Actress Goldie Hawn Visits Children's Hospital to Teach Benefits of Mindfulnes
 
Actress Goldie Hawn leads a gratitude circle with young patients and their parents at UCSF Benioff Children's Hospital San Francisco on
 Actress Goldie Hawn stood in the playroom of the UCSF BenioffChildren’s Hospital San Francisco, surrounded by children and their parents. She addressed her audience by asking each person, “What are you grateful for?”

“My cat,” a little girl said, grinning up at Hawn.

“The nurses taking care of my kid,” a father said, gripping his son’s hand.

“Hope,” a young boy said quietly.

Goldie Hawn
Hawn led the gratitude circle before speaking about the cognitive and health benefits of gratitude and mindfulness, principles that underlie Mind Up, her foundation’s curriculum that teaches children to regulate their emotions and concentration by practicing mindful awareness, like deep breathing.

“When we feel grateful, the heart opens up and we can help each other,” she told the group. “If you’re nervous, scared or sad, just breathe. Every inhale energizes the body and every exhale relaxes the body.”

Hawn’s strategies for improving wellbeing  complements the work of specialists at the hospital who use similar techniques to help patients manage pain and stress, said Michael Towne, manager of UCSF Benioff Children’s Hospital’s Child Life Services.

“A life-threatening diagnosis takes an enormous psychological toll on the kids and their families,” he continued. “Mindfulness gives the kids some control over their fear and pain, a powerful tool when they have no control over their illness.”

On each floor, whimsically painted gratitude trees line the hallways. Patients write what they’re grateful for and stick them to the branches. The trees are hugely popular because it allows for a small moment to focus on something positive, Towne said.

Along with stress and pain management, mindfulness has been gaining traction as an effective tool for treating depression, said UCSF psychiatrist Stuart Eisendrath, MD, who studies how mindfulness-based cognitive therapy (MBCT) affects the patients with depression for whom medication has failed. His research has shown that the mindfulness practice shifts brain functions toward a healthier mindset.

“People with depression ruminate on negative thoughts about something that happened in the past,” said Eisendrath. “MBCT trains patients to selectively focus their attention on the here and now.”

Depressed people have brain abnormalities that prevent the logical, problem-solving regions of the brain from functioning properly. Instead, they have an overactive amygdala, a region of the brain that processes emotion.

“The amygdala clouds the thought process with emotion. It prevents the logic region of the brain from keeping negativity in perspective.” Eisendrath said.

During an eight-week course, patients learn to focus on their breath and let go of negative thoughts as they pop up. Eisendrath took a functional magnetic resonance imaging (fMRI) of each participant’s brain before and after the course, and followed up clinically one year after the treatment.

“We saw pretty dramatic results after just eight weeks. The mindfulness training increased activation in the brain region responsible for emotion regulation and decreased the amygdala, the alarm bell,” Eisendrath said.
Focusing on Non-Judgmental Thoughts

The UCSF Osher Center forIntegrated Medicine applied this technique to help homeless youth. They partnered with the Larkin Street Youth Services, the largest service organization in the city for homeless youth.

“These teens are runaways. You can only imagine how troubling their experiences have been,” said Kevin Barrow, MD, the Osher Center’s director of mindfulness programs and co-director of the Mindfulness for Urban Youth project.  “If you’re constantly pushing the painful memories away, you’re never going to sleep well; you’re going to keep yourself busy because you don’t want those memories to come up.” 

The Lisa and John Pritzker Family Fund funded the program to make a series of mindfulness workshops available to kids at the Larkin Street Youth Services center.  The curriculum director and lead instructor, Forest Fein, MA, teaches participants how to focus on the breath and to be completely non-judgmental about anything that comes to the surface.

“Someone might say,  ‘I feel terrible about myself because my parents threw me out,’ and we would ask them, ‘How does that feel in your mind? Study it,’” Barrows said.

“Mindfulness trains you to control the kind of attention you bring to these traumatizing memories. It’s open, it’s accepting. It gives you a container to hold these things,” he continued. “They learn to be unafraid of confronting their past.”

Barrows thinks the growing popularity of mindfulness is due to the chaotic nature of modern day life. “It’s the perfect medicine for our times. There’s so much going on – screens, obligations, distractions – and breathing and practicing mindfulness taps into a deep human desire for peace. “

Mindfulness Practice for Caregivers

Along with children and families, caregivers can be susceptible to emotional distress from caring for very sick children. 

Growingawareness of widespread compassion fatigue and burnout in nurses and physicians has led to a movement to support the mental health of hospital staff. Eight years ago, Helge Osterhold, PhD, started the UCSF Benioff Children’s Hospital Staff Support Program. One way the program aims to promote care team well being is to build mindfulness into caregiving to help staff  relax and recharge throughout their shift.  

“Mindfulness is a key skill to being present with the patients,” said Osterhold. “If you’re fatigued and tired, you’re only half present to what the patient is telling you, and you’re more likely to make mistakes.

Nurses and staff attend a weekly mindfulness meditation class
Besides offering a variety of caregiver retreats and classes, Osterhold spearheaded ‘mid-day mindfulness’ a daily guided meditation that is offered with Spiritual Care Services Monday through Friday at noon. Everyone meets in a peaceful meditation room on the first floor of the hospital to recharge, reflect and refocus. The program also trained more than 40 nurses to lead simple yoga classes at the nurse’s stations. The 5- to 10-minute yoga class promotes mindful breathing, coordinated with some movement, said Osterhold. They call it ‘You Time.’

Additionally, during the nurses huddle – when nurses finishing a shift hand over the duties and debrief about the patients for that day – some units begin by saying three good things that happened during the shift. Beginning on a positive note helps the new nurses avoid feeling like they’ve walked into an overwhelming environment and aids the leaving shift with a sense of accomplishment.

“The hope is it will always help the patient,” Osterhold said. We’re not doing it for indulgence – we’re recognizing how hard these caregivers are working to care for these patients and families.”

Only Hospital in Northern California to Achieve Top 10 National Status



UCSF Medical Center is one of the nation's premier hospitals for the 14th consecutive year, ranked as the eighth best hospital in the country, according to the 2015-2016America's Best Hospitals survey from U.S. News & World Report.

It is the only hospital in Northern California ranked in the top 10 nationally on the Honor Roll, which highlights hospitals that are exceptional in numerous medical specialties. UCSF shone in such areas as cancer, neurology and neurosurgery and urology. 

UCSF earned top-tier status in 14 out of 16 adult medical specialties. Additionally, it ranked No. 1 in the San Francisco-Oakland metropolitan area. U.S. News & World Report evaluated nearly 5,000 hospitals across the country.

The annual rankings, now in their 26th year, recognize hospitals that excel in treating patients who need an especially high level of care. 

"This achievement is very gratifying and validates our daily commitment to providing the best health care possible," said Mark R. Laret, chief executive of UCSF Medical Center and UCSF Benioff Children'sHospitals. "Patients come to UCSF from many places in the country and the world to gain from the expertise of clinical experts at the very top of their fields and to benefit from the latest research and innovative treatments that are a hallmark of our work. It's an honor to work on behalf of these patients who are treated by physicians, nurses and the many other practitioners and staff providing a wellspring of compassion and innovation." 

UCSF ranked among the nation's top 10 hospitals in seven adult specialties: cancer, diabetes and endocrinology, gynecology, nephrology, neurology and neurosurgery, rheumatology and urology.

Additionally, UCSF ranked among the country's best hospitals for seven other adult specialties: cardiology and heart surgery, ear, nose and throat, gastroenterology and GI surgery, geriatrics, orthopedics, psychiatry and pulmonology. Ophthalmology was also noted for its high performance.

Of the nearly 5,000 hospitals analyzed, less than 3 percent were nationally ranked in even one specialty.

"We are very proud of the work carried out every day at UCSF Medical Center by our health care practitioners. Their dedication and commitment to excellence exemplify UCSF's core values, and are the frontline of UCSF's mission of advancing health locally and worldwide through excellence in education, research and patient care," said UCSF chancellor Dr. Sam Hawgood.

In a separate set of pediatricrankings last month, UCSF Benioff Children's Hospitals ranked among the nation's top children's hospitals in nine pediatric specialties, earning its highest marks in diabetes and endocrinology; cancer; neurology and neurosurgery; neonatology; and nephrology. It ranked as the best children's hospital in the Bay Area in five specialties. This year, the rankings for UCSF Benioff Children's Hospitals were based on both of its locations — San Francisco and Oakland.

UCSF Medical Center is the academic medical center of UC San Francisco. The medical center's nationally preeminent programs include children's health, neurological disease and disorders, organ transplantation, women's health and cancer. In its long history of providing exemplary medical treatment, UCSF Medical Center has made significant advances in recent years as part of its overall goal of delivering the highest quality safest care.

U.S News publishes the annual Best Hospitals rankings to help guide patients who need a high level of care because they face particularly difficult surgery, a challenging condition or extra risk due to age or multiple health conditions. Objective measures such as patient survival and safety data, nurse staffing levels and other data largely determined the rankings in most specialties.

"An Honor Roll hospital has much to be proud of," Ben Harder, chief of health analysis at U.S. News, said in a statement.

The rankings were publishedonline on July 21.

The specialty rankings and data were produced for U.S. News by RTI International, a leading research organization based in North Carolina. U.S. News used the same data, as well as the new Best Hospitals for Common Care ratings, first published in May, to produce the state and metro rankings.


killed - murdered
Someone with access to firearms is three times more likely to commit suicide and nearly twice as likely to be the victim of a homicide as someone who does not have access, according to a comprehensive review of the scientific literature conducted by researchers at UC San Francisco.


The meta-analysis, published online Jan. 20 in Annals of Internal Medicine, pools results from 15 investigations, slightly more than half of which were done after a 1996 federal law prohibited the U.S. Department of Health and Human Services from funding research that could be seen as promoting gun control. The review excluded studies that relied on survey data to estimate gun ownership and focused instead on studies that included more specific information about whether victims had access to guns.


All but two of the studies were done in the United States, where gun ownership is higher than anywhere else in the world and firearms cause an estimated 31,000 deaths each year. The review included studies about deaths by suicide and homicide but not accidental deaths.


Researchers found striking gender differences in the data. When firearms were accessible, men were nearly four times more likely to commit suicide than when firearms were not accessible, while women were almost three times more likely to be victims of homicide.

Andrew Anglemyer, PhD, MPH
“Our analysis shows that having access to firearms is a significant risk factor for men committing suicide and for women being victims of homicide,” said Andrew Anglemyer, PhD, MPH, an expert in study design and data analytics in Clinical Pharmacy and Global Health Sciences at UCSF, who is also a U.S. Army veteran. “Since empirical data suggest that most victims of homicide know their assailants, the higher risk for women strongly indicates domestic violence.”


Firearms play a significant role in both suicide and homicide, accounting for slightly more than half of all suicide deaths and two-thirds of homicide deaths, according to 2009 data from the 16-state National Violent Death Reporting System, which is run by the U.S. Centers for Disease Control and Prevention.


About 75 percent of suicides occur in the victims’ homes, and a similar percentage of female homicide victims die in their homes. The figure is about 45 percent for men.


Since not all of the studies assessed whether victims had firearms in their homes, the meta-analysis does not draw conclusions about the associations between suicide or homicide and the location of the firearms, but merely whether victims had access to them.


Researchers adjusted for biases they detected in the original studies, such as failing to account for mental illness, domestic violence or arrest history or inadvertently influencing the reports of victims’ friends and relatives about whether they had access to firearms. But the overall results did not change significantly.


In some cases, such as in the selection of participants for studies on suicide, the bias in the original studies may have underestimated the association between access to firearms and suicide, because both study and comparison groups were recruited from health care settings where they may have been seeking treatment for suicidal planning.


Of the 15 studies included in the meta-analysis, the only one that did not find a statistically meaningful increase in the odds of death associated with access to firearms was from New Zealand, where guns are much less available than they are in the United States. And even that study did find an increase, although not a statistically significant one.


Other authors on the paper include UCSF epidemiology researcher Tara Horvath, MA, and George Rutherford, MD, professor of epidemiology at UCSF. All authors are associated with the Cochrane Collaboration, an international network of independent researchers who evaluate data for the benefit of health care practitioners, policy makers, patients and consumer advocates.


The authors reported no conflicts of interest and did not receive any grant support for their research.


UCSF is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. It includes top-ranked graduate schools of dentistry, medicine, nursing and pharmacy, a graduate division with nationally renowned programs in basic biomedical, translational and population sciences, as well as a preeminent biomedical research enterprise and two top-ranked hospitals, UCSF Medical Center and UCSF Benioff Children’s Hospital.

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