consumption spectacle, selling cars, fashion, home appliances, and other commodities along with consumer life-styles and values. It is also the home of sports spectacle like the Super Bowl or World Series, political spectacles like elections (or more recently, scandals), entertainment spectacle like the Oscars or Grammies, and its own spectacles like breaking news or special events. Following the logic of spectacle entertainment, contemporary television exhibits more hi-tech glitter, faster and glitzier editing, computer simulations, and with cable and satellite television, a fantastic array of every conceivable type of show and genre. TV is today a medium of spectacular programs like The X-Files or Buffy, the Vampire Slayer, and spectacles of everyday life such as MTV's The Real World and Road Rules, or the globally popular Survivor and Big Brother series. Real life events, however, took over TV spectacle in 2000-2001 in, first, an intense battle for the White House in a dead-heat election, that arguably constitutes one of the greatest political crimes and scandals in U.S. history (see Kellner 2001). After months of the Bush administration pushing the most hardright political agenda in memory and then deadlocking as the Democrats took control of the Senate in a dramatic party re-affiliation of Vermont’s Jim Jeffords, the world was treated to the most horrifying spectacle of the new millennium, the September 11 terror attacks and unfolding Terror War that has so far engulfed Afghanistan and Iraq. These events promise an unending series of deadly spectacle for the foreseeable future.6 Hence, we are emerging into a new culture of media spectacle that constitutes a novel configuration of economy, society, politics, and everyday life. It involves new cultural forms, social relations, and modes of experience. It is producing an ever-proliferating and expanding spectacle culture with its proliferating media forms, cultural spaces, and myriad forms of spectacle. It is evident in the U.S. as the new millennium unfolds and may well constitute emergent new forms of global culture. Critical social theory thus faces important challenges in theoretically mapping and analyzing these emergent forms of culture and society and the ways that they may contain novel forms of domination and oppression, as well as potential for democratization and social justice. Works Cited Debord, Guy. Society of the Spectacle. Detroit: Black and Red, 1967. Gabler, Neil. Life the Movie. How Entertainment Conquered Reality. New York: Alfred A. Knopf, 1998. Kellner, Douglas. Grand Theft 2000. Lanham, Md.: Rowman and Littlefield, 2001. Kellner, Douglas. From 9/11 to Terror War: Dangers of the Bush Legacy. Lanham, Md.: Rowman and Littlefield, 2003. Kellner, Douglas. Media Spectacle. London and New York: Routledge, 2003. Ritzer, George. The McDonaldization Thesis: Explorations and Extensions. Thousand Oaks, Cal. and London: Sage, 1998. Wolf, Michael J. Entertainment Economy: How Mega-Media Forces are Transforming Our Lives. New York: Times Books, 1999. Notes 1 See Douglas Kellner, Media Spectacle. London and New York: Routledge, 2003. 2 Wolf's book is a detailed and useful celebration of the "entertainment economy," although he is a shill for the firms and tycoons that he works for and celebrates them in his book. Moreover, while entertainment is certainly an important component of the infotainment economy, it is an exaggeration to say that it drives it and is actually propelling it, as Wolf repeatedly claims. Wolf also downplays the negative aspects of the entertainment economy, such as growing consumer debt and the ups and downs of the infotainment stock market and vicissitudes of the global economy. 3 Another source notes that "the average American household spent $1,813 in 1997 on entertainment -- books, TV, movies, theater, toys -- almost as much as the $1,841 spent on health care per family, according to a survey by the US Labor Department." Moreover, "the price we pay to amuse ourselves has, in some cases, risen at a rate triple that of inflation over the past five years" (USA Today, April 2, 1999: E1). The NPD Group provided a survey that indicated that the amount of time spent on entertainment outside of the home –- such as going to the movies or a sport event – was up 8% from the early to the late 1990s and the amount of time in home entertainment, such as watching television or surfing the Internet, went up 2%. Reports indicate that in a typical American household, people with broadband Internet connections spend 22% more time on all-electronic media and entertainment than the average household without broadband. See “Study: Broadband in homes changes media habits” (PCWORLD.COM, October 11, 2000). 4 Gabler’s book is a synthesis of Daniel Boorstin, Dwight Macdonald, Neil Poster, Marshall McLuhan, and other trendy theorists of media culture, but without the brilliance of a Baudrillard, the incisive criticism of an Adorno, or the understanding of the deeper utopian attraction of media culture of a Bloch or Jameson. Likewise, Gabler does not, a la cultural studies, engage the politics of representation, or its economics and political economy. He thus ignores mergers in the culture industries, new technologies, the restructuring of capitalism, globalization, and shifts in the economy that are driving the impetus toward entertainment. Gabler does get discuss how new technologies are creating new spheres of entertainment and forms of experience and in general describes rather than theorizes the trends he is engaging. 5 The project was designed and sold to the public in part through the efforts of the son of a former President, George W. Bush. Young Bush was bailed out of heavy losses in the Texas oil industry in the 1980s by his father's friends and used his capital gains, gleaned from what some say as illicit insider trading, to purchase part-ownership of a baseball team to keep the wayward son out of trouble and to give him something to do. The soon-to-be Texas governor, and future President of the United States, sold the new stadium to local taxpayers, getting them to agree to a higher sales tax to build the stadium which would then become the property of Bush and his partners. This deal allowed Bush to generate a healthy profit when he sold his interest in the Texas Rangers franchise and to buy his Texas ranch, paid for by Texas tax-payers (for sources on the scandalous life of George W. Bush and his surprising success in politics, see Kellner 2001 and the further discussion of Bush Jr. in Chapter 6). 6 See Douglas Kellner, From 9/11 to Terror War: Dangers of the Bush Legacy. Lanham, Md.: Rowman and Littlefield Citation reference for this article Substitute your date of access for Dn Month Year etc... MLA Style Kellner, Douglas. "Engaging Media Spectacle " M/C: A Journal of Media and Culture< http://www.media-culture.org.au/0306/09-mediaspectacle.php>. APA Style Kellner, D. (2003, Jun 19). Engaging Media Spectacle . M/C: A Journal of Media and Culture, 6,< http://www.media-culture.org.au/0306/09-mediaspectacle.php>