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Behavioral Science, Nutrition, Obesity, Research, Women's Health

Obesity and smoking together may decrease taste of fat and sweet but increase consumption

puddingA study from Washington University School of Medicine in St. Louis and Philadelphia’s Monell Center has found that obese women who smoke cigarettes may have reduced sensitivity to the tastes of sweetness and fat in food and may be more likely to eat more calories.

Researchers engaged 47 female participants ages 21 to 41, grouped as follows: obese smokers, obese nonsmokers, normal-weight smokers, and normal-weight nonsmokers. All of the participants tasted vanilla puddings and were asked to rate the sweetness and creaminess of each one. The researchers found that the women who were obese and smokers rated less creaminess and sweetness in the puddings than the other three groups did.

From a release:

[Study author Yanina Pepino, PhD,] cautioned that the study only identified associations between smoking and taste rather than definitive reasons why obese smokers were less likely to detect fat and sweetness. But the findings imply that the ability to perceive fat and sweetness — and to derive pleasure from food — is compromised in female smokers who are obese, which could contribute to the consumption of more calories.

“Obese people often crave high-fat foods,” she said. “Our findings suggest that having this intense craving but not perceiving fat and sweetness in food may lead these women to eat more. Since smoking and obesity are risk factors for cardiovascular and metabolic diseases, the additional burden of craving more fats and sugars, while not fully tasting them, could be detrimental to health.”

The results were published in the journal Obesity.

Previously: Obesity is a disease – so now what?How eating motivated by pleasure affects the brain’s reward system and may fuel obesity and The brain’s control tower for pleasure
Photo by dutchfulthinking.blogspot.com

Aging, Medicine and Society, Stanford News

Stanford Distinguished Careers Institute encourages “personal reflection and intellectual exploration”

Stanford Distinguished Careers Institute encourages "personal reflection and intellectual exploration"

PizzoStanford University announced today a new center to support highly accomplished leaders who are mid-career in public or private sector positions and seeking new resources and influences to prepare for their next steps. The Stanford Distinguished Careers Institute (DCI) will offer 20 participants access to faculty and classes in all seven of Stanford’s schools, including the School of Medicine. Additionally, the DCI Fellows will participate in specially designed programs including a core program of weekly seminars and discussions, one-to-two day meetings on key issues, and monthly dinners with faculty scholars and Stanford and Silicon Valley community leaders.

Philip Pizzo, MD, former dean of the medical school, is founding director of the institute, which is a partnership with the Stanford Center on Longevity.

From a Stanford News article:

“We know what role universities play in early life and in stimulating the first phase of careers,” said [Pizzo], who returned to teaching in 2012 after serving as dean of Stanford School of Medicine for 12 years. “What is their role in mid- to later-career life transitions and journeys?”

“Life should be filled with new journeys and new opportunities, and shouldn’t be affixed to traditional stopping points that are no longer relevant,” said Pizzo, who is the David and Susan Heckerman professor of pediatrics, and of microbiology and immunology at Stanford. “We need to recalibrate the way we think about the life journey, and recognize that individuals have different things to offer and to gain at different stages in life.”

Pizzo said the institute will serve as a transition to new ventures for participants, allowing them to build on their life experiences to create something unique that will improve themselves and the world.

“The new way forward that emerges from participating in the institute can be one long-anticipated and hoped-for, or one not yet imagined,” he said.

Previously: The legacy of Stanford’s Philip Pizzo and Phil Pizzo, the marathon man, moves on
Photo by L.A. Cicero

Behavioral Science, Mental Health, Public Safety, Stanford News

Stanford’s Keith Humphreys on Golden Gate Bridge suicide prevention: Get the nets

GGBridgeOver on the Huffington Post, Keith Humphreys, PhD, professor of psychiatry and behavioral science at Stanford, writes about a tragic phenomenon in the Bay Area: the popularity of suicide by jumping from the Golden Gate Bridge. He makes a case to put public money toward installing nets and other suicide-prevention services there and in other suicide “hotspots.”

From the post:

Professor Richard Seiden [PhD] painstakingly tracked down death records for the 515 individuals who had been prevented by police from jumping off the bridge from 1937 to 1971. Remarkably, only 6 percent had committed suicide. Even if every individual who died in what was believed to be an accident were assumed to have intentionally caused their own deaths, the proportion of suicides rose only to 10 percent. In other words, 90 percent or more of people stopped from committing suicide at the Golden Gate Bridge lived out the full natural extent of their lives.

Previously: Full-length video available for Stanford’s Health Policy Forum on serious mental illnessLucile Packard Children’s Hospital partners with high schools on student mental health programs and ECT for depression – not so shocking
Photo by image_monger

Cancer, Emergency Medicine, Medicine and Society

An emergency medicine physician’s take on honoring your emotions

But how do you really feel? Over on KevinMD.com, Anoop Kumar, MD, reflects on his personal and professional experiences with cancer. The emergency physician cares for people with acute complications from cancer and related treatments. In the post, Kumar describes his journey through the death of his grandmother when he was in seventh grade, the bursting of a dam of emotional supression later on, and the continued leaking of grief as he confronts his confusion, sadness and loss around the event.

Inspired by a 2010 article in The Guardian, Kumar urges readers dealing with hardship to “be positive. Or be negative. Or be confused. But whatever you are, be yourself.”

Previously: Becoming Doctors: Stanford med students reflect and share experiences through podcasts

Events, Medical Education, Stanford News

At Med School 101, teens learn that it’s “so cool to be a doctor”

At Med School 101, teens learn that it's "so cool to be a doctor"

Students exam brain of animals during the brain lab session at Medicine on the sidelines at Med School 101 at Stanford University School of Medicine on Friday, March 28, 2014. ( Norbert von der Groeben/ Stanford School of Medicine )

“I was once in high school,” anesthesiologist Sean Mackey, MD, PhD, told a roomful of ninth-through-twelfth-graders Friday at Med School 101. Now he runs a large NIH-funded lab, takes care of patients, makes scientific discoveries, and helps people get better. Mackey delivered his talk on pain and the brain to the aspiring medical professionals at a high level. “This is the same talk that I give a national audience of experts,” he said – for his younger audience he just explains the jargon. And he includes clips from The Princess Bride, selected with the help of his 17-year-old son, to illustrate certain pain points.

Classes at Med School 101 tend to swing this way – with the instructors not mincing science while still making learning about medicine as fun as it is. In its eighth year, Med School 101 drew 140 students from 10 local high schools to Stanford’s Li Ka Shing Center for Learning and Knowledge to try on white coats, so to speak. Ann Weinacker, MD, chief of staff at Stanford Hospital & Clinics, welcomed students in the morning and shared, “It is so cool to be a doctor.”

Sleep expert Rafael Pelayo, MD, explained to the students attending his lecture why we sleep and outlined some common sleep disorders in adults and children and how medical science has addressed them. “When I started at Stanford 20 years ago, we didn’t know what caused narcolepsy,” Pelayo said. “Now we know it’s an autoimmune disease.”

For her session on global health, Sherry Wren, MD, a professor of surgery, talked about her experience volunteering with Doctors Without Borders in Africa. She caught students’ attention with some sobering statistics: Only 3.5 percent of surgeries worldwide are done in low-income countries; 2 billion people have no access to surgery; and in Africa alone, 42 million people presently have problems that could be treated by surgery.

In the ever-popular session, “So you want to go to med school?” with Charles Prober, MD, senior associate dean of medical education, students named different specialties within medicine and Prober explained their functions and sub-specialties. Questions on preparing for a career in medicine, and on what it takes to get into a good medical school, flowed, with Prober telling the students that the name of their college doesn’t matter as much as what they do there. (Check out the @SUMedicine Twitter feed and the hashtag #SUMed101 for more.)

While Prober mentioned the “big three” list of uses for an MD – patient care, research and education – many of the presenting faculty described other ways to be involved in health care, including public health, nursing, and physician assistant roles.

One young lady told me she was in seventh grade when she got the idea that she might want to be a doctor, but really solidified her plans in eighth grade. Where is she now? “Ninth grade.”

Previously: Med School 101 kicks off on Stanford campus todayLive tweeting sessions at Stanford’s Med School 101Bay Area students get a front-row seat to practicing medicine, scientific research and A quick primer on getting into medical school
Photo, of students in a brain-focused session, by Norbert von der Groeben

Grand Roundup

Grand Roundup: Top posts for the week of March 23

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

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.

Free DIY microscope kits to citizen scientists with inspiring project ideas: Through the Ten Thousand Microscope Project, Manu Prakash is giving away 10,000 build-your-own paper microscope kits to citizen scientists with the most inspiring ideas for how to use his new invention, called the Foldscope.

At Match Day 2014, Stanford med students take first steps as residents: During Match Day 2014, medical students around the country learned where they would be paired to begin residency. Tracie White reports on this year’s event from the Li Ka Shing Center for Learning and Knowledge, where Stanford students opened envelopes containing the news.

Stanford microscope inventor featured on TED Talk: In a TED Talk video, Manu Prakash builds and demonstrates his 50-cent paper microscope.

What the experience of Swedish snuff can teach us about e-cigarettes: Addiction expert Keith Humphreys, PhD, uses the example of Swedish snuff (known as “snus”) to examine the fundamental question at play in the current e-cigarette debate: Would it be a net harm or a net benefit to public health?

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

What are the consequences of sleep deprivation?: Brandon Peters, MD, an adjunct clinical faculty member at the Stanford Center for Sleep Sciences and Medicine, explains how lack of sleep can negatively affect a person’s well-being in this Huffington Post piece.

Imaging, In the News, Orthopedics, Research

Goo inside bones provides structural support, study finds

Goo inside bones provides structural support, study finds

As high-schoolers swarm the med school campus today, hold human brains and satisfy their taste for science, I can’t help but wish the show “You Can’t Do That on Television” still existed and that the producers would set up in the parking lot and slime each participant upon completion of the day. But a welcome alternative is news that scientists have discovered gooey matter inside human bones.

In a 60-Second Health piece, writer Dina Fine Maron explains how “a combination of imaging techniques and modeling has revealed that our bones are filled with a natural chemical goo that’s key to the bones’ function as support structures,” and that the information could be used to inform osteoporosis treatment and prevention. The researchers’ findings were published in the Proceedings of the National Academy of Sciences.

Previously: Exploring the use of yoga to improve the health and strength of bones, 419 million year-old fish fossil may reveal origins of the human jaw and  Teen girls become orthopaedic surgeons for a day

Health and Fitness, In the News, Obesity, Public Health

In Boston, doctor’s orders may include discounted bike-share memberships

Some Boston docs are delivering a dose of preventive care the old-fashioned way. Encouraging physical exercise under the city’s new “Prescribe-a-Bike” program, physicians at Boston Medical Center can refer low-income patients to a $5 bike-share membership, complete with helmet.

Common Health reports:

“Obesity is a significant and growing health concern for our city, particularly among low-income Boston residents,” BMC President and CEO Kate Walsh said in a statement. “Regular exercise is key to combating this trend, and Prescribe-a-Bike is one important way our caregivers can help patients get the exercise they need to be healthy.”

Previously: A bike helmet that doubles as a stress-o-meter and Modest increases in bike ridership could yield major economic, health benefits

Nutrition, Research

Cereal-eaters: How much are you really consuming?

cereal_smallAs any fan of lightweight, delicate Cocoa Krispies knows (though perhaps I’m generalizing my experience), sometimes it’s difficult to judge how much cereal you’re really eating. A study from Penn State on flake size, portion control and calorie consumption in breakfast cereals has shown that participants given smaller flakes poured a smaller volume into their bowls but still consumed greater heft and more calories than participants given larger flakes.

From a release:

According to [nutritional sciences professor Barbara Rolls, PhD], national dietary guidelines define recommended amounts of most food groups in terms of measures of volume such as cups.

“This can be a problem because, for most foods, the recommended amounts have not been adjusted for variations in physical properties that affect volume, such as aeration, cooking, and the size and shape of individual pieces.” Rolls said. “The food weight and energy required to fill a given volume can vary, and this variation in the energy content of recommended amounts could be a challenge to the maintenance of energy balance.”

In the study, 41 adult participants ate cereal for breakfast once a week for four weeks. Some ate the standard-sized wheat flakes, while others consumed the same cereal crushed to 80, 60 or 40 percent of its original volume. All participants poured as much as they wanted from opaque containers of equal-weight amounts of cereal and ate as much as they wanted.

The study authors report that “as flake size was reduced, subjects poured a smaller volume of cereal, but still took a greater amount by weight and energy content.” Still, the study notes, “subjects estimated that they had taken a similar number of calories of all versions of the cereal.”

The study (registration required), funded in part by the National Institutes of Health, was published in the Journal of the Academy of Nutrition and Dietetics.

Previously: Can dish color influence how much you eat? and Smaller plates may be a tool to curtail childhood obesity
Photo courtesy of Barbara Rolls, Penn State

Events, Medical Education, Medical Schools, Stanford News, Technology

Using technology and more to reimagine medical education

Using technology and more to reimagine medical education

Over on The Health Care Blog, Michael Painter, MD, JD, shares his thoughts from a recent meeting at Stanford’s medical school inviting medical education leaders to debate big questions in their field. Painter, a senior program officer at the Robert Wood Johnson Foundation, explained that meeting participants discussed ways that educators can use technology and other tools “to help create a durable culture of health for all.”

From the post:

In 2013 we extended a $312,000 grant to Stanford Medical School that will support work by five medical schools, Stanford, Duke, University of Washington, UCSF and University of Michigan, as they create a consensus knowledge map of the critical things medical students should learn.

Why a knowledge map? The simple answer: because there isn’t one, and we need one if we’re going to build massive core online medical education content.

Why change now? There’s building pressure on fortress academia: pressure to push health care toward high value, pressure for health care to center itself on the patient rather than the professional, and pressure from technology, specifically the ability to move previously closely held knowledge of the expert more efficiently to the learner.

Here’s where this mapping effort also starts to get interesting. It wouldn’t be that surprising if these education leaders ticked through all the reasons why change is too hard—why it can’t or won’t happen. Instead something marvelous is happening: they’re challenging each other to examine the time they spend with their students—asking if they ignite the kind of passion in their learners that others ignited in them.

An even more hopeful sign—these leaders want to connect the teaching of new healers—from the beginning—with the key partner: the patient. Their early reimagining is fixed on patient and story.

Previously: A closer look at using the “flipped classroom” model at the School of MedicineCombining online learning and the Socratic method to reinvent medical school courses, Using the “flipped classroom” model to re-imagine medical education and Stanford professors propose re-imagining medical education with “lecture-less” classes

Stanford Medicine Resources: