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In the News, Public Health, Sleep

A window of time for better sleep

A window of time for better sleep

SleepThe only time I consider myself a “morning person” is when I have jet lag. But I’ve learned that if I’m in bed by 10:30 PM, I can be relatively cordial and not hit the snooze button the next morning.

Based on my own sleep patterns, it didn’t surprise me to read in a recent Time article that the time we go to bed affects the structure and quality of our sleep. As described in the piece, there’s a shift that occurs from non-REM, deep sleep, to the lighter dream-inspired REM sleep, and it happens during the night regardless of what time we go to bed. But going to bed late will deprive us of some of the deep non-REM sleep that replenishes the brain and body. Writer spoke with several sleep experts and reports:

When it comes to bedtime, [Matt Walker, PhD, head of the Sleep and Neuroimaging Lab at the University of California, Berkeley], says there’s a window of a several hours – roughly between 8 PM and 12 AM – during which your brain and body have the opportunity to get all the non-REM and REM shuteye they need to function optimally. And, believe it or not, your genetic makeup dictates whether you’re more comfortable going to bed earlier or later within that rough 8-to-midnight window, says Dr. Allison Siebern, associate director of the Insomnia & Behavioral Sleep Medicine Program at Stanford University.

“For people who are night owls, going to bed very early goes against their physiology,” Siebern explains. The same is true for “morning larks” who try to stay up late. For either type of person- as well as for the vast majority of sleepers who fall somewhere in between – the best bedtime is the hour of the evening when they feel most sleepy.

Siebern goes on to suggest trying out different bedtimes, plus making sure to wake up at roughly the same time every morning. These two factors can help maximize our natural sleep cycles and help prevent us from hitting the snooze button.

Previously: Stanford docs discuss all things sleep, “Sleep drunkenness” more prevalent than previously thought and Mindfulness training may ease depression and improve sleep for both caregivers and patients 
Photo By: FloodG

 

In the News, Public Health, Sleep

Stanford docs discuss all things sleep

Stanford docs discuss all things sleep

“Drowsiness is red alert!” is a phrase coined by Stanford’s William Dement, MD, PhD, who is often referred to as the “Father of Sleep Medicine.” It’s also a phrase he wrote on the wall of KQED’s green room this morning as a guest on Forum. Dement, along with Stanford sleep expert Rafael Pelayo, MD, and UC  Berkeley’s Matthew Walker, PhD, discussed sleep, or lack thereof, in the United States.

KQED ForumDuring the hour-long segment, the panel weighed in on the detrimental effects that poor sleep has on people’s physical and mental health, and took numerous calls from listeners. The experts also emphasized that quality, not just quantity, of sleep is important. “You should wake up feeling refreshed,” Pelayo told listeners. “You don’t leave restaurants feeling hungry, [so] you should not wake up in the morning feeling tired.”

Previously: Stanford researcher examines link between sleep troubles and suicide in older adults, Catching some Zzzs at the Stanford Sleep Medicine Center, Exploring the effect of sleep loss on healthCatching up on sleep science and Thanks, Jerry: Honoring pioneering Stanford sleep research
Related: Sleep legend Dement keeps last class wide awake
Photo by Margarita Gallardo

Applied Biotechnology, Ophthalmology, Public Health, Stanford News, Technology

Stanford-developed eye implant could work with smartphone to improve glaucoma treatments

Stanford-developed eye implant could work with smartphone to improve glaucoma treatments

eyeGlaucoma, caused by rising fluid pressure in the eyes, is known as the silent thief of sight. Catching the disease in the early stages is critical because if detected too late it leads to blindness. Regular monitoring and controlling of the disease once detected is invaluable.

Now, Stephen Quake, PhD, professor of bioengineering at Stanford, and Yossi Mandel, MD, PhD, an applied physics and ophthalmologist at Bar-Ilan University in Israel, have developed a tiny eye implant that would allow patients to take daily or hourly measurements of eye pressure from home.

A recent Stanford Report article explains how the device works:

It consists of a small tube – one end is open to the fluids that fill the eye; the other end is capped with a small bulb filled with gas. As the [internal optic pressure] increases, intraocular fluid is pushed into the tube; the gas pushes back against this flow.

As IOP fluctuates, the meniscus – the barrier between the fluid and the gas – moves back and forth in the tube. Patients could use a custom smartphone app or a wearable technology, such as Google Glass, to snap a photo of the instrument at any time, providing a critical wealth of data that could steer treatment. For instance, in one previous study, researchers found that 24-hour IOP monitoring resulted in a change in treatment in up to 80 percent of patients.

“For me, the charm of this is the simplicity of the device. Glaucoma is a substantial issue in human health. It’s critical to catch things before they go off the rails, because once you go off, you can go blind. If patients could monitor themselves frequently, you might see an improvement in treatments,” Quake added.

The full report (subscription required) is published in the current issue of Nature Medicine.

Previously: What I did this summer: Stanford medical student investigates early detection methods for glaucomaTo maintain good eyesight, make healthy vision a priority and Instagram for eyes: Stanford ophthalmologists develop low-cost device to ease image sharing
Photo by Magmiretoby

Autoimmune Disease, Evolution, Immunology, Microbiology, Nutrition, Public Health, Stanford News

Civilization and its dietary (dis)contents: Do modern diets starve our gut-microbial community?

Civilization and its dietary (dis)contents: Do modern diets starve our gut-microbial community?

hunter-gatherer cafe

Our genes have evolved a bit over the last 50,000 years of human evolution, but our diets have evolved a lot. That’s because civilization has transitioned from a hunter-gatherer lifestyle to an agrarian and, more recently and incompletely, to an industrialized one. These days, many of us are living in an information-intensive, symbol-analyzing, button-pushing, fast-food-munching society. This transformation has been accompanied by consequential twists and turns regarding what we eat, and how and when we eat it.

Toss in antibiotics, sedentary lifestyles, and massive improvements in public sanitation and personal hygiene, and now you’re talking about serious shake-ups in how many and which microbes we get exposed to – and how many of which ones wind up inhabiting our gut.

In a review published in Cell Metabolism, Stanford married-microbiologist couple Justin Sonnenburg, PhD, and Erica Sonnenburg, PhD, warn that modern civilization and its dietary contents may be putting our microbial gut communities, and our health, at risk.

[S]tudies in recent years have implicated [dysfunctional gut-bug communities] in a growing list of Western diseases, such as metabolic syndrome, inflammatory bowel disease, and cancer. … The major dietary shifts occurring between the hunter-gatherer lifestyle, early Neolithic farming, and more recently during the Industrial Revolution are reflected in changes in microbial membership within dental tartar of European skeletons throughout these periods. … Traditional societies typically have much lower rates of Western diseases.

Every healthy human harbors an interactive internal ecosystem consisting of something like 1,000 species of intestinal microbes.  As individuals, these resident Lilliputians may be tiny, but what they lack in size they make up in number. Down in the lower part of your large intestine dwell tens of trillions of  single-celled creatures – a good 10 of them for every one of yours. If you could put them all on a scale, they would cumulatively weigh about four pounds. (Your brain weighs three.)

Together they do great things. In a Stanford Medicine article I wrote a few years back, “Caution: Do Not Debug,” I wrote:

The communities of micro-organisms lining or swimming around in our body cavities … work hard for their living. They synthesize biomolecules that manipulate us in ways that are helpful to both them and us. They produce vitamins, repel pathogens, trigger key aspects of our physiological development, educate our immune system, help us digest our food and for the most part get along so well with us and with one other that we forget they’re there.

But when our internal microbes don’t get enough of the right complex carbohydrates (ones we can’t digest and so pass along to our neighbors downstairs), they may be forced to subsist on the fleece of long carbohydrate chains (some call it “mucus”)  lining and guarding the intestinal wall. Weakening that barrier could encourage inflammation.

The Sonnenburgs note that certain types of fatty substances are overwhelmingly the product of carbohydrate fermentation by gut microbes. These substances have been shown to exert numerous anti-inflammatory effects in the body, possibly protecting against asthma and eczema: two allergic conditions whose incidence has soared in developed countries and seems oddly correlated with the degree to which the environment a child grows up in is spotlessly hygienic.

Previously: Joyride: Brief post-antibiotic sugar spike gives pathogens a lift, The future of probiotics and Researchers manipulate microbes in the gut
Photo by geraldbrazell

Public Health, Public Safety, Research, Technology

Mining Twitter to identify cases of foodborne illness

During this year’s Big Data in Biomedicine conference at Stanford, Taha Kass-Hout, MD, chief health informatics officer for the U.S. Food and Drug Administration, talked about the potential of social media to monitor food safety saying, “You are what you eat, and in this world, you are what you tweet.” Taking this concept into a real-world setting, officials at the Chicago Department of Public Health developed an algorithm to mine Chicago-based tweets for sentiments of food illnesses and, as a result, were able to investigate incidents of food poisoning that would have otherwise gone unnoticed. According to a recent article in Popular Science:

… in a recent project, the city of Chicago sought food poisoning cases by setting an algorithm to mine Chicago-area tweets for complaints. The Chicago Department of Public Health’s Twitter bot, plus a new online complaint form, helped the department identify 133 restaurants for inspections over a 10-month period. Twenty-one of those restaurants failed inspection and 33 passed with “critical or serious” violations. Not a bad haul.

Chicago is now working with the health departments of Boston and New York to see if its system could work in those cities, according to a report city researchers published with the U.S. Centers for Disease Control and Prevention. Plus, Twitter isn’t the only social media platform cities are looking to mine for public health violations. In May, New York City’s department of health reported on using an algorithm to spot Yelp reviews that point to food poisoning cases. New York’s Yelp project led the city to discover three restaurants that had multiple violations. All the Yelp cases the city inspected had otherwise gone unreported, New York officials wrote in their own CDC report.

The Chicago bot was pretty simple, as Twitter-reading computer programs go. It searched for tweets geo-located to Chicago and its surrounding suburbs that mentioned “food poisoning.” Human staff then read the tweets to determine if they were relevant. (Sounds fun.) Staff marked tweets as relevant or not relevant, to give the algorithm data to better learn what tweets to pull in the future. Then staff members responded to relevant tweets themselves.

Previously: Videos of Big Data in Biomedicine keynotes and panel discussions now available online, Discussing access and transparency of big data in government and Improving methods for tracking flu trends using Twitter

From August 11-25, Scope will be on a limited publishing schedule. During that time, you may also notice a delay in comment moderation. We’ll return to our regular schedule on August 25.

Cancer, Parenting, Pediatrics, Public Health, Research

Study shows number of American teens using sunscreen is declining

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Despite an increase in cases of melanoma, the most dangerous type of skin cancer, growing percentage of high school students get a failing grade when it comes to using sunscreen. HealthDay reports:

The number of U.S. teens using sunscreen dropped nearly 12 percent in the last decade, a new report shows.

During that same time period, the number of teens using indoor tanning beds barely decreased. Both indoor tanning and failure to use sunscreen increase the risk of skin cancers, including deadly melanomas, the researchers noted.

“Unfortunately, we found a decrease in the overall percentage of teens who reported wearing sunscreen, from 67.7 percent in 2001 to 56.1 percent in 2011,” said lead researcher Corey Basch, an associate professor in the department of public health at William Paterson University in Wayne, N.J.

“Using sun-protective behaviors like applying sunscreen and avoiding intentional exposure to tanning devices will be key [to lowering cancer risk],” she added.

Use of indoor tanning devices by white girls decreased only slightly, from 37 percent in 2009 to 29 percent in 2011, she said.

Study authors say more research is need to understand why teens aren’t following national guidelines regarding sun protection.

Previously: Melanoma rates exceed rates of lung cancer in some areas, Beat the heat – and protect your skin from the sun, Working to protect athletes from sun dangers and Stanford study: Young men more likely to succumb to melanoma
Photo by Alex Liivet

From August 11-25, Scope will be on a limited publishing schedule. During that time, you may also notice a delay in comment moderation. We’ll return to our regular schedule on August 25.

Global Health, Infectious Disease, Public Health, Public Safety, Stanford News

Biosecurity experts discuss Ebola and related public health concerns and policy implications

Biosecurity experts discuss Ebola and related public health concerns and policy implications

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More than 1,800 people in the West African nations of Liberia, Sierra Leone and Guinea have contracted the Ebola virus since March and the death toll has surpassed 1,000, according to the latest figures from the World Health Organization. As the number of cases and death continue to climb many are concerned about what can be done to curtail the outbreak and the likelihood of it spreading to the United States.

In a Q&A recently published by the Center for International Security and Cooperation and The Freeman Spogli Institute for International Studies, Stanford biosecurity experts David Relman, MD, and Megan Palmer jointly answer these questions and others related to the public health concerns and policy implications of the outbreak. On the topic of broader lessons about the dynamics and ecology of emerging infectious diseases that can help prevent or respond to outbreaks now and in the future, they respond:

These latest outbreaks remind us that potential pathogens are circulating, replicating and evolving in the environment all the time, and human action can have an immense impact on the emergence and spread of infectious disease.

We are starting to see common factors that may be contributing to the frequency and severity of outbreaks. Increasing human intrusion into zoonotic disease reservoir habitats and natural ecosystems, increasing imbalance and instability at the human-animal-vector interface, and more human population displacement all are likely to increase the chance of outbreaks like Ebola.

The epicenter of this latest outbreak was Guéckédou, a village near the Guinean Forest Region. The forest there has been routinely exploited, logged, and neglected over the years, leading to an abysmal ecological status quo. This, in combination with the influx of refugees from conflicts in Guinea, Liberia, Sierra Leone, and Cote d’Ivoire, has compounded the ecological issues in the area, potentially facilitating the spread of Ebola. There seems to be a strong relationship between ecological health and the spread of disease, and this latest outbreak is no exception.

While forensic analyses are ongoing, unregulated food and animal trade in general is also a key factor in the spread of infectious diseases across large geographic regions. Some studies suggest that trade of primates, including great apes, and other animals such as bats, may be responsible for transit of this Ebola strain from Central to Western Africa.

Overall, Relman and Palmer remind the public, “It’s important that we not lose sight of more chronic, but less headline-grabbing diseases that will be pervasive, insidious long-standing challenges for Africa and elsewhere.”

Previously: Stanford global health chief launches campaign to help contain Ebola outbreak in Liberia and Health workers use crowdsourced maps to respond to Ebola outbreak in Guinea
Photo by European Commission DG ECHO

From August 11-25, Scope will be on a limited publishing schedule. During that time, you may also notice a delay in comment moderation. We’ll return to our regular schedule on August 25.

Ethics, Events, Health Policy, Medicine and Society, Public Health, Transplants

Stanford Health Policy forum on organ-donation crisis now available online

Stanford Health Policy forum on organ-donation crisis now available online

The latest Stanford Health Policy Forum, which focused on ways to end our country’s organ-donor shortage, is now available online. More than 100,000 Americans currently need organ transplants, and the panelists discussed a variety of solutions for solving the problem. Among the ideas brought to the table was a compensation system for donors – an option that was also the focus of an article in today’s San Francisco Chronicle.

Previously: At Stanford Health Policy Forum, panelists dig into the issue of organ donationHow can we end the donor organ shortage?, Stanford visiting professor and founder of kidney-exchange program wins Nobel economics prize and One gift saves three young lives 

In the News, Public Health, Research, Science, Stanford News, Technology

NPR highlights Google’s Baseline Study and what it might teach us about human health

NPR highlights Google's Baseline Study and what it might teach us about human health

Late last month, my colleague reported on Stanford partnering with Google [x] and Duke on a research study to better understand the human body. On the most recent edition of NPR’s Science Friday, project collaborator Sanjiv Sam Gambhir, MD, PhD, professor of radiology at Stanford, discussed the project and joined Jason Moore, MD, professor of genetics at Dartmouth College, in a segment called “Will big data answer big questions on health?”

According to Gambhir, what makes the new project unique is the focus on understanding the baseline of healthy human beings. Will it ultimately yield meaningful data about what makes us healthy? Listen here for the researchers’ thoughts.

Previously: Stanford partnering with Google and Duke to better understand the human body

Addiction, In the News, Public Health, Public Safety

Can the “24/7 sobriety” model reduce drunken disorderly conduct and violence in London?

beer_london_pubIn an article published yesterday in the Telegraph, Stanford addiction expert Keith Humphreys, PhD, discusses how public officials in London are turning to the United States’ “24/7 sobriety” model in an effort to reduce repeat offenders convicted of alcohol-related crimes. The program, which combines mandatory sobriety and daily breathalyser tests, was created under Humphreys’ guidance. He writes:

Research by the RAND Corporation – a US-based non-profit global policy think tank – found that 24/7 sobriety dropped repeat drink driving arrests by 12 per cent. The same study also yielded a pleasant surprise: domestic violence arrests dropped by 9 per cent, despite not being a focus of the programme. Removing alcohol from the lives of criminals can apparently have radiating benefits beyond those directly related to their most recent offence.

In light of its positive results, judges across the U.S. have been adopting the 24/7 sobriety approach. This week, under the leadership of Mayor Johnson and his team, a pilot of the programme will be launched in South London. Leaping the pond will come with some challenges, particularly around delivering sanctions swiftly within the constraints of British law, but local tailoring of innovations is always an essential part of making them spread.

In any event, with over one million alcohol-related assaults occurring nationally each year and many London boroughs being regularly marred by violence and disorder on weekend evenings, the time for new approaches to binge drinking criminal offenders has clearly arrived. The judges and probation officers who are undertaking this pilot should be applauded for refusing to accept the status quo.

Previously: Text messages after ER visit could reduce young adults’ binge drinking by more than 50 percent, Study shows legal drinking age of 21 saves lives and reduces health risks for young adults, Alcoholism: Not just a man’s problem and Stopping criminal men from drinking reduces domestic violence
Photo by Paul Downey

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