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Family

Panic during birth emergencies can lead to patients dying. These women have a solution.

True
Johnson & Johnson

As a midwife, Tiffany Lundeen's heard her share of emergency scenarios gone wrong. But there's one that keeps getting replayed over and over:

A health care provider who's still learning the ropes comes up against a hemorrhaging mother, and there's no one with more experience on call. As the panic sets in, the procedures that were once easy to remember in training fly out the window.

Paralyzed by fear, the provider doesn't take any actions to save the mother's life and ends up referring her to a nearby hospital. Because the referral process takes some time, the mother bleeds out on the way there.

Since postpartum hemorrhaging (PPH) is the leading cause of maternal mortality worldwide, this scenario can happen just about anywhere. However, it's most common in developing countries where clinics are often manned by providers who aren't experienced in emergency protocol.

That's why Lundeen, together with her friend, Dr. Dilys Walker, decided to develop a smart tool to help guide providers through lifesaving PPH procedures.

[rebelmouse-image 19346939 dam="1" original_size="700x358" caption="Photo via UCSF VirtualMentor/YouTube." expand=1]Photo via UCSF VirtualMentor/YouTube.

Walker and Lundeen work together at the University of California at San Francisco (UCSF) Global Health Sciences. During a discussion they had back in 2017, the two women realized that a major impediment to maternal and newborn emergency care was the Safe Childbirth Checklist.

Basically it's a list that helps birth attendants remember all the essential preventative practices that can effectively diminish the rate of maternal and newborn mortalities.

The problem, however, is that the list is written down.

"In terms of my workflow in taking care of women and babies during childbirth, using a paper checklist wouldn't be very practical for me," Lundeen explains. "I'd rather have something that could prompt me audibly."

This makes even more sense in an emergency situation — how can providers keep checking a list when they're in the middle of trying to save a life and grappling with all the stress and panic that comes with that?

While a mentor who provides audible, step-by-step instructions seemed like the perfect solution, they wanted to be sure it would work in places that needed the most help.

So they took the idea to Kenya.

A nurse during a PPH simulation in Kenya. Photo by Melanie Wise, used with permission.

They partnered with Dr. Anthony Wanyoro, an OB-GYN who's on staff at Kenyatta University and at two maternity hospitals in Kenya. Wanyoro has long been dedicated to reducing maternal mortality rates in Kenya, so from the moment Lundeen and Walker proposed what they were calling the Virtual Mentor to him, he was on board.

"The idea of bringing an expert in the room to help focus, guide, and center everyone sounded like the right thing," Walker says.

Walker had actually been working for years with a nonprofit called Pronto International, which helps train birth attendants through simulation all over the world. That, along with their partnership with Wanyoro, provided the perfect platform to test out the Virtual Mentor in real-life settings.

For the past year, Lundeen, Walker and Wanyoro have been working with health care providers in Kenya to make sure the steps and language their prototype will use are the most helpful. It's been a lot of trial and error, but the nurses and midwives have been incredibly receptive and optimistic about their work.

Wanyoro in a brainstorming session in Kenya. Photo by Melanie Wise.

According to Lundeen, during testing, many of the midwives said, "As soon as I heard the voice, I didn't feel scared anymore because I knew I wouldn't forget to do the right thing."

The project's still in the very early stages, but thanks to the funds they've received from being a GenH finalist, they've been able to get going on their prototype's software.

GenH acknowledges and rewards innovators who are taking world health care to the next level. Needless to say, Lundeen, Walker and Wanyoro fit the criteria.

Aside from the monetary help, GenH has provided the medical practitioners with invaluable resources to help them turn their clinical idea into a model that can be reproduced anywhere.

Once they have a fully functional prototype, they plan to do rigorous testing to see just how much of a difference being aided by a virtual mentor makes to health care providers during a birth emergency.

If the testing ultimately shows its usefulness, they hope to one day develop software for a whole host of emergency birth scenarios, including pre-eclampsia and newborn resuscitation. They also want the mentor to be able to log what procedures providers complete, which in turn will cut down how much providers have to document after the fact — a major frustration in the medical profession.

Lundeen can already see the positive impact her innovation is having. And one day, in the not too distant future, she can see the difference it could make in any medical emergency where experts are lacking.

[rebelmouse-image 19346944 dam="1" original_size="700x355" caption="Lundeen and Walker perform a PPH simulation. Photo via UCSF VirtualMentor/YouTube." expand=1]Lundeen and Walker perform a PPH simulation. Photo via UCSF VirtualMentor/YouTube.

"We know exactly how useful it could be," says Lundeen. "And we are totally committed to working and thinking through all the technical and clinical challenges."

If the guesswork in medical emergencies was taken out of the equation, doing nothing out of fear or to avoid liability would become a thing of the past. In fact, what were once dubbed life-threatening scenarios might be permanently downgraded to run-of-the-mill.

And it's all thanks to three medical professionals who recognized the importance of having your hands free.

Family

If you know someone who might be suicidal, here are 12 helpful suggestions from experts.

A lot of people in the United States live with suicidal thoughts.

One study suggested that about 15% of Americans will have suicidal thoughts in their lifetime. About 40,000 Americans die by suicide each year.

I could tell you more statistics too, like how more than half of those are by firearm or how men are three and a half times more likely to die by suicide than women. I can tell you a lot of statistics. And those statistics are important. But for most of us, they're just numbers.

But when it's not just numbers — when it's your dad, spouse, or someone you love who you think is in danger — what the heck are you supposed to do?

This is a situation that, unfortunately, some of us might have to deal with one day. And it can be incredibly scary.

But there are things we can do and words we can say that situation. Dr. Christine Moutier, chief medical officer for the American Foundation for Suicide Prevention, gave me a few tips for how to start that conversation:

1. Trust your gut.

There are some definite warning signs and risk factors for suicide, such as the person saying they feel they have no reason to live or if they've made suicide attempts before. But there can be subtler clues as well, such as giving away prized possessions or withdrawing from friends and family. So if something sets off your radar, it's important to act on that.

"If your gut is telling you something, trust it," said Moutier.

2. Be the one to take action.

Photo from iStock.

Let's say it was your dad who you were worried about. It's natural to want to wait and talk with the rest of the family before reaching out to him. But unfortunately, what sometimes happens is that while everyone is talking about how Dad needs help, nobody is actually talking to Dad.

Instead, Moutier said, you should act as if you're the only person who has noticed. Be the person who reaches out.

3. Don't worry about being the "right" person.

Sometimes we might feel like it's not our place to bring up our worries. Continuing the Dad example, we might think, "Oh, well, he's much closer to Mom than he is to me." But people can be really good at hiding things.

Again, you should act as if you're the only person who has noticed. Because you might be.

4. Set up a heart-to-heart.

Photo from iStock.

When you're ready to talk to the person, schedule a private conversation. It doesn't have to be dramatic. Even just a basic "I'd like to talk to you about something" or an "I just want to check in and see how things are going" can work.

The idea is to make sure they know it can be a private, personal conversation.

5. Once the conversation is started, say what made you worried.

Be direct about what tweaked your radar. "You've been drinking more lately, and talking a lot about feeling overwhelmed and trapped. How are things going? What's on your mind?"

"That lets the person know there's a reason that you're concerned and you're not hiding information from them," said Moutier. "You're being very direct."

It's OK to not bring up many specifics or your worries about suicide just yet. Leave it open-ended and let them talk about what's on their mind.

6. Then just listen.

Photo from iStock.

Your goal right now is to just understand what they're going through. Though it might be tempting to offer solutions, people who are seriously in trouble have likely already spent a lot of time and mental energy trying to figure out their problems. What they need right now is a release valve, not a life coach.

7. If you're still worried — even a little bit — ask directly about suicide.

At this point, they may or may not have already talked about suicidal thoughts. But if there's even a shadow of a doubt in your mind, it's OK to ask about it.

When you do, be direct. Calm, yes, but direct. Something like: "When you’re feeling this way, does it ever get to the point where you’re thinking of ending your life?”

8. Seriously. Be direct.

Sometimes we feel afraid of saying something blunt. We might be afraid the person will get mad or that we might plant the idea in the person's head or somehow make the situation worse.

"In fact, the research shows that it actually does quite the opposite," said Moutier. "For people who are having suicidal thoughts, it's almost like this sense of relief to be able to discuss what's been on their mind."

9. If it turns out they are experiencing thoughts about suicide, help them get help.

The veteran population is disproportionately affected by suicide too. Photo from iStock.

A lot of suicidal people might be afraid of the stigma surrounding suicidal thoughts, or they might feel like they're too far gone to help. But sometimes all a person needs is someone else to give them permission.

So open up the dialogue. Something as simple as "I'd think the world of you if you made an appointment with a doctor" might be enough to get them started.

10. If you think they are in immediate danger, try to keep them safe and call someone.

Sometimes a person may be having suicidal thoughts but no definite plan or means.

But if the person actually does have both a plan and the means to carry out that plan, you may be beyond judgment calls. In that case, stay with them, try to remove anything that could be dangerous like firearms or pills, and call either 911 or a suicide helpline. (By the way, they can also talk to you on behalf of someone else.)

11. Whether they're suicidal or not, try to follow up with them later.

It can never hurt to just check in and see how they're doing.

12. Finally, take care of yourself.

As you're taking care of someone else, it's important to also be taking good care of yourself. Make sure you have your own emotional support network and, if needed, talk to a professional yourself.

Talking to someone who you think is suicidal might be scary.

But it can also be a win-win. If nothing else, you get a heart-to-heart with a friend or coworker, and you'll show them you're there to support them. And if it's serious, you might help save a life.

Family

Diseases, beware: A chemist may have found a way to detect you sooner.

Imagine being hit with a dangerously high fever hundreds of miles away from the nearest hospital.

You live in a rural area, have little money for treatment or transportation, and don't have an easy way to physically get to the hospital.

When you're eventually able to see a doctor and take some tests, that's when he tells you some disconcerting news — you have malaria, your condition has already worsened, and now your treatment options are limited.

If only there had been a way to find out sooner, when more could be done.

The streets of Timbuktu in Mali. Image via iStock.

That's the harsh reality many people face in sub-Saharan Africa when it comes to malaria.

According to UNICEF, more than a million people die from malaria each year, and 90% of those cases of malaria occur in sub-Saharan Africa. What's even more heartbreaking is that the majority of those deaths are children under the age of 5.

Malaria also hurts the continent economically — Africa loses up to $12 billion every year due to a loss in productivity.

A close-up of the culprit. Image via CDC Global/Flickr.

Luckily, chemists at Ohio State University are developing a way to test for malaria without having to visit a doctor.

And all the patient needs is a piece of paper!

This would help people get malaria diagnoses sooner — if the test is positive, they know it's critical to go to the doctor, and when they do go, it would already be for treatment and not just for testing.

Currently, patients can take a Rapid Diagnostic Test (RDT) to find out if they have malaria or not, but the climate in Africa combined with the considerable expense of the test often prevent it from being an option. However, these are issues a new home test can address.

Image by Pam Frost Gorder, used with permission.

The man leading this charge is Abraham Badu-Tawiah, an assistant professor of chemistry and biology at Ohio State.

Having grown up in Ghana, he knew he wanted to come up with a way to provide an accurate diagnosis for people far away from a proper medical facility.

"Our main motivation is really to get to know whether you’re sick or not sick early enough so that we don’t wait or think it’s too late," said Badu-Tawiah. "If it’s just in the initial stages, you can actually take your time and do something to focus on getting well."

So how does this piece of paper work?

As a patient, all you would need to do is put a drop of blood in the reservoir, fold the paper in half, stick it in an envelope and then mail it to their lab. After a round of testing, you get your results. That's it!

Image by Pam Frost Gorder, used with permission.

The paper itself uses a special wax ink that creates a barrier to keep the blood sample in place. It's also charged with ionic probes that can tag the specific antibodies that act as biomarkers (basically, indicators) of a particular disease. Even better, the ionic probes aren't affected by light, temperature, or humidity and can keep the sample intact for up to 30 days — ideal for patients in sub-Saharan Africa.

Once the lab has the paper, they just dip it in an ammonia solution, peel the layers apart and put it in front of a mass spectrometer — the device that can find the disease biomarker and tell whether someone is sick or not.

Right now, the testing needs to be done in special labs because mass spectrometers aren't immediately available in developing nations and they're very expensive. However, smaller, less expensive ones are already in the process of being developed. So help is on the way!

It's also possible to use this device to test for certain cancers. In time, hopefully all of them.

In the Journal of the American Chemical Society, Badu-Tawiah and his colleagues state that they can test for any disease where the human body produces antibodies. This includes ovarian cancer and cancer of the large intestine.

But they're not stopping there.

"It will cover all kinds of cancer eventually when we advance in knowledge," added Badu-Tawiah. "What we need is to be able to identify a specific biomarker for each cancer."

The paper is designed to be very affordable at just 50 cents a piece.

Image by Pam Frost Gorder, used with permission.

And that number could go even lower once they enter mass production. Access for all, regardless of location, is incredibly important to Badu-Tawiah.

"Making the resources accessible to a lot of people I think is the solution. That’s why I came up with this idea to build a bridge and to connect the rural and the cities," he said. "This will be useful for a lot of people, not only in Africa, but in the U.S. and many other places. It will change lives."

The scientists are also working very hard to make the testing process less invasive and more comprehensive.

Image by Pam Frost Gorder, used with permission.

"Our next move is actually going down from blood to saliva and then to urine," says Badu-Tawiah. "We are really hopeful that within a few years, this will come to fruition."

They're also developing a separate method that is able to detect malaria, syphilis, HIV, and tuberculosis all on the same device.

Pretty amazing, right?

This type of research has the potential to change how the world approaches deadly diseases.

Just thinking about how a drop of blood on a piece of paper could potentially replace a long journey to a testing facility is an exciting development.

In places from Africa to the U.S., this kind of innovation could one day be available at the corner drug store. It has a long way to go, but the prospects so far are exciting.

In this instance, it really is the smallest things — like a 50-cent piece of paper — that can make the biggest difference.

Family

How your phone's camera could help detect a rare cancer in kids.

What wasn't available for his son may now save other kids.

True
Facebook

In 2008, 1-year-old Noah Shaw was diagnosed with a rare form of eye cancer called retinoblastoma.

By the time he received the diagnosis, the cancer had progressed and the treatment plan was extremely intense.

Months of chemo and radiation followed, and Noah had to undergo surgery to remove his right eye to keep the cancer from spreading to his brain.

All images from Bryan Shaw, used with permission.

That's a lot to go through in your first year of life.

As worried parents often do, Bryan and Elizabeth Shaw wondered if there were any missing warning signs that would have helped get Noah's diagnosis sooner.

They remembered the photographs that first raised concerns. Instead of the usual red dot of a pupil, they had noticed one of Noah's eyes appeared different from the other.

Being a scientist himself, Bryan wanted to see if he could track down when that difference first appeared. Bryan and Elizabeth turned to Noah's baby pictures to see how early this symptom showed up in photos before he was diagnosed.

Lo and behold, a clear warning sign is exactly what they found.

It's all about a white reflection that appears in the eye in photos with a camera flash.

Blood vessels in the back of the eye will normally reflect red, but if there is a tumor or other issue present, the eye may appear differently.

For Noah, that white glow first began appearing in photos when he was just 12 days old.

The presence of a white glow in a child's eye can help determine whether a baby has leukocoria, an early indicator of an eye problem ranging from a refractive error, where a baby needs glasses, to a rare form of cancer, like in Noah's case.

Noah, now a lively 7-year-old, is doing great. But Bryan never stopped thinking about how he could help other kids detect their eye problems earlier on.

"If I would have had some software in it telling me, 'Hey, go get this checked out,' that would have sped up my son's diagnosis and the tumors would have been just a little bit smaller when we got to them. There might have been fewer," Bryan told NPR.

A chemist at the University of Baylor, Bryan decided to shake up his career path by exploring life as a software designer too.

Bryan launched a free app called CRADLE that screens kids for leukocoria through their photos.

Created with the help of Baylor colleagues and graduate students, the app is available on both iPhone and Android for free under the name CRADLE, which stands for ComputeRAssisted Detector of LEukocoria. Clever.

The app can search your device for all photos that might contain white eye, given that leukocoria can show up inconsistently. It can also be used in real-time, snapping a photo through the app itself.

Even better? The app is working.

If the app finds a photo that could be a leukocoria, it recommends a visit straight to the pediatrician.

"Multiple families have used it to catch cancer in their children at such early stages — way before doctors — that the children received only laser treatment, no chemo, no radiation, no eye removal," Bryan said in an email to Upworthy.

And while retinoblastoma itself is very rare — fewer than 12 out of 1 million children aged 0-4 will develop it — the app goes beyond to help with other eye problems.

Shaw says "white eye" in kids is a symptom of a lot more than cancer. The app has caught Coats' disease, myelinated retinal nerve fiber layer, and a bunch of refractive errors (i.e., kids needing glasses).

Posting and sharing photos is more than just a great way to connect and document life: It can now share valuable information about the health of a child's eyes.

Bryan knows early diagnosis is key and parents see their kids a lot more than doctors do. While it's no substitute for being seen by an actual doctor, there is no question that this app can make a difference.

"From here, the software is going to get better," he told People. "It's going to get more accurate as we collect more and more pictures to train it and make it smarter."

Keep the pictures comin'.

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