Ask Stanford Med

“Hello, Mrs. Jones. Your goal last time we talked was to do 30 minutes per day of brisk walking five days per week. Were you able to reach this goal?”

In 2007, Stanford researchers showed in a study of 218 older, inactive adults that computer-generated phone calls appeared to be an effective, low-cost way to encourage sedentary adults to exercise. In the trial, those participants in both the group called by trained health educators and the group called by a computer asking questions like the one above and delivering an interactive, individualized program wound up completing a regular 150-minute per week exercise program.

Now Abby King, PhD, and colleagues have found that the increases in regular physical activity seen during the year-long study were maintained in a subsequent six-month follow-up period – regardless of whether the participants had received human or automated advisor-initiated telephone contacts during those first 12 months. In looking at the trajectory of physical activity change over 18 months, the researchers also saw that the greatest physical activity increases for participants occurred during the first six months of intervention.

I recently discussed these findings with King, who told me that while advice and support is often important in maintaining healthy behaviors, “it doesn’t necessarily have to be delivered in person or by a human at all.” Below King talks more about the study, which appears online in the journal Health Psychology.

How significant is it that participants in the study – regardless of the intervention they received – were able to maintain their healthy habits? Were you surprised by what you found?

Given that participants in such programs tend to decrease their physical activity levels when instructor-initiated support ends, it is quite encouraging to see that both groups were able to “step up” and take charge of their programs during the maintenance period. Both groups received specific information from their physical activity advisors on how to do this during the initial program.

Your results also show the importance of the first six months of programming in establishing sustained physical activity change. How critical is this? Has this been shown in other studies, as well?

This study substantiates the observation seen in some of our prior studies as well as in those of others in the field that the initial six months of programming is a “critical period” for establishing the types of behavioral habits and skills necessary for continued behavioral success.

In your paper you and your co-authors call these automated technologies “attractive intervention tools” because of their reach, availability and cost. Can you explain how they might be beneficial in less-developed countries, where trained health educators are not in large supply?

The growing pervasiveness of mobile phones worldwide, particularly in less-developed countries, sets the stage for a “paradigm shift” with respect to how evidence-based health promotion programs can reach individuals regardless of where they live. Tele-health and the use of automated communication technologies allow for the types of “borderless health promotion” that can potentially make a substantive difference in the health promotion field worldwide.

What are your next steps? Are you conducting/planning more work in this area?

Based on this study, my group is currently collaborating with Dr. Marcia Stefanick here at Stanford and her colleagues in developing an automated tele-health physical activity coaching program specifically for older women. We have initially piloted the automated program with a group of older women here in the Bay Area, and were quite encouraged by the initial results from that effort. The goal is to be able to reach thousands of older women across the country with an easy to use automated tele-health program that is personalized to their needs and preferences.

Previously: Eat a carrot and exercise – or your iBird dies, Research shows remote weight loss interventions equally effective as face-to-face coaching programs and Monitoring patient wellness from a distance
Photo by comedy_nose

Cardiovascular disease is the reigning cause of mortality in the United States, with heart disease and stroke accounting for 2,200 deaths per day. As a result, many of us know someone who has had cardiovascular problems, and some of us have a concern over our own risk for heart disease or stroke.

In recognition of American Heart Month, we’ve asked Stanford interventional cardiologist William Fearon, MD, to respond to your questions about cardiovascular research, including advancements in diagnosing, treating and preventing heart disease and stroke.

Fearon’s clinical focus includes interventional cardiology, coronary artery disease and aortic stenosis, and his general research interest is coronary physiology. His recent focus is on the potential benefits of using a relatively new technology called “fractional flow reserve,” or FFR, to accurately determine which patients require artery-opening stents. In a study published last August, he and colleagues showed that FFR can be useful in identifying those patients with stable coronary artery disease who should have early placement of artery-opening stents, versus be treated solely with medical therapy, such as aspirin or statins.

Questions can be submitted to Fearon by either sending a tweet that includes the hashtag #AskSUMed or posting your question in the comments section below. We’ll collect questions until Monday (Feb.11) at 5 PM Pacific Time.

When submitting questions, please abide by the following ground rules:

• Stay on topic
• Be respectful to the person answering your questions
• Be respectful to one another in submitting questions
• Do not monopolize the conversation or post the same question repeatedly
• Kindly ignore disrespectful or off topic comments
• Know that Twitter handles and/or names may be used in the responses

Fearon will respond to a selection of the questions submitted, but not all of them, in a future entry on Scope.

Finally – and you may have already guessed this – an answer to any question submitted as part of this feature is meant to offer medical information, not medical advice. These answers are not a basis for any action or inaction, and they’re also not meant to replace the evaluation and determination of your doctor, who will address your specific medical needs and can make a diagnosis and give you the appropriate care.

Previously: Guidewire technology improves heart patient care, New tool for heart disease saves both lives and money, Stanford researchers describe experimental treatment for deadly heart disease, Ask Stanford Med: Cardiologist Jennifer Tremmel responds to questions on women’s heart health and Ask Stanford Med: Cardiologist Jennifer Tremmel taking questions on women’s heart health
Photo by Eva Blue

Almost a month into the New Year, some of you may feel like your willpower to stick to your 2013 resolutions and meet certain goals is running low. Don’t fret. While willpower may not be an unlimited resource, there are ways to train your brain to boost self-control and measures to reduce temptation.

Earlier this month, we asked Stanford health psychologist Kelly McGonigal, PhD, to respond to your questions about the latest research on willpower and how to use those insights to achieve your resolutions. Below she answers a selection of the questions submitted via Scope and our @SUMedicine Twitter feed.

@CGarnavi asks: What aspects of the neurological underpinnings of willpower influence the psychology of willpower? Can these be overcome?

You can think of the brain as having two different modes. One mode focuses on immediate, short term survival, immediate gratification and avoiding pain and discomfort. The other mode takes the long-view including remembering your biggest goals and values, thinking about future consequences and going after long-term rewards. I call these modes the “impulsive self” and the “expansive self.” It’s the impulsive self that tends to get us in to trouble, either by doing things we later regret or by preventing us from taking action that is difficult but important.

Which mode you’re in is based on the relative activation of different systems of the brain. The impulsive self is based more in the mid-brain, which includes the stress, cravings and habit systems of the brain. The expansive self is located more in the frontal cortex and includes the areas that control attention, motivate positive action, think about the future and regulate what’s going on in the mid-brain. We switch back and forth between these two modes and which systems of the brain are most responsive to the challenges we meet. The relative dominance of these two systems shapes our choices. To give one example, Caltech researchers have shown (.pdf) that you can predict the foods dieters will choose by how reactive the prefrontal cortex is in the face of temptation.

I’m very interested in practices that train the brain to either rest in, or be more responsive from, the frontal regions of the expansive self and less controlled by the midbrain’s cravings and stress. So far, the best evidence seems to be for moderately vigorous exercise, adequate sleep and mindfulness meditation. For example, a recent study of smokers trying to quit showed how mindfulness disrupts the functional connectivity of the craving network in the brain.

The thing I most want to encourage people to understand is that we all have these two brain modes and these two versions of ourselves. Even people who struggle deeply with addiction, procrastination, depression or anxiety can learn skills for shifting toward greater self-control. The rule of thumb seems to be that if it’s good for your body and your physical health, it’s probably also good for your brain and for self-control.

One of my favorite “brain training” exercises is called surf the urge, which has been demonstrated to help people resist temptation, overcome anxiety and regulate other destructive impulses. You can learn it here with a short guided practice MP3.

Continue Reading »

Past data suggests that four out of five people who adopt New Year’s resolution’s will eventually break them, and that a third will throw in the towel before the end of January. The good news is that, contrary to popular belief, willpower is not a trait that you’re either born with or without.

As Stanford health psychologist Kelly McGonigal, PhD, explained in her book The Science of Willpower, self-control is a complex mind-body response that can be compromised by stress, sleep deprivation and nutrition, and it can be strengthened through certain practices. In her book, McGonigal discusses why willpower is not an unlimited resource, how the brain can be trained for greater self-discipline, and how we use past good behavior to justify indulgences. She also provides other insights on self-control from psychology, economics, neuroscience and medicine.

To help you stick to your New Year’s resolutions and break bad habits, we’ve asked McGonigal to respond to your questions about the latest research on willpower and about ways to increase your self-discipline. Questions can be submitted to McGonigal by either sending a tweet that includes the hashtag #AskSUMed or posting your question in the comments section below. We’ll collect questions until Friday (Jan.11) at 5 PM Pacific Time.

When submitting questions, please abide by the following ground rules:

• Stay on topic
• Be respectful to the person answering your questions
• Be respectful to one another in submitting questions
• Do not monopolize the conversation or post the same question repeatedly
• Kindly ignore disrespectful or off topic comments
• Know that Twitter handles and/or names may be used in the responses

McGonigal will respond to a selection of the questions submitted, but not all of them, in a future entry on Scope.

Finally – and you may have already guessed this – an answer to any question submitted as part of this feature is meant to offer medical information, not medical advice. These answers are not a basis for any action or inaction, and they’re also not meant to replace the evaluation and determination of your doctor, who will address your specific medical needs and can make a diagnosis and give you the appropriate care.

Previously: Stanford health psychologist Kelly McGonigal discusses how stress shapes us, Boosting willpower and breaking bad habits, Stanford health psychologist offers tips for increasing your willpower and The science of willpower
Photo by Michael McCullough

Year after year, many of us adopt New Year’s resolutions to slim down, and by the end of January we’re often back at square one. Perhaps it’s time to reconsider a different weight-loss plan: Instead of trying to immediately lose weight, vow to maintain your weight for a period of two months before shedding any pounds.

While this recommendation may sound a bit odd, a past study from Stanford researchers showed that a maintenance-first approach helped individuals shrink their waistlines and keep from regaining the weight. In the following Q&A, lead author Michaela Kiernan, PhD, senior research scientist at the Stanford Prevention Research Center, discusses the method and tips for implementing it to achieve your 2013 weight-loss goals.

In a 1:2:1 podcast, you discuss how an “all or nothing” mentality can negatively impact goals to keep those pounds off. How does the “maintenance-first approach” address this and other psychological challenges associated with shedding pounds?

Often people adopt New Year’s resolutions in an attempt to change their behavior in an intensive focused effort. This approach may work in the short term but it can be hard to sustain that type of focus in the long term. As a result, people give up and revert to their old ways – the “all or nothing” approach. In contrast, maintaining behavior changes over time may need a more subtle “fine-tuning” approach, in which the day-to-day experience is more positive and doesn’t require such intensive effort.

In our trial, we asked one group to learn a set of maintenance skills before losing weight, so that they had a chance to experiment and experience what it was like to “fine-tune” their lifestyle habits. The other group lost weight in the more traditional manner by losing weight first and then trying to maintain it.

How do the skills used to maintaining weight differ from those used in losing weight?

Losing a significant amount of weight can require considerable attention. For instance, keeping daily food records has been found to be a useful strategy for losing weight. However, most people can’t diligently record what they ate or drank multiple times a day for long periods of time, so they quit and regain the weight. Therefore, for weight maintenance, we focused on identifying a set of skills that would make the day-to-day experience positive while not requiring overwhelming amounts of effort. For instance, we encouraged people to learn to maintain their weight without keeping food records and instead to use their bathroom scale to inform them when to fine-tune their eating and physical activity habits with small, quick and easy adjustments they can make on the fly.

For those interested in mastering the skills of maintaining weight before they begin losing weight in the New Year, can you provide an outline of the approach used in the clinical trial?

Here are a few key areas. First, actively search out yummy, healthy foods that you enjoy eating as much as the high-calorie foods you’re replacing. If you don’t, you’ll feel deprived and continue to dwell on the unhealthy high-calorie foods you’re missing – and eventually you’ll go back to eating them. Finding tasty replacements will take proactive efforts to try a lot of new foods. At the same time, be sure to incorporate eating a few of your favorite high-calorie foods into your routine – and then eat them mindfully to savor and enjoy them.

Second, start to “make peace with the scale.” Try weighing yourself daily without the pressure of trying to lose weight. Watch how your body weight fluctuates for a few weeks at your current weight. Many people are pretty surprised that their weight fluctuates from day to day as much as it does. Then, a few weeks in, set a personalized range of about five pounds that accounts for your own body’s fluctuations and a little “give” for vacations and holidays.

Third, use the range to tell you when to make “fine-tuning” changes to your eating and activity habits. For instance, if your weight is fluctuating within a few pounds near the top of your five-lb range, you may want to eat 20 percent less during meals for a few days and get out for extra walks at lunch. Alternatively, if your weight is fluctuating at the bottom of the range, you may want to enjoy another glass of wine or share a favorite dessert with a friend. Develop a”‘quiver” of fine-tuning strategies that work for you.

Finally, navigate those pesky but always occurring disruptions in life that affect weight. For instance, strategically lose a few pounds with your fine-tuning strategies and get to the bottom of your range before going on vacation so you can mindfully indulge in your mother-in-law’s amazing sugar cookies during vacation.

Previously: Learning weight-maintenance skills first helps prevent diet backsliding, Stanford study shows, Can a food-tracking app help promote healthy eating habits?, Examining how friends and family can influence our weight loss and Research shows remote weight loss interventions equally effective as face-to-face coaching programs
Photo by Lisa Creech Bledsoe

From Dec. 24 to Jan. 7, Scope will be on a limited holiday publishing schedule. During that time, it may also take longer than usual for comments to be approved.

It’s that time of year again: The holiday season is officially upon us. As we start gathering to celebrate with family and friends, it may seem tempting to splurge on a second plate of hors d’oeuvres, an extra glass of eggnog or an additional piece of pie. But as Stanford nutrition expert Christopher Gardner, PhD, discusses in the following Q&A, overindulging - even just for the short term – may have long-term consequences on our health. He offers some food for thought on how to take a healthier, yet still enjoyable, approach to eating during the holidays.

How much harm to our health could be done by granting ourselves a free pass on eating healthy during the holidays and then resolving to turn over a new leaf in the New Year?

It would be wrong to think that short-term overindulgence does no harm to our bodies. There are tests that have been done to show an almost immediate adverse impact on our blood vessels from eating a highly processed, low-nutritional-quality, junk-food meal. The more challenging question is: How much long-term harm does this do to our bodies? That is harder to measure. Equally important, and also difficult to quantify, is the potential harm to our mood and enjoyment of life if we don’t let loose once in a while and have fun with our food. Food isn’t just a source of nutrition, it’s an outlet of creativity, an important aspect of cultural heritage, an opportunity for exploration and, at times, a source of sheer pleasure.

I’m a big fan of Jesse Cool’s 80:20 rule. Cool currently runs the Cool Café at Stanford’s Cantor Art Center as well as other local eateries. Her 80:20 rule states: Make your regular day-to-day food choices with good health in mind 80 percent of the time, and 20 percent of the time go ahead and take some extra liberties with your food. Just don’t let the 20 percent grow over time to be 50 percent! And also consider that healthful food is not mutually exclusive from creativity, heritage, exploration and pleasure. They can all be one and the same!

Many people have switched to cooking with non-nutritive sweeteners as a way to cut back on calories and still enjoy their favorite holiday dishes. What does the scientific evidence indicate about the effectiveness of using non-nutritive sweeteners to help people maintain or lose weight?

There aren’t many good studies to draw on to form strong conclusions here. But the available evidence suggests substituting for sugar with a “non-nutritive sweetener,” which includes artificial sweeteners and natural sweeteners such as stevia, reduces calories and sugar consumption. Both of which would be good for the majority of us, all else being equal.

The key here is the “all else being equal” part. There are several ways using non-nutritive sweeteners can backfire. For example, if later in the same meal, or even in the same day, that choice leads you to eat more sugar or more calories, then it negates what you were trying to accomplish. The limited evidence out there indicates this may happen a lot either consciously (e.g. rewarding yourself later for earlier good behavior) or unconsciously (e.g., you are simply hungrier later). The term that describes this is “compensation.” The one area with artificial sweetener use that doesn’t seem to involve a lot of compensation, and therefore is likely helpful, is with beverages. But overall, water is the optimal choice for quenching your thirst.

Continue Reading »

A friend recently told me she hopes to get all her holiday shopping done within the next two weeks. “I just don’t want to stress out about it, and December is always so busy,” she said. I could tell by the look on her face that she, like many of us, was already anxious about finding time to do other seasonal activities like prepare elaborate meals, wrap presents and travel to visit family. While the holidays are often joyful occasions, the time can also make us worry about our to-do lists and boost our stress levels, and the dark, short days of winter can dampen our moods.

So this month we asked David Spiegel, MD, director of the Stanford Center for Stress and Health and medical director of the Stanford Center for Integrative Medicine, to respond to readers’ inquiries about stress and depression during the holidays. Below he answers a selection of the questions submitted via Scope and our @SUMedicine Twitter feed.

Dave P. asks: Research shows that when it comes to long-term health, how you react to stress is really what matters. Limiting sources of stress seems nearly impossible during the holidays, [so can] you share some tips for how to better deal with stress and potentially reduce its negative health effects?

You are right that in most cases we cannot eliminate stress. We do, especially at holiday time, often take on more than we can handle. So it is wise to prioritize stressors. If you add some new tasks, such as preparing parties, cooking extra food, tree decorating, buying presents or sending holiday letters, you may want to plan to reduce other activities. Take some leave time from work or ask for help. The key is taking stressors one at a time and developing a plan for dealing with them. Feeling overwhelmed by stressors is yet another stressor. You want to be active rather than passive in managing your holiday assortment of stressors.

Serena asks: What does the scientific evidence indicate about the effectiveness of using natural remedies, such as fish oil, Vitamin B6 or St. John’s wort to treat seasonal stress and/or depression?

There had been great enthusiasm about St. John’s wort in particular in the treatment of mild to moderate depression since it has an effect on the serotonin brain neurotransmitter system (preventing reuptake in the synapse – the connecting space between neurons) that is similar to the action of many currently used antidepressant medications. However, recent studies do not indicate much of an effect on depression.

With that said, there is a substantial placebo component to the treatment of stress and depression. So some of the benefit of any treatment comes from doing something that provides an expectation of improvement. Even when people know they are taking placebos, they sometimes benefit. Fish oil has other dietary benefits, as does Vitamin B6, so taken in moderation they could help and won’t hurt. There is recent evidence from a 25-week multicenter randomized clinical trial that RCT WS 1490 (a special extract from kava-kava) is effective in treating mild anxiety in comparison with placebo.

L. Reed asks: What are some signs that seasonal depression could be part of a larger mental health concern?

There are people who feel blue during the holidays because they are separated from loved ones or miss family and friends who are gone. Some may feel that others seem to have more holiday activities than they do. But if the sadness goes beyond feeling like a response to specific problems or losses and starts to generalize to how you feel about yourself as a person, it is time to seek professional help. If you start to feel hopeless, helpless, and/or worthless, or have thoughts of harming yourself, it is a larger mental health concern.

James asks: Is it true that suicides decrease during the holidays? Wouldn’t that be an argument that depression [also] decreases during holidays?

Depression is as high or higher than usual during the holidays because, among other reasons, of seasonal affective disorder. Those who are especially sensitive to the short period of light in the dead of winter are prone to become more depressed. Two things may reduce the actual rate of suicide during the holidays. First, there are more people around because it’s a time that friends and family come together, so individuals are less likely to be alone even if they are depressed. Second, the most dangerous time for suicide is not during the depths of depression – many people in that situation are just overwhelmed and miserable and cannot plan and carry out anything, including their own deaths. A more dangerous period is when they are pulling out of their depression because they now have more energy but still carry with them the self-loathing and despair that goes with it. Then they may be more prone to act on their self-destructive thoughts.

Continue Reading »

The holiday season is fast approaching; soon we’ll be sitting down at the table for Thanksgiving feasts, gathering and sharing gifts with loved ones, and raising a glass to toast the New Year. While holidays are often joyful occasions, the time can also raise stress levels as we try to find time in our already-busy schedules to prepare elaborate meals, wrap presents and travel to visit family. Factor in winter’s short, dark days, inclement weather and the high emotions that can run when we’re around family, and it’s no wonder the holidays are often fraught with feelings of anxiety, stress, depression and loneliness.

Now is the time to take action to minimize the stress that accompanies the holidays. To help you keep calm and carry on, we’ve asked David Spiegel, MD, director of the Stanford Center for Stress and Health and medical director of the Stanford Center for Integrative Medicine, to respond to your questions about managing stress and depression.

Spiegel is internationally known for his work in gauging the effects of the mind on physical health. During his career, he has authored more than 500 research papers and chapters in scientific journals and books and has won numerous awards for his research on stress and health.

Questions can be submitted to Spiegel by either sending a tweet that includes the hashtag #AskSUMed or posting your question in the comments section below. We’ll collect questions until Friday (Nov. 9) at 5 PM Pacific time.

When submitting questions, please abide by the following ground rules:

• Stay on topic
• Be respectful to the person answering your questions
• Be respectful to one another in submitting questions
• Do not monopolize the conversation or post the same question repeatedly
• Kindly ignore disrespectful or off topic comments
• Know that Twitter handles and/or names may be used in the responses

Spiegel will respond to a selection of the questions submitted, but not all of them, in a future entry on Scope.

Finally – and you may have already guessed this – an answer to any question submitted as part of this feature is meant to offer medical information, not medical advice. These answers are not a basis for any action or inaction, and they’re also not meant to replace the evaluation and determination of your doctor, who will address your specific medical needs and can make a diagnosis and give you the appropriate care.

Previously: David Spiegel discusses the healing properties of hypnosis, Emotional, social support crucial for cancer patients, How to stay fit and active this holiday season, Stanford study shows depression symptoms may predict breast cancer survival and Stanford psychiatrist David Spiegel’s path west
Photo by matt

While the 2011 influenza season was especially mild, that may not be the case this year. To help you and your family prepare for the flu season, we asked Corry Dekker, MD, medical director of the Stanford-Lucile Packard Children’s Hospital Vaccine Program, to respond to your questions about the flu and vaccine research.

In the following Q&A,  she answers a selection of the questions submitted via the @SUMedicine Twitter feed and Scope, which range from the effectiveness of the flu shot to concerns related to vaccinating children.

Austin Peer asks: Approximately what percentage of patients receiving the injection still contract the virus? Additionally, what is the selection process for choosing which strains of the virus will be contained in the vaccine from year to year?

The definition of influenza vaccine effectiveness is complicated by many considerations, but the general answer is that it provides 70-90 percent protection overall. Among the factors that need to be kept in mind is that influenza vaccine composition is redefined every year. Some years this results in a vaccine with a good match to the viruses that circulate during flu season. However, during other years the vaccine is not so well matched against one or more of the three influenza strains chosen. Differences in match from year to year, the design of clinical studies and endpoints used to define effectiveness and in the populations tested also contribute to variation in the published rates of vaccine effectiveness.

Every year, viruses are chosen to represent influenza A/H3N2, A/H1N1 and influenza B for the upcoming year’s flu vaccine. Selection of the virus strains is made in late February by the World Health Organization (WHO) after detailed analysis of influenza viruses collected by more than 100 national centers during the prior year’s flu seasons. A prediction is made for the next season based on this analysis and availability of new candidate virus strains is confirmed. After the WHO makes their general recommendation, each country determines which exact virus strains will be used in their licensed vaccines. For the United States, the group deciding this is the federal Food and Drug Administration  in consultation with their advisory committee of vaccine experts

Dave P. asks: A recent article in the Scientific American reports there is a lack of scientific evidence that flu vaccines are effective for the elderly or very young. What is your perspective on this research?

I think the research confirms that while there is certainly room for improved influenza vaccines for individuals at the extremes of age and for those with some medical conditions associated with poor vaccine response, there is still value to getting immunized. Importantly, we can’t predict at the individual level who will be protected and who will still become sick from influenza infection. This was borne out in a study reported this week from Centers for Disease Control and Prevention that indicated that 43 percent of 817 children who died of influenza over the eight influenza seasons in the United States had no pre-disposing illness and the time from symptom onset to death was in fact shorter among children with no underlying high-risk conditions compared with children with at least one high-risk condition. This reinforces our current recommendation to vaccinate all children annually against influenza if older than 6 months of age, with very rare exceptions.

For the elderly, the only trial that compared vaccinated vs. unvaccinated individuals using a randomized, controlled design was done in the Netherlands during the 1991-1992 influenza season. Vaccine efficacy was 58 percent for preventing clinically-defined influenza with serologic confirmation of infection in this study. Because we now recommend that everyone get a flu shot, it is no longer possible to do such studies with unvaccinated controls. In the future, studies that use more specific endpoints of culture and/or PCR confirmation of infection will help refine effectiveness estimates across multiple influenza seasons. Although, the adequacy of vaccine strain match to circulating influenza strains will always complicate things.

Continue Reading »

Last month, Kristin Sainani, PhD, a clinical assistant professor at the School of Medicine, launched an online science-writing class that teaches researchers how to clearly and concisely communicate their work. The course, titled Writing in the Sciences, is available through Coursera, and it drew thousands of students shortly after being introduced.

Curious to know more about what prompted Sainsani to develop the class and her teaching methods, I contacted her to discuss the project. Below she talks about the importance of teaching researchers how to explain their work to broad audiences and offers some tips for conveying complex scientific concepts in a reader-friendly manner.

A recent article states that your mission is to enable scientific literature to change. What motivated you to pursue this goal?

I am partly motivated to change the literature because, like all scientists, I have to read it. It’s frustrating that so many papers are unnecessarily difficult to get through. Scientists assume that because they are talking about complex ideas, the language also must be complicated and unreadable. This is simply untrue.

A second motivation is that better writing improves transparency. As a peer reviewer, I encounter lots of poorly written papers. I often wonder if the authors are intentionally being obscure in places to hide flaws or shortcomings in their methods. I wonder how many errors slip through peer review as a consequence of obscure language.

A final motivation is that better writing increases access to the knowledge. When you get your ideas across to as many scientists as possible, from as many diverse disciplines as possible, this moves science forward. If your article can only be understood by a handful of other people, this lessens its impact.

Why is it important that scientists be able to easily communicate their work to the general public?

The public needs to be adequately informed about science to rationally debate issues from genetically modified foods to global warming to health-care economics. Scientists have a responsibility to communicate effectively with the general public to help inform the public discourse, as well as to help increase general scientific literacy.

Continue Reading »