Unlocking Human Potential: Q&A with Tiffany Shlain

Speaking during TEDMED 2014’s “Human Nature Inside and Out” session, filmmaker Tiffany Shlain captivated her audience with a personal and insightful talk about the unique strengths of the human brain and how we can unlock our potential. We reached out to her for more insights from her talk topic.

Tiffany Shlain on the TEDMED stage [Jerod Harris].

Tiffany Shlain on the TEDMED stage [Photo: Jerod Harris, TEDMED 2014].

 

What motivated you to speak at TEDMED?

I love the mash-up of scientists and artists coming together. Combining art and science is at the root of all of my films, talks, creativity and my upbringing.

Why does your talk matter now?

These days, there is a great deal of conversation about how technology can impact humans. These conversations tend to either be based on fear and anxiety, or are overly idealistic. Meanwhile, there are also conversations taking place about revamping the education system, and focusing on the sciences and engineering. The problem is that I haven’t seen those conversations overlap yet. I want to emphasize what they point to the potential of humanity. Our focus should be on the strengths that are unique to humans, and how we can work in concert with the things we can program machines to do, in order to flourish in the 21st century. This is the conversation we need to be having.

If you had more time on the TEDMED stage, what else would you have talked about?

My talk was the basis of a new film my team is in the process of finishing, called “The 21st Century Brain.” That film will then be the beginning of a longer project we’ll be working on over the next few years. People are ready for this conversation, and I’m excited to dive deeper into it.

Are there any action items you want your viewers to take?

I hope people will practice the human strengths I discuss – metacognition, empathy, creativity, and initiative – and begin working them into their daily lives.

What is the legacy you want to leave?

Through my talks and films, I hope to inspire people to ask questions, laugh, and think deeply about what it means to be human in our ever-changing world.

Introducing the 2015 TEDMED Editorial Advisory Board

We’re excited to share something new to TEDMED!

In preparation for TEDMED 2015 and the selection of 60+ speakers and performers, we’re honored to introduce TEDMED’s Editorial Advisory Board.

Board members will offer their expertise, insights and wisdom to assist in the shaping of our stage program themes, topics, speakers and performers while also advising on TEDMED’s overall editorial strategy. Vetting by the Board will help ensure that TEDMED speakers and stage program topics continue to meet the highest standards of scientific relevance and rigor.

To form this Board, we drew upon our remarkable TEDMED community, gathering 20 highly creative, accomplished, diverse and innovative movers and shakers. Each member embodies a spirit of generosity, depth of knowledge and breadth of experience that will contribute immeasurably to the quality and impact of this year’s stage program.

Inclusiveness is a big part of TEDMED’s DNA. That’s why our Board is made up of representatives from across health and medicine as well as the worlds of business and technology, foundations and academia, philanthropy and design, and journalism and communications. This diversity allows us to approach proposed topics and themes through multiple lenses.

We’re delighted to welcome the members of the TEDMED Editorial Advisory Board and we thank them for their collaboration:

Pam Belluck is a health and science writer for The New York Times. She covers a range of subjects, but tends to focus on the most controversial and complex topics related to the brain, behavior, and reproductive health. An award-winning journalist, Belluck has been the recipient of a Knight fellowship, a Fulbright and the Best American Science Writing.

Carlos Bustamante, PhD, is a Stanford professor, population geneticist and MacArthur “Genius” Fellow who analyzes genome-wide patterns of variation within and between species to address fundamental questions in biology, anthropology and medicine. Bustamante was Stanford’s inaugural co-host at TEDMED 2014 and has also been featured on TEDMED’s Great Challenges Program.

Christopher Elias, MD, MPH, is the President of the Bill and Melinda Gates Foundation’s Global Development Program, where he leads efforts in integrated and innovative delivery, finding creative new ways to ensure that solutions and products get into the hands of people in developing countries who need them most.

Harvey Fineberg, MD, PhD, is the President of the Gordon and Betty Moore Foundation and the Presidential Chair of UCSF. He previously served two consecutive terms as president of the Institute of Medicine. Harvey studies medical decision-making, asking important questions about how new medical technologies are rolled out and how we cope with new illnesses and threats of epidemics. He spoke at TEDMED 2013.

Adam Gazzaley, MD, PhD, is a Professor of Neurology, Physiology and Psychiatry at UCSF and the Founding Director of the Neuroscience Imaging Center. Adam was UCSF’s inaugural co-host at TEDMED 2014.

Carleen Hawn is the Founder and CEO HealthSpottr. Prior to founding Healthspottr, Carleen was an associate editor with Forbes and senior writer and west coast bureau chief for Fast Company magazine.

Peter Hopkins is the Cofounder and President of Big Think, a cutting-edge online knowledge company that makes people and companies faster and smarter through efficient e-learning from world renowned experts. Peter also spearheaded the creation – and currently serves as the Principal – of Floating University, a joint venture with the Jack Parker Corporation that aims to foster content innovation in higher education.

Jeff Karp, PhD, is an Associate Professor at Brigham and Women’s Hospital and Harvard Medical School. His research focuses on stem cell engineering, biomaterials and medical devices inspired by nature. He shared his work at TEDMED 2014.

Mohit Kaushal, MD, MBA, is an Associate Professor at Stanford University and a visiting scholar at the Brookings Institution. He is also a partner at Aberdare, a venture capital firm focused on transformational healthcare opportunities. Mohit has also served on TEDMED’s Hive curatorial board.

Sandeep “Sunny” Kishore, MD, PhD, is an Internal Medicine Resident at Yale University. He’s been a founder of a global health organization, a Delegate to the UN General Assembly, a Fellow at MIT Dalai Lama Center for Ethics & Transformative Values, a Soros Fellow and the first Lancet awardee for community service. Sunny was a TEDMED 2012 speaker and also co-hosted the TEDMED 2014 DC stage.

Rupa Marya, MD, is a hospitalist and an Assistant Professor of Internal Medicine at UCSF. She is also the lead singer, composer and musical director of Rupa & the April Fishes, a band that seeks to celebrate beauty in pluralism and reinvigorate appreciation for living music with their diverse, global sounds. Rupa & the April Fishes performed at TEDMED 2014.

Vivek Murthy, MD, MBA, is the U.S. Surgeon General. Prior to his confirmation, he was a physician at Brigham and Women’s Hospital in Boston, and a Hospitalist Attending Physician and Instructor in Medicine at Harvard Medical School. He is also the President and cofounder of Doctors for America.

Betsy Nabel, MD, is the President of Brigham and Women’s Hospital, a practicing cardiologist, a biomedical researcher, a patient advocate, a Professor of Medicine at Harvard Medical School, and the first Chief Medical Advisor of the NFL. She was previously the Director of the National Heart, Lung, and Blood Institute. She spoke at TEDMED 2014.

Ivan Oransky, MD, is the Vice President and Global Editorial Director of MedPage Today. Previously, Ivan was Executive Editor of Reuters Health, Managing Editor of Scientific American and Deputy Editor of The Scientist. Ivan is Vice President of the Association of Health Care Journalists, and serves on its Board of Directors. Ivan spoke at TEDMED 2012.

Manu Prakash, PhD, is an Assistant Professor of Bioengineering at Stanford University.Manu serves as a core member of graduate program in Biophysics and an affiliate of Woods Institute of the Environment at Stanford University. In 2014, Manu was nominated as MIT Tech Review TR35 and Popular Science Brilliant 10.

Carla Pugh, MD, PhD, is a Surgeon and the Director of the Health Clinical Simulation Program at the University of Wisconsin. Her work focuses on fine-tuning students’ haptic skills as a standardized part of clinical education and daily practice. She spoke at TEDMED 2014.

John Qualter is the co-founder and Chief Creative Officer of BioDigital Systems, where he leads digital content creation and consulting for clients in the device, pharmaceutical and communications industries. John is a pioneer in the field of biomedical visualization, promoting the implementation of high-end 3D media in the healthcare industry. He spoke at TEDMED 2012.

Teeb Al-Samarrai, MD, is a physician, writer and epidemiologist with a diverse background in neuroscience, anthropology, and domestic and international public health. She previously served as a CDC Epidemic Intelligence Service Officer assigned to the New York City Department of Health and Mental Hygiene and currently serves as Deputy Health Officer & Tuberculosis Controller with the Santa Clara County Public Health Department in California, focusing on immigrant and refugee health.

Nina Tandon, PhD, MBA, is the CEO and Co-Founder of EpiBone, the world’s first company to grow living human bones for skeletal reconstruction. She is also an Adjunct Professor of Electrical Engineering at Cooper Union. Named one of the 100 Most Creative People in Business by Fast Company in 2012, Nina was a TEDMED 2014 speaker and is a Senior TED Fellow.

Abraham Verghese, MD, MACP, is a physician,Professor and Vice Chair for the Theory and Practice of Medicine at Stanford University’s School of Medicine and the author of the novel Cutting for Stone. In the modern era of medicine, where patients can seem to be mere data points, Abraham believes in the value and ritual of the physical exam, and in the power of informed observation. He spoke at TEDMED 2014.

It Takes a Village to Combat Childhood Obesity: Last Week’s Hangout Participants Address Unanswered Questions

Last week, a multidisciplinary group of experts joined us for a Great Challenges live online event to discuss whether it truly takes a village to prevent conditions such as childhood obesity. With NPR Correspondent Allison Aubrey moderating, these experts took a close look at community-based prevention initiatives that have led to sustainable health solutions, including reductions in childhood obesity, and discussed how those approaches can be applied elsewhere.

If you weren’t able to join us, check out the recast below.

Thanks again for sending your questions and comments via social media! We had such great questions that an hour did not leave time enough to address them all. So, we asked our panelists, Angela Diaz, Karen Peterson, Belinda Reininger and Risa Wilkerson to offer their thoughts on the remaining questions. Here’s what they had to say:

Conditions such as childhood obesity are more prevalent in lower income areas – these are precisely the ones that may not have the resources to take meaningful action. How can these communities create a program that might have an impact?

Angela: In the absence of additional resources, collaboration becomes even more important. One may build new program opportunities on top of tasks you need to do anyway. For example, a graduate program may need to place students to practice nutrition education or physical education and could be added to the resources available at a local early education center. Or changing the way an organization conducts their regular business may not require additional funding, but instead, a consideration to do things differently. For example, a daycare center offers daily snacks to their kids. An activity that requires no additional resources is setting standards for types of snacks served.

Risa: The Healthy Kids, Healthy Communities initiative supported 49 partnerships to increase children’s access to healthy foods and opportunities for physical activity through changes in policies, systems and environments in those communities at greatest risk for childhood obesity based on race, ethnicity, income and geographic location. The Growing a Movement report provides insights on what is achievable in low-income communities through collaboration among community-based organizations, residents, decision makers and other partners. Much was achieved by these partnerships. I realize that being part of a grant-funded program provides many advantages and yet there are ways communities can replicate some of these efforts, even if on a smaller scale or a longer time frame.

The examples cited (Brownsville, Blue Zones communities) are affiliated with large organizations – they are very special circumstances that many communities cannot replicate. Can a community take steps to better prevent chronic conditions without the backing of a powerful organization?

Angela: When you set the table for collaboration, any individual, small organization, tenant association or civic group can contribute towards health: a scout working on is Eagle project can mark trails in a local park that is used by families during the weekend, thus providing more opportunities for physical activity. A tenant association can organize a “Play Street” during the summer staffed by neighbors and summer youth employment participants from a local multi-service agency.

Belinda: Preventing chronic disease in a community takes more than one large organization – it takes numerous large and small organizations coming together. Large organizations can be helpful when you have grants where costs are reimbursed after the work is done, simply because these organizations tend to be more able to float those costs more easily than smaller organizations. However, smaller organizations are usually able to be more nimble in hiring and purchasing. The strengths of both types of organizations move things forward.

Risa: Any community can take steps toward better conditions even without a large funder behind the scenes. Perhaps there is an existing community coalition or partnership that can help organize efforts. If not, start small to develop one. It is important that coalitions meaningfully engage those residents whom are most affected by the current conditions. A first step can be assessing the situation by looking at health and safety data (most county health departments can help with this) and talking to residents about the barriers they face to eating healthy food and being physically active. From there, choosing small steps toward change to help built trusting relationships and to build energy toward change. This can include collective efforts to invest in improving (even cleaning up) a local park or starting a community garden.

What’s the single most important piece to the puzzle of preventing chronic disease on a community level?

Angela: When neighbors are socially and civically active, they can turn a community around. If neighbors have an opportunity to work together and achieve a small win, like getting a street clean, getting together and watching “Weigh of the Nation” or a similar documentary at a local community center, they may be inspired to take the next step to get more deeply involved with other issues in their neighborhood, like rallying to bring more healthy options to their local grocers.

Risa: There is no single solution. It’s a complex issue and one that requires work at the systems level. What is important is that we don’t rely only on programs, promotion and education to move the needle. We also have to work on changing policies and the social and built environments to support people’s desire to make healthy choices.

In your opinion, is it possible that childhood obesity is not the problem but a symptom of a larger issue at hand? What might that issue be?

Angela: Letting the food industry produce, market and profit from unhealthy, overly processed, high calorie-low nutritional food in the name of corporate freedom, with little regard for health is part of the larger issue. Some subsidies favor the over-production of some crops, for example, corn. Over-diversified crops result in a product flooding the market and then the need for that product to be put to use.

How can lessons learned from Brownsville or the Blue Zones be best applied to other communities? Is it a matter of policy change? Health education? Is it a community-driven process?

Angela: Again, I cannot stress enough that a good place to start is setting the table for people to come together, build relationships and start to talk about what they are doing and where there are opportunities to build on each other’s agenda. This community-driven process can be more powerful than any externally imposed, single lead program or intervention you can think about.

Belinda: Yes – it is all of that. Any community can use the evidence-based Community Wide Campaign approach. It includes media, risk factor screening and health education, policy and environmental changes.

Community leaders in Brownsville and in Blue Zones could be thinking: “Hey, we’ve found a big piece of the puzzle to solve childhood obesity! Now all we have to do is tell the world and everybody will follow our example!” How much has this actually happened? Why isn’t it happening, or happening more?

Angela: We, in public health, are obsessed with replication. There may be some principles that can be used to guide others, but at the end of the day, the relationships and the process are going to be more important and transformative than any specific content we seek to replicate from one place to another.

Based on the success stories we’ve discussed today, what’s the most important step a community looking to improve the health of its population and encourage behavior focused on prevention needs to take?

Angela: Community building is about relationship building. It is relationship, relationship, relationship. One of the most important things for the wellbeing of a community and its members is to feel connected, to be socially and civically engaged, to have common goals and work toward those goals. A good place to start is setting the table for people to come together, build relationships and start to talk about what is important to the community, what are they doing and where there are opportunities to build on each other’s agenda. Another good thing to do is to build shared history – like neighborhood traditions of health related activities that become part of a shared culture. Finally, we must always remember that community-based work is an iterative process: we advance and win some, but sometimes we need to go back to the drawing board as we fine-tune our work in response to input from our community partners.

Karen: Take the long view to developing engaged, sustained community partnerships using the organizations that are active in different community settings. Community success stories often involve not only a focus on “evidence-based behaviors” such as decreasing screen time and sugar-sweetened beverages, but also the use of “evidence-based interventions” (tested with sound evaluation designs) put together to impact all parts of a child’s day – using a community based participatory approach or alternatively, a partnership model. The interface between communities and other “levels of influence” should be considered. In particular, communities are in a position to make sure the organizations most directly responsible for caring for children (schools, childcare, etc.) have the resources they need and that they are active participants in providing their views and expertise in how to solve obesity.

Belinda: Assemble a strong and action-oriented group of partners to establish a plan with short and long-term goals based on needs of the community. Definitely use an evidence-based approach to select strategies. Get started and don’t take no for an answer. You may have to regroup at times, but keep moving forward towards goals as a group.

Giving Sight to Innovation: Q&A with Uzma Samadani

Uzma Samadani is the cofounder of Oculogica, a neurodiagnostic company that, through eye movement tracking, specializes in detecting concussions and other brain injuries otherwise invisible on radiologic scans. She shared her journey of discovery on the TEDMED 2014 stage. We caught up with Uzma and learned more about her vision and methods of discovery.

Uzma Samadani at TEDMED 2014 discusses her eye tracking innovation for diagnosing brain injury.

“I hope people who hear my talk are inspired to work hard and make their own discoveries.” Uzma Samadani at TEDMED 2014. [Photo: Sandy Huffaker for TEDMED]

Who or what has been your main source of inspiration that drives you to innovate?

Necessity was the mother of invention, and serendipity the father. We sought to develop an outcome measure for a clinical trial for severely injured vegetative patients when we developed the eye-tracking algorithm that we subsequently realized could detect concussion. We had expected to use the eye-tracking algorithm to calculate how well people could pay attention and fixate their gaze, but then were surprised to find that it actually showed us what was wrong with the brain. Now that we have discovered this technology, we understand its implications: it enables us to detect previously ‘invisible’ brain injury. We are inspired, driven even, to innovate and make this technology available to everyone who has sustained trauma. We can help people who previously would not have had objective measures indicating brain injury.

Why does your talk matter now? What do you hope people learn from your talk?

My talk is not so much about brain injury directly as it is about a moment of discovery – the rare shock of finding something remarkable and considering its implications, then the doubt, and the concern about artifact. And then, the gradual realization that we have discovered something real and potentially extremely helpful for humankind. I hope people who hear my talk are inspired to work hard and make their own discoveries.

What is the legacy you want your work to leave?

Brain injury is the single greatest cause of death and disability for Americans under the age of 35 years of age. By creating a biomarker and outcome measure for injury, we can test treatments and therapies and also evaluate prophylactics such as helmets. The true measure of our success will be its utility: to other researchers, to clinicians and to the people who sustain injury.

How can we harness the power of imagination to innovate in the pediatric health space?

shutterstock_193115849Innovation in health today occurs incessantly. We see new ideas daily, and the progress we’re making is exciting. But, most of that progress is being made in adult health. While there are 75 million children in the United States today, too often we take the approach of treating children like “little adults,” despite the fact that they have an entirely different set of needs, and those needs change year by year. This lag in pediatric health innovation has inspired TEDMED’s Shirley Bergin to serve as a judge at this year’s inaugural Impact Pediatric Health Pitch Competition at South by Southwest Interactive. (By the way, if you’re innovating in pediatric health, you have a few more days to apply!)

So how can we harness the power of imagination to innovate in the pediatric health space? To gain a better understanding of the barriers facing innovation in pediatric health and how we can move forward, we interviewed a handful of pediatric innovators – including several TEDMED Hive alumni. Read on to hear what they had to say.

What do you think is the biggest problem facing pediatric health today? What can be done to address it?

  • Jessica Eisenberg, VoiceItt: Childhood disabilities are on the rise…Since we are a long ways off for a cure for many of these conditions, we can develop technology to greatly enhance their quality of life. We are living in an exciting period where the development in technology has the potential to break down the gaps between people with disabilities and society, and help them to be fully included in society.

  • Lynn E. Fiellin, play2PREVENT Lab: I think one of the biggest challenges facing pediatric health today, particularly around preventive health, is finding children and teens where they “are.” Healthy kids don’t engage in the health care system beyond “well-child” visits and kids with chronic medical conditions have a number of other issues to address. Beyond vaccination during early childhood, the provision of preventive care…is fairly limited. Innovations in technology focused on preventive care in teens allow us to engage teens and provide them with messages and skill-building to develop behaviors that can lead to lifelong health.

  • Kyle J. Rose, mySugr: One major challenge for parents and healthcare professionals alike is knowing how much independence to give to children regarding the management of their health. How much and at what point?…Educational initiatives…often result in outstanding clinical outcomes, not to mention increased quality of life for both the child and their family.

  • M. Jackson Wilkinson, Kinsights: Misinformation. Parents are in a state of constant information starvation, and as healthcare tightens its belt, they get less face time with healthcare professionals than ever before, and the advice they get from friends, family, and the Internet is usually not vetted. As with so many other fields, pediatrics (and parenting) is in need of a strong dose of information literacy, and it’s innovators who can help develop tools to help patients and parents find the right information for them, rather than playing a dangerous game of telephone.

Why do you think innovation in the pediatric health space often lags behind other areas? 

  • Amy Baxter, Buzzy: In pediatrics, patients aren’t as articulate about what bothers them in healthcare. You don’t have the option of “voting with your feet” when you’re carried to a doctor’s appointment in a car seat. And since children don’t make the financial decisions, they don’t drive the marketplace. Many pediatric products have to come from pediatricians or parents who see a need and have the empathy and time to make them reality.

  • Kyle Rose, mySugr: The pediatric health environment has stricter regulations, for good reason. However, unfortunately in the world of medicine this can add a significant barrier to enter this market. This is true whether it’s a start-up with a new medical device or even a major Pharma company.

  • Roberto Flores, SmileTrain: Children do not have a voice in science, in the government or in a medical office. They need others to speak for them…This is a unique aspect of pediatric care that affects everything from innovation to financial support for children’s health…Innovation in the pediatric space can lay the groundwork for innovation in the adult medical arena and vice versa.

  • M. Jackson Wilkinson, Kinsights: Everything is a little more complicated for a pediatric patient. Parents are often more protective with their child’s health than an adult might be with their own, so it can be difficult to get cooperation for even simple experimental care. Couple that with increasingly complicated privacy regulations, and it’s often just enough to dissuade interested entrepreneurs and researchers.

What can be done to spread the notion that children are not just “little adults” in terms of medical needs?

  • Jessica Eisenberg, VoiceItt: Because it’s more difficult to understand the symptoms and needs of a child, we cannot make a diagnosis and rehabilitation plan in a short office visit. More time and effort must be invested with children to build up their confidence in expressing their needs. The more understanding we have, the more we can spread this notion.

  • Lynn Fiellin, play2PREVENT Lab: The use of innovative methods of reaching kids is much more likely to have greater impact, given that kids now are growing up with innovative technologies and they are “hard-wired” to interact with and respond to them. Demonstrating the successful use of new innovations in pediatric health will help to show stakeholders that innovative health care for kids needs to be designed specifically for them, not only to reach them, but to have a sustainable effect.

  • Kyle J. Rose, mySugr: The healthcare system will need a fundamental shift from short-term to long-term visions, in particular from the payer perspective. Young people do have specific needs. We need to address those needs and also be there to support them as they transition from pediatrics to adults, a time period when they need us most and where patients often fall through the cracks of the healthcare system.

  • Roberto Flores, SmileTrain: A child is different at all phases of development. A person who holds a newborn infant, plays with a child in preschool, plays soccer with a middle schooler and debates with a teenager, will realize that at different ages children’s bodies work differently, heal differently, have different needs, and are often affected by distinct medical problems. As pediatric care involves so many different types of “people” the need for innovation in the pediatric space is that much greater.

How can we better assess pediatric healthcare needs and encourage companies to innovate in them?

  • Jessica Eisenberg, VoiceItt: Bringing together technological companies and associations that have a deep understanding the pediatric population is the key element needed to instigate innovation.

  • Amy Baxter, MMJ Labs: Parents are the best motivators.  Educate them about what is really important for health, and do it transparently…Ignoring parents’ intelligent regard toward their healthcare decisions makes the healthcare providers look suspect, and parents seek other sources of information.

  • Lynn E. Fiellin, play2PREVENT Lab: I believe the best way to assess healthcare needs, in kids, and all individuals, is to review the literature, [and] interview the stakeholders…Once you identify the areas in need, companies need to recognize that looking at new ways of reaching individuals, thinking outside the box, is much more likely to have the desired effect of engaging this population and connecting with them about their most relevant healthcare issues.

  • Kyle J. Rose, mySugr: We believe that the evidence is already there. It is critical to show payers and government systems that if young people are healthy when young that this leads to higher productivity overall. The health economics speak incredibly loudly. Governments could encourage companies via special programs and funding for such outcome-based initiatives.

What inspires you to work in this area?

  • Jessica Eisenberg, VoiceItt: Giving a child back his voice, witnessing an expression of love, a joke or saying he is hungry or cold is one of the most incredible and emotional sights you can witness. Few things are more rewarding than hearing individual stories of connection, love and gratitude on a daily basis.

  • Donna Brezinski, Little Sparrows Technologies: As both a pediatrician and a mother, I am inspired to innovate in the area of pediatric health because in many ways I see children as our role models for innovation. Children have very few predefined expectations of what the world should be, and as such, are boundless in their view of what is possible…As innovators we should emulate their openness to imagine so that we can envision what our world could be rather than be restricted by what it is.  Innovating for children grants us freedom to be hopeful for the future.

  • Lynn E. Fiellin, play2PREVENT Lab: Before I moved into this field, I was doing intervention research with many young adults struggling with the consequences of risk behaviors they had engaged in during adolescence—specifically risky sex and drug and alcohol use. I thought if we could “turn back the clock” and teach them the necessary preventive health skills when they were young teens, we could help them to avoid these serious health consequences.

  • M. Jackson Wilkinson, Kinsights: The families. Parents and families devote so much time, energy, and resources to doing their best to raise a happy, healthy child. When you see how devoted they are, it’s hard not to want to clear aside everything standing in their way. Sometimes it’s something as simple as making sure you don’t ask the same questions over and over, and other times it’s incredibly sophisticated, but there’s a ton of work to do, so I’m happy to pick up my shovel and get to it.

Brain in Progress: Why Teens Can’t Always Resist Temptation

by Nora Volkow, Director of the National Institute on Drug Abuse at the NIH

It’s National Drug Facts Week, when middle and high schools all over the country host events to raise awareness about drugs and addiction, with the help of scientists from the National Institute on Drug Abuse (NIDA). The issues I discussed in my TEDMED talk—the changes in the brain common to obesity and drug addiction—are especially pertinent to the struggles teens face to resist drugs, because adolescence is a crucial period both of susceptibility to the rewards of drugs and of vulnerability to the long-term effects of drug exposure.

“My obsession is to engage the health care system in addiction.” Nora Volkow on Nora Volkow at TEDMED 2014. [Photo: Sandy Huffaker for TEDMED.]

“My obsession is to engage the health care system in addiction.” Nora Volkow at TEDMED 2014. [Photo: Sandy Huffaker for TEDMED.]

Adolescence is a time of major brain development—particularly the maturation of prefrontal cortical regions involved in self-control and the neural circuits linking these areas to the reward regions. The prefrontal cortex, where we make decisions and comparative judgments about the value of different courses of action, is crucial for regulating our behavior in the face of potential rewards like drugs and food. Adolescents are prone to risky behaviors and impulsive actions that provide instant gratification instead of eventual rewards.  In part, this is because their prefrontal cortex is still a work in progress.

The incomplete maturation of the prefrontal cortex is a major factor in why young people are so susceptible to abusing drugs, including alcohol, tobacco, marijuana, and prescription drugs. There are numerous pressures in their lives to try these substances (stress and peers, for example), but inadequate cognitive resources to help them resist. Because their brain architecture is still not fully developed, adolescents’ brains are more susceptible to being radically changed by drug use—often specifically by impeding the development of the very circuits that enable adults to say “later” … or “not at all” … to dangerous or unhealthy options. Thus, when drug abuse begins at a young age, it can become a particularly vicious cycle. Research shows that the earlier a teen first uses drugs, the likelier he or she is to become addicted to them or to become addicted to another substance later in life. It is likely that the same dynamics are at play when it comes to fattening food and the brain’s reaction to it.

Though parents may get frustrated by their teens’ poor decisions at times, they usually forgive them—because on some level adults understand that kids’ internal guidance systems aren’t yet fully functional. People often have a harder time extending that same forgiveness to adults who suffer from addictions or obesity, because we think they should be better able to control their impulses.  But, the fact is that their internal guidance systems, too, are compromised. For such individuals, it is not a question of free choice or just saying no to temptation; in many cases, only externally offered support and treatment can create the conditions in which their guidance systems can be gradually restored to proper working order.

Averting obesity and drug use also requires that, as a society, we take responsibility for the environments we create for young people. Instead of school cafeterias with an array of cheap, tempting foods high in calories and low in nutrients, we must expose young decision makers to food options that strengthen their health and resolve. Instead of stress-filled or empty time that promotes drug use, kids need access to appealing, healthy, and meaningful activities that encourage them to take pride in themselves and their behavior. Arming young people with scientific information about their bodies, brains, and the substances that can affect them is also crucial—which is the goal of National Drug Facts Week.

Obesity and drug abuse are medical issues, not moral failings. It is gratifying to present the converging science clearly showing this in a forum like TEDMED, composed of people who are informed and curious about the latest medical science. My hope is that the general public becomes more compassionate about these issues, supports wider access to treatment, and understands the importance of greater investment in research on the dynamic ways our brain can be changed by our behavior and vice versa.

Neuroscientist Nora Volkow, director of the National Institute on Drug Abuse at the NIH, applied a lens of addiction to the obesity epidemic in her TEDMED 2014 talk. We are excited to share Nora’s original piece on the TEDMED blog.

Check out our archived Facebook chat discussion with Nora about food addiction from studying the brain chemistry of people with drug addictions.

Making Social Determinants a True Vital Sign: Last Week’s Hangout Participants Address Unanswered Questions

Last week, a multidisciplinary group of experts joined us for a Great Challenges live online event to discuss how we can work towards making social determinants of health a true vital sign. Moderated by Philadelphia NPR Senior Health Reporter Taunya English, these experts discussed ways to incorporate social determinants of health, such as housing and education, into everyday clinical encounters.

If you were unable to join us, please check out the recast below.

We had so many questions from our audience that our hour-long broadcast was not time enough to address them all (once again, thank you for sending your questions our way!). We asked Pedro “Joe” Greer, Professor and Chair of the Department of Humanities, Health, and Society Associate Dean for Community Engagement at the Florida International University, and Marc Nivet, Chief Diversity Officer of the Association of American Medical Colleges, to weigh in on a few additional questions. Read on to see their responses.

What does the typical medical school include in its social determinants training?

Marc: More than 90 percent of our medical schools include topics related to social determinants. Through the accreditation process, we know that most medical school curricula include didactic and experiential learning programs in community health, health disparities, population health management, and prevention and health maintenance. Medical schools are often starting earlier by integrating this content in premedical programs, like the Summer Medical and Dental Education Program, which includes lectures and community activities to expose aspiring medical students to these issues while in college.

Has it been tough to make room on the syllabus – and convince school administrators that social determinants training is important for future health care providers?

Marc: Through the NIH-National Institute on Minority Health and Health Disparities-funded national learning collaborative Urban Universities for HEALTH, we have learned that leadership involvement is key to transformational change within institutions that leads to measurable improvement in communities. Our project leadership includes presidents of universities as well as deans of several health professional schools including medicine. Because leaders are engaged, strategic plans include a strong focus on training providers that understand the social determinants of health. This has led to significant changes, which include the development of pipeline programs, incorporation of holistic admission practices, and curricula innovations that include training about social determinants.

Does a patient’s socioeconomic status ultimately influence physicians’ decision-making regarding management of patients?

Joe: Unfortunately it does, but by dealing with the social factors perhaps we can make determinations based on medical need, and not a patient’s income.

How do we measure social determinants outside of asking questions?

Joe: We are currently developing a new methodology with the RAND Corporation that is embedded in our electronic health records and Social Portal.

How can we improve health of patients when mental health services are often cut in public system?

Joe: Behavioral health should be intimately tied to physical health. At Florida International University, we are currently trying that model and have hired a psychiatrist to be on our family medicine faculty. We are also working with our social work school and their mental health therapist – as well as the nursing school.

What role does cultural competence play in the provision of care? Is maintaining cultural competence a responsibility of the provider?

Marc: Cultural competence training equips health care providers with a set of knowledge and skills to become responsive to the needs of all patients, not solely racial and ethnic minorities. Cultural competence training helps the provider critically consider how a multitude of factors may influence health and health behaviors including but not limited to their own biases, the patient’s culture, the health care system, and larger societal issues. Once licensed, physicians must participate in continuing medical education to stay current in their field, and this also includes cultural competence training. Hospitals and clinics also provide health care providers with on-site training.

Joe: Cultural sensitivity is vital to improving the health of our patients, from the culture of economics, regions of the USA, country of origin, generations in this country, education, sexual preference, religious beliefs, and on and on.

How might health literacy factor into the issue of social determinants as a vital sign? To what extent is it the physician’s role to educate patients?

Marc: An individual’s educational experiences, socioeconomic background, experience with the health care system and history of access to quality care influence health literacy. Physicians play a critical role in health literacy by working with the patient to assess their ability to understand and follow through on health-related information. Ultimately, it is the responsibility of the health care team and the hospital and clinic leadership to ensure that health information is easy to understand and useful to support the patient’s health.

Paging Dr. Salsa: Q&A with Gerardo Contino

Gerardo Contino, “El Abogado de la Salsa,” and former lead singer of the Cuban mega-group NG La Banda, invigorated the TEDMED 2014 audience with timba — a progressive, raucous style of salsa, with his band, Los Habañeros. We caught up with him to learn about his vision and impressions of TEDMED 2014 speakers.

Gerado Contino TEDMED 2014
Gerardo Contino y Los Habañeros on the TEDMED 2014 stage. Photo: Robert Benson for TEDMED.

What motivated you to perform at TEDMED?

I’ve understood the power of music to heal ever since I was nine years old and sitting at the bedside of my sister, who was diagnosed with an aggressive cancer at the age of 14. I’d sing to her and we’d play her favorite music tapes while she was recovering from surgery or chemotherapy. Music was the one thing that could make her smile during that time. After moving to the United States from Cuba, I began volunteering with a non-profit organization, Musicians On Call, where I sang at the bedside of sick children in order to provide them with some relief and variety. I wanted to share this power of music to heal with the TEDMED community.

What are the top three TEDMED 2014 talks or performances that left an impression with you?

Elizabeth Holmes (CEO, Theranos): Loved this talk because I really felt that they are revolutionizing science and the ways in which all of us as patients, can have access to our health information. It also made me think how useful this technology would have been for my sister when she was undergoing chemotherapy, as the doctors had difficulties finding her veins after a while.

Diana Nyad: This talk stood out to me and was so inspiring. She demonstrated that anything is possible at any age and this was very inspiring to me as an artist. She really demonstrated the saying, you can achieve whatever you set your mind to. And to top it all off, she was a great storyteller and really funny.

Tig Notaro: Tig’s talk really moved me. The fact that when she was at the height of her career, she was diagnosed with cancer and also underwent the personal dramas of losing her mother and breaking up with her partner, all in the span of a few months — that would take the life out of anyone. But instead, she turned it around and opened up to her audiences about what she was going through and used that as a form of not only coping with what was going on in her life, but also strengthening herself.

What is the legacy you want to leave?

A stronger community of Latino artists who are of Afro-Latin and indigenous backgrounds.

What’s next for you?

I’m releasing a new album in 2015 that includes a wider fusion of music, especially dedicated to mixing South American and Caribbean beats. I’m also developing a new project that will include an album and documentary about the various Afro roots of Latino music from African diaspora communities throughout the Americas. The album will feature fifteen songs from fifteen different communities throughout North, Central, and South America.

Discovering Beauty in Science: Q&A with Zachary Copfer

At TEDMED 2014, microbiologist and artist Zachary Copfer tells delightful stories about how bacteria became his artistic medium of choice.  We recently caught up with Zachary to hear more about him, his TEDMED experience, and what lies ahead.

Ultimately, I hope people see my work or watch my talk and say "Wow science is awesome, give me a lab coat because I want in on this!" - Zachary Copfer. (Photo by Jerrod Harris, for TEDMED).

Ultimately, I hope people see my work or watch my talk and say “Wow science is awesome, give me a lab coat because I want in on this!” – Zachary Copfer. (Photo by Jerrod Harris, for TEDMED).

Why does this talk matter now? What impact do you hope the talk will have?

I hope the talk will have the same impact that I strive for my artwork to have on viewers: to get people excited about science. Science is amazing, fun and beautiful! In my artwork, I have found a way to play with science to inspire in others the overwhelming sense of awe I feel when I step back and think of how complex and amazing the universe is.

Please list the top 3 TEDMED2014 talks or performances that left an impression with you, and why.

Naming the top three is almost impossible; I couldn’t even keep track of the number of talks that made me think “oh wow” or gave me goosebumps. Two speakers who instantly come to mind are Diana Nyad and Kitra Cahana. As amazing and awe-inspiring as I feel science to be, nothing can match the power of hearing stories about the human spirit. These talks both gave me goosebumps and had me tearing up a bit. Peggy Battin’s talk was another that left me thinking as I walked out of the auditorium. The issues she explored were issues that a lot of people don’t like to think about, let alone discuss. That makes it all the more important to have people like Peggy discussing them publicly so that others may start to feel more comfortable with them.

What is the legacy you want to leave?

The simplest way to put it would be to say that I want my legacy to be a smile. A shared smile evokes in other people an almost indescribable sensation. A genuine smile is a selfless act that makes other people feel welcome, connected and cared for in a way that few other expressions can communicate. A smile also says that life is fun and is meant to be enjoyed at every moment. To live a life that makes people feel the same way they feel when they receive a genuine smile would be the greatest legacy I believe one could leave behind.

What’s next for you?

To keep playing with science. To explore the aesthetic possibilities of scientific theories and to find ways to share them with others.

Sink or Swim, Do or Die: Q&A with Diana Nyad

Marathon swimmer Diana Nyad returned to the TEDMED stage in 2014 to share lessons of her world record-setting solo 110-mile swim from Cuba to Miami at age 64. We caught up with the open water swim champion about her TEDMED experience and what’s up next for her in 2015.

When you achieve your dreams, it’s not so much what you get, it’s who you become.” Diana Nyad on the TEDMED 2014 stage. Photo: Sandy Huffaker for TEDMED

What motivated you to speak at TEDMED 2014?

TEDMED 2010 was my first TED experience. The range and brilliance of the speakers blew my mind. These dedicated innovators are quite literally solving the medical mysteries of our time, and so I was both humbled and honored to appear on stage in their midst. It was a no-brainer to accept the 2014 invitation and to again mix in with our leading health and medical minds.

What kind of meaningful or surprising connections did you make at TEDMED 2014?

I found Marc Koska and his world-changing work with one-time-use syringes deeply moving. This is a classic tale of a man with a social conscience, determined to literally save millions of lives with plain determination. Thirty years ago, Marc was casually reading a magazine and it shocked him to his very core to learn how many millions of people worldwide either die of or are infected with horrific diseases, due to the use of contaminated syringes. He was shot down everywhere he went but eventually implemented the one-time-use needle that cannot be picked up and used to prick the skin a second time. Marc Koska is a shining example of both the work that TEDMED spotlights and those human beings who refuse to let humanity suffer when there are other choices.

How can we learn more about your upcoming book and one-woman show?

Knopf will publish my “Memoir of Inspiration” sometime in 2015. The world premiere of my one-woman show, “ONWARD!” will be on February 19022, 2015 at Studios Theater in Key West, FL and then we move to a bigger theater in Ft. Lauderdale the following weekend. We hope to develop the show for Broadway next!