From the category archives:

Innovators’ stories

Judy Wang, MS, is a program manager in the Telehealth Program at Boston Children’s Hospital. She is currently serving on the Mayor’s ONEin3 Council, which works on projects dedicated to maximizing the positive impact that young people have on the City of Boston.

young health tech entrepreneurs

(ITU/Rowan Farrell creativecommons.org/licenses/by/2.0/legalcode)

If you Google the term “millennials,” you’ll see that Google automatically fills in such search terms as “millennials lazy,” “millennials spoiled,” “millennials trophy kids” and “millennials entitled.” Ouch.

As part of the Mayor’s ONEin3 Council and a Founding Hacker for MIT’s H@cking Medicine, I could not disagree more with this assessment of my generation. I’ve observed young people increasingly drawn to civically minded work with public impact—including work in health tech. Full story »

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Thomson Reuters most highly cited scientists

It’s not every day you wake up and find out you’ve been named one of the most influential people in science. But that day recently came to seven Boston Children’s Hospital researchers, when Thomson Reuters named them as some of the most highly cited scientists in the world.

Every few years, the information broker and news outlet combs through its Web of Science and InCites systems—which track the scientific literature—to see whose work other researchers consistently refer to in their papers. It then creates two categories: highly cited papers (those that “rank in the top 1 percent by citations for their field and year of publication”) and hot papers (ranking “in the top 0.1 percent by citations for their field”). Full story »

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Clinical excellence is the foundation of patient care. But at a recent TEDx Longwood event, Elaine C. Meyer, PhD, RN, co-founder and director of the Institute for Professionalism and Ethical Practice at Boston Children’s Hospital and an Associate Professor of Psychology at Harvard Medical School, offered insight on the other half of the health care equation: the human connection and the power of conversation.

Meyer’s moving presentation makes clear how communication—listening and sharing words of comfort—profoundly impacts patient experiences, as does its absence. Through heartfelt stories, including her own experience as a patient, her talk empowers physicians, nurses, social workers, psychologists and other medical staff to “be present” and communicate with patients and families compassionately.

“Dig deep, find your inspiration to have conversations,” Meyer says, because patients remember the words spoken to them and how those words made them feel.

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Drug-eluting contact lens

(Credit: John Earle Photography)

Growing up, my grandmother’s eyes were always a problem. For years, she was losing her central vision to glaucoma, and numerous surgeries and treatments did not seem to help. Later in life, she could not see my face but could always tell who I was when I was close.

Glaucoma is the leading cause of irreversible blindness worldwide. While FDA-approved medications such as latanoprost can prevent vision loss by reducing pressure in the eye, their beneficial effects are limited by poor patient compliance: At six months of treatment, compliance is estimated to be little more than 50 percent.

Why? First, the medications are typically delivered as eye drops, and the drops themselves can cause stinging and burning. The drops also contain preservatives that can cause ocular surface disease.

Perhaps most importantly, latanoprost and other glaucoma drugs halt the disease’s progression but do not reverse it. Taking the drugs does not provide positive feedback that will motivate patients, such as relieving pain. Full story »

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Wong-Baker pain faces subjective objective pain assessment systems neuroscience David Borsook

Subjective measures of pain, like the Wong-Baker face scale (above), are useful in assessing patients' pain, but objective measures would be far better.

“How much pain are you in?” It’s a harder question than you think. Tools for assessing patients’ pain—be they children or adults—rely on their perception: a subjective measure that eludes quantification and can change in response to any number of emotional, psychological or physiological factors.

Being able to objectively quantify pain could open the door to better pain management (especially for patients with chronic or neuropathic pain), better anesthetic dosing during surgical procedures, better understanding of addiction (and how to avoid it) and more.

To do so, we need measurable markers: physiologic parameters that reliably and quantitatively change during the experience of pain. But according to pain researcher David Borsook, MD, PhD—of Boston Children’s Hospital’s departments of Anesthesiology, Perioperative and Pain Medicine and Radiology—discovering such markers requires a better understanding of the larger context and of events that trigger pain, a perspective he refers to as “systems neuroscience.” Full story »

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Old car aging blood cell hematopoietic stem cell blood disorder Derrick Rossi

Like an old, unused car, our aging blood stem cells can accumulate damage over time that they can't fully repair.

My first car was my grandfather’s 1980 Chevrolet Malibu. For about two years before my family gave it to me, it sat unused in Grandpa’s garage—just enough time for all of the belts and hoses to rot and the battery to trickle down to nothing.

Why am I telling this story? Because it’s much like what happens to the DNA in our blood-forming stem cells as we age.

Hematopoietic stem cells (HSCs) spend very little of their lives in an active, cycling state. Much of the time they’re quiescent or dormant, keeping their molecular and metabolic processes dialed down. These quiet periods allow the cells to conserve resources, but also give time an opportunity to wear away at their genes.

“DNA damage doesn’t just arise from mistakes during replication,” explains Derrick Rossi, PhD, a stem cell biology researcher with Boston Children’s Hospital’s Program in Cellular and Molecular Medicine. “There are many ways for damage to occur during periods of inactivity, such as reactions with byproducts of our oxidative metabolism.”

The canonical view has been that HSCs always keep one eye open for DNA damage and repair it, even when dormant. But in a study recently published in Cell Stem Cell, Rossi and his team found evidence to the contrary­­—which might tell us something about age-related blood cancers and blood disorders. Full story »

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Tracking patients between clinical visits

A randomized trial will soon test whether web-based updates from parents and teachers improve outcomes in ADHD, autism and more.

Eugenia Chan, MD, MPH, is a developmental-behavioral pediatrician and health services researcher in the Division of Developmental Medicine at Boston Children’s Hospital. She runs the Developmental Medicine Centers ADHD Program and is co-developer of ICISS Health, a web-based disease monitoring and management system.

When I set out with my collaborator Eric Fleegler, MD, MPH, to build a web-based tracking system for children with attention deficit hyperactivity disorder (ADHD), we focused on a single problem—getting parents and teachers to fill out symptom questionnaires in time to help doctors make informed clinical decisions at follow-up visits. We had no inkling of the possibilities that this kind of software platform could hold, or how it might grow in the future. Full story »

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Alina Morris, Archivist, Boston Children’s Hospital, contributed to this post.

In 1914, Boston Children’s Hospital, then simply called The Children’s Hospital, constructed the 145-bed Hunnewell Building, joining Harvard Medical School as one of several founding members of the Longwood Medical Area.

As the hospital’s oldest continuously occupied building, Hunnewell has presided over many of the century’s great medical advances and innovations. We celebrate a portion of them in this slideshow honoring Hunnewell’s 100th anniversary—and invite you to help write the next 100 years of history October 30-31 at Boston Children’s Global Pediatric Innovation Summit + Awards 2014.

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Surgical Sam beating heart pediatric trainer mannequin simulation Simulator Program The Chamberlain GroupWe often see medical magic in Hollywood, but it’s not often we see Hollywood magic brought into medicine. Now, Boston Children’s Hospital’s Simulator Program and special-effects collaborators at The Chamberlain Group (TCG) have done just that.

Simulation has become a key component in team training, crisis management, surgical practice and other medical training activities. With simulation, medical teams can add to and hone their skills in an environment where people can make mistakes without risking patient harm—”practicing before game time,” says Boston Children’s critical care specialist Peter Weinstock, MD, PhD, who runs the Simulator Program.

Mannequins are a key part of simulation, and Weinstock’s team, working together with companies, designers and engineers, has developed eerily lifelike ones that can bleed and “respond” to interventions based on computer commands from a technician.

But there are some things Weinstock’s mannequins haven’t been able to capture up to now, like the movements of a beating heart.

That’s where TCG and a new mannequin called Surgical Sam come in. Full story »

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Bioengineered blood vessels

A bioengineered network of blood vessels

Juan Melero-Martin, PhD, runs a cell biology and bioengineering lab in the department of Cardiac Surgery at Boston Children’s Hospital. In May, he received an Early Career Investigator Award from Bayer HealthCare, part of the prestigious Bayer Hemophilia Award.

In 1982, insulin became the first FDA-approved protein drug created through recombinant DNA technology. It was made by inserting the human insulin gene into a bacterial cell’s DNA, multiplying the bacteria and capturing and purifying the human insulin in bioreactors. Full story »

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