Gaining Wisdom in the Family, Workplace, Community, and Society

By guest contributor and TEDMED speaker, Dilip V. Jeste, MD.

Wisdom is a complex human trait. It includes several components: 1) ability to make appropriate social decisions, 2) overall happiness coupled with control over emotions, 3) helping others through compassion and altruism, 4) self-knowledge and ability to reflect, 5) humility to know the limits of one’s knowledge, and 6) decisiveness when needed. I believe there is an evolutionary purpose to wisdom – it enhances individual well-being along with one’s usefulness to society. Wisdom includes much more than intelligence – that is why wise people are typically intelligent, but not all intelligent people are wise!

The basic concept of wisdom is similar across the globe and has been essentially unchanged over the known history of human behavior. However, there are some cultural differences. For example, spirituality would be considered an essential component of wisdom in some cultures, but not in others. Aging is associated with increased wisdom. As I mention in my TEDMED talk, wisdom likely compensates for the loss of fertility and of physical health that accompanies aging, and allows wise grandparents to transfer their life knowledge to younger generations.

Aging is associated with increased wisdom. (Image: Shutterstock.)
Aging is associated with increased wisdom. (Image: Shutterstock.)

How do these concepts of individual wisdom apply to the wisdom of larger groups such as a family, workplace, sports team, community, or society? A large majority of the members of a wise group would have high levels of wisdom; however, it is not necessary for all members of the group to be particularly wise. Indeed, it is more useful to have diversity in multiple forms including some individuals with varied levels of wisdom. A critical necessity is having wise leadership. Openness to new experience is an essential criterion for group wisdom, but not necessarily for individual wisdom.

A wise workplace will be productive and creative, but will also be happy. Businesses that focus solely on sales or profits would not be considered wise if they require constant or unhealthy competition among their members. Similarly, a collegiate sports team that seeks to win at all costs rather than to ensure high graduation rates and a milieu of collaboration, cooperation, and empathy toward less gifted competitors, is not a wise team, regardless of the number of championships it wins. The trick is in balancing a drive for excellence and hard work, with grace in defeat and magnanimity in victories.

How can wisdom be fostered in such groups? An important means would be through behavioral strategies. Wise parents seek to raise their children to be better decision makers, less impulsive, and with more control over their emotions, more caring of their siblings and friends, while avoiding egotism or ambivalence, and promoting self-reflection. Successful parents do not rely only on teaching their children to embrace these values; they also act as role models of such behaviors by reinforcing positive behaviors and not rewarding untoward ones.

Psychiatrists, psychologists, and other therapists and counselors seek to modify the high-risk behavior of persons with mental illnesses, such as delusions, aggression, or suicidal depression, with cognitive behavior therapy (CBT). The focus of CBT is on 3c’sCatch the untoward behavior, Check that it is unhelpful, and then Change it to helpful behavior. The same principles can be applied to replace unwise behavior with wise behavior at workplace, on sports teams, and in various businesses. While employees who sell the largest volume of products can be rewarded, so too should be rewarded the people who help develop a collegial milieu which increases other workers’ level of happiness leading to greater overall productivity. For example, in basketball, they would reward players with the most assists along with those who scored the most points.

The responsibility for making a group wise lies primarily with its leadership, which then makes sure that the culture promoting wisdom trickles down the chain of command, and reaches the workers on the lowest rung. Ultimately, promoting group wisdom is not merely a nice thing to do– it is a smart thing to do!

 



Dilip Jeste

 

In his TEDMED talk, geriatric psychiatrist and neuroscientist Dilip V. Jeste reveals how our brains compensate for physical aging, and discusses an unexpected evolutionary advantage to growing old–gaining sage wisdom–which holds great promise to benefit society as a whole. Watch Dilip’s talk here.

References:

Jeste DV and Vahia I: Comparison of the conceptualization of wisdom in ancient Indian literature with modern views: Focus on the Bhagavad Gita. Psychiatry 71:197-209, 2008.

Meeks TW and Jeste DV: Neurobiology of wisdom: An overview. Archives of General Psychiatry 66:355-365, 2009.

Jeste DV and Harris JC: Commentary: Wisdom – A neuroscience perspective. Journal of the American Medical Association 304:1602-1603, 2010.

Jeste DV, Ardelt M, Blazer D, Kraemer HC, Vaillant G, and Meeks T: Expert consensus on the characteristics of wisdom: A Delphi Method study. Gerontologist 50:668-680, 2010.
Bangen KJ, Meeks TW and Jeste DV. Defining and assessing wisdom: A review of the literature. American Journal of Geriatric Psychiatry 21:1254-1266, 2013.

Jeste DV and Oswald AJ. Individual and societal wisdom: Explaining the paradox of aging and well-being. Psychiatry 77:317-330, 2014.

Thomas ML, Bangen KJ, Ardelt M, Jeste DV. Development of a 12-item abbreviated three-dimensional wisdom scale (3D-WS-12): Item selection and psychometric properties. Assessment 24, 2015.

Meeks TW, Cahn R, and Jeste DV: Neurobiological foundations of wisdom. In Siegel R, Germer C (eds.): Wisdom and Compassion in Psychotherapy. New York, NY: Guilford Press. pp. 189-202, March 7, 2012.

Sanders JD, Meeks TW and Jeste DV: Neurobiological basis of personal wisdom. In Ferrari M, Westrate MN (eds.): The Scientific Study of Personal Wisdom. New York, NY: Springer. pp. 99-114, 2013.

The future of infusing art into anatomy

Achilles_anatomy
Greek street artist, Achilles, used the rooms of an abandoned building to create a spatial journey through layers of a human head, from the skull to the face.

By guest contributor and TEDMED speaker Vanessa Ruiz

Eaton-Houdon Écorché by Scott Eaton
Eaton-Houdon Écorché by Scott Eaton

When we talk about the future of medical illustration and learning anatomy, it’s often tied to advances in technology. What advances in technology will allow students to learn anatomy faster, allow them to memorize terms more efficiently, or provide better methods for them to interact with anatomy without actually touching a cadaver? But if you look at all of the resulting technologies, such as 3D anatomy apps, augmented reality organs, or virtual reality cadavers, the foundation still lies within an established ideal of anatomical representation. We’ve simply moved the same anatomical imagery from a textbook page to a screen. But instead of trying to change the medium by which we learn to technology, why not change the mindset of the approach to an artistic one, to engage a broader audience? Why shouldn’t the public, rather than just medical professionals, have access to learning anatomy?

Nearly 10 years ago it was difficult to find many artists featuring anatomy as a subject in their artwork. And I’m not referring to “the figure” as it is studied in art. I’m talking about the muscles, skeleton and viscera— what lies beneath the skin. Today the acceptance of anatomical art in pop culture is palpable. It’s pulsing in the trends of film, street art, advertising, interior design, and even fashion. A quick web search for “anatomical heart necklace” yields an overwhelming amount of resulting iterations. What is fascinating is that this anatomical art movement has risen exponentially alongside the rather stagnant practice of anatomy education. With all of the advances in medicine, the time and resources allocated to teach anatomy to medical students is diminishing. This is why students often turn to technology such as anatomy apps to supplement their learning.

Danny Quirk paints the musculature of the forearm on Anna Folckomer of Immaculate Dissection
Danny Quirk paints the musculature of the forearm on Anna Folckomer of Immaculate Dissection

But, as the boundary between science and art blurs, it is no longer sufficient to talk about either on their own. We need to see how each informs the other. This crossover between medical illustration, art, and anatomy learning is beginning to take place. We’ve gone beyond the “Anatomy Coloring Book.”

The dramatic anatomical body paintings by medical artist Danny Quirk, of Immaculate Dissection, are now used to teach anatomy to anyone from physical therapists to athletic trainers to bodywork practitioners; the technique has been so popular that it’s been replicated in anatomy classes around the world.

Sculpting anatomy by hand from the skeleton outward has become a means for not only artists to learn anatomy, but for medical students as well. This is where the distinction between viewing a body in 3D versus tangibly building a body becomes clear; building by hand requires spatial knowledge and memory– tying doing with learning instead of looking and memorizing.

The truest delivery of anatomy to the public takes the form of street art. A growing number of artists are vibrantly broadcasting anatomy on the streets in a vast array of styles. Street artists are pushing their work to be site specific and interactive.

heArtbeats by Lanoc
heArtbeats by Lanoc

Imagine the immersive experience of learning anatomy by walking through rooms of an abandoned building. As dynamic as Achilles‘ warehouse anatomy above, this piece by Croatian street artist Lanoc shows an anatomical heart pumping blood through industrial air ducts. It is site-specific street art, pulsing with life.

Austrian street artist, Nychos, is famous for his explosive views of anatomy. He recently started a series of anatomical charts using his edgy, hard metal style.

The Human Skeleton Anatomy Sheet by Nychos
Imagine seeing this in a doctor’s office: The Human Skeleton Anatomy Sheet by Nychos

While the public is embracing anatomical art, there are many medical professionals that still see medicine and art as two separate subjects. A radiologist approached me after my TEDMED talk and excitedly told me that she creates art from X-rays. When I asked her to see it she said that she never shares it because she doesn’t think it is special or it might be looked down upon by her peers. I encourage artistic expression in medical professionals because it is natural and deeply tied to medicine.

It can be argued that there are only so many ways to represent anatomy, but I counter that by all the astounding ways that artists are able to portray anatomy in their work. Artists have broken anatomy out of the confines of the medical world and are now beginning to reintroduce it back in with a whole new approach and style. The future of medical illustration doesn’t depend solely on advances in technology; it begs to be pushed further by artists. I feel compelled to showcase and catalog contemporary anatomical art, as well as promote the artists and medical illustrators that are pushing the boundaries of anatomical visualization. Because one day, they will be part of the history that leads to something greater– when the public will fully appreciate and understand its own anatomy.


Watch anatomical artist and curator Vanessa Ruiz’s TEDMED talk, in which she shares how she fulfilled her dream to take anatomy to the streets, and make medical illustration– and the resulting public knowledge of the human body– intersect with contemporary art. Check out her website, streetanatomy.com, which showcases human anatomy in art, design and pop culture.

What’s Missing From Engineering and How to Solve It

Sangeeta Bhatia
Sangeeta Bhatia

In her TEDMED talk, Harvard-MIT physician, bioengineer and entrepreneur Sangeeta Bhatia showed how miniaturization, through the convergence of engineering and medicine, is transforming health– specifically, through the promise of nanotechnology for early detection of cancer. She’s also been a huge advocate for the participation of women and girls in the Science, Technology, Engineering and Mathematics (STEM) fields. We asked her to share more about her dedication to empowering girls to develop their skills in the STEM fields.

engineering
What we desperately need: the best minds, and their talent.

 

TEDMED:

In addition to your work in bioengineering, medical research and being a professor, you’ve been a huge advocate for the participation of women and girls in STEM-related fields. How are these two strands of your work related?

SANGEETA:

They are absolutely related! We need the best and brightest minds to realize these kinds of technological visions. The engineering pipeline is only 20-25% female; only 3% of tech startups are led by women. If I look around at the workforce in engineering at the moment in our country, it’s only 11 to 12 percent women. And the data shows that we lose women from this discipline all the way along what we call the ‘leaky pipeline’ that starts at age 11 and progresses all the way through to the workforce and to the board room– presently 40 percent of women who earn engineering degrees quit the profession or never enter the field at all.

Some years ago, some colleagues and I at MIT started this organization, Keys to Empowering Youth, to target girls between 11 and 13 years old, the critical earliest age range at which girls drop out of engineering. We bring them into labs at MIT and other universities where they have hands-on experiences with experiments. Over the course of the day, these girls see how fun, exciting and accessible it can be. They meet women who are college students in the Society of Women Engineers and are a little further up the pipeline than them as mentors. And the girls ask their mentors questions like, What is mechanical engineering? Electrical Engineering? Computer Engineering? What is the job that you hope to do? Is it fun? And we have seen that they can definitely be inspired.

Here are my two daughters, wdaughter 1ho turned 9 and 12 this year, having fun in my lab! We need girls to be inspired, we need them to have mentors, and we need them to have role models. I hope that my talk on the TEDMED stage can inspire more girls all over the world to choose to develop their skills in engineering and deploy them to revolutionize human health. We would all benefit.

TEDMED:

Your lab is known for choosing and training people to work in an interdisciplinary way. How do you go about accomplishing this?

SANGEETA:

We consider ourselves a bioengineering lab focused on impacting human health so we tend to attract people across a spectrum of science, technology and medical expertise. We select people that are ‘best athletes’ in the sense that they’ve excelled in whatever they were doing, they complement our mission, are invested in our approach and play well with others. Once they arrive we tell everyone that they can spend 20% of their time ‘tinkering.’ Over the years, the students have started calling these ‘submarine’ projects. They surface them to me if and when they turn into something exciting. And if they never do, that’s okay too. The point is that science can be full of failure and we need ways to play and stay creative, motivated and engaged. It just so happens that some of our most exciting advances have come out of such submarine projects.

TEDMED:

You’ve spoken about the power of mentors in your own training. Can you talk about a mentor who has had outsize influence on your work and life and how they became such an effective mentor for you?

SANGEETA:

I’ve been fortunate to have a series of very powerful mentors in my training, all of whom saw more for me, at critical moments, than I saw for myself. The most influential mentor is my father who first encouraged me to become an engineer by bringing me to a friend’s lab at MIT to learn about the intersection of engineering and medicine. Later, he would also encourage me to become an entrepreneur. Last year, he was my guest of honor when I was inducted to the National Academy of Engineering and we got to celebrate the journey together. I believe that family aspirations for their children, and especially for young girls, are critically important to keeping the technology pipeline at its fullest.

In graduate school, my academic father, Mehmet Toner, encouraged me to become a researcher and a professor when it wasn’t anywhere on my radar. It’s so important to have people to take the time to say to someone you believe in, “You would be good at that.” As a mentor now myself, I try and remember to do this and I encourage others to do the same. Ultimately, it may be the biggest impact we make.

Radiation Doesn’t Scare Me: Negative health effects vs. relocation trauma

By guest contributor and TEDMED 2015 speaker Holly Morris

This spring marks the 30th anniversary of the Chernobyl Nuclear Power Plant accident in Ukraine, the world’s worst nuclear accident. Today, Reactor No. 4 simmers under its “sarcophagus,” a concrete cover hastily built immediately after the accident, now cracked, rusted and leaking radiation. Its long delayed “New Safe Confinement,” the structure being built to cover the reactor, has been repeatedly delayed, and is now years overdue. This story of nuclear disaster is in its early chapters.

Inside Chernobyl’s 1000-square-mile “Exclusion Zone,” known simply as “the Zone,” lies the most contaminated land on Earth, including hundreds of unmarked (and unmapped) burial sites where machinery from the clean up after the 1986 accident was dumped. These days, Ukraine’s four other nuclear power plants also dispose of their spent fuel inside the Zone.

But amidst the complicated real-life equations and compromises–where science and politics meet to duke out the viability of nuclear energy–the long, deep, human parable of Chernobyl is often lost. That story is partly embodied in an unlikely community of some 100 people, called “self settlers” who, today, live inside the Zone. Almost all of them are women in their seventies and eighties; they are the last of a group of some 1200 people who defied authorities and illegally returned home after being evacuated.

“Radiation doesn’t scare me. Starvation does," states Hanna, a babushka of Chernobyl (photos credit: Yuli Sollsken)
“Radiation doesn’t scare me. Starvation does,” states Hanna, a babushka of Chernobyl (photos credit: Yuli Sollsken)

One self-settler, Hanna, told me how she snuck through the bushes back to her village in the summer of 1986. “Shoot us and dig the grave,” she told the soldiers who nabbed her and other family members, “otherwise we’re staying.” Then she handed me a chunk of warm salo, raw fat, from her just-slaughtered pig.
Why would they choose to live on deadly land? Were they unaware of the risks, or crazy enough to ignore them, or both? These women see their lives, and the risks they run, decidedly differently.

It’s all about context– the women had already survived Stalin’s famines, and Nazi atrocities, and were simply unwilling to leave their homeland in the face of an enemy that was invisible–radiation.

So long as they were well beyond child bearing, self-settlers were eventually allowed by officials to return. Five happy years, the logic went, is better than fifteen condemned to a high-rise on the outskirts of Kiev. Despite the hardship, the wolves, the radiation – all of the women chose to return to be near the graves of their parents, and babies; to the villages, they say, where they know, exactly, where the sun will rise. There is a simple defiance common among them: “They told us our legs would hurt, and they do. So what.”
The benefits of hardy live-from-the land realities are complicated by an environment laced with radioactive contaminants such as cesium, strontium and americium. The upper estimates of the eventual Chernobyl death toll are in the tens of thousands. Thyroid cancers are sky high, and that Chernobyl evacuees have suffered the trauma of relocated peoples everywhere, including anxiety, depression, alcoholism, and disrupted social networks.

To be clear, the nuclear accident was a miserable tragedy that clobbered the health and economy of a region. But relocation trauma is another, less-examined fallout of Chernobyl. As one Chernobyl medical technician put it about the old people who relocated: “Quite simply, they die of anguish.”

Home is the entire cosmos of the rural babushka, and connection to the land is palpable. Chernobyl babushka sayings go, “Those who left are worse off now. They are all dying of sadness,” “When you live outside your village, you leave your soul,” “Motherland is Motherland. I will never leave.” The surprising truth seems to be that these women who returned home have, according to local officials and journalists, (and the women themselves) have outlived their counterparts who accepted relocation– by some estimates, up to 10 years.

How could this be? Certainly, their exposure at an older age put them at smaller risk. (Younger animals– this includes humans– are more susceptible to the effects of radiation.) But consider a less tangible though equally powerful idea. Does happiness affect longevity? Is the power of motherland, so fundamental to that part of the world, palliative? Are home and community forces that can rival even radiation? I believe so and without exception, the women of the Zone do too.

I’m traveling to Ukraine this spring to screen “The Babushkas of Chernobyl” with the film’s central characters, Hanna Zavorotyna, Valentina Ivanivna and Maria Shovkuta. They continue to gather mushrooms, brew moonshine, and scare off wild boars who would mess with their gardens. Radiation or not, the babushkas are at the end of their lives. In their 80’s now, they are frail, and smaller; it feels as if they are a whisper away from being gone. But their existence and spirit will live on, leaving us wondering about the relative nature of risk, about transformative connections to home, and about the magnificent tonic of personal agency and self-determination– unexpected lessons from a nuclear tragedy.

Check out the Babushkas of Chernobyl trailer:

The Babushkas Of Chernobyl Trailer by Holly Morris on Vimeo.


 

Holly Morris on the TEDMED stage (photo credit: Sandy Huffaker for TEDMED)Watch Holly’s TEDMED talk, Chernobyl: Flourishing lives in the dead zone.

Follow her @HollyMorris and learn more about Holly’s other projects at HollyMorris.com.

Healthy risk-taking for “at-risk” individuals

By Kayt Sukel, science journalist, TEDMED 2014 speaker and guest blog contributor

How can we encourage individuals from “at-risk” populations to take healthy  risks, when we can’t even agree on what risk actually is?

To start, I think we need to make sure that individuals, public health systems, and educational systems are using the same vocabulary when they discuss these kinds of issues. The word “risk” is used in so many different ways—and we tend to talk about it in rather contradictory extremes. “Risk is bad. It will lead to poverty, danger, and death.” Or, “Risk is good. It’s the key ingredient for happiness and success.” The truth, as is often the case, resides somewhere in the middle. As I learned while researching The Art of Risk: The New Science of Courage, Caution & Chance, work in neuroscience shows, more and more, that risk is a key component to learning and skill building. Yet, people still tend to talk around risk. There has recently been a more conscious effort, in the psychological and epidemiological communities, to try to use the term “risk” less—especially when the parties mean “impulsivity,” “sensation seeking,” or some other manner of negative behavior.

We also need to acknowledge that there is risk in every decision one makes, every single day. While the science shows that risk is necessary for learning and growth, that doesn’t mean it’s comfortable or easy. Saying yes to everything is exhausting. Being judged for the risks you take, especially when it somehow gets linked back to the color of your skin, your socioeconomic background, or your gender, is infuriating. Educators and other stakeholders need to understand that, for at-risk populations, putting yourself out there can come at a significant cost. Sure, in the long term, it may not be as great a cost as not pursuing an important professional or personal goal. But we should acknowledge that risk, especially one that makes you vulnerable to criticism and ridicule, is a scary proposition. And, if there isn’t some sort of scaffolding there (in the form of good mentorship, for example) it can be hard for at-risk individuals to see what the long term benefit of risk-taking could be. It’s important that we collaborate, as a community, to make sure that scaffolding is there–for everyone–so we do have room to encourage healthy risks.

The good news is that already have the tools in our arsenal to encourage healthy risk-taking in all populations. We’ve had them for a long time. It’s as simple as providing safe arenas in the arts, sports, and sciences where students even as young as elementary age can learn how to question, to innovate, to fail, to engage, and to move forward.

I know, it may seem like I’m contradicting myself. Risky behavior in safe arenas? What does that even mean? To me, it’s a matter of giving individuals, all individuals, opportunities to test themselves in new ways. Giving them places to do it where the cost of failure is not too great to bear. Time and time again, we’ve seen that music, art, theatre, science clubs, sports, and other extracurricular activities all provide opportunities for individuals to try new things and really work at the edge of their performance ability. This teaches those students key lessons in emotional regulation, problem solving, teamwork, personal responsibility, and perseverance. If we can make these arenas more inclusive, it’s there that we can empower females (both cis and trans) and LGBTQ populations—as well as other at-risk populations—to better understand their own strengths and weaknesses and, ultimately, develop really healthy risk-taking skills. The kind of skills that transcend the school and playground—and help them become more successful in everyday life, no matter what kind of goals they decide to pursue.

Unfortunately, these are exactly the kinds of programs that we keep cutting, both inside and outside schools. If we continue along that vein, it will not only be to the detriment to at-risk populations, but to society as a whole.

—————————————————————-

kaytJournalist and science writer Kayt Sukel shared insights into the neuroscience of risk-taking and how play during childhood and adulthood impacts the way we make decisions as adults in her 2014 TEDMED talk, Eliminating Penalties for Playing Out of Bounds. Check out her new book, The Art of Risk: The New Science of Courage, Caution and Chance.

Imagining a culture of healthier childhood

TEDMED speaker and pediatric endocrinologist Louise Greenspan has been a co-investigator in a uniquely comprehensive longitudinal North American study following young girls through puberty. We asked her to design a fantasy health intervention with unlimited resources. Here’s her vision:

Image courtesy of Shutterstock

We all know the expression, ”It takes a village to raise a child.” My fantasy intervention is based on that concept, however it expands on what the village is and what it provides. Today’s industrialized societies have fractured the extended family, resulting in most parents not having support from their own elders in raising their children. Many young parents don’t have the basic knowledge they need to support their growing families in healthy ways. While concepts about child rearing naturally change between generations, there is still a lot to be learned from those who have gone before us.

I’d love to support an intervention that provides education and assistance to families beginning from the moment they find out they are pregnant. The idea would be to start with pregnant mothers, by providing nutritional education and enhanced psychological and educational support, regardless of socioeconomic status. This education would take place in classes with members of the neighborhood who are also pregnant, thus building community.

After delivery, new parents would be encouraged to breastfeed and learn how to nurture their babies by visiting health workers who could come into the home. As the children grow, these home health workers would provide assistance and education to parents on how to feed their children, how to support their developing brains, and also how to discipline them. This way, parents could learn the facts they need to know, as well as start to develop a healthy authoritative approach to setting limits with their children. These trained workers would be available for parents to turn to for advice, to supplement the way some of us were once able to turn to our mothers and grandmothers for advice (but with the latest in knowledge and skills). The health workers would also set up support groups for families who live near each other or hold groups and classes as well.

At age 3, all children would be offered high quality preschool with a healthy lunch provided for all, and the parental support and education could continue, informed by these community schools. Parents would learn how to deal effectively with the challenges presented by their ‘threenagers’ and other toddler challenges. At entry to elementary school, the support and education would be augmented so that it would also be provided directly to the children themselves while also continuing with their families. All kids would have weekly lessons in cooking and healthy eating, and be active participants in growing and preparing healthy food at their school as part of the curriculum. Parents and guardians would participate in sessions about how to feed their children healthfully, assist their children educationally, as well as continue to be given tools about how to effectively parent their children.

Health Education would be taught to the children directly, starting in kindergarten with practical life skills, including cooking. In the early grades, the education might focus on the importance of eating a healthy balanced diet and on getting enough physical activity and sleep. As the children age, lessons would include classes on their body and health, with puberty education starting in third grade, separate from sex education, which could start in sixth grade. In third and fourth grade, children would learn about puberty and the body changes that will start and happen to everyone over the next few years. In middle school, kids would continue to discuss puberty, but would now have discussions about sex and sexuality. In high school, these topics would be discussed in more depth. The lessons learned about cooking, healthy eating, and exercise would continue throughout these years. There would also be age-appropriate mindfulness-based stress-reduction education through all of the grades, with an emphasis on this in high school. Parenting assistance and education throughout these years would reinforce these concepts and would perhaps also focus on how to enforce healthy sleep habits and limitations on screen time. The outcomes examined in this intervention would include rates of childhood obesity, early puberty, and psychological and educational diagnoses issues across the socioeconomic spectrum.

Could an intervention like this help reduce childhood health care disparities? Could it reduce parental stress and anxiety? Might it lead to more teens heading to college, thus reducing educational disparities? It is my dream to be able to study the effects of such a holistic, longitudinal, health education intervention. My hunch is that it could be game-changing.

Louise Greenspan is co-author of the The New Puberty: How to Navigate Early Development in Today’s Girls. Learn more by watching her TEDMED talk, “Weighing the causes of early puberty.”

Recognizing the TEDMED 2016 Research Scholars

Image courtesy of ShutterstockEach year, TEDMED relies on a carefully selected group of passionate, objective experts spanning the biomedical spectrum from across the globe, including faculty, post docs, graduate students, medical students, public health professionals, entrepreneurs, innovators and science journalists. These experts help assess the credibility of the science upon which TEDMED’s editorial priorities are based.

We deeply appreciate the time and energy our 2016 Research Scholars devote to enriching the quality of our curation process. We asked them to share more about their attraction to the program and their experience so far — here is what a few of them had to say:

“I’ve loved seeing the diversity of nominations, and the challenge of whittling down the array of fascinating people to those who will make a great TEDMED program,” says Layla McCay. “Having had the experience of being in the TEDMED audience myself, I know I want to encounter ideas I can trust, be thrilled by game changers, find synergies across disciplines, and start thinking differently about how things are done – and could be done. I’ve found the experience of reviewing nominations to be rather like a being a judge at The Moth storytelling show: how engaging are the nominees’ stories? Inspiring? True? How compellingly can nominees present their ideas to a discerning TEDMED audience? But it’s made even more interesting because I also have to ask: what’s the evidence behind nominees’ ideas, why are they the right people to speak on the topic, and how might these ideas have an genuine, meaningful impact on people’s health?”

Image courtesy of Shutterstock.“TEDMED makes a communication impact without oversimplifying research in science and health. This is my goal too. I wanted to learn with those who reach and inspire people across cultures from all walks of life,” observes Amy Price. “Reviewing nominations has opened my eyes to the value and power of hard work clothed in elegant simplicity.”

Maya Das wanted to be a Research Scholar in order to “contribute to a forum that brings together people who are seeking innovative solutions to tackle the complexities of health and medicine.” Her experience reviewing nominations has allowed her “to devote time to exploring current issues in health and medicine, to consider broader public policy questions related to clinical research, and to systematically examine what makes someone a credible and engaging ‘expert.’”

With great pride, we recognize the dedication of the 2016 class of TEDMED Research Scholars:

Ron Alfa, MA – Neuroscience, Medicine

Bhagwan Aggarwal, PhD, MBA – Healthcare Industry

Aimee Arnoldussen, PhD – Neuroscience, Medical Devices

Benjamin Bearnot, MD – Medicine

Christos Bergeles, PhD – Medical Imaging & Robotics

Alexander Blum, MS – Telecommunications, International Development

Edward Cliff, BMedSci (Hons) – Medicine

Maya Das, MD, JD – Clinical Research, Health Informatics

Lisa Fitzpatrick, MD, MPH – Medicine, Public Health

Jonathan Fritz, JD, MS – Healthcare IT

Mary Joy Garcia-Dia, DNP, MA, RN – Nursing, Healthcare IT

Holly Goodwin, MBA – Applied Physiology & Bioinformatics

Emilie Grasset, PhD – Immunology

Amy Ho, MD – Medicine

Andrew M. Ibrahim MD, MSc – Medicine, Health Policy, Design

Sherese Johnson, MPH, PMP – Public Health

Neeti Kanodra, MBBS – Pulmonary & Critical Care Medicine

Syed Khalid, BS – Medicine, Medical Devices, Neuroscience

Tamar Lasky, PhD – Epidemiology

Layla McCay, MBChB, MS – Health Policy, Psychiatry

Vanessa Mason, MPH – Digital Health

Maria Noviani, MD – Medicine, Cellular Therapy, Immunology

Madhukar Patel, MD, MBA, ScM – Surgery, Bioengineering

Bryon Petersen, PhD – Stem Cell Biology, Bioengineering

Miguel Pineda, MD – Medicine (Urology)

Amy Price, PhD – Neuroscience

Priya Raja, BA – Medicine, Public Policy

Sudah Yehuda Kovesh Shaheb, MD – Endocrinology, Medical Anthropology

Arpi Siyahian, PhD – Biotechnology

Jing Wang, PhD, MSN, MPH, RN – Nursing

Sebastian Wernicke, PhD – Bioinformatics

Teresa Wilson, MA – Healthcare IT

Flaura Winston, MD, PhD – Pediatrics, Behavioral Science, Injury Prevention

Wendy Youngblood, MA – Education, Humanities

Marta Gaia Zanchi, PhD – Digital Health, Biodesign Innovation

Charting the Next Course: Women Speak from a Mighty River

By Christine McNab, guest contributor. Can Tho, Viet Nam

She’s petite, yet stands tall and steady, strong shoulders and arms steering eight foot-long oars through a swift Mekong current. It’s dawn, and many women do the same, navigating their low wooden boats through a jigsaw of vessels at the Phong Dien floating market. Women here do a brisk trade in produce, exchanging pounds of watermelon, daikon, pineapple, cabbage, morning glory, onion and squash for Vietnamese Dong. The bounty from the Mekong Delta provides much of the food energy for Vietnam’s 90 million people. Women are at the heart of this essential commerce.

“Vietnamese women are often in charge of driving the small boats, and buying and selling at the fruit and vegetable markets,” says Maru, my guide. The work is taxing – a technique combining crossed arms and oars to nudge the boat through narrow spots; a one-legged start of a long motorized rotor for speed, and hours under a searing sun. Our driver, Tay, has been steering boats for more than twenty years. “Women here work very hard,” Maru tells me.

I want to find out a lot more about Tay and Maru, and I will this week as part of my new multimedia project, A River Runs with Her: the Lives of Women and Girls on the Mekong.

Near Can Tho, Viet Nam, March 2016. Photo: Christine McNab
Tay has done the hard work of steering boats on rivers and tributaries of the Mekong Delta for more than 20 years. (Near Can Tho, Viet Nam, March 2016. Photo: Christine McNab)

I’m devoting 2016 to this self-funded project for many reasons. For one, I believe attaining gender equality is at the heart of international development. Many studies, history, and a lot of common sense tell us that we can only make progress when women have the same rights, access to education, health, jobs and justice as men. Women have made great strides in much of the world, but in too many places, women and girls are simply valued less. Equality means equal value, and it also means equal voice.

We don’t hear from women enough. The Economist recently published an excellent essay on the importance of the Mekong River to biodiversity, culture, and Asia’s economy. I admired the reporting, but noticed there wasn’t a single female voice in the piece. Instead, women were in the kitchen making soup or in bars serving beer. I want to hear more from these women.

The newest international Global Goals for Sustainable Development, set by international leaders last September, include important targets for women’s equality, for education, health and participation in governance. The goals are hopeful and ambitious. I wondered what women living in communities along the Mekong think about these goals? What do they need to achieve them?

And then, there’s the mighty Mekong itself, a legendary, 2700-mile artery connecting six countries, many cultures and one of the most bio-diverse areas of the world. Its waters are a lifeblood for millions. As the climate changes, the Mekong, and the traditions and economic lives of millions are changing with it.

Tay doesn’t speak much as she drives her boat down a Mekong Delta tributary. But I want to know what she thinks about all of this. I think it’s her time, and time for all women, to tell the world what they think.

Learn more about A River Runs with Her project in this 1-minute video.

To follow the project, see www.ChristineMcNab.com, add http://www.christinemcnab.com/her-stories/ to your RSS feed, or follow along on Facebook.
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Christine McNab is a global public health worker and communications expert. Her TEDMED talk illuminates the story of how she combined her passions and partnered with the Gates Foundation to create what might be the most artistically crafted vaccine promotion campaign ever.

Precision medicine for understudied populations

by Roxana Daneshjou, guest contributor

Precision medicine, which leverages a patient’s genetics to help make medical decisions, has the potential to revolutionize medicine. Its applications are numerous: from predicting who may have an adverse reaction to a medication, to allowing targeted therapies of cancer with particular mutations. In 2015, President Obama’s State of the Union announced an initiative to further our understanding of precision medicine and to build the infrastructure to implement it. An important part of this initiative is building a large diverse research cohort to help discover disease-gene and drug-gene associations. The key word is diverse – because genetic risk factors can be population-specific. In the past, individuals of African, Hispanic, and Middle Eastern ancestry have been understudied. Only by including individuals from all different ancestral backgrounds can we hope to implement precision medicine in an inclusive way.

In 2011, Russ Altman’s research group was pondering the importance of inclusive precision medicine when it became clear that several studies examining the baseline genetic variation across the globe, 1000 Genomes and the International HapMap Project, had an underrepresentation of Middle Eastern populations. As a scientist of Iranian descent who had undergone direct-to-consumer genotyping with 23andMe, I wondered how to make sense of my data when no baseline genetic study of the Iranian population existed. When scientists Dr. Mostafa Ronaghi and Dr. Pardis Sabeti approached Dr. Altman’s group about the idea of creating such a baseline, I was immediately interested. Through the generous support of the PARSA Foundation, we began our journey to create a genetic baseline of the Iranian population.

Our first roadblock appeared when we spent months exploring the feasibility of collecting samples in Iran. Due to the economic sanctions at that time, it turned out that establishing a collaboration with an Iranian university and collecting samples there would be nearly impossible. In the United States, however, the Iranian diaspora has created a sizeable population generally representing the diversity of sub-ethnic groups in Iran.  We turned to this population to collect our samples and conducted high coverage sequencing of 77 healthy individuals. This data can be used for answering some questions about the population’s history and also as a baseline for scientists interested in studying disease in this population.

Since our aim is to enable other scientists to answer important questions about disease risk and treatment in individuals of Iranian ancestry, we are committed to sharing our data. Our website, irangenes.com, already has summary data of population level genetic variants. We’re currently working on uploading all of our genomic data on a secure server so that scientists can submit proposals to use our raw data.  Since the sanctions on Iran were lifted in January 2016, we have corresponded with scientists in Iran who are using our summary data to help advance precision medicine there. We are also working on uploading all of our genomic data to a secure server as a part of the precision medicine initiative so that scientists can submit proposals to use our raw data.

In addition to the medical applications, we were also interested in learning more about the Iranian population’s history through its genetics. Based on our data, the Iranian population is genetically distinct from other Middle Eastern populations. However, it is important to remember that any two humans share 99.9% of their genome. Moreover, as has been seen in previous studies in other populations, the different Iranian sub-ethnic groups have a lot of genetic overlap. Though capturing the breadth of human genetic diversity is important to inclusive precision medicine, these studies also show us that – at our core – we are a singular human family.

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Roxana Daneshjou is an MD/Ph.D. student at Stanford and is supported by the Paul and Daisy Soros Fellowship for New Americans.

New Genetic Spectra Across Earth’s Cities & Far Beyond

by Chris Mason, guest contributor

Since speaking at TEDMED 2015, there have been a number of updates to the science I described in my talk. These areas include: space genomics, beer-omics, extreme microbiomes, global city metagenome sampling, epitranscriptome discoveries in RNA viruses, and DNA as music in microgravity.

Image based on images courtesy of ShutterstockSpace Genomics and Genomic DJs

First, we have completed the first whole-genome sequencing profile of two astronauts’ genomes (the Kelly Twins). Also, in collaboration with our NASA collaborators, (Aaron Burton and Sarah Castro-Wallace) we have been sequencing DNA in microgravity; this will be used for 2016 plans to send an Oxford Nanopore Sequencer onto the International Space Station with astronaut Kate Rubin. We are preparing for the return of astronaut Scott Kelly to Earth next week, and are strategizing how to make genome-guided medicine a part of the standard of care for new astronauts. Our goal is to monitor, protect, and potentially repair astronauts’ biology through an integrated view of the layers of the genome, transcriptome, proteome, all the epi-omes, and the microbiome.

In collaboration with Harvard Medical School’s Consortium on Space Genetics, we’ve formally launched a new research focus for Weill Cornell medical students on the study of space genetics and aerospace medicine. This allows new medical students to learn and train in the methods of space genomics, data analysis, and new technology development for space missions. They’re also trained in synthetic biology, materials science, nanofabrication, microbiome engineering, and gene drives. These skills are taught in our class called “How to Grow Almost Anything (HTGAA) – NYC” that is part of the BioAcademany. Work by Elizabeth Hénaff in the 2015 class also helped with our plan for the Gowanus Canal and extreme microbiomes.

Extreme Microbiomes

Microbiomes can lead to a bounty of discovery for new biology, drugs and molecules. We have been systematically hunting for these microbes around the world as part of the eXtreme Microbiome Project (XMP). Among those sampled sites, we have already found that Brooklyn’s Gowanus Canal, a SuperFund site, holds a suite of unique and potentially protective microbes, and we have been designing artificial sponges to hold these in the canal during the remediation process. This is part of a larger project of urban microbiome monitoring and design, called the Brooklyn Bioreactor, which is a collaboration between our laboratory at Weill Cornell, the landscape architecture firm Nelson Byrd Woltz, the Gowanus Conservancy, and the community laboratory Genspace. Lastly, in collaboration with Shawn Levy at HudsonAlpha, we have started collecting data about beer microbiomes, which show an interesting blend of differences depending on the yeast strain used.

Global Metagenome Collection Day

The Metagenomics and MetaDesign of Subways and Urban Biomes Consortium has now reached 43 cities around the world, and a global City Sampling Day (CSD) event is planned for June 21, 2016, to match the collections of the global Ocean Sampling Day (OSD) group. These seasonal molecular snapshots will begin to expand our search for novel microbiomes, new molecules, will aid us in mapping the distribution of antimicrobial resistance (AMR) markers, and enable a better understanding of urban biology and ecosystems.

Epitranscriptome Discoveries and Sounds of RNA

Last but not least, we have just published the first demonstration of another realm of RNA modifications, collectively called the “epitranscriptome.” Specifically, we show that HIV’s RNA genomes also harbor modified RNA bases, and they impact how infectious the virus may be for a patient. We are now on a search across all RNA viruses to see how common these types of modifications are. We are also working to get direct RNA sequencing in nanopores operational, to enable listening to the “music” of the genome as it moves through the pore, as we demonstrated was possible with single enzymes in 2012. These methods and algorithms can help us discern new and peculiar nucleic acids that might be found not only in our lab, but in far-flung places on Earth and beyond.

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In his TEDMED 2015 talk, geneticist and urban metagenome researcher Chris Mason of Weill Cornell Medicine shares how he’s mapping his expertise into the distant future of outer space in the interest of humanity’s interplanetary survival.