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Grand Roundup

Grand Roundup: Top posts for the week of July 6

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

It’s time for innovation in how we pay for medical schoolJoanne Conroy, MD, chief executive officer of Lahey Clinic & Medical Center in Burlington, Mass., discusses options to decrease undergraduate medical school debt. This post originally appeared on Wing of Zock.

Without exercise, Americans are growing more obese, according to Stanford researchers: Inactivity rather than overeating could be driving the surge in Americans’ obesity, according to a study by Stanford researchers that includes first author Uri Ladabaum, MD.

The behavioral consequences of overindulgence: Researchers from the Stanford Graduate School of Business have conducted a series of experiments on how overindulgence affects our pleasure in food. Their findings offer insights for both individuals that have trouble eating and drinking in moderation and those who are picky eaters.

Fewer than six degrees of separation: the small world of higher education: In this entry of the SMS Unplugged series, med student Hamsika Chandrasekar discusses the need to address diversity of undergraduate institutions in medical school.

Stanford patient on having her genome sequenced: “This is the right thing to do for our family”: Patient Julie Prillinger’s genome was among the first to be sequenced through a pilot program of the new Clinical Genomics Service at Stanford Hospital & Clinics. The pilot phase of the service is limited to specific patient groups.

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

The mystery surrounding lung-transplant survival rates: A 2012 article in the San Francisco Chronicle offered a look at the challenges facing lung transplant patients and explored why a significant number don’t live beyond the five-year mark, despite improvements in survival rates.

Ethics, Genetics, Medicine and Society, Parenting, Pediatrics, Stanford News

Genome testing for children: What parents should consider

Genome testing for children: What parents should consider

Genome testing: Would you do it?

Okay, next question: Would you have your child’s whole genome tested?

In the recent issue of Stanford Medicine News, Louanne Hudgins, MD, chief of medical genetics and director of perinatal genetics at Lucile Packard Children’s Hospital Stanford, weighs in on the issue: “I strongly advise parents against whole-genome testing for their children unless performed in the context of a medical evaluation following formal counseling regarding its utility, limitations and possible unrelated findings,” she said.

In the piece, Hudgins comments on privacy and ethics considerations, and explains why what we partially know (for instance, if your child is found to have a gene predisposing him or her to a disease) can sometimes provide more cause for worry or false hope than helpful or conclusive information.

The whole piece (a short one) is worth a read.

Previously: Stanford patient on having her genome sequenced: “This is the right thing to do for our family”, Personal molecular profiling detects diseases earlier, Stanford geneticist discusses genomics and medicine in TEDMED talk and Medical practice, patents, and “custom children”: A look at the future of reproductive medicine

Medicine and Society, Science, Stanford News, Technology

Residential learning program offers undergrads a new approach to scientific inquiry

Residential learning program offers undergrads a new approach to scientific inquiry

SIMILE studentsTwenty-two Stanford freshmen spent the last school year living, studying and socializing immersed in scientific inquiry. In its inaugural year, the residential education program SIMILE: Science in the Making Integrated Learning Environment drew interest from and selected a diverse group representative of the student body, many of whom don’t intend to become physicians or scientists or even plan to major in related fields. SIMILE students take pre-major requisites including writing, rhetoric and breadth requirements focused on the historical, cultural and social contexts of science. They also complete hands-on projects, attend field trips and regularly interact with faculty and guest lecturers in the program. Housed in the all-freshman Burbank House with ITALIC (Immersion in the Arts: Living in Culture), SIMILE students attend lectures and discussion sections in-house and have some shared activities with the new arts-focused residential academic program there.

A recent Stanford Report piece notes:

In the fall, Paula Findlen, [PhD,] a professor of Italian history and director of SIMILE, and Reviel Netz, a professor of classics, team-taught Inventing Science, Technology and Medicine. The class explored how those scientific fields emerged from the human desire to understand nature – empirically, mathematically and philosophically – and to control the environment.

Findlen said the program offered a “big picture view” of how human interactions have changed over the centuries, using history as the lens to understand the invention of science, technology and medicine.

“Fundamentally, SIMILE is a program about the history of knowledge,” she said.

Previously: Exploring global health through historical literatureThoughts on the arts and humanities in shaping a medical career and Intersection of arts and medicine a benefit to both, report finds
Photo by Jeremy Moffett

Health and Fitness, Nutrition, Obesity, Parenting, Pediatrics, Stanford News

Childhood obesity expert to parents: Reduce your child's screen time

Childhood obesity expert to parents: Reduce your child's screen time

screen-tvTake a few minutes to read a brief and informative piece about the negative health effects of too much screen time for children and how you can set boundaries for your kids – or perhaps yourself. In a Stanford Medicine News Q&A, pediatrician Thomas Robinson, MD, MPH, director of the Center for Healthy Weight at Lucile Packard Children’s Hospital Stanford, explains how watching TV or playing video games contributes to inactivity, overeating and obesity. Robinson also speaks to the modern-day concern of restricting access to screen devices that can also be educational tools, such as the iPad.

From the Q&A:

What’s the relationship between excessive screen time and childhood obesity?

It’s a true cause-and-effect relationship. The more time kids spend with screens, the less time they are spending being active. The best evidence supports two primary mechanisms—that kids eat more while watching screens and that exposure to food advertising leads to an increased eating of high-sugar, high-fat and calorie-dense foods. Lots of research shows that kids—and adults—eat more when distracted by a screen. So one of the most important things a family can do is eliminate eating while watching TV and other screens.

Previously:  Talking to kids about junk food ads, This is your 4-year-old on cartoons, Study: Too much TV, computer could hurt kids’ mental health, Does TV watching, or prolonged sitting, contribute to child obesity rates? and Paper explores effects of electronic media on kids’ health

Global Health, Medicine and Literature, Stanford News

Exploring global health through historical literature

Exploring global health through historical literature

deskPhysician-authors, including Abraham Verghese, MD, and efforts such as Stanford’s Arts, Humanities and Medicine Program draw the general public’s attention to issues important to the medical field. They may also elicit reader empathy by discussing real-world problems, even in fictional contexts, while situating literature and the arts in an influential position.

This relationship between medicine and literature is longstanding and complex. A Stanford News article discusses some examples of public health and humanism in historical literature and profiles the work of Alvan Ikoku, MD, PhD, an Andrew W. Mellon Fellow in the Humanities at Stanford.

From the piece:

As a scholar of 19th- and 20-century movements in international literature and health, [Ikoku] studies the place of long narrative forms, especially novels, in the development of tropical medicine and global health.

In his current book project, Forms of Global Health, Ikoku reads not Dickens or Gaskell, but writers such as Joseph Conrad and Andre Gide, who added to a “library of metaphors about the tropics and colonial spaces,” one that was referenced by “the fathers of tropical medicine” – returnees from colonial medical services, particularly malariologists, who wrote and lectured publicly about the need to establish a new medical specialty for the colonies.

Ikoku points out that literature provided an opportunity for readers to not simply feel an emotion, but to also actively help define a medical field and its knowledge base.

The article notes that Ikoku taught a course for Stanford students from many disciplines this spring called “The Literature of Global Health,” examining “how literary and medical writers have used narrative to explore the ethics of care in the developing world.”

Previously: Thoughts on the arts and humanities in shaping a medical careerMedical students and author Khaled Hosseini share their muse with Stanford community and Intersection of arts and medicine a benefit to both, report finds
Photo by Ben Sutherland

Public Health

Another reason to skirt traffic: health risks associated with noise pollution

trafficMapping out a 4th of July weekend adventure, I’m scheduling my drive down the I-5 by counting backward from arrival in time for a 10:30 a.m. yoga class. And, like many Californians, while planning my life around yoga I’m also thinking about alternate driving routes and factoring in time for road congestion. With tomorrow’s commute front-of-mind, I was interested to read about a recent report on the unhealthy effects of noise pollution from traffic – something I hadn’t considered. (But yoga seems like a good return to center following a sympathetic nervous system-stimulating drive.)

Scientists at Chalmers University of Technology in Sweden have recommended strategies to improve urban environments in ways that reduce traffic noise and stress-related health effects such as stroke and heart disease that may be linked with it, according to a release.

More from the release:

Last fall, [Tor Kihlman, PhD,] and [Wolfgang Kropp, PhD,] initiated a meeting between international experts from the automotive industry, universities and government agencies in Innsbruck to discuss technical possibilities to achieve better urban environments.

“Many of the needed measures are ideal for implementation in dense cities. They are often in line with what is required to tackle climate change. Here are double benefits to point to,” says Tor Kihlman, mentioning three examples: the procurement of quiet public transport, reduced speed, and the usage of buildings as as effective noise barriers, through good urban planning.

The new report describes the first steps needed, politically, for society to move towards substantially reduced health effects caused by traffic noise.

Previously: Study shows link between traffic noise, heart attackCan commuting by car or public transit negatively impact your health? and The hazards of sitting in traffic
Photo by Samantha Bilodeau

Aging, Mental Health, Research, Stanford News

Everyday conversations may help older adults bounce back from hardship

JapaneseLadyAs a fan of obituaries, oral histories and encounters with people who have had long lives, I was delighted to come across a humanities study finding that conversation is good for the subjects of the stories, too. Yoshiko Matsumoto, PhD, a Stanford professor of Japanese language and linguistics, has been studying conversations of older people, who, with long lives, have faced challenges such as health problems and losses of loved ones. Her research documents which types of conversation play a particularly important role in supporting the subjects’ well-being and can provide family members and care providers “potential tools for building resiliency following change.”

More from a recent Stanford Report article:

Matsumoto’s most recent work specifically focuses on older women’s discourse about the illness or death of their husbands, with particular attention to conversations that also include humor and laughter. “These instances are not uncommon in my data, although they are a surprising combination,” Matsumoto says.

Matsumoto’s linguistic analyses of more than 60 hours of recorded conversations illustrate that there is in fact a structure to such discourse. Her findings suggest that by reframing a serious story through an ordinary, or “quotidian,” perspective, the women she studied infused their dialogue with cathartic smiles.

In one instance, a woman jokingly described how she used to chide her husband about his smoking and drinking habits – the very cause of his death. Matsumoto notes that by shifting the narrative perspective from somber to the ordinary, the speaker helped everyone involved regain the feeling of normality.

Previously: Depression, lifestyle choices shown to adversely affect memory across age groups, Helping older adults live independently using mobile-health technology and How social media and online communities can improve clinical care for elderly patients
Photo by Debs

Behavioral Science, Mental Health, Stanford News

Using mindfulness-based programs to reduce stress and promote health

Using mindfulness-based programs to reduce stress and promote health

JamesLeeIn a Stanford BeWell Q&A, Mark Abramson, DDS, the founder and facilitator of Mindfulness-Meditation Based Stress Reduction programs at Stanford Hospital & Clinics and the Stanford School of Medicine, discusses the origins of such practices and how they can be applied in health settings and other areas such as business and education. Abramson leads an eight-week mindfulness meditation course through Stanford’s Health Improvement Program.

From the Q&A:

What is Mindfulness-Based Stress Reduction?

Mindfulness-Based Stress Reduction was originated by Jon Kabat-Zinn, [PhD,] who applied the traditional meditation practice of mindfulness (defined here as non-judgmental awareness) to medical centers. He created an eight-week treatment program for medical illnesses as well as general stress issues. In his program, he used a combination of mindfulness meditation, body awareness, and yoga to assist people with pain and a range of conditions and life issues. MBSR is now a common part of the treatment regimen in many hospital settings.

Meditation looks easy, but can be quite difficult. What is the simplest way to get started?

There are two phenomena that make meditation difficult. The first is the expectation people have that they’re going to go into a mystical, magical place where the mind shuts off and they will be in a special state. This expectation has ruined people’s practice more than anything else. Mindfulness is really just observing yourself through your natural senses — such as your taste, hearing, smelling and feeling. Even the thoughts you have are observable experiences.

The second difficulty is the habitual tendency for our minds to go off on tangents. It is difficult to stay focused; we slip away and we come back. I try to see that as part of the practice.

Previously: Med students awarded Schweitzer Fellowships lead health-care programs for underserved youthA campus-wide call to pause and reflect, Learning tools for mindful eating and Stress, will-power top reasons why Americans fail to adopt healthy habits
Photo of James Lee by Emily Hite

Grand Roundup

Grand Roundup: Top posts for the week of June 22

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

Empowered is as empowered does: Making a choice about living with lupus: Inspire contributor Pattie Brynn Hultquist writes about her experience living with the autoimmune disease systemic lupus erythematosus and how she became an empowered patient.

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.

Student transitions in medicine: putting blinders on: In the latest installment of SMS Unplugged, medical student Moises Gallegos discusses the importance of mentorship and support during medical school transitions.

Talk from the hand: the role of gesture in verbal communication: An Italian study found that the sight of gestures combined with the sound of speech created a whole-body system of communication in which movement played an important role in helping listeners understand language that was unclear.

Secrets of fat cells discoveredMary Teruel, PhD, and colleagues have studied the life cycle of fat cells and what findings could mean for the treatment of obesity and diabetes.

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

The mystery surrounding lung-transplant survival rates: A 2012 article in the San Francisco Chronicle offered a look at the challenges facing lung transplant patients and explored why a significant number don’t live beyond the five-year mark, despite improvements in survival rates.

Global Health, Health Disparities, Pregnancy, Research, Women's Health

In poorest countries, increase in midwives could save lives of mothers and their babies

In poorest countries, increase in midwives could save lives of mothers and their babies

midwifeThe World Health Organization reports that most maternal deaths are preventable; yet, preterm birth complications rank among the top 10 causes of death in low- and lower-middle-income countries. Two recent studies from the Johns Hopkins Bloomberg School of Public Health have explored the role skilled midwives may play in saving the lives of women and their babies in poor counties.

In one study, published in The Lancet, researchers found that deploying a small number of midwives – 10 percent more every five years through 2025 – in the world’s 26 poorest countries could stave off a quarter of the maternal, fetal and infant deaths there.

From a release:

The estimates were done using the Lives Saved Tool (LiST), a computer-based tool developed by Johns Hopkins Bloomberg School of Public Health researchers that allows users to set up and run multiple scenarios to look at the estimated impact of different maternal, child and neonatal interventions for countries, states or districts. For this analysis, the tool compared the effectiveness of several different alternatives including increasing the number of midwives by varying degrees, increasing the number of obstetricians, and a combination of the two.

In the other study, published in PLOS One, researchers used the LiST tool in the world’s 58 poorest countries, where they found that 7 million maternal, fetal and newborn deaths will occur between 2012 and 2015. The release continues:

If a country’s midwife access were to increase to cover 60 percent of the population by 2015, 34 percent of deaths could be prevented, saving the lives of nearly 2.3 million mothers and babies.

The researchers say boosting coverage of midwives who provide family planning as well as pregnancy care to 60 percent of women would cost roughly $2,200 per death averted as compared to $4,400 for a similar increase in obstetricians. Midwives are cheaper to train and can handle interventions needed during uncomplicated deliveries, while obstetricians are needed when surgical interventions such as cesarean sections are necessary, [lead author Linda Bartlett, MD] says. Midwives can administer antibiotics for infections and medications to stimulate or strengthen labor, remove the placenta from a patient having a hemorrhage as well as handle many other complications that may occur in the mother or her baby.

Previously: Indonesia’s cash transfer programs are valuable, Stanford health fellow findsStudy cautions babies born at home may be at increased risk for health problemsSimple program shown to reduce infant mortality in African country and Should midwives take on risky deliveries?
Photo by Vinoth Chandar

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