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Stanford News, Surgery, Videos

The importance of human connection as part of the patient experience

The importance of human connection as part of the patient experience

When I first heard Tim Engberg describe the feeling of intense loneliness and separation from humanity he felt as he was being wheeled on a gurney into surgery, I immediately pictured myself in a hospital bed staring at the ceiling, desperate for the touch of a familiar hand, afraid.  When you’re well, you forget so quickly how lonely and scary it is to be sick, and in Engberg’s case, with enormous pain in his neck, an infection threatening to render him paralyzed, and the enormity of the looming surgery, the sense of aloneness was overwhelming.

Engberg just so happens to be the vice president of Stanford Health Care’s Ambulatory Care. Most of his days he spends as an executive of a hospital, thinking about how to ensure that patients are being taken care of in the best possible way. Like many of us, it took being a patient himself to fully understand what a difference our nurses and doctors make and how they can pull someone back from the brink of despair to full recovery, or as Engberg puts it, “back into the human race.”

Engerb’s story is captured in the video above.

Biomed Bites, Immunology, Research, Transplants, Videos

Marked improvement in transplant success on the way, says Stanford immunologist

Marked improvement in transplant success on the way, says Stanford immunologist

This is the third installment of our Biomed Bites series, a weekly feature that highlights some of Stanford’s most compelling research and introduces readers to innovative scientists from a variety of disciplines.

“Boost your immune system” is practically a mantra for some health-savvy folks who chug vitamin C or oregano oil (yep!) to ward off errant germs. But sometimes having a weaker immune system is a good thing. Take transplant patients: If their immune system attacks invaders with too much gusto, then the new organ is at risk as well.

But transplant patients don’t want to completely dismantle their immune systems – and that’s where Stanford immunologist Sheri Krams, PhD, comes in. “We want to specifically temper the immune response to that new foreign organ,” Krams says about her work in the video above.

Transplant patients can survive for decades by taking immunosuppressive drugs, yet long-term use of these drugs can weaken bones, muscles and leave patients more vulnerable to infection. But through basic research, this basic transplant conundrum is changing, Krams says:

We’ve made major strides in the field of transplantation in the last few years…  We’re thinking that our research, in a very short period of time, will markedly improve the quality of life for transplant recipients and people that will be receiving stem cell transplants.

Learn more about Stanford Medicine’s Biomedical Innovation Initiative and about other faculty leaders who are driving forward biomedical innovation here.

Becky Bach is a former park ranger and newspaper reporter who now spends her time writing about science or practicing yoga. She’s currently a science writing intern in the medical school’s Office of Communication & Public Affairs.

Previously: Stanford study in transplant patients could lead to better treatmentExtracting signal from noise to combat organ rejection and Kidney-transplant recipients party without drugs — immune-suppressing anti-rejection drugs, that is

Events, Medicine and Society, Stanford News, Videos

How Stanford Medicine celebrated TEDMED

How Stanford Medicine celebrated TEDMED

Earlier this month, TEDMED, an annual global event dedicated to exploring the promise of technology and potential of human achievement in health and medicine, was held simultaneously in San Francisco and Washington D.C. Stanford Medicine served as a medical research institution partner for the event and hosted a reception to cap off Day Two of the three-day conference; the video above captures the evening’s activities and offers a taste of the future of biomedicine.

Previously: Abraham Verghese discusses stealing metaphors and the language of medicine at TEDMED and Stanford Medicine partners with TEDMED on “first-ever gathering on the West Coast”

Bioengineering, Imaging, Research, Stanford News, Videos

How CLARITY offers an unprecedented 3-D view of the brain’s neural structure

How CLARITY offers an unprecedented 3-D view of the brain's neural structure

Last year, Stanford bioengineer Karl Deisseroth, MD, PhD, and colleagues in his lab announced their development of CLARITY, a process that renders tissue transparent, sparking excitement among the scientific community. As explained in the above video, released yesterday by the National Science Foundation, researchers had been unable to directly study the human brain’s circuitry because much of the organ is covered in an opaque tissue. But using CLARITY researchers can “chemically dissolve the opaque tissue in a post-mortem brain, and in place of that tissue, they insert a transparent hydrogel that keeps the brain intact and provides a window into the brain’s neural structure and circuitry.” For this reason, the technique is “hailed as an important advance in whole-brain imaging.”

Previously: Process that creates transparent brain named one of year’s top scientific discoveries, An in-depth look at the career of Stanford’s Karl Deisseroth, “a major name in science”, Peering deeply – and quite literally – into the intact brain: A video fly-through and Lightning strikes twice: Optogenetics pioneer Karl Deisseroth’s newest technique renders tissues transparent, yet structurally intact

Clinical Trials, Ethics, Health Policy, Stanford News, Videos

Video explains why doctors don’t always know best

Video explains why doctors don’t always know best

“Over 85 percent of our major medical guideline recommendations are not based on high-quality evidence,” said Robert Califf, MD, director of the Duke Translational Medicine Institute, in an article I recently wrote for Inside Stanford Medicine.

This was the inconvenient truth that Stanford bioethicist David Magnus, PhD, had to explain to patients during focus groups, as he began developing policy recommendations for conducting ethical comparative-effectiveness research within physician practices.

“We had to dispel the myth that doctors always know which treatments are most effective for individual patients,” Magnus told me. “The truth is, in the absence of good evidence, these choices are often influenced by advertising, insurance coverage and local preferences.”

Gathering better treatment evidence is a key objective of the Affordable Care Act’s health-care reform mandate. It provides incentives for medical practices to continually evaluate the relative effectiveness of competing medical interventions as a way of delivering better, less costly care to more people. The widespread adoption of electronic medical records is enabling researchers to conduct these head-to-head comparisons in more automated ways, reducing the time and expense associated with the highly controlled clinical trials used to evaluate new drugs and devices.

A communications challenge with these new approaches, however, is how to explain the risks and rewards of participation to patients. In focus groups, Magnus found that no meaningful discussions could take place until his research team had educated patients on some fundamental concepts of medical research, such as standards-of-care, randomization and informed consent. To help with this process, his team produced three short, animated videos that would rapidly get everyone up to the same level of understanding. Magnus and his collaborators are making these videos available to all for educational purposes.

The first video, “Which Medication is Best?,” explores the influences and uncertainty associated with physicians’ prescribing preferences. “Research on Medical Practices” explains medical record reviews, study randomization and randomization of clinics and hospitals; and “Informing or Asking” describes ways to explain study participation to patients.

Magnus and his bioethicist collaborators from the Seattle Children’s Research Institute and University of Washington expect to publish their final ethics policy recommendations later this year.

Previously: Bioethicists say criticisms of preemie oxygen study could have “chilling effect” on clinical researchStanford biomedical ethicist discusses Choosing Wisely Initiative and Will new guidelines lead to massive statin use?
Videos by Booster Shot Media

Medical Education, Medical Schools, Stanford News, Videos

Stanford students design “enrichments” for lions, giraffe and kinkajou at the San Francisco Zoo

Stanford students design "enrichments" for lions, giraffe and kinkajou at the San Francisco Zoo

My job took me to the zoo.

It was a rather unorthodox assignment for a medical writer, but one of our faculty at Stanford medical school was teaching a rather unorthodox class at the San Francisco Zoo. A dozen Stanford sophomores signed up to spend two intensive weeks there learning about animal welfare and behavior and designing “enrichments” to make life more interesting for the lions, a giraffe and a kinkajou at the zoo.

These included a “Poop Shooter” to lob animal poop into the lion’s cage, a urine-soaked scratcher for a lone giraffe and a “Robo-Flower” to automatically dispense smoothies to the kinkajou, a tree-dwelling rainforest mammal that looks like a cross between a squirrel and a raccoon.

“Zoo animals have pretty good welfare already,” said Stanford’s Joseph Garner, PhD, an associate professor of comparative medicine who helped design and lead the class. “So it’s not about fixing things. It’s about how we can turn this animal on a little. How can we help the keepers manage the animal and improve the experience for guests.”

“It’s like if you lived in the same room your whole life. We want to change it up, keep it fresh and interesting – something novel,” said student Jennifer Ren.

For Floyd the giraffe, the students shook things up a bit by building a scratcher soaked in female giraffe urine to make it appealing to him. Instead of lurking in a corner of his paddock near the female enclosure, Floyd ventured out into his large pad to explore his new toy, where he was a lot more visible to zoo-goers.

“The giraffe is one of the largest and strongest animals on the planet, so building something that he is not going destroy in 30 seconds is a real challenge,” Garner said.

For the lions, the students adapted a conveyor-belt system to periodically shoot giraffe poop into the lion’s cage, where the male lion in particular found the aromatic pellets extremely interesting.

“Lions lie around all day watching and waiting. But when the zoo put the enrichment in, it was like somebody just flipped a switch,” Garner said. “The male lion was up and about and smelling and searching for the giraffe droppings, and performing all of this wonderful lion behavior.”

The students took their assignments very seriously, videotaping the animals’ responses and designing charts and graphs to measure the results, which they presented at a zoo ceremony last Friday in which they were celebrated for their contributions.

The students said they came away with a whole new perspective on zoos and wildlife behavior, as well as a gratifying sense of having designed something to improve the animals’ lives.

Previously: How horsemanship techniques can help doctors improve their art
Photo in featured entry box by Norbert von der Groeben

Science, Stanford News, Videos

Science is like an ongoing mystery novel, says Stanford neurobiologist Carla Shatz

Carla Shatz

We all know that Carla Shatz, PhD, director of the interdisciplinary institute Stanford Bio-X, is a pioneering scientist — her work in early brain development and in Alzheimer’s disease has earned her many accolades. Now she’s being featured in a videos series celebrating women pioneers in science.

I want to say first that it always rankles a bit when people are celebrated as being “pioneering women in XXX”. That makes it seem like if they weren’t women they wouldn’t have made the pioneer cut. Carla is a pioneer period. And also a woman. And gave a great interview.

One interesting point she made had to do with what she wished she’d known before starting a career in science. She said, “If you really like science and you like research, that is the joy and the easy part. The hard part is managing the teams and the research itself – the people.”

She went on to talk about the people who influenced her (her dad) and her first scientific experiment (it had to do with Siamese cats, and initially didn’t work).

When it comes to women in science, her answer was straightforward. She said we need talented people working on critical problems, and women are half the population. Without them, there are fewer people working on these important questions. She also said that she worries about the diminished funding for science driving the best minds (male and female) into other fields.

Her answer to what gets her up in the morning should help lure at least a few of those potential best minds into a scientific career, even with weak funding. She said:

Every day when I come to work I am so excited to be here and go to my lab and do experiments and be with my students. It’s part of an ongoing mystery. I can hardly wait to see the next part of the mystery that is going to be solved.

The series is sponsored by Scientista, which supports women in math and science, The Scientist magazine, Lab Manager and Mettler Toledo.

Previously: They said “Yes”: The attitude that defines Stanford Bio-X and Pioneers in science
Photo be Steve Fisch

Biomed Bites, Research, Science, Stanford News, Videos

Studying the drivers of metastasis to combat cancer

Studying the drivers of metastasis to combat cancer

Today we’re launching Biomed Bites, a weekly series created to highlight some of Stanford Medicine’s most compelling research and introduce readers to promising scientists from across the basic and clinical sciences.

One might not think there’s much of a connection between grapes and cancer cells, but Amato Giaccia, PhD, has found some similarities. “The tumor microenvironment is very analogous to the microenvironment you would have in Napa Valley, where different types of grapes grow in different areas depending on the richness of the soil and the different climate and weather that exist,” explains the Stanford radiation oncologist and cancer biologist in the video above. “In a similar matter, tumors require different environments for them to be able to grow and… metastasize.”

Giaccia and his colleagues study the genetic and epigenetic regulators of metastasis, and their work could lead to the development of therapeutics that inhibit or eradicate the process, which contributes to 90 percent of cancer-related deaths. “Understanding the drivers of metastasis and how to best target them is going to have a major impact on cancer survival and mortality in the future,” Giaccia says.

Learn more about Stanford Medicine’s Biomedical Innovation Initiative and about other faculty leaders who are driving forward biomedical innovation here.

Previously: Cellular culprit identified for invasive bladder cancer, according to Stanford study, Potential anti-cancer therapy starves cancer cells of glucose and Nomadic cells may hold clues to cancer’s spread
Photo in featured entry box by Lee Coursey/Flickr

Cancer, Men's Health, Stanford News, Videos

Stanford experts talk new diagnostic technology for prostate cancer

Stanford experts talk new diagnostic technology for prostate cancer

This month is National Prostate Cancer Awareness Month, and Stanford urologic oncologists are sharing their knowledge about prostate cancer diagnosis and treatment, both online and in person. This Saturday, at a free community talk hosted by the Stanford Cancer Center, several experts will be on hand to answer questions and discuss prostate cancer screening, “watchful waiting,” diagnostic advances, and treatment options. In an online Q&A and the video above, Eila Skinner, MD, chair of urology, and James Brooks, MD, chief of the urologic oncology division, and others provide more insight on the disease. And during the month of September, more information about prostate cancer, including the benefits of targeted prostate biopsy, will be offered on Twitter via @StanfordHosp.

Previously: Managing a prostate cancer diagnosis: From leader to follower, and back again, New technology enabling men to make more confident decisions about prostate cancer treatment, Six questions about prostate cancer screening, Ask Stanford Med: Answers to your questions on prostate cancer and the latest research and Making difficult choices about prostate cancer

Patient Care, Pediatrics, Stanford News, Videos

Pediatric patients create vibrant mural with help from Hewlett-Packard and DreamWorks Animation

Pediatric patients create vibrant mural with help from Hewlett-Packard and DreamWorks Animation

Here’s a feel-good story that will lift your spirits. Over at Lucile Packard Children’s Hospital Stanford, patients are working with volunteers from Hewlett-Packard and DreamWorks Animation to construct a unique piece of artwork designed digitally or drawn by hand. As described in the above video, the DreamWorks team worked with children in the hospital’s onsite school to create imaginary creatures, and next built a background and composited the patients’ art into a large mural. Then, Hewlett-Packard printed the custom designs onto PVC-free wallpaper. The final mural now hangs in Hewlett-Packard’s Palo Alto headquarters.

Previously: Ensuring young dialysis patients make the grade

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