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Events, Health and Fitness, Nutrition, Obesity, Stanford News, Women's Health

Women’s health expert: When it comes to prevention, diet and exercise are key

Women's health expert: When it comes to prevention, diet and exercise are key

16262076932_96f8309b43_zThis Monday was the sixth annual Stanford Women’s Health Forum, hosted by Stanford’s Women and Sex Differences in Medicine center (WSDM), and I was happy to have been present for the lively talks. The forum focused on prevention, and the keynote, delivered by Marcia Stefanick, PhD, professor of obstetrics and gynecology and WSDM director, highlighted physical activity and weight management as the key preventative actions for women to take.

High blood pressure remains the number one preventable cause of death in women, with physical inactivity and high BMI, both of which contribute to high blood pressure, in third and fourth place. (For the curious readers, smoking comes in second.) Because prevention requires changes in behavior, behavior was what Stefanick focused on. Rather than reinforcing many women’s feelings of embarrassment about their weight, she said, providers should help women feel that they can do something about it.

Healthier behaviors must include diet and exercise. Both fatness and low fitness cause higher mortality; realistic expectations about how to change both should factor into care. Stefanick emphasized that weight loss should be slow: 10 percent of one’s body weight baseline over six months, or one pound per week for moderately overweight people, and no more than two pounds per week. And we need to stop being so sedentary, Stefanick exclaimed. The classic principles of exercise apply – gradually increase the frequency, intensity, and/or duration of exertion. Adults should be getting at least two and a half hours of moderate-intensity aerobic physical activity per week, in addition to doing muscle-strengthening activities at least twice a week, the conference flyer read.

However, citing the problems of eating disorders and older women losing weight without trying, Stefanick stressed that “weight management is a spectrum; there are extremes at both ends.” In describing variations on mesomorphic, endomorphic, and ectomorphic body types, she stated that “we don’t know what the optimal body type is.” It probably varies for each person.

Something I found particularly interesting was Stefanick’s description of gynoid vs android fat distribution patterns (which I learned as “pear” and “apple” body shapes, respectively). Gynoid distribution around the hips, thighs, and butt is more common in women, and includes more subcutaneous fat, while in android distribution, which is more common in men, fat collects around the belly and chest and is actually dispersed among the organs. Such intra-abdominal fat is more damaging to health, as it affects the liver and lipid profile and can cause heart disease, but it’s also much easier to get rid of through exercise (which is one reason men overall have less trouble losing weight than women).

In the spirit of more personalized care, Stefanick also discussed how recommended weight changes during pregnancy should vary according to the person’s prenatal BMI. Someone underweight could gain up to 40 pounds and be healthy, she pointed out, while obese people might actually lose weight during pregnancy for optimal mother-baby health.

Previously: Why it’s critical to study the impact of gender differences on diseases and treatmentsWhen it comes to weight loss, maintaining a diet is more important than diet typeApple- or pear-shaped: Which is better for cancer prevention?A call to advance research on women’s health issues and To meet weight loss goals, start exercise and healthy eating programs at the same time
Photo by Mikaku

Big data, BigDataMed15, Events, Public Health, Research

Big Data in Biomedicine conference kicks off today

Big Data in Biomedicine conference kicks off today

14243103692_67ec6354f0_zThe third annual Big Data in Biomedicine conference kicks off today on the Stanford campus. The three-day event brings together thought leaders from academia, information technology companies, venture capital firms and public health institutions to explore opportunities for extracting knowledge from the rapidly growing reservoirs of health and medical information to transform how we diagnose, treat and prevent disease.

The year’s program will cover the intersection of disciplines as widespread as genomics, population health, neuroimaging and immunology; it will also touch on crowdsourcing, ethical and legal issues and “learning” health systems. Delivering the opening keynote will be Sharon Terry, president and CEO of Genetic Alliance. Other keynote speakers include Kathy Hudson, PhD, deputy director for science, outreach and policy at the National Institutes of Health; France Córdova, PhD, director of the National Science Foundation; Michael Levitt, PhD, professor of structural biology at Stanford and recipient of the 2013 Nobel Prize in Chemistry; and Lloyd Minor, MD, dean of Stanford’s School of Medicine.

Those unable to attend in person can tune in to the live webcast via the conference website. We’ll also be live tweeting the keynote talks and other proceedings from the conference; you can follow the coverage on the @StanfordMed feed or by using the hashtag #bigdatamed.

Previously: Countdown to Big Data in Biomedicine: Leveraging big data technology to advance genomics, Countdown to Big Data in Biomedicine: Mining medical records to identify patterns in public health and Harnessing mobile health technologies to transform human health
Photo from the 2014 Big Data in Biomedicine conference by Saul Bromberger

Events, LGBT, Medical Schools, Medicine and Society, Patient Care

Advice for clinicians on addressing gender- and sex-related issues

Advice for clinicians on addressing gender- and sex-related issues

2633907150_6303146d75_zFor great patient care, a doctor needs to understand the patient’s life and the patient needs to feel comfortable sharing. This can be especially challenging when it comes to the LGBT community, which was part of the impetus for a talk on the Stanford Medicine campus last week. The event focused on challenges faced by sexual and gender minorities (SGM) in medicine, not just as patients, but as physicians and medical students as well.

Matthew Mansh, a fourth-year Stanford medical student; Gabriel Garcia, PhD, professor of medicine and associate dean of medical school admissions at Stanford; and Mitchell Lunn, a research fellow at UCSF and a graduate of Stanford’s medical school, are all part of Stanford’s LGBT Medical Education Research Group. After hearing the three speak, I walked away with a greater understanding of how important and challenging it is for doctors to have intimate conversations with their patients.

Of the three, Lunn’s talk was the most oriented towards helping practitioners be more sensitive about  He began by laying out some terminology (terms are moving away from assuming two genders – bisexual is falling out of favor, for example), but emphasized that even the most sophisticated labeling won’t tell you which organs patients have or which sex acts they’re doing. Providers have to ask and be comfortable with the terms they should use to ask, Lunn said.

Coming from an anthropology background, I know how hard it can be to not make assumptions. But Lunn emphasized that it’s crucial for clinicians to try: Patients overwhelmingly answer when asked about things in their lives, and they subsequently receive better care, such as screenings for HIV and hepatitis. Among the barriers to providers asking about sex and gender practice/expression are fears of being intrusive, cultural differences, ignorance regarding the clinical relevance of such questions, patient’s lack of genital complaints, and uncertainty of how to ask. Most of these can be combated with provider education; as for how to ask, Lunn says it doesn’t matter as long as the doctor’s questioning makes no assumptions and is the same for everyone.

Intake forms could ask preferred pronouns, for example. Stigmatizing language like “atypical practices” and questions like “Are you married?” should be avoided. Questions about sex and gender practices can be grouped with those about drug use, wearing a seat belt, and going to the dentist – the goal is to normalize these conversations; people don’t want to be targeted or singled out. In every intake visit, Lunn says to his patient: “I talk to my patients about gender identity – do you know what I mean by that?” Crack the door like this and most who are gender nonconforming will go through it, he assures.

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Big data, Events, Stanford News

Countdown to Big Data in Biomedicine: Technical showcase to spotlight companies’ innovations

Countdown to Big Data in Biomedicine: Technical showcase to spotlight companies' innovations

14222209716_d3072f7737_zLater this week, thought-leaders from academia, information technology corporations, venture capital firms, the U.S. government and foundations will convene for the Big Data in Biomedicine conference to explore opportunities for mining the rich repositories of biomedical information.

In addition to sessions on topics ranging from crowdsourcing to genomics, the conference will include a technical showcase where conference-goers can peruse displays and demos highlighting companies’ innovations related to big data. Part technology expo and part networking opportunity, the technical showcase will include light refreshments and be held under a tent on the lawn of the medical school’s Li Ka Shing Center for Learning and Knowledge.

Participants for this year’s event include advanced patient monitoring firm Flashback Technologies, which will present an innovative index for body-fluid levels in trauma situations and a device to do it on the spot; Zephyr Health, a company that pairs real-world data with predictive analytics to provide insights that are strategic and actionable; Samsung, which will show how the company’s personal devices are moving into human health solutions; and Personalis, a startup providing researchers and clinicians with accurate DNA sequencing and interpretation of human exomes and genomes.

The conference is part of Stanford Medicine’s Biomedical Data Science Initiative, which strives to make powerful transformations in human health and scientific discovery by fostering innovative collaborations among medical researchers, computer scientists, statisticians and physicians. The event runs from Wednesday through Friday.

Previously: Countdown to Big Data in Biomedicine: Leveraging big data technology to advance genomics, Countdown to Big Data in Biomedicine: Mining medical records to identify patterns in public health and Harnessing mobile health technologies to transform human health
Photo from last year’s technical showcase by Saul Bromberger

Events, Stanford News

Stanford’s Health Matters happening on Saturday

Stanford's Health Matters happening on Saturday

kid on helicopterTomorrow, Stanford Medicine opens its doors to the public as part of its annual Health Matters event. On the agenda: medical and health talks (sample topics: how to stay healthy and injury-free while working out, what you need to know about heart disease prevention, and what researchers are learning about longevity and aging) and a series of interactive exhibits. Among those hands-on activities: cooking demonstrations and Q&As with Stanford nutritional experts, a meet-and-great of the stars of Stanford’s canine wellness program, and the opportunity to hop on and learn more about the lifesaving technologies that happens in the Life Flight helicopter.

Parts of the event will be live tweeted; if you can’t physically be here, follow along on @StanfordHealth all day.

Previously: Stanford Medicine’s community open house happening on May 16 and Stanford Medicine community gathers for Health Matters event
Photo by Alex Johnson

Events, Patient Care, Stanford News

Stanford Medicine 25 Skills Symposium to focus on building leaders for the bedside medicine movement

Stanford Medicine 25 Skills Symposium to focus on building leaders for the bedside medicine movement

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Physicians once relied on the five senses to diagnose patients and used sight, touch, sound and smell to assess health and identify illness. Today, medical technologies are often doctors’ first diagnostic tool.

In this age of increased reliance on technology, how can health practitioners reconnect with their patients at the bedside? And how can medical educators promote a culture of hands-on medicine?

These questions will take center stage Sept. 28-29 at the inaugural Stanford Medicine 25 Skills Symposium. The symposium will feature thought leaders in bedside medicine, including Stanford physician-author Abraham Verghese, MD; Steve McGee, MD, a professor of medicine at the University of Washington and Andrew Elder, FRCP, a consultant in acute medicine of older age at the Western General Hospital in Edinburgh.

“We are hoping to attract junior and mid-career faculty who are interested in the art of teaching at the bedside,” said John Kugler, MD, an assistant professor of medicine and co-director of the Stanford Medicine 25 Skills Symposium.

During the two-day event, attendees will learn to improve their physical exam technique, develop bedside teaching skills, and master clinician demonstrations. Several sessions will help attendees identify ways to foster a culture of bedside medicine at their home institutions. “Every attendee will leave with the skills and knowledge to confidently take trainees to the bedside,” Kugler explained.

The symposium will continue beyond September 29 by way of regular virtual meetings where participants will be able to exchange ideas and continue the conversation about bedside medicine.

To learn more about the Stanford Medicine 25 program and to register for the event, visit the symposium website.

Lindsey Baker is the communications manager for Stanford’s Department of Medicine.

Previously: Abraham Verghese a saintliness in so many of my patients, Stanford’s Abraham Verghese honored as both author and healer, A call for extended bedside manner training and Abraham Verghese discusses reconnecting to the-patient at the bedside
Photo by Guson Kang

Big data, Events, Videos

Countdown to Big Data in Biomedicine: Leveraging big data technology to advance genomics

Countdown to Big Data in Biomedicine: Leveraging big data technology to advance genomics

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During last year’s Big Data in Biomedicine conference, David Glazer, director of engineering at Google, described how the search giant is developing technological tools to help those working in life sciences to store, process, explore, and share genomic data.

In this 2014 Big Data in Biomedicine video, Glazer explains how he and colleagues fed a computer network 10 million random YouTube videos and asked the system to look for patterns. The computer determined that most frequently occurring sequence of 1s and 0s in the sample was that of a human face. Not surprisingly, the face of a cat was the second most-frequent pattern the computer found.

While these examples of machine pattern-recognition capabilities may not be earth-shattering to those who spent an inordinate amount of time watching YouTube videos, the findings demonstrate the potential of computers to rapidly identify significant patterns in large volumes of biomedical information. Imagine researchers performing the same experiment, but instead of YouTube videos they used genomic data. “We don’t have 10 million genomes available for this type of analysis, yet,” he said. “But as we move in that direction the tools are ready.”

Watch the full presentation to learn how Google is working to remove computing restraints to advance genomic research. And check out Glazer at the 2015 Big Data in Biomedicine conference, which will be held May 20-22 at the Li Ka Shing Center for Learning and Knowledge at Stanford.

Previously: Countdown to Big Data in Biomedicine: Mining medical records to identify patterns in public healthStanford bioengineer discusses mining social media and smartphone data for biomedical research, Using genetics to answer fundamental questions in biology, medicine and anthropologyExamining the potential of big data to transform health care and Registration for Big Data in Biomedicine conference now open

Events, Health and Fitness, Medicine and Society, Stanford News

Stanford Medicine’s community open house happening on May 16

Stanford Medicine's community open house happening on May 16

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Mark your calendar for Health Matters, Stanford Medicine’s community open house, being held this year on Saturday, May 16. There will be wellness dogs and a helicopter, chair massages, tasty food and plenty of informative presentations on topics ranging from breast cancer and dementia to exercise and diet.

And, it’s all free (except for the tasty food).

A few of the presentations include:

  • “Dispelling the myths: Realistic strategies for maintaining cognitive health and preventing dementia” with Frank Longo, MD, PhD
  • “Tips for safe workouts: How to stay healthy and injury-free” with Jason Dragoo, MD
  • “Anti-inflammatory foods” with Kylie Chen, RD
  • “Approaching the second half of life with health and vitality: The latest research on longevity and aging” with Anne Brunet, PhD
  • “Teen mental health and your family — Practical information and insights”, a panel presentation

Throughout the day, the Life Flight helicopter is expected to be available, as will be the canine stars of the Pet-Assisted Wellness (PAWs) program. The pavilion will also feature a look at the MyHeart Counts heart-health app, cooking demonstrations, emergency preparation information and Stanford experts available to answer your health questions.

The event will be held at the Li Ka Shing Center for Learning and Knowledge. If certain talks particularly strike your fancy, register here to reserve a space. Some events, such as the medical school session for high school students, will or have already filled up.

Previously: Stanford Medicine to open its doors to community during Health Matters event, An ounce of action is worth a ton of theory: Med student encourages community engagement and Stanford Medicine community gathers for Health Matters event

Events, In the News, Medical Education, Medicine and Society

Former Brown University President Ruth Simmons challenges complacency on diversity

Former Brown University President Ruth Simmons challenges complacency on diversity

Ruth SimmonsWhen Ruth Simmons went away to college from a poor section of Houston, she didn’t have enough money to buy clothes. Now, after serving as the president of Brown University and of Smith College, Simmons, PhD, has not only the money, but also the flexibility to select which speaking invitations she accepts.

And at first, Simmons admitted Friday at the third talk in the Dean’s Lecture Series, she was tempted to decline the request to speak on diversity. After a lifetime of refusing to be defined as the “black” woman or the “poor” girl, she didn’t want to be known as a diversity expert.

But: “My initial cynicism gave way to the concern I have for the state of diversity in higher education and society at large,” she said. Just look at the recent events in Baltimore, she said; clearly something is amiss.

Nationwide, there is strong support for the abstract concept of diversity, Simmons said. “But when disassembling diversity into its component parts, support fractures depending on what was at issue.” When pressed about issues such as fair pay, employment opportunities and integration, communities disintegrate into divergent factions.

And in the past, people stuck together in like-minded communities, wary of what she called the “jangle and discord of clashing opinions.” With advances in technology, and the increasing diversity of the U.S., isolation and insulation are no longer possible, she said.

Modeling ways to live together, while airing and respecting difference views, is a responsibility that students and faculty at elite universities need to take on, Simmons said. And universities must be prepared to institutionalize debates and create processes for disagreement. Inherent in the protection of diversity is the protection of free speech, she said.

Top universities should also not shy away from high expectations related to diversity. And their efforts to enhance and support diversity in all forms — race, income, sexual orientation, gender — should go beyond “laissez-faire statements on inclusion.” She lauded Dean Lloyd Minor, MD, for his efforts.

Minor agreed that “diversity is close to my heart.” He said he is motivated by the “fundamental belief that diversity makes us better as individuals and as society, but also because diversity is critical for the work we’re trying to achieve here at Stanford Medicine. In order to lead the biomedical revolution, we must have a diverse community.”

Previously: Panel on diversity calls for transformative change in society, courageous leadership from individuals, Intel’s Rosalind Hudnell kicks off Dean’s Lecture Series on diversity and Diversity is initial focus of new Stanford lecture series
Photo by Norbert von der Groeben

Events, Medical Education, Medicine and Literature, Medicine and Society, Stanford News

Stanford’s Medicine & the Muse event mixes music, dance and pediatrics

Stanford's Medicine & the Muse event mixes music, dance and pediatrics

The annual Medicine & the Muse symposium is one of senior associate dean Charles Prober’s favorite events of the year, and now it’s one of mine too. Prober, MD, the senior associate dean of medical education, kicked off the evening with introduction of this year’s theme, “transformation and triumph.”

It’s a talent show Stanford Medicine style, with medical students providing the singing (ranging from an Italian opera duet to a foot-tapping mariachi tune), dancing (a group modern piece), film (gritty images from the aftermath of Typhoon Haiyan) and readings (a children’s book replete with illustrations of a mop-headed kindergartner who lost her teddy bear in the hospital and a witty novel excerpt about an incoming medical student leaving her plush Upper East Side existence).

Then, throw in chief communications officer Paul Costello’s thought-provoking interview with author and pediatrician Perri Klass, MD, and you have a full evening of entertainment. Klass has written novels, non-fiction books, and numerous essays and journalism articles.

“Transformation and triumph” is a message that captures both the transition of medical students into full-fledged doctors and many aspects of pediatrics, Klass said. She went on to discuss her drive to write; the urge that keeps her at her computer late in the night, spilling out her reflections on that day’s cases. And she explained her work as the national medical director of Reach Out and Read, a non-profit that provides books to low-income children.

The goal as a pediatrician is to get illnesses and other afflictions out of the way so children can blossom and reach their potential, she said. For some families, that means quite literally providing a book, which can serve of the basis for parents to develop an interactive, close relationship with their children.

Klass also offered advice for physicians hoping to hone their writing chops: “Just read good stuff, and write good stuff.”

Previously: A lesson in voice and anatomy from an opera singer, Stanford Medicine Music Network brings together healers, musicians and music lovers and Stanford’s Medicine and the Muse symposium features author of “The Kite Runner”
Photos by Norbert von der Groeben

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