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Events, Medicine and Society, Stanford News

“You just get lifted away from the earth”: Film spotlights dance program for Parkinson’s patients

“You just get lifted away from the earth": Film spotlights dance program for Parkinson’s patients

capturing grace still

Tomorrow and Saturday, “Capturing Grace,” a documentary film following participants of a dance program for people with Parkinson’s disease generated by New York’s Mark Morris Dance Group (MMDG), will be screened at Stanford. Filmmaker and former KQED Forum host Dave Iverson, and David Leventhal, previously a leading dancer of MMDG and now the director of Dance for PD, will also be on campus holding workshops and discussions.

A Stanford News piece today describes the film as “the centerpiece of a two-day exploration of the intersection of dance and medicine” and offers these details:

Since his Parkinson’s diagnosis in 2004, Stanford alumnus Iverson has been an education champion for the progressive disorder of the nervous system that affects movement. He wrote, reported, directed and co-produced the 2009 PBS Frontline documentary My Father, My Brother and Me, using his family’s saga with the disease as a starting point to explore the larger issues of scientific research, the quest for a cure and the political controversies surrounding stem cell transplants. He also works as a contributing editor for the Michael J. Fox Foundation for Parkinson’s Research.

[Said Iverson:] “One thing I’ve come to believe about Parkinson’s is that it’s a disease of subtraction. It takes things from you one by one. And one of the many things I learned from the people in the class is that if you are confronted with a disease of subtraction, you better believe in addition. You better start adding things back into your life. For the people we profiled in Capturing Grace, I think dance helped get them back on the plus side of the ledger.”

I recently talked with Iverson, who told me that, despite his Frontline documentary’s title, “Capturing Grace” has proved more personally involving. “It’s more about what happens to people when they have to respond to something that’s unwelcome in their lives,” he said. The participants featured in the film gather at the MMDG studios in Brooklyn to take classes given by professional dancers of one of the world’s leading modern dance troupes, and they learn repertory to perform, including dances by Mark Morris.

“It isn’t a miracle and it’s not a treatment,” Morris says in the film. Different from art therapy, the program provides instruction in movement and an opportunity to share what professional dancers experience daily – the heightened sense of awareness found by coordinating one’s body and mind to move freely and deliberately through space, guided by music, in communion with others – with a deadline of a performance offering additional motivation to show up, practice, and stay focused on a goal.

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Events, Science, Science Policy, Stanford News, Technology

The challenge – and opportunity – of regulating new ideas in science and technology

The challenge – and opportunity – of regulating new ideas in science and technology

running image

Innovation in science and technology holds promise to improve our lives. But disruptive business models, do-it-yourself medical devices, and open platforms also introduce corporate and personal risks. How can the public stay safe from unknown consequences as a company’s product or service matures? In a recent panel co-sponsored by Stanford’s Rock Center for Corporate Governance and Center for Law and the Biosciences, experts in law, business, and ethics discussed what happens when science and technology outrun the law.

Talk of drones, app-based car services, and music-sharing technologies teased out key issues currently disrupting legal paradigms. But biomedical science took center stage. “Health is more regulated than any other [area]” said panelist Hank Greely, JD, the Deane F. and Kate Edelman Johnson Professor of Law and director of the Center for Law and the Biosciences. He characterized the FDA’s processes as useful in slowing innovation in the health space but noted that rigorous pre-market regulation “won’t work in most parts of the economy.”

What happens when regulation is beyond reach? Greely noted that even if the FDA could limit an entrepreneurial company, it couldn’t conquer the DIY market. He referenced a procedure known as transcranial direct current stimulation, which, by applying electrodes to the head, can feel like “Adderall through a wire” or alter a person’s mood according to placement. A transmitting device is so simple to make, Greely said, “the hardest part will be finding an open Radio Shack.”

Moderator Dan Siciliano, JD, faculty director of the Rock Center and professor of the practice of law, asked the panelists which under-regulated technologies they found frightening. Vapor cigarettes, answered Eleanor Lacey, JD, for luring youth through fruit flavors and targeting them through advertising channels prohibited for regular cigarettes. (As previously reported on Scope, the FDA announced last spring that it would regulate the sale, but not marketing, of e-cigarettes.)

Lacey, vice president, general counsel and secretary of SurveyMonkey, discussed regulation issues involving health information that is transmitted on the company’s platform, where users own their data. She pointed to instances of users creating surveys on which respondents shared HIPAA-protected information, admitted suicidal thoughts, or confessed to crimes. The company cooperates with law enforcement in a very narrow set of sensitive situations but also upholds neutrality of the user-owned space and the user right to control the content: “You don’t want us to be able to shut it down,” Lacey said.

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Applied Biotechnology, Parenting, Pediatrics, Research, Sleep, Stanford News, Technology

Biodesign fellows take on night terrors in children

Biodesign fellows take on night terrors in children

baby on bed

Standing in the Clark Center’s grand courtyard, gazing upward at scientists ascending an outdoor staircase and traversing the exterior corridors on the top two floors, one senses that big ideas take shape here. But how?

Prototyping, say Andy Rink, MD, and Varun Boriah, MS, who spent the last year as Biodesign fellows. Part of Stanford’s Bio-X community, the Biodesign Program trains researchers, clinicians and engineers to be medical-technology innovators during its year-long fellowship. Fellows learn the Biodesign Process, which could be likened to design thinking for health care. On teams of two or four, the fellows identify a substantial health-care need and generate ideas to solve it using medical-device innovation.

Though most Biodesign projects take root after fellows complete a “clinical immersion” shadowing health-care workers in a hospital to observe problems, Rink found his inspiration when visiting family and waking up to a 3-year-old relative’s screams from recurring night terrors. The problem was not so much that it affected the child – pediatricians may advise that children will likely outgrow the condition – but that it affected the parents, Rink saw.  The parent’s lost sleep and anxiety over their child’s well being had huge effects on their quality of life. (In some cases, these are so severe that Xanax and Valium may be prescribed to the children as a last-ditch effort.) What if a treatment could be found that involved no medication and no parental intervention, offering everyone a solid night’s sleep?

The physician and engineer are working with School of Medicine sleep researchers Christian Guilleminault, MD, professor of psychiatry and behavioral sciences, and Shannon Sullivan, MD, clinical assistant professor of psychiatry and behavioral sciences, on a clinical method to treat night terrors in children. In a first-floor room of the Clark Center, they’re protoyping an under-mattress device that senses how deeply a child is sleeping and is able to prevent the nightly episodes from occurring, creating a healthier sleep cycle for the children.  This relieves the parent’s anxiety, and helps the entire family sleep better.

Faculty and students from more than 40 departments across Stanford’s campus, including the schools of medicine, business, law, engineering and humanities and sciences, play a role in Biodesign, as do experts from outside the university. Fellows work closely with the Institute of Design at Stanford, attending – and then teaching – the school’s d.bootcamp. They also have access to the’s facilities and consult regularly with their faculty. Some of the’s methods – focusing on big problems, encouraging radical collaboration, prototyping early and user-testing before focusing on functionality – guide the trajectory of Biodesign projects.

Physicians who are Biodesign fellows often work outside their specialty, and engineers bring a mix of academic and industry experience to the design table. While faculty mentors may simply provide advice to fellows, Guilleminault and Sullivan have become invested in the course of the research as lead investigators on the study. For their involvement, they were both honored with the Biodesign Specialty Team Mentorship Award.

Fellow Boriah noted that medical-device innovation is moving from products like catheters to systems such as health IT, mobile health and software. A former CEO and co-founder of a wearable patient blood-diagnostics device, he said the Biodesign program has provided valuable “access to clinical reality.” Rink, a surgical resident at Northwestern University, said that as a fellow, he’s been “exposed to a side you don’t see in a hospital.”

The researchers are currently recruiting participants ages 2-12 for their study. Rink and Boriah are also working with the Stanford-supported StartX to see their project into the next stage of development.

Previously: Sleep, baby, sleep: Infants’ sleep difficulties could signal future problemsStudying pediatric sleep disorders an “integral part” of the future of sleep medicine and At Med School 101, teens learn that it’s “so cool to be a doctor” 
Photo by MissMayoi

Global Health, Nutrition, Research, Stanford News

Stanford researchers address hunger in new book on food security

Stanford researchers address hunger in new book on food security

riceA piece from Stanford’s Freeman Spogli Institute for International Studies notes how experts across campus are working together to address the complex global problem of hunger. A new book, The Evolving Sphere of Food Security (Oxford University Press, August), discusses the problem from numerous perspectives, including medicine, in its 14 chapters. The book’s editor, Rosamond Naylor, PhD, is director of the Center on Food Security and the Environment, which is housed jointly within the FSI and the Woods Institute for the Environment.

From the piece:

“This book grew out of a recognition by Stanford scholars that food security is tied to security of many other kinds,” said Naylor, who is also William Wrigley Senior Fellow at the Freeman Spogli Institute for International Studies and the Stanford Woods Institute for the Environment. “Food security has clear connections with energy, water, health, the environment and national security, and you can’t tackle just one of those pieces.”

Stanford has a long history of fostering cross-disciplinary work on global issues. It is in this spirit that the idea for the book was born, Naylor said. The book weaves together the expertise of authors from the fields of medicine, political science, engineering, law, economics and climate science.

A recurring theme throughout the book – also reflected in its title – is the evolving nature of the food security challenges countries face as they move through stages of economic growth. At low levels of development, countries struggle to meet people’s basic needs. For example, Naylor’s chapter on health, co-authored with Eran Bendavid [MD] (medicine), Jenna Davis [PhD] and Amy Pickering [PhD] (civil and environmental engineering), describes a recent study showing that poor nutrition and rampant disease in rural Kenya is closely tied to contaminated, untreated drinking water. Addressing these essential health and sanitation issues is a key first step toward food security for the poorest countries.

Previously: Seeking solutions to childhood anemia in ChinaWho’s hungry? You can’t tell by lookingCould a palm oil tax lower the death rate from cardiovascular disease in India? and Foreign health care aid delivers the good
Photo by Thomas Wanhoff

Grand Roundup

Grand Roundup: Top posts for the week of July 13

The five most-read stories this week on Scope were:

“As a young lung cancer patient, I had to find my own path”: Fighting stage IV with full forceInspire contributor Emily Bennett Taylor, a Stage IV lung cancer survivor and spokesperson/patient advocate, discusses her choice to pursue aggressive treatment following diagnosis at age 28.

The woman in the elevator: dealing with death in medical training: In the latest installment of SMS Unplugged, medical student Jennifer DeCoste-Lopez shares her insight on dealing with death and loss in medical training.

Mourning the loss of AIDS researcher Joep Lange: Stanford researchers specializing in HIV/AIDS are among those around the world mourning the loss of Dutch scientist Joep Lange, MD, PhD, a leading AIDS researcher who died in the recent Malaysian Airlines crash in Ukraine.

Stanford bioengineer develops a 50-cent paper microscopeManu Prakash, PhD, assistant professor of bioengineering, has developed an ultra-low-cost paper microscope to aid disease diagnosis in developing regions. The device is further described in a technical paper.

Stanford team develops nanotech-based microchip to diagnose Type 1 diabetes: Researchers here, including pediatric endocrinologist Brian Feldman, MD, PhD, have invented a cheap, portable, microchip-based test for diagnosing type-1 diabetes. The test could speed up diagnosis and enable studies of how the disease develops.

And still going strong – the most popular post from the past:

Researchers explain how “cooling glove” can improve exercise recovery and performance: The “cooling glove,” a device that helps people cool themselves quickly by using their hand to dissipate heat, was created more than a decade ago by Stanford biologists Dennis Grahn and Craig Heller, PhD. This video demonstrates the device and explains how it can be used to dramatically improve exercise recovery and performance.

Behavioral Science, Health and Fitness, Mental Health, Research

Exercise and relaxation techniques may help ease social anxiety, study finds

Exercise and relaxation techniques may help ease social anxiety, study finds

TrishWardMeditationPicPhysical exercise and relaxation techniques are common forms of stress-relief. Now, a new study has found that both may help people with social anxiety perceive their surroundings as less threatening environments.

Researchers from Queen’s University in the U.K. conducted two experiments measuring anxiety in participants. In both experiments, the participants were shown point-of-light displays describing a human but not indicating which way the stick figure was facing or whether it appeared to be approaching or receding. Facing-the-viewer bias, a possible biological protective mechanism, may lead people to assume the figure is approaching and posing a threat. And, according to the study, people who are more anxious may place their attention on more threatening stimuli, thereby increasing anxiety.

The researchers tested two means of altering participants’ perception of threat when looking at the stick-figure displays. From a release:

“We wanted to examine whether people would perceive their environment as less threatening after engaging in physical exercise or after doing a relaxation technique that is similar to the breathing exercises in yoga (called progressive muscle relaxation),” researcher [Adam Heenan, a PhD candidate,] said in a statement. “We found that people who either walked or jogged on a treadmill for 10 minutes perceived these ambiguous figures as facing towards them (the observer) less often than those who simply stood on the treadmill. The same was true when people performed progressive muscle relaxation.”

“This is a big development because it helps to explain why exercising and relaxation techniques have been successful in treating and mood and anxiety disorders in the past,” Heenan said.

The research was published in PLOS ONE.

Previously: Research brings meditation’s health benefits into focusAh…OM: Study shows prenatal yoga may relieve anxiety in pregnant womenStudy reveals initial findings on health of most extreme runners and The remarkable impact of yoga breathing for trauma
Photo courtesy of Trish Ward-Torres

CDC, Nutrition, Pediatrics, Public Safety, Research, Stanford News

"Happy Meal ban": Where are we now?

"Happy Meal ban": Where are we now?

MuppetBabiesA newly released Centers for Disease Control report of a study conducted at Stanford has examined the effects of San Francisco’s 2010 “Happy Meal ban.” The ban prohibited the free distribution of toys with unhealthy meals; the fast-food restaurants McDonald’s and Burger King instead sold the toys for 10 cents. Though neither restaurant complied with the ordinance’s specific calls for changes in nutritional content, improvements have been made.

As reported by

…over the study’s two-year period, McDonald’s in particular made big changes to its Happy Meals, said [Jennifer Otten, MD,] of the University of Washington School of Public Health — first in California, then nationally.

The fast food giant cut the amount of French fries it serves in Happy Meals in half, replacing them with apples; stopped serving caramel sauce with apples; and began offering nonfat chocolate milk to customers. Otten said those substitutions were “pretty dramatic,” — they reduced the calories in a Happy Meal by 110, and cut the sodium and fat content of the meal as well.

Otten and her colleagues, including senior author Abby King, PhD, concluded in the study, “Although the changes…  did not appear to be directly in response to the ordinance, the transition to a more healthful beverage and default side dish was consistent with the intent of the ordinance. Study results… suggest that public policies may contribute to positive restaurant changes.”

Previously: How fast-food restaurants respond to limits on free toys with kids’ meals, Toying with Happy Meals, How food advertising and parents’ influence affect children’s nutritional choices and Living near fast food restaurants influences California teens’ eating habits
Photo by Ursala Urdbeer

HIV/AIDS, In the News, Public Health

Free, one-minute HIV testing…while you shop for clothes?

Free, one-minute HIV testing...while you shop for clothes?

outoftheclosetPerhaps you’re familiar with cafe-laundromats or sushi restaurants with tap dancing. But did you ever visit a second-hand clothing and furniture store to take care of your health-care needs? An audio segment and post on the KERA News (Dallas) blog features a local Out of the Closet shop with a free HIV testing site, and soon a community pharmacy, inside their thrift store – making it the 22nd branch of the U.S. chain to have both.

Bret Camp, the Texas regional director of the AIDS Healthcare Foundation, which operates the thrift stores, said in the post, “Our pharmacy will have everything from blood pressure meds to diabetes supplies…How many places can you go and look at jeans while you’re waiting for your medication?”

More from the post:

It’s an innovative idea, says [Douglas Owens, MD,] a professor of medicine at Stanford University who also serves on the U.S. Preventive Services Task Force.

A number of organizations, including the CDC and U.S. Preventive Services Task Force recommended universal HIV testing. Of course testing is only the first step, Owens says.

“When people get an adequate treatment for HIV, the drugs reduce their infectivity and so treatment for HIV not only benefits the person who has HIV; it also provides a very important public health benefit that reduces transmission,” Owens explains in the audio segment.

Previously: Task force recommends HIV screening for all people aged 15 to 65, Using Facebook to prevent HIV among at-risk groupsTask force issues draft recommendation for universal HIV screening and National HIV screening and testing could be very cost-effective
Photo by Marilyn Roxie

Health Disparities, LGBT, Mental Health, Patient Care, Stanford News

Stanford med student discusses his documentary on LGBT vets' health

Stanford med student discusses his documentary on LGBT vets' health

doublelifeWhen Stanford anesthesiologist Audrey Shafer, MD, welcomed attendees to a screening of “The Camouflage Closet” on campus recently, she noted the artistic accomplishments and service work of the film’s director, Michael Nedelman. (And also mentioned he was “a Stanford medical student in his spare time.”) Nedelman, who will be entering his third year here, conducted a project with nine LGBT veterans, all patients at the Veterans Affairs Palo Alto Health Care System, exploring their experiences of trauma and recovery.

Nedelman and his collaborators engaged in a community-based participatory method of film-making, allowing participants to tell their stories through art as a path toward empowerment. The participants were provided with cameras to document their stories; they also had a say in the editing process. And while the project was neither officially sanctioned research nor therapy, many of the participants found the process therapeutic. Christine Stout-Holmes said this in the film about sharing her story:

It’s healing. It makes me feel like, “Hey, I don’t have to be agoraphobic.” “Hey, I don’t have to isolate.”

Of course, I feel fists beating me on my back, but I know that that’s not now. And I know that what I’m doing now is going to benefit clinicians, and vets, and hopefully artists, and young girls to know that every story is important.

Since the film’s premiere last June, it has screened at the National Queer Arts Festival, the 31st annual Gay and Lesbian Medical Association conference, and at universities, film festivals and VA hospitals across the U.S. and in Mexico.

Below, Nedelman answers questions about his work.

You have a BA in film studies from Yale. How did you decide to attend med school, and have your interests in art and medicine always intersected?

It took me a while to understand exactly how my interests in art and medicine intersected, but it turned out they had a common ancestor in my love of story.

A few years out of college, I was working at Mount Sinai in New York City on both clinical research and documentary film studies. Whether or not there was a camera in the room, I loved hearing people’s stories, and turning those stories into something meaningful. But in a medical context, I also saw the opportunity to get involved in these stories – to reach past the lens and make a tangible difference.

Combining the two wasn’t really a new concept, though. My first major work in college was a photography project addressing preventable blindness in South India. As with “The Camouflage Closet,” I loaned out cameras to rural vision clinic patients who were able to document their restored sight through images that were important to them. But I had no idea that hyphenating doctor-filmmaker was even an option until I discovered, and later met with, filmmakers like Maren Grainger-Monsen, MD, and Gretchen Berland, MD. Something clicked when I figured out that patient care and digital media could go hand-in-hand.

What are some of the issues faced by this population that you’re most interested in exploring through storytelling?

Some of the issues I found most compelling are not just the unique challenges faced by some individuals (e.g. witch hunts of the pre-DADT – “Don’t Ask, Don’t Tell” – era, increased rates of military sexual trauma, barriers to accessing care), but also the creativity and strength that come from their recovery narratives. Alongside some of the heavier moments in the film, there’s some humor, too. I think I personally learned a lot from the veterans’ resilience, and how their pride – for being LGBT, and for being veterans – factors into their personal growth.

What do you hope viewers will take away from your film?

I hope viewers will come out of the film with a desire to learn more about the unique challenges, types of trauma, and sources of resilience among a previously silenced community. I think there’s a lot to identify with in the film, whether or not you identify as LGBT or a veteran, and there’s a lot to be said for turning empathy into action. This is partly why we also created an accompanying educational resource that summarizes previous research, evidence-based suggestions for culturally relevant care, and resources for clinicians and veterans.

The veterans were excited that clinicians and providers would see and learn from their work. But at the end of the day, I wonder if some of them might have answered this question a little differently. Something we often heard among the vets was, “Even if just one other veteran out there sees this and knows they aren’t alone, we’ve accomplished what we came here to do.”

Previously: Documentary on LGBT veterans’ PTSD, trauma and recovery premieres tomorrow and Photography and storytelling may help poor women with HIV cope with their illness
Film still from “The Camoflauge Closet” courtesy of Michael Nedelman

Ethics, In the News, Research, Transplants

Physicians more likely to become organ donors, Canadian study finds

Physicians more likely to become organ donors, Canadian study finds

When receiving advice from a physician, one might wonder what the doctor would choose for him- or herself. Recently we discussed here a study on doctors’ preferences for their own end-of-life care. Now, a study published in the Journal of the American Medical Association has reported on physicians’ views and behavior surrounding their own organ donation.

As a news@JAMA piece reports on the Canadian study, physicians are nearly 50 percent more likely than non-physicians to register as an organ donor. More from the piece:

Despite waiting lists for organs in many countries, the percentage of individuals registered in national organ donation registries in most countries is below 40%. The United States fares a bit better than average, with 48% of adults registered as organ donors.

Concerns about organ donation have led to lower-than-average rates of registration in Ontario, Canada, where only about 25% of adults have registered. Currently, there are more than 1500 people on transplant waiting lists in Ontario.

Study author Alvin Ho-ting Li, BHSc, a PhD candidate at Western University in Ontario, Canada, discusses the study’s purpose and findings further in a Q&A section of the piece.

Previously: More on doctors and end-of-life directivesStudy: Doctors would choose less aggressive end-of-life care for themselvesStudents launch Stanford Life Savers initiative to boost organ donation and Family ties: One sister saves another with live liver donation

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