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Autism, In the News, Neuroscience

A tribute to Oliver Sacks, from a science writer

A tribute to Oliver Sacks, from a science writer

Library-stacksThe news this weekend of neurologist and writer Oliver Sacks’ death brought back a crystalline memory of myself at 18, searching through the library stacks for a copy of his 1973 book, Awakenings. I needed it because the brains did not show up.

An explanation is in order: The spring semester of my college-freshman biology class included a six-week lab elective. Of a few dozen elective options, I picked “The Brain” because the descriptive blurb said each student would get to dissect a sheep brain. I was a bit grossed out by the idea of a sheep brain in front of me on a tray, but my curiosity outweighed my squeamishness. I intensely wanted to examine a real brain.

However, on the first day of The Brain, our teaching assistant broke the bad news: No brains. The room moaned in dismay.

“I know,” he said. “I’m really sorry. To make it up to you, I’m going to let you each do a short report on anything you want, as long as it has some relationship to the brain.”

I had seen the movie version of Awakenings a few years earlier (with Robin Williams playing Sacks) and remembered my mom saying that there was a book, too, but that she had heard it was clinical and dull. Well, I thought, clinical isn’t so bad, and I can stomach dull if it lets me present a book report about a weird brain disease. The TA approved my topic, and off I went to the university’s biomedical library, where the long, dim, badly ventilated staircases gave me attacks of claustrophobia.

Up the dreaded stairs, through the overheated, papery-smelling stacks to the book itself: A library edition, small and lightweight in my hands, bound in an ugly turquoise cover. A book that, once I opened it, I could not put down. Yes, the writing was clinical – there were medical words, and patients were disguised behind names like “Miriam H.” – but dull? No. An adventure in the brain: patients who had been frozen for decades with post-encephalitic parkinsonian syndrome coming to life again when Sacks gave them a drug, only to slowly sink back into their freeze as the drug stopped working for them.

The main thing I remember thinking is: Eeeeeeee! I want to write stories like this! It did not seem like a dream that had any hope of being realized, since I had no intention of becoming a neurologist. I let the impulse go, prepared my Brain report (a success), and subsequently read many more of Sacks’ books – with great pleasure.

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In the News, Medical Education, Mental Health, Stanford News

An Rx for physician burnout

An Rx for physician burnout

artsy stethoscope - 250Burnout, which is characterized by emotional exhaustion, a sense of depersonalization and a lack of a sense of personal accomplishment, is on the rise among physicians and medical residents and students in the United States. A lengthy article (subscription required) published Friday in Time examines the growing problem and the movement to save physicians’ mental health:

Experts warn that the mental health of doctors is reaching the point of crisis—and the consequences of their unhappiness go far beyond their personal lives. Studies have linked burnout to an increase in unprofessional behavior and lower patient satisfaction. When patients are under the care of physicians with reduced empathy—which often comes with burnout—they have worse outcomes and adhere less to their doctors’ orders. It even takes people longer to recover when their doctor is down.

Many factors contribute to physician burnout, including long-hours, a high-pressure work environment, the stigma against weakness and mistreatment from higher-ranking physicians. Efforts are underway to change the culture of medicine and alleviate these sources of stress, and much of the story focuses on what’s happening here at Stanford:

In 2011, [Ralph Greco, MD, professor of surgery a Stanford,] Chaplain [Bruce Feldstein, MD,] and a few other colleagues, including [Arghavan Salles, MD, former chief resident of general surgery at Stanford], got together to discuss how to change things. “When people go somewhere new, they lose everything that was around them that supported them, and it’s very natural to doubt them- selves,” says Salles. “I had this idea that we could have sessions where people talk to each other, and then it wouldn’t be so lonely.”

They put together a program at Stanford to promote psychological well-being, physical health and mentoring. Every week, one of the six groups of surgery residents has a mandatory psychotherapy session with a psychologist. Each senior resident mentors a junior resident, and residents are given time for team bonding. Young doctors rarely have time to go see a doctor of their own, so the wellness team issues lists of doctors and dentists it recommends. And there’s now a refrigerator in the surgery residents’ lounge, stocked with healthy foods. They call the program Balance in Life.

“We knew we couldn’t necessarily prevent suicide—too complicated for us to solve it,” Greco says. “But we needed to feel we did everything we could do to prevent it, if we could.”

Previously: Stanford’s “time banking” program helps emergency room physicians avoid burnoutKeeping an even keel: Stanford surgery residents learn to balance work and lifeA call to action to improve balance and reduce stress in the lives of resident physicians and Program for residents reflects “massive change” in surgeon mentality
Photo by Lidor

Health Disparities, In the News, Nutrition, Public Health

Turning brown bananas into ice cream: Repurposing surplus food reduces hunger, creates jobs

Turning brown bananas into ice cream: Repurposing surplus food reduces hunger, creates jobs

8421632884_224d355c21_zAccording to a recent report, the United States is one of the most wasteful countries in the world. Up to 40 percent of American food is thrown in the trash, which seems absurd given that food insecurity and hunger are still such problems in this country. Adequate nutrition is a basic for preventing disease and promoting health.

But students at Drexel University are working on improving the situation. They developed a program to use would-be supermarket waste in producing value-added food products. Not only can these products be provided to hungry people, they can be sold back to the supermarket in a mutually-beneficial relationship that could also support new jobs.

The strategy – called a “Food System-Sensitive Methodology”, or FSSM – was developed as part of the Environmental Protection Agency’s Food Recovery Challenge, and is described in a recent Food and Nutrition Sciences article. Drexel culinary arts and food science students decided to reach out to supermarkets because these stores are some of the biggest producers of waste: They throw out produce that is bruised, marked, or misshapen, or remove food simply to make room for fresher shipments. For their pilot project in West Philadelphia, students collected thousands of pounds of fruits and vegetables from local supermarkets and improved their value and palatability by developing recipes in the student-run Drexel Food Lab, a research group that aims to address real-world food issues.

Americans are used to cosmetically pristine produce, and many won’t eat a brown banana even when they’re hungry. Jonathan Deutsch, PhD, director of Drexel University’s Center for Hospitality and Sport Management, explains in a press release how FSSM addresses this: “For example, we took those brown bananas, peeled them, froze them and food processed them to create banana ice cream, which is much more appealing.” Drexel has given facelifts to similarly lackluster items, like canned peas. This requires chefs to think in a new, more sustainable way: Instead of concocting a recipe and then buying ingredients, they must be creative with what’s given to them.

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Aging, Global Health, In the News, Public Health, Research

As life expectancy rises worldwide, many are living longer with illness and disability

10812180384_18496a55f3_zGood news: Average life expectancy has continued to climb over the past two decades. The downside is that those extra years are often marked by chronic disease or disability, according to a new analysis published in the Lancet.

In the study, an international team of researchers examined fatal and nonfatal health loss across countries in an effort to help direct global-health policies to improve longevity and quality of life regardless of where a person lives.

HealthDay reports:

The analysis of data from 188 countries found that life expectancy for both sexes increased from just over 65 years in 1990 to 71.5 years in 2013, while healthy life expectancy rose from almost 57 years to slightly more than 62 years.

“The world has made great progress in health, but now the challenge is to invest in finding more effective ways of preventing or treating the major causes of illness and disability,” study author Theo Vos, a professor at the Institute for Health Metrics and Evaluation at the University of Washington in Seattle, said in a journal news release.

The rise in overall life expectancy is due to significant declines in illness and death caused by HIV/AIDS and malaria, the researchers said, along with major advances in combating infectious diseases, nutritional deficiencies, and mother and baby health problems.

Earlier this year, Laura Carstensen, PhD, director of the Stanford Center on Longevity, spoke at the Big Data in Biomedicine conference about modern society’s gains in life expectancy and called it an “unprecedented” time in history. During her presentation, she presented data on the current aging population and what aging might look like in the future.

Previously: A look at aging and longevity in this “unprecedented” time in history, “Are we there yet?” Exploring the promise, and the hype, of longevity research and Living loooooooonger: A conversation on longevity
Photo by jennie-o

In the News, Media, Medicine and Society, Public Health, Research, Science

Science for popular audiences is not just “adding to the noise”

Science for popular audiences is not just "adding to the noise"

4787885058_d174638233_zIf you’re reading this blog, chances are you’re a fan of popular science – i.e. scientific research made accessible to people who aren’t professional academics. Many academics, myself included, are also in favor of taking cutting-edge knowledge and sharing it broadly with the public.

But some scientists hesitate to share their work on forums like blogs and other social media. According to a recent SciLogs post, they worry that their knowledge might be wrong or incomplete, be misinterpreted, or just add more static to the internet’s noise. But, as the post lays out, those who think about such things are precisely those who should be publishing for broader audiences. Those who publish misinformation are not stopping to question the quality of the knowledge they broadcast; doubt and the recognition of ignorance are the hallmarks of true scientists. Adding even a small amount of high-quality research to the “science media ecosystem” helps.

Moreover, much of the public seems to have little trust in media, much trust in scientists, and is more receptive to information that acknowledges uncertainty. So bring on the science blogs!

Previously: Can science journals have beautiful prose?, The disturbing trend of science by press release, Science rapper “busts a move” to explain Nobel discovery, Science writer Deborah Blum on blogging: “There were so many smaller stories I wanted to tell” and Veteran blogger offers tips for starting a science blog
Photo by Robin Bray-Hurren

In the News, Media, Medical Education, Medicine and Society, Myths, Pregnancy, Research

Reality TV influences perspectives on pregnancy, study shows

Reality TV influences perspectives on pregnancy, study shows

272417047_806faa2243_zA new University of Cincinnati study on the influence that television programs have on pregnant women has found that most women are more affected by TV representations of childbirth than they think.

The study, funded by the NSF and conducted by Danielle Bessett, PhD, assistant professor of sociology, followed a diverse group of 64 women over the course of two years and investigated how they understood their television viewing practices related to pregnancy and birth. It found that class, as measured by education level, had the greatest influence on whether a woman acknowledged television as a significant source of pregnancy-related information. Highly educated women and those who worked outside the home were more likely to dismiss TV, while those with less education and who were unemployed or took care of children at home were more likely to report watching and learning from such shows as TLC’s “Baby Story” and “Maternity Ward” and Discovery Health’s “Birth Day.”

The particularly interesting finding is that TV portrayals affect women’s perceptions even when they don’t believe they have an influence. Bessett developed the term “cultural mythologies of pregnancy” to describe how TV, film, media, and word of mouth create expectations about “the way things are.” Most reality TV and fictionalized programming presents childbirth as more dramatic and full of medical interventions than the majority of births really are, and these images made a lasting impression on women.

As quoted in the press release, Bessett says, “Hearing women –– even women who said TV had no influence on them –– trace their expectations back to specific television episodes is one of the few ways that we can see the power of these mythologies.” Many women mentioned pregnancy representations they had seen long before they got pregnant.

Women who reported watching TV considered it part of a comprehensive childbirth education program and would often evaluate the programs’ reliability, while women who disavowed television saw it as entertainment or education for children, likely from a desire to be seen as valuing science and medical expertise.

“If we believe that television works most insidiously or effectively on people when they don’t realize that it has power, then we can actually argue that the more highly educated women who were the most likely to say that television really didn’t have any effect on them, may in the end actually be more subject to the power of television than were women who saw television as an opportunity to learn about birth and recognized TV’s influence,” hypothesizes Bessett.

“This research implies that many women underestimate or under-report the extent to which their expectations of pregnancy and birth are shaped by popular media,” concludes Bessett, suggesting that “scholars must not only focus on patients’ professed methods for seeking information, but also explore the unrecognized role that television plays in their lives.”

Previously: New reality shows shine harsh light on teen pregnancy and Study: TV dramas can influence birth control use
Photo by johnny_zebra

Genetics, In the News, NIH, Science, Technology

The quest to unravel complex DNA structures gets a boost from new technology and NIH funding

The quest to unravel complex DNA structures gets a boost from new technology and NIH funding

5232013153_7808b471a2_zIf you’ve ever tried folding a map, packing an overnight bag or coiling a string of holiday lights, you know that the way you arrange an object affects how much space it takes up and how easy it is to use in the future. This same principle is true of DNA.

As a recent article in Science News explains, the way a DNA double helix is folded, packed and coiled is known to have a big effect on how much space it requires and how easy it is to access the information stored within. But, until recently, researchers lacked the technology to fully explore these four-dimensional DNA structures.

Now, new technology and last year’s launch of the National Institutes of Health‘s five-year, $120 million, 4D Nucleome project is helping researchers reveal the complex architecture of DNA. William Greenleaf, PhD, assistant professor of genetics at Stanford, discusses the significance of a genome‘s arrangement in the Science News article:

Like the genetic text within it, the genome’s shape holds specific instructions. “The way it’s compacted forms this sort of physical memory of what the cell should be doing,” Greenleaf says.

Loops of DNA that aren’t needed by a particular cell are tucked away from the biological machinery that reads genetic blueprints, leaving only relevant genes accessible to produce proteins. Studies have shown that sections of the genome that are shoved toward the edges of a nucleus are often read less than centrally located DNA. Such specialized arrangements allow cells as diverse as brain cells, skin cells and immune cells to perform different jobs, even though each contains the same genome. “In different cell types, there are very large changes to the regions that are being used,” Greenleaf says.

Much more remains to be understood about how a genome’s shape directs its activity. Future maps might zero in on functionally interesting regions of the genome, Greenleaf says. But he cautions there is also a benefit to unbiased, general exploration. Focusing on one location in the nucleome might lead researchers to miss important structural information elsewhere, he says.

Previously: DNA origami: How our genomes foldPacked and ready to go: The link between DNA folding and disease and DNA architecture fascinates Stanford researcher – and dictates biological outcomes
Photo by: Kate Ter Haar

Addiction, In the News, Myths, Patient Care, Public Health, Public Safety

“24/7 Sobriety” program may offer a simple fix for drunken driving

"24/7 Sobriety" program may offer a simple fix for drunken driving

8684229367_2826035583_zEvery now and then I read a story that takes what I think I know about a certain topic and turns it upside down. Today, my understanding of programs to reduce drunk driving were upended by an article written by Keith Humphreys, PhD, professor of psychiatry and behavioral science at Stanford.

As Humphreys explains, many people mistakenly believe that no one can overcome a drinking problem without treatment involving a professional’s help. This, he says, is a myth, and the success of the “24/7 Sobriety” program highlights the importance of exploring and adopting new ways to combat drunken driving. From the Wall Street Journal article:

Offenders in 24/7 Sobriety can drive all they want to, but they are under a court order not to drink. Every morning and evening, for an average of five months, they visit a police facility to take a breathalyzer test. Unlike most consequences imposed by the criminal justice system, the penalties for noncompliance are swift, certain and modest. Drinking results in mandatory arrest, with a night or two in jail as the typical penalty.

The results have been stunning. Since 2005, the program has administered more than 7 million breathalyzer tests to over 30,000 participants. Offenders have both showed up and passed the test at a rate of over 99%.

Counties that used the 24/7 Sobriety program also had a 12% decrease in repeat drunken-driving arrests and a 9% drop in domestic-violence arrests, according to a 2013 study.

A possible reason why this program works — when attempts to help people with drinking problems often fail — is that the twice daily breathalyzer tests have immediate consequences, Humphreys explains. “It turns out that people with drug and alcohol problems are just like the rest of us. Their behavior is affected much more by what is definitely going to happen today than by what might or might not happen far in the future, even if the potential future consequences are more serious.”

Previously: Can the “24/7 sobriety” model reduce drunken disorderly conduct and violence in London?Alcoholism: Not just a man’s problem and Stopping criminal men from drinking reduces domestic violence
Photo by: KOMUnews

Big data, Cardiovascular Medicine, Chronic Disease, In the News, Research, Stanford News

Using “big data” to improve patient care: Researchers explore a-fib treatments

Using "big data" to improve patient care: Researchers explore a-fib treatments

Turakhia photoA Stanford cardiac electrophysiologist and colleagues have used a unique research method to learn more about atrial fibrillation. Mintu Turakhia, MD, and collaborators at Medtronic and Massachusetts General Hospital, extracted data out of decades of continuously recorded medical information from implanted medical devices – pacemakers and defibrillators — in 10,000 heart patients. Then they linked it to medical records, and analyzed it.

The researchers’ goal was to explore whether patients who experienced sudden attacks of a-fib, an irregular and rapid heart rate caused by spasms of the heart’s upper chambers, should be treated with long-term anticoagulants like those who had permanent a-fib or whether perhaps temporary drug therapy could be considered an option. They wanted to know if a patient’s risk of stroke changes as a-fib comes and goes.

The results, which were published recently in Circulation: Arrhythmia and Electrophysiology, found that patients were at an increased risk of stroke the first seven days after their hearts went into a-fib.

A-fib, which afflicts more than 3 million Americans, is known to increase a patient’s risk of stroke – but exactly when this risk occurs is controversial. Currently, physicians recommend long-term anticoagulation for patients, whether the a-fib occurs in sudden attacks or is continuous. This study indicates that transient use of anticoagulants could be an option for some patients and deserves further investigation. Future treatment plans might explore the idea of some kind of wearable device that shows when a patient goes in and out of a-fib, then taking medications just when needed rather than for a lifetime, said Turakhia.

Turakhia told me the study also provides an important example of how using “big data” research methods can ultimately lead to improved clinical care. In an email, he explained:

This is truly a big data approach where we took raw data from implanted pacemakers and implanted defibrillators and linked it to clinical data. The medical device data comes from home remote monitoring systems that patients have and goes to the cloud. We pulled the raw data off the cloud and linked it to VA (Veterans Affairs) electronic health records, VA claims, Medicare claims, and death records. This is truly a novel approach where we are assembling highly disparate data sources and linking them to gain insight into disease.

Previously: A little help from pharmacists helps a-fib patients adhere to prescriptions, Study highlights increased risk of death among patients with atrial fibrillation who take digoxin and What is big data?
Photo of Turakhia by Norbert von der Groeben

Behavioral Science, In the News, Research, Science

“Benign masochism” motivates common strange behaviors

"Benign masochism" motivates common strange behaviors

14674431439_be72558bd3_zI can recall many times I’ve offered something to a friend saying, “Smell this, it’s disgusting!” And more than once, the friend obliged. According to a National Geographic blog piece, the psychological motivation behind the appeal of stinky things is the same as the appeal of roller coasters, painfully spicy foods, and deep tissue massage. Likewise with reading sad novels or watching scary movies (though this last one is not something I personally enjoy). So what’s the common thread?

“Benign masochism,” a term coined by Paul Rozin, PhD, professor emeritus of psychology at the University of Pennsylvania, describes how humans enjoy negative sensations and emotions when they’re reassured that no harm will come to them. A “safe threat,” in other words.

The blog post is centered on our enjoyment of disgust, inspired by the massive audience at a recent blooming of a corpse flower at UC Berkeley’s Botanical Gardens. Valerie Curtis, PhD, a research director at the London School of Hygiene and Tropical Medicine and Psychology Today’sDisgustologist“, is quoted as saying the phenomenon is not dissimilar from kids playing war games in which they can “practice” their reactions to unpleasant situations.

“The ‘play’ motive leads humans (and most mammals, especially young ones) to try out experiences in relative safety, so as to be better equipped to deal with them when they meet them for real,” she says. “We are motivated to find out what a corpse smells like and see how we’d react if we met one.” Gross!

Previously: Looks of fear and disgust help us see threats, study shows
Photo by Dave Pape

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