In the latest edition of Stanford University’s Open Office Hours, health psychologist Kelly McGonigal, PhD, answers reader-submitted questions on coping with stress during the holiday season. In the first of this series of videos, above, McGonigal addresses common holidays stressors and tools to close the gap between your expectations and the reality of experiencing the winter holidays as an adult. She also offers tips on evaluating research on meditation, following through on your New Year’s resolutions, and managing everyday stress in and beyond this season.

McGonigal emphasizes that some stress is healthy. She takes time to answer a high-schooler who is experiencing anxiety and self-doubt while applying to colleges, replying:

In part, what those inner experiences tell you is that you’re pursuing something that you care about. And in a way they can be a signal to you that you’re on the right track. One of the best pieces of advice I ever got from one of my teachers was, if I ever felt like I wanted to run in the opposite direction from something, that was probably the best signal my body and brain could give me to head straight at it. Because that was my body and brain really noticing that this is something incredibly important to me, and that anxiety or self-doubt was a signal to pursue – not to run away or back down.

…

Your direct experience of going after what you want will help you realize that, not only
can you handle the stress, but that you have what it takes to overcome obstacles.

Follow Stanford University’s YouTube channel or Facebook page for more of McGonigal’s answers to be posted this week, and view a list of previous Open Office Hours sessions here.

Previously: Need coping tips this holiday season?, Ask Stanford Med: Answers to your questions about willpower and tools to reach our goals, Ask Stanford Med: David Spiegel answers your questions on holiday stress and depression and Stanford health psychologist Kelly McGonigal discusses how stress shapes us

A touching story in Pacific Standard about people born as intersex individuals caught my attention today. Writer Alice Dreger begins by quoting a note she received from a man named Jim; he wrote to her about a community resource Dreger helped establish that he says “basically saved my life.” Jim was born with androgen insensitivity syndrome.

Dreger writes:

I offered to meet the next morning at the local tea place. And then I started wondering, as I often do with these out-of-the-blue communiqués, if this message was a fake. Was I being set up?
…
But the minute I saw Jim, I knew he was real. I knew he was real because he started crying, and couldn’t talk. It was a reaction I’d seen before among people with disorders of sex development (DSD) who had been too closeted to meet another person with their condition, but who could get up the gumption to ask to meet me. I served as a way out of the closet, and so I represented the first human they came upon when they opened the door. I always tried, in my reaction, to signal simply, “Yes, you are a fellow human, and I am glad you are here.” I always have trouble not crying myself.

Previously: Is the International Olympic Committee’s policy governing sex verification fair?, Researchers challenge proposed testosterone testing in select female Olympic athletes and Bay Area’s first DSD parent support group meets this week 
Related: Stanford author explores struggles of intersex individuals, their families and doctors and Karkazis on intersex people
Via @edyong209

Celebrities draw attention to fashion and beauty trends, charitable causes and fitness crazes, among other things. Now, a study has found that media attention given to a celebrity’s cancer diagnosis may be a powerful motivator to help more people quit smoking.

Scientists from San Diego State University, the Santa Fe Institute, the University of North Carolina and the Johns Hopkins Bloomberg School of Public Health examined Internet news searches and found that more people seek information on smoking cessation after a celebrity has publicly struggled with cancer than on New Year’s Day or World No Tobacco Day, both popular quitting times.

From a release:

Using the case of former Brazilian President Lula da Silva, who was diagnosed with laryngeal cancer in October 2011 and attributed his cancer to his long-held smoking habit, the researchers analyzed both media coverage of smoking cessation and the public’s online search activity surrounding the event.

By mining Google News archives, the team found Brazilian news coverage of quitting increased as much as 500 percent immediately after the diagnosis — and remained 163 percent higher for one week — before returning to typical levels. At the same time, Brazilian Google searches related to quitting smoking increased by 67 percent.

However, long after the media stopped covering Lula’s diagnosis, the public had not forgotten. Two weeks after the diagnosis, quitting-related Google searches remained 153 percent higher than expected, and remained 130 percent and 71 percent higher three and four weeks respectively after Lula’s announcement.

Study co-author Benjamin Althouse, PhD, an epidemiologist at the Santa Fe Institute, added, “In practical terms, we estimated there were about 1.1 million more quit-smoking queries in Brazil the month after Lula’s diagnosis than expected. Not only will quitting prevent throat cancer, but it can prevent nearly all cancers, including lung, stomach, breast, etc.”

The paper was published in the journal Preventive Medicine.

Previously: Quitting smoking for the baby you plan to have together, Craving a cigarette but trying to quit? A supportive text message might help and Smoking rates increasing in the developing world
Photo by cogdogblog

“Those children are sitting on the graves of their siblings,” said a Ugandan colleague, in a tragic reminder of the impact of childhood diseases in rural Africa.

Stanford bioengineering professor Manu Prakash, PhD, took this picture two weeks ago while conducting clinical field evaluations of his lab’s various ultra-low-cost disease diagnostics inventions.

His latest project is an electromagnetic patch that non-invasively detects live parasitic worms in infected patients.

To help test this novel idea, Prakash and co-investigator Judy Sakanari, PhD, a research pathologist at the UC San Francisco School of Medicine, received a $100,000 Grand Challenges Explorations award from the Gates Foundation.

The first prototypes will be used to detect the worm that causes onchocerciasis, or “river blindness,” which afflicts approximately 37 million people in Africa, Central and South America, and Yemen. Transmitted through repeated bites of blackflies, it is a major cause of preventable blindness.

Current diagnostic methods require the use of expensive ultrasound equipment to determine whether parasitic worms are alive under the skin or inside lymph nodes. Prakash’s more frugal design consists of a Bandaid-sized patch embedded with a sensitive sensor that detects minute electrical changes when worms wiggle under the skin or form calcified cysts. He expects that the final device will cost less than $10 and will be easier to use in rural settings.

Prakash and Jim Cybulski, a Stanford mechanical engineering PhD student, were also working at several sites to clinically evaluate “Foldscope,” an inexpensive microscope made of folded paper that is being mass produced and used for diagnosing diseases like malaria, schistosomiasis, African sleeping sickness, tuberculosis and various filarial diseases in field conditions. Cybulski recently won a Global Health Equity Scholars Fellowship fellowship (NIH-funded) for field testing this device.

The magnitude of the malaria problem in Uganda, which has one of the highest rates of infected mosquitoes in the world, became crystal clear during their trip.

“There was one hut where we trapped 400 mosquitoes in one night,” said Prakash. “And some public health centers that we visited had almost 100 malaria cases per day, with mothers of large families bringing in at least one child a week for testing.”

He added, “Being in the field gives meaning to working in global health. It teaches you empathy, a driving force so strong that transforms ideas into actions.”

Prakash’s lab is also exploring how to develop “human capital” in these resource-constrained settings, a strategy that would generate more jobs and build the infrastructure to provide these services locally. “We are looking at various ways to bring appropriate tools and training to these young college graduates who don’t have much to do,” he said.

Previously: Is the worm turning? Early stages of schistosomiasis bladder infection charted, Compound clogs Plasmodium’s in-house garbage disposal, Using cell phone data to track and fight malaria and Image of the Week: Malaria developing
Photo by Manu Prakash

Not many over-the-counter drugs can substantially improve your health. However, according to the U.S. Preventive Services Task Force, aspirin can reduce the risk of cardiovascular disease for some people. There is also building evidence that daily low-dose aspirin reduces risk of breast cancer, colon and other gastrointestinal cancers, and may even slow down dementia.

When a doctor agrees that the benefits of daily low-dose aspirin outweigh the potential side-effects, aspirin can be an effective, practical and inexpensive way to save lives and save billions in taxpayer-paid healthcare costs. Yet less than 50 percent of those thought eligible to take daily aspirin appear to be doing it. Why?

I recently submitted these ideas as part of the Target Simplicity Challenge - a pioneering “crowdsourcing” effort led by Target to identify new ideas for simplifying healthcare. I found out about the challenge on Twitter (thanks, @seattlemamadoc!), typed it up and even shot some video on my iPhone. The judging panel of doctors, designers, marketing executives and other industry experts liked it enough to make it one of eight finalists in the competition. This week I’m off to Target headquarters in Minneapolis to talk more about the idea before the winners are announced later in the month. The grand prizes include the opportunity to work with Target on turning my idea into reality.

And the public got a say, too – as you can read about on Target’s site.

We need to stop and think about the easiest and simplest ways possible for people to take advantage of existing scientific evidence that will make them healthier. Doctors and medical researchers should work together with experts in design and marketing to identify more evidence-based opportunities to make prevention and healthcare simpler.

Aspirin is inexpensive and available widely over the counter, but still, we could make it easier to take for those people who could benefit. Short of legislating aspirin counseling (a good idea opined in the New York Times), we need fresh and exciting approaches. I really think better design will increase the appeal of daily aspirin for chronic disease prevention and hope I have the chance to find out.

Christina Clarke, PhD, MPH, is a research scientist at the Cancer Prevention Institute of California (CPIC) and a member of the Stanford Cancer Institute. Part of the Stanford Cancer Institute, the Cancer Prevention Institute of California conducts population-based research to prevent cancer and reduce its burden where it cannot yet be prevented.

Previously: Another big step toward building a better aspirin tablet and New research shows aspirin may cut melanoma risk
Photo by brxO

A posse led by Stanford microbe sleuth and microbiologist David Relman, MD, has apprehended Staphylococcus aureus, one of the most notorious sources of serious infections, lurking in formerly unsuspected nasal hideaways. The discovery may explain why attempts to expunge S. aureus from the bodies of hospitalized patients being readied for surgery often meet with less than perfect results.

About one in three of us are persistent S. aureus carriers, and another third of us are occasional carriers. This bacterial shadow, which abounds on skin (especially the groin and armpits) and is quite at home in the nose, does us no harm most of the time. But if it gets into the bloodstream or internal organs, it can cause life-threatening problems such as sepsis, pneumonia and endocarditis (infection of heart valves). That makes S. aureus not such a good thing to be coated with if you’re about to have your skin punctured by a catheter or pierced by a scalpel.

This is exacerbated by the all-too-frequent presence, particularly in hospital settings, of S. aureus strains resistant to an entire family of antibiotics related to methicillin. In 2011, more than 80,000 severe methicillin-resistant S. aureus infections and more than 11,000 related deaths occurred in the U.S. alone, along with a much higher number of less-severe such infections.

In a study just published in Cell Host & Microbe, Relman – who pioneered the use of ultra-high-volume gene-sequencing techniques to sort out the thousands of species of microbes that communally inhabit our skin, orifices and innards – and his team used this method to show that mucosal sites way up high in our nose, where standard S. aureus-elimination techniques may not reach, can serve as reservoirs for S. aureus. That may, at least in part, explain why efforts to rid patients of this potentially nasty bug have so often fallen short of the mark, as I noted in my news release about the new findings:

Rigorous and somewhat tedious regimens for eliminating S. aureus residing on people’s skin or in their noses do exist, but it’s typically a matter of weeks or months before the bacteria repopulate those who are susceptible. The new study offers a possible reason why this is the case.

Previously: Cultivating the human microbiome, Anti-plaque bacteria: Coming soon to your toothpaste? and Eat a germ, fight an allergy
Photo by OakleyOriginals

In case you haven’t seen it, Foreign Policy magazine recently announced its Top 100 Global Thinkers of 2013. These movers, the piece accompanying the list notes, “have made a measurable difference in politics, business, technology, the arts, the sciences, and more” this year. Stanford Medicine’s Sanjay Basu, MD, PhD, was named one of the top thinkers – alongside luminaries such as Angela Merkel, the Intergovernmental Panel on Climate Change, and Pope Francis. Basu and University of Oxford’s David Stuckler, MPH, PhD, are being honored for research on the public health effects of different economic policy responses to the recession – or as the magazine puts it, “for warning that austerity can be deadly.”

Previously: Could a palm oil tax lower the death rate from cardiovascular disease in India?, Can food stamps help lighten America’s obesity epidemic? and New evidence for a direct sugar-to-diabetes link

Symptoms of a concussion after the moment of impact or trauma may be obvious (such as passing out), fuzzy (feeling slow or having difficulty remembering), or not be present at all. But what about damage that can’t be seen? Stanford undergraduate Theo Roth, a senior majoring in biology, is first author of a study with researchers from the National Institutes of Health that observes the brain’s response to a concussion at the cellular level.

Using an intracranial microscope, the researchers examined the effects of traumatic brain injury in mice for a few hours immediately after a head injury. A Stanford Report article today explains the cellular mechanics noted in the study:

The brain’s first line of defense is called the meninges, a thin layer of tissue that wraps the brain and creates a nearly impermeable barrier to harmful molecules. At the direct site of the injury, however, Roth found that the meninges can become damaged, tearing blood vessels and causing hemorrhaging. As cells in the meninges and other nearby tissues die, their toxic innards – in particular, molecules called reactive oxygen species (ROS) – can leak through the meninges onto healthy brain cells.

The brain tries to plug the holes in the meninges, Roth said, by quickly mobilizing special cells called microglia toward the site of the injury, a reaction that had never been seen in living brains before this study. The patch isn’t perfect, however, and some ROS and other potentially toxic molecules still leak through to the brain cells. Within nine to 12 hours after the initial injury, brain cells begin to die.

The researchers also looked for ways to prevent the damage they had observed in mice, finding that the natural antioxidant glutathione could neutralize ROS molecules and minimize damage if applied soon after injury. And, the article reports, these findings could have implications for treating concussions in humans.

The study (subscription or purchase required) was published online in Nature.

Previously: Now that’s using your head: Bike-helmet monitor alerts emergency contacts after a crash, Traumatic brain injuries: An issue both on the battlefield and the playing field, Kids and concussions: What to keep in mind and Measuring vs. reporting concussions in cheerleading
Photo by longhairbroad

If you followed the news on this year’s Stanford Medicine X conference, you might be familiar with the term ePatient: “empowered, engaged in your care, and equipped with knowledge about your condition,” as a Medicine X blog post describes. Later today, eight ePatient alumni will be joining in conversation via Google+ Hangout and Twitter to discuss features of the Medicine X ePatient program, eligibility requirements and how to apply for 2014.

Visit this page on the Medicine X blog to join the Hangout today at 5:30 PM Pacific time and use #MedX on Twitter to ask the panelists questions.

Previously: “You belong here”: A recap of Stanford Medicine X, Stanford Medicine X hosts Google+ Hangout tonight, Stanford Medicine X hosts live chat on Thursday with Bryan Vartabedian and Wendy Sue Swanson and ePatients discuss the “healing process” of IDEO Design Challenge at Medicine X

Though more than two months have passed, it seems like only yesterday that we announced Thomas Südhof, MD, and Michael Levitt, PhD, as Nobel winners. Now our heroes are participating in Nobel Week 2013 – a seven-day celebration in Stockholm, Sweden that began last weekend with a series of lectures. Video and slides from the  lectures by Südhof and Levitt are now available here and here, and today’s award ceremony can be seen on the Nobel website.

Holly MacCormick is a writing intern in the medical school’s Office of Communication & Public Affairs. She is a graduate student in ecology and evolutionary biology at University of California-Santa Cruz.

Previously: Stanford’s Michael Levitt wins 2013 Nobel Prize in Chemistry, Nobel winner Michael Levitt’s work animates biological processes, Stanford’s Thomas Südhof wins 2013 Nobel Prize in Medicine and Discussing the brain in Spain: Nobel Laureate Thomas Südhof addresses the media
Photo of Michael Levitt, left, and Thomas Südhof, on campus earlier this fall, by L.A. Cicero/Stanford News Service