Whitney Palmer

Healthcare. Politics. Family.

Right From the Start

Published in the Spring 2016 University of North Carolina Greensboro Research Magazine

By Whitney L.J. Howell

The best foot forward. It’s what we all want for our children in those first few years. But, the question is — how do we get there?

Nationally and locally, debates rage. It’s difficult to find consensus on the best way to educate our children or even prepare them to be educated. One thing we can be sure of? It’s no simple task. It will require a lot of work and collaboration to get it right.

UNCG is leading the way. Here, researchers have investigated — sometimes for years — what it takes to make sure children are healthy and ready to learn. And, now, investigators are combining their knowledge, resources, and networks to meet these challenges directly.

Faculty and staff, from the UNCG Department of Human Development and Family Studies to the UNCG Center for Youth, Family, and Community Partnerships, conduct basic research, translate research into evidence-based practice, and help create local, state, and national educational policy. As they reach out to families, help towns and cities identify and intervene with struggling children, and teach professionals vital skills for the classroom, these investigators have one goal in mind — giving every child the right start.

“We take what we glean from research and teaching and put it together to make a difference. That knowledge shouldn’t remain in the academy,” says Dr. Chris Payne, director of the Center for Youth, Family, and Community Partnerships. “It’s our mission to work for the greater good of our community.”

The Importance of Early Social & Emotional Development

For children to maximize their educational experiences, it’s critical they come into the classroom ready to learn. That makes the first five years invaluable to healthy growth, Payne says. During that time, approximately 90 percent of brain structures develop, establishing the foundation for how a child learns and processes information.

The healthiest growth occurs, explains Payne, when children have secure relationships with their caregivers and feel free to express emotions, including fear, anger, and happiness.

Emotion Regulation

Although school carries an inherent focus on grades, academic ability isn’t the only factor determining whether a child is actually classroom-ready. Another key indicator is whether he or she can appropriately regulate emotions, says Dr. Susan Calkins. “The more structured preschool and school environments present a unique set of challenges to children — challenges that require emotional readiness.”

If you visit the Human Development and Family Studies (HDFS) professor’s lab while her team collects data, you’ll observe children singing, counting, or playing games. Others might be crying and flailing fists. They’re expressing a wide range of emotional abilities, dependent on their age and experiences.

While some children control their impulses by employing various learned strategies, others lack these skills and have trouble delaying gratification or managing frustrating tasks. Their negative emotional responses indicate immature emotional readiness.

“Being able to manage emotions is critical for academic achievement, school readiness, and mental health,” Calkins explains. Without emotion regulation skills, children can’t establish positive student-teacher and peer-to-peer relationships. If they can’t express themselves or manage their feelings in ageappropriate ways, they also risk social rejection. “If children don’t master emotional regulation, they face challenges for years to come.”

To help children reach appropriate levels of emotional maturity, adults must recognize their natural responses and know how to handle them, Calkins says. To find the tools parents and caregivers need, she and her team have recruited children from more than 450 families to participate in the RIGHT Track study.

Although we can begin to understand emotion regulation by observing the behavior of and collecting information from children and their caregivers, collecting data at the physiological level also provides a key piece of the puzzle in understanding not only how emotional regulation develops but also the degree to which it impacts various areas of the child development.

In one component of the study, Calkins team attaches heart rate electrodes to each child to measure their physiological arousal and then presents them with a frustrating task. Two-year-olds are asked to open a cookie jar that was glued shut or wait to open a present, while 5-yearolds are tasked with unlocking a box using a set of keys that does not actually include the correct key.

The team watches both the child’s actions as well as the caregiver’s responses. Did the children quit or did they stick with the task? Did the parent offer guidance or withdraw from the situation? Children and parents returned to the lab for more advanced tests as they aged.

“So far, we’ve seen that children who get extremely frustrated with these tasks also experience behavior problems,” Calkins says. “These kids who lack skills to control their emotions and cope are also more likely to experience depression and academic and health issues and to engage in substance abuse and risky sexual behavior later in life.”

There are many ways children can rein in overwhelming feelings. Distractions, such as singing songs, diverting concentration, or engaging in self-soothing behaviors, can effectively control emotions.

Knowing how to implement these behaviors helps a child navigate social and academic environments, says Calkins. They also help children stay focused on tasks and enhance their autonomy. When children have these skills, they can approach difficult situations without adult intervention.

Calkins’ findings are important not just for parents but for educators too. Early development of a positive teacher-student relationship can help children sidestep many of the aforementioned problems. “This is critical knowledge, especially in today’s kindergarten climate where we’re getting young children ready for a series of tasks and tests.”

Parent-Child Relationships

Healthy emotion regulation is imperative for children to achieve school readiness, but of course they can’t do it alone. Parents must be involved, points out HDFS professor Esther Leerkes. And, at every step, parents must provide age-appropriate guidance or children won’t internalize the correct skills.

“The quality of parenting matters. We know that how parents respond when a child is upset can help children learn to regulate their emotions — which in turn affects their early cognitive development and school readiness,” she says. “We also know if children struggle emotionally, they are more likely to struggle academically.”

Inside Leerkes’ lab, parents and young children are completing a treasure hunt. They must find the best route for a bear to cross a body of water and reach a prize on an island. While the child’s goal is getting to the treasure, the research team’s objective is to determine how differing parenting styles affect a child’s emotional and cognitive abilities and early readiness for school.

The kids and adults are participants in the School Transition and Academic Readiness (STAR) project. With over $6 million in funding over the last decade from the National Institute of Child Health and Human Development, Leerkes and her collaborators are following over 500 children from age 4 to the first grade.

It matters, she says, whether parents engage children in stimulating ways. The adults can choose to withdraw from the game, take it over, or engage the child and guide him or her through the process, helping them understand and make decisions.

The most successful children, she says, have emotionally supportive parents. They were involved in play and offered age-appropriate guidance, praise, and encouragement. Children faltered when parents took charge, became frustrated, or didn’t participate at all. Children were also more likely to lose interest, appear bored, or withdraw when parents pushed too hard or became negative.

Leerkes’ team also assesses the children’s physiological and neural activity as they problem solve.

For example, the team puts each child through a Stroop test. These tests tax participants by requiring them to inhibit their initial responses — a child might be required to say the word “night” when they see a picture of the sun. The researchers observe which regions of the brain are active, and they record how many picture presentations the children get right.

They’re looking to see, Leerkes says, what types of brain activity correlate to high performance levels. One day, their findings could help predict a child’s level of academic performance and perhaps even help identify children who need early interventions.

In another study with infants and toddlers, the team monitors both parents and children as children are presented with frightening or frustrating situations. Leerkes’ team has found that a younger child’s emotional control is strongly linked to the caregiver’s behavior and emotions. If parents exhibit frustration, irritation, or anxiety — identified by elevated heart rates accompanied by poor regulation — children aren’t as able to control their emotions and behavior. To minimize a child’s exposure to negativity, Leerkes suggests that parents pay attention to their own emotions while interacting with their children. Imagine your child’s perspective, she advises, and calm yourself by pausing to take deep breaths and relax when you can feel your own strong emotions rising.

When parent-child interaction is positive, everyone benefits, Leerkes says. Children develop better emotional control, and they use that skill to maintain their attention and manage their frustration, both critical for adaptive peer relationships and active engagement in school. And parents proudly watch their children succeed in school transitions.

Child Care Program Quality and Teacher Support

In laying the foundation for school readiness and a lifetime of success, we know that quality of parent-child interactions and the home environment is critical. But quality in other child care environments, including preschools and child care centers, is just as crucial.

It’s important for parents to know what an early childhood program offers, how effective their teachers are, and where the curricula are strong. In 1999, HDFS faculty Dr. Deb Cassidy, Dr. Linda Hestenes, Dr. Sharon Mims, and Dr. Steve Hestenes began collaborating with the N.C. Division of Child Development and Early Education to help parents make these important choices.

Their long-running N.C. Rated License Assessment project, which has received over $50 million in funding, rates child care programs throughout the state — currently over 7,000 programs. Of these, 45 percent of child care centers and approximately 11 percent of home-based programs have earned the top, five-star rating.

The N.C. Rated License Assessment project is just one of many ways UNCG is helping improve the overall quality of child care and education statewide. Another example? In conjunction with the N.C. Department of Public Instruction, HDFS Associate Professor Catherine Scott-Little is providing technical support for a new North Carolina K-3 assessment system. The system collects data on students from kindergarten through third grade, to help individualize their teaching and learning. Teachers, support staff, and families provide information for the assessment from observations, conversations, work samples, and more.

Teachers are better prepared and can better personalize teaching strategies when they understand how children learn. The K-3 Assessment system will arm teachers with a more complete picture of each of their students, improving their instruction and helping to meet their individual needs. With the information from the assessment Scott-Little is helping to design, teachers can more effectively target and teach to areas where high-need children need the most help.

A well-educated, prepared teaching staff is the biggest factor in achieving a five-star rating in the current N.C. Rated License guidelines. But finding the best qualified teachers to choose from can be difficult in the current environment of student loan debts and low teacher wages statewide. UNCG is taking steps to help grow our pool of highly educated teachers and to make sure they are supported and paid a living wage to keep them in the field.

HDFS Professor Deborah Cassidy has led the charge in preparing North Carolina teachers for more than two decades. Her latest focus is the EQuIPD (Education Quality Improvement & Professional Development) program. Funded by a Smart Start grant from the Guilford County Partnership for Children, EQuIPD is bringing professional development directly to existing early childhood professionals in Guilford County.

“Traditionally, early childhood professionals struggle to find the time and resources to get the continuing education and professional development they need,” says Cassidy. “Through this program, our staff brings interconnected services, such as peer coaching and training, directly to teachers and directors in early childhood settings. Together, we are implementing strategies we know have a direct impact on increasing the quality of early care and education.”

Another example of efforts in this area, says Cassidy, is UNCG’s mentoring program, which pairs teachers working in higher-quality programs with those working in lower-quality programs over a four month period. Mentors — who receive a stipend — meet regularly with mentees to discuss problems, strategies, and tactics. These conversations help identify opportunities for reaching children, as well as actions that might hamper a child’s academic progress. The connections are designed to give teachers a safe, reliable sounding board to analyze problems.

“The relationships that develop are more important than the content discussed. Being an early-education teacher can be isolating,” Cassidy says. “Having someone to discuss issues with can be invaluable.”

It’s also important, Cassidy says, for teachers to feel comfortable instructing students on complicated subject matters. To foster that confidence, UNCG supports community-training events that raise awareness of early-education topics through keynote speakers and workshops. For example, a recent session offered guidance for teaching science and math in age-appropriate ways. The hope, she said, is these sessions will enhance teachers’ abilities to create strong curricula that reach children of all readiness levels.

But having high-quality teachers who know how to reach students and who have targeted curricula that teach to every student’s needs means nothing if those teachers don’t make it into or stay in the classroom. There’s only one way to ensure high quality teachers are available, Cassidy says. Current and future educators must receive salaries that accurately reflect the time and effort that goes into the job.

To highlight this dire need, HDFS hosts Worthy Wage Day, an event that invites community leaders and politicians to work a child-care job for two hours, earning a teacher’s hourly pay — $10.97. They’re presented an honorary check during a press conference and are given the opportunity to discuss their experience.

Not only does Worthy Wage Day give community leaders a first-hand view of what teaching and caring for young children actually requires, but it also highlights the dire income insecurity experienced by many of North Carolina’s early-education teachers. Up to 45 percent receive income support. In fact, many can’t afford to enroll their own children where they work. Until this inequality is sufficiently addressed, Cassidy says, the state will continue to struggle to maintain a well-educated, dedicated, quality teacher workforce.

To read the article at its original location: http://research.uncg.edu/wp-content/uploads/2016/04/onlineUNCGResearchSpring016.pdf

 

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May 25, 2016 Posted by | Education, Politics | , , , , , , , , , , , , , , , , , | Leave a comment

Teaching Radiologists to Be Business Leaders

Published on the Dec. 23, 2015, DiagnosticImaging.com website

By Whitney L.J. Howell

Today’s radiologists do more than examine images and diagnose problems. They’re expected to understand revenue streams, keep up with coding and billing updates, and participate in mergers and acquisitions decisions.

But, currently, Falgun Chokshi, MD, MS, assistant professor of radiology and imaging services in the neuroradiology division at Emory Healthcare said at RSNA 2015 said, too few radiologists are prepared for these types of activities.

“Providing business leadership skills is a way to empower our trainees so they can go into a complex and very rapidly changing world of radiology and health care delivery and become active players,” he said. “These teachings provide valuable and necessary nonclinical tools, knowledge, and insight that have historically never been afforded in our training environment.”

The most effective way to impart this knowledge, he said, is to create a targeted curriculum and identify residents and fellows who could benefit from it the most. At Emory, this effort is known as P3R2 – Practice, Policy, and Professionalism for the Radiology Resident. Chokshi shared some lessons learned.

To read the remainder of the story at its original location: http://www.diagnosticimaging.com/rsna-2015/teaching-radiologists-be-business-leaders

December 24, 2015 Posted by | Education, Healthcare | , , , | Leave a comment

MYLES to Go

Published on the Dec. 18, 2015 Burroughs Wellcome Fund website

Asking Questions in the Great Smoky Mountains

By Whitney L.J. Howell

In the Great Smoky Mountains, Madison High School senior Chloe Schneider discovered something she never knew before. The mountains are home to a rich variety of snail species – but, some of them are in severe trouble.

Ordinarily, knowing details about the state’s mollusk population serves as a random bit of trivia for a party game. But, for Schneider, this knowledge was critical. Nearly 50 percent of North Carolina’s snails are endangered, but the ones in the Great Smokies are losing ground thanks to environmental changes.

The Millenial Youth Led Expedition (MYLES) of Science program showed the Marshall, N.C. native why it’s important to understand the impacts on the snails’ ecosystem.

“We could really tell how the acid rain has affected the environment and, how if we continue to have acid rain and pollution in the environment, that things will only get worse. Snails won’t be able to live in those areas anymore,” said Schneider, describing the work of her six-person team. “It’s crazy to see how much impact we have and how what we release into the environment can affect other species.”

MYLES, a Burroughs Wellcome Fund (BWF)-supported initiative, introduces high school students to science along the Appalachian Trail. BWF funded MYLES in 2013 with a nearly $60,000, three-year grant to support up to 100 participating students. Over the past two years, according to Dottie Shuman, Ph.D., MYLES grant administrator, surveys conducted at the beginning and end of each week-long program show the program meets BWF’s goal of fostering an augmented interest in and knowledge of science.

During six week-long summer expeditions, she said, students work alongside college-student guides and National Park Service (NPS) rangers, learning protocols and collecting data about the Western N.C. mountains to support long-standing NPS research projects. Students can also present their findings at scientific conferences throughout the school year.

“These students are excited about real science – testing hypotheses and setting up data collection,” she said. “They come back with knowledge about the natural resources at our fingertips, and they’re excited about protecting them.”

And, students don’t leave the program empty-handed – they take some scientific equipment with them. They carry hand lenses and water-test kits home to continue their investigations on their own.

In addition, according to NPS ranger and MYLES program staffer Susan Sachs, program staff hope students will leave MYLES thinking of science as a viable career option.

“A lot of times when students think of science, they think of lab coats and being indoors,” Sachs said. “We want to show them how we use science to study and protect the parks.”

To meet this goal, students participate in on-going NPS research into snail and salamander habitats and the outside influences affecting them. The six-person teams are also encouraged to form their own research questions and hypotheses, but all data gathered contributes to the investigations that have been active for at least a decade, Sachs said.

For example, this past summer, several teams examined how acid rain has impacted the mountain’s snail and salamander populations. Air quality in the area has improved over the past 10 years, but damaging rains still fall with greater amounts hitting the higher elevations, she said. Teams gathered data about soil pH and species diversity, compared it to historical data, and analyzed whether said diversity has increased or decreased over time. They determined, Sachs said, that fewer salamanders now live in the more highly-acidic, upper elevations.

“We use student data to look at salamander health. We might not notice the decline in population if we didn’t have the data students collect,” she said. “This way, we can monitor how changes in moisture and climate change affect these amphibians.”

Frequently, students take their new-found knowledge back into the high school classroom. In fact, two-time participant and high school junior Jalen Ward said hands-on experience with forming hypotheses and analyzing data has been helpful in his advanced placement science classes at Fike High School in Taylor, N.C. But, more importantly, he said, it’s impacted his future plans.

“I’d like to major in biology and maybe be a wildlife biologist working with North Carolina’s wildlife,” he said. “I enjoy the outdoors, so working with nature would be a way to do for a living what I already love to do.”
It’s that type of insight into the value of science as a career and forward-thinking that makes the MYLES program so important, Sachs said. It doesn’t take long for students to develop a deep appreciation for the significance of outdoor science and the opportunities for investigations it presents.

“After this program, science isn’t just something they learn in school. There’s a real value to it,” she said. “A lot students think we do a study and have answers. But, they learn that questions often only lead to more – and better questions.”

To read the story at its original location: http://www.bwfund.org/newsroom/awardee-profiles/myles-go

December 18, 2015 Posted by | Education, Science | , , , , | Leave a comment

The challenges of healthy aging

Published in the Fall 2015 University of North Carolina at Chapel Hill Gillings School of Global Public Health Carolina Public Health Magazine

By Whitney L.J. Howell

Globally, the number of people 60 years old and older is growing exponentially. By 2050, these individuals will constitute nearly one-quarter of the world’s population.

Identifying strategies that will allow adults to age safely and with good quality of life, to maintain their abilities and safeguard their independence is vital – and is a high priority at the UNC Gillings School of Global Public Health.

“People are aging – me included – and we need a plan to help them live fully,” says Julie MacMillan, MPH, managing director of the School’s Research and Innovation Solutions office. “At the Gillings School, through strong collaborations, we want to create opportunities for people to live as healthfully and independently as possible.”

School leaders take a three-pronged approach to meeting those needs, including innovation, evaluation and education. Partnerships through the Gillings Global GatewayTM (sph.unc.edu/global-health) offer support.

Evaluation

Identifying needs is a first step, MacMillan says.

Peggye Dilworth-Anderson, PhD, professor of health policy and management, collaborates with UNC and Cambridge University (U.K.) colleagues to reduce later-life dementia risks. Using community-based participatory research, her team explores relationships between cognitive health, protective factors and modifiable risk factors to help develop cognitive, health-sustaining interventions that can be used with vulnerable groups of older adults in the U.S. and U.K.

Dilworth-Anderson is a venerated national leader in aging issues, having served as a Presidential appointee on the White House Conference on Aging Advisory Committee (2002-2005), president of the Gerontological Society of America (2009-2010) and appointed member of the Institute of Medicine’s Forum on Aging, Disability and Independence (2012- 2014). In October 2015, she was invited by AARP, in partnership with AgeUK (ageuk.org.uk), to serve a two-year term on the governance committee of the new Global Council on Brain Health (aarp.org/gcbh). The committee includes physicians, scientists, policy experts and others who will recommend best practices regarding brain health maintenance.

Funding for some of the UNC-Cambridge initiative was provided by Drs. Dennis and Mireille Gillings. Dennis Gillings, PhD, CBE, appointed by U.K. Prime Minister David Cameron as World Dementia Envoy, leads a global council to raise funds for research toward a cure for Alzheimer’s disease and other dementias.

Wayne Rosamond, PhD, epidemiology professor at the Gillings School and adjunct professor of emergency medicine in the UNC School of Medicine, identifies ways emergency medicine services (EMS) staff can communicate with hospitals while en route. These strategies could ensure immediate availability of emergency department resources, personnel and scanning equipment, of special importance in situations such as stroke, in which a few minutes can make a big difference in prognosis. Steve Marshall, PhD, epidemiology professor and director of the UNC Injury Prevention Research Center, and Jason Franz, PhD, biomedical engineering assistant professor, study factors that contribute to adult falls.

Epidemiology postdoctoral fellow Vineet Menachery, PhD, is using a recent National Institute on Aging award to support his research on the SARS coronavirus. He is identifying changes in immune response in the context of aging that could modify treatment of older adults who develop respiratory infections, a leading cause of death in that population.

Innovation

The Global Aging and Technology Collaborative aims to promote innovation and collaboration with global partners, says Heather Altman, MPH, project manager for the collaborative and doctoral candidate in the School’s Executive Doctor of Public Health program. The group leverages the expertise of more than 100 interdisciplinary researchers, practitioners and entrepreneurs to adopt creative, affordable and practical solutions that enhance quality of life and support people’s ability to age at home and in their communities. Altman is also Carol Woods Retirement Community’s community connections director, a long- held position that inspires and continues to enrich her work in aging at the UNC Gillings School.

With the help of a career development award from the UNC Institute on Aging, Altman is evaluating a tool that will help leaders assess the livability of their communities for older adults.

Education

Gillings School students also learn about older adults’ challenges, including food insecurities, by working with Amanda Holliday, MS, RD, clinical assistant professor of nutrition and licensed dietitian/nutritionist.

“Living older with chronic conditions has a nutritional component,” Holliday says. “Independence is intertwined with food. We need to consider how each person will manage his or her own nutrition if s/he wants to stay at home.”

Holliday’s students investigate older adults’ struggles in several ways. They complete daily living activities in a suit that impairs hearing and eyesight. Holliday also connects students with alumni living abroad to learn how other societies care for older adults, and she helps them secure study-abroad opportunities focused on aging, such as with the National Health Service’s Universal Malnutrition Screening Initiative, in England.

Overall, MacMillan says, the School prepares students to be leaders in a number of public health arenas. “When our students get excited, they’re a powerful force, no matter what challenge they take on,” she says. “They always make us think – and make us stronger. I’m particularly proud of our students who seek solutions for the challenges of aging, because they will make a difference in all our lives – and eventually, in their own.”

To read the article at its original location: http://sph.unc.edu/cphm/the-challenges-of-healthy-aging/

December 11, 2015 Posted by | Education, Healthcare | , , , , , , , , | Leave a comment

Official Research Arm of the Women’s Football Foundation

Published in the Fall 2015 University of North Carolina at Greensboro Research Magazine

By Whitney L.J. Howell

It’s no secret that playing football puts players at risk for sustaining a concussion. Research on this topic has accelerated over the past decade, with most work focusing on male players. But women play collision football too, and their numbers are growing.

This rise has researchers asking whether women experience concussions differently and if they need different assessments, treatments, and guidelines. Dr. Donna Duffy and her colleagues are trying to find these answers. It’s imperative, she says, because female football players are just as physical as their male counterparts while facing a high risk of injury.

This year, UNCG became the official research arm for the Women’s Football Foundation, or WFF. With WFF support, Duffy and her collaborators want to investigate whether female collision sport athletes have different normal neurocognitive and neuromotor performance. She also wants to determine whether women’s performance drops after sustaining a concussion, how long those changes will last, and whether there are any long-term effects.

“We have a real opportunity to work with the Women’s Football Foundation in their overarching goal to improve the safety of women’s football — to make it safer and to address issues that haven’t otherwise been looked at,” says Duffy, who is also director of UNCG’s Program for the Advancement of Girls and Women in Sport and Physical Activity. “We hope that our work will inform players, coaches, and league stakeholders.”

Ultimately, Duffy hopes to create sex-specific guidelines for when players can return to the game. The researchers also want to craft returnto-work recommendations to ensure that working-age women don’t return to a full workday before they’re healthy enough.

Most current women’s sports research focuses on contact sports, such as soccer or lacrosse, where concussions happen by accident. Duffy’s research is different, highlighting concussions from collision football that result from intentional, aggressive contact. In many instances, concussions in women are blamed on weaker neck muscles, but that assumption doesn’t hold true among female football players, Duffy says. Other factors contribute. For example, she says, pilot data collected from videotaping games of 50 women on two football teams in North Carolina — the Durham Phoenix and the Charlotte Queens — showed that most women play more than one position. This increases time spent on the field and risk of injury.

Duffy’s team assessed the players’ neurocognitive and neuromotor functions at the start, middle, and end of the season, with additional assessments of players diagnosed with a concussion. This year, the researchers plan to gather data from five more teams. All results will be collected in a database and used to determine whether any neurocognitive and neuromotor changes are related to concussion, as well as how collisions that don’t result in diagnosed concussions can impact cognitive function.

Duffy and her team also conducted a women’s health survey with 30 out of the 31 WFF teams. Approximately 700 women answered questions that touched on biological and psychosocial issues women in sports face, including how women portray and negotiate their femininity when not playing a sport. The survey gathered data about a player’s individual and family injury history and broached questions of equity and how women have been treated in their roles as female collision sport athletes.

When all the research is merged, Duffy says, a new picture of female athletes will emerge. “We’re looking to debunk the myths about the stereotypical understanding of what female athletes look like and are built like.”

To read the article at its original location: http://research.uncg.edu/wp-content/uploads/2015/12/onlinefall2015.pdf

December 9, 2015 Posted by | Education, Healthcare | , , , , , , , , | Leave a comment

International Voice

Published in the Fall 2015 University of North Carolina at Greensboro Research Magazine

By Whitney L.J. Howell

Women in Sport and Physical Activity Journal — the world’s only peer-reviewed journal dedicated to highlighting issues facing women and girls in sports — now resides at UNCG.

The university’s Department of Kinesiology manages and publishes the journal with Dr. Diane Gill as editor-inchief and Dr. Donna Duffy as managing editor. The publication was acquired for $1 from the National Association for Girls and Women in Sports.

The association asked UNCG to acquire the journal, Duffy says, because of the school’s history as a women’s college. Fusing UNCG’s expertise with women’s sports and the journal’s focus will significantly further what is known about how women play and the challenges they face.

“Purchasing and publishing the journal has elevated our status and the visibility of the program. We have a presence on the international stage,” says Duffy. “We’ll be helping women in sports, physical activity, recreation — in anything where movement is involved.”

In addition to continuing the journal online, UNCG has also resurrected the print version of the journal. After hosting a women’s hockey team from Pakistan, Duffy learned that slow Internet speeds and government controls in some countries significantly limited journal access. Providing print copies circumvents that problem.

To read the article at its original location: http://research.uncg.edu/wp-content/uploads/2015/12/onlinefall2015.pdf

December 9, 2015 Posted by | Education, Healthcare | , , | Leave a comment

Movement for Health: Setting the pace nationally in kinesiology

Published in the Fall 2015 University of North Carolina at Greensboro Research Magazine

By Whitney L.J. Howell

Ever since its early days, UNCG has had a strong reputation for excellence in sports, sports medicine, and movement-related health. Today’s kinesiology department has not let that legacy fade. Instead, the faculty are picking up the mantle and carrying it to exciting new places.

Maintaining optimal movement is crucial at any age. It’s vital that we know what impacts motion, how we can preserve it, and — in the worst case scenarios — how to recapture it after injury. Unexpectedly, the big answers aren’t coming in the form of little pills or injections. They’re taking shape as high-tech solutions merged with interventions based on personal physical effort.

At every turn, UNCG is leading the charge not only for the healthy to hold onto their capabilities, but for the injured and cognitively-impaired to reclaim their abilities as well.

Virtual Reality — Not Just For Video Games Anymore

If you walk into Dr. Chris Rhea’s research lab, you might think you’ve walked onto an animated movie set or into the planning stages for video game graphics. At any given point, there’s likely someone covered in reflective dots, walking on a treadmill, or being filmed by a 3D high-definition camera that records the body as a stick figure.

But what you’re really seeing is novel, state-of-the-art research into how individuals who’ve suffered a stroke or had an amputation might learn to reclaim their normal walking patterns.

Rhea’s lab is one of roughly 10 nationwide contributing to this type of research. The main tool supporting his work is virtual reality, or VR. VR itself isn’t new, but it’s just now being applied to this type of medical research, making Rhea’s investigations groundbreaking.

To help individuals who’ve suffered strokes, Rhea pairs the treadmill with a complicated mathematical pattern recognition algorithm and a software program. The software measures the body’s angles, trunk rotation, and limb symmetry to record exactly what the walker does and then runs that data through the algorithm.

Doing so creates an objective, baseline assessment, he says, that is used to build an avatar, which is projected on a split-screen alongside the participant’s walking pattern. Individuals use the avatar as a guide, trying to copy its movements to retrain their bodies into healthy walking patterns.

“Most healthy people have a range of movements within certain signatures, but if you get outside that range, it increases your risk for an injury due to a fall. That’s what we see with stroke patients,” he says. “The software and algorithms give us a quantitative way to measure walking patterns in different clinical populations and help them make changes.”

So far, Rhea’s team has mostly tested this technique with undergraduate students — approximately 600. But nearly 100 participants recruited from local doctors’ offices have contributed as well.

Rhea also works with individuals with amputations, but in a slightly different way. Working closely with clinicians, he and his students designed a VR program that helps these individuals learn how to walk with prosthetic devices without falling. Input from the community clinicians who treat these individuals frequently is critical, he says, to creating a program that pushes a participant’s abilities without exhausting him or her too quickly.

These participants wear a headset, called the Oculus Rift, which simulates a walk through the woods or down a street, so individuals can move at their own pace. Obstacles appear at intermittent times and heights, and participants must navigate around or over them to successfully complete the task.

“The goal with this project is to see if we can train these individuals in a virtual environment to step over objects,” Rhea says. “And can they transfer that ability to the real world?”

As with the research with stroke patients, the lab is still finetuning this technique, using undergraduate students to tweak the methods. It won’t be ready for clinical use until the team has identified which programs are most effective and efficient.

The wait, though, has its benefits. Over the next few years, Rhea’s VR rehabilitation advancements will likely be more affordable and accessible for the broader clinical community. Not only is the software required to run the programs rapidly becoming open-source, meaning it’s freely available to anyone, but the Oculus Rift headset the participants with amputations use to simulate walks is much cheaper than similar equipment purchased in previous years. For example, when Rhea’s group purchased a VR headset in 2011, its price tag was $37,000. Today, the smaller, more portable Oculus Rift exists for a fraction of the cost — $350.

Rhea’s lab has also invested in a new omnidirectional, lowfriction, bowl-shaped treadmill called the Virtuix Omni that is roughly half the size of a standard treadmill. When paired with the lower-cost Oculus Rift, the $500 Virtuix creates an effective rehabilitation system for less than $1,000, well within the budgets of most clinics.

Other elements of Rhea’s work have applications far outside the traditional clinic. With $1 million in funding from the U.S. Department of Defense, his team is designing a smartphone-based app to test whether soldiers injured in the field have sustained a concussion severe enough to be removed from duty.

“This research is important because concussion can range from mild to severe, with the mild version being more difficult to detect — yet it could still have serious implications on balance and cognitive ability,” he says. “There’s not really a good way to test in the field for mild concussions. But the last thing you want is someone with a concussion making life-and-death decisions for themselves or their entire unit.”

Time available to test whether a soldier has sustained a concussion is limited in a combat zone, and usually a combat medic, not a doctor, is the only medical personnel available. Consequently, the military needs an easy-to-use, accurate tool that can diagnose concussion severity within minutes. Rhea’s team is using existing smartphone technology to create one.

Most smartphones contain accelerometers, devices that detect speed, as well as orientation changes. That means they can pick up on subtle balance shifts, Rhea says, making them perfect tools for concussion diagnosis. A field medic can simply Velcro a smartphone with this app to the injured soldier’s thigh and have him or her walk in place for two minutes while the phone collects data on acceleration and side-to-side movements. After 15 seconds of analysis, a green, yellow, or red light will appear, signaling whether the soldier should be removed from duty and given medical attention.

This app could also be useful on the sidelines of high school and college football games, he adds.

Rhea’s team is currently collecting data from and testing the app with civilian patients, some who are healthy and some concussive, as well as with healthy and concussive military personnel. He hopes to have a perfected app to the Department of Defense in less than two years.

Exercise for a Lean, Strong Mind

Physical activity has always been important to Dr. Jennifer Etnier, but she never wondered about how it might impact mental capacity and thought processes until her parents repeatedly asked her to help program their VCR to record football games. Her mother eventually grasped the concept, but her father never did.

“I wondered if there were differences in older adults’ ability to learn and retain novel tasks and whether exercise and physical activity influenced that,” says Etnier. “Can exercise and physical activity help preserve cognitive ability into advanced age?”

To date, that answer has been unclear. Being able to say “yes” could make it easier to motivate older adults to exercise more — if they’re concerned about maintaining their cognitive capacity. Now, Etnier is beginning to do just that. Initial results from her two-year National Institutes of Health-funded research study show staying active can safeguard mental capabilities. In fact, that benefit extends all the way down to school-age children.

To delve into how exercise impacts cognitive performance, Etnier and her team have designed studies with older adults, college students, and elementary pupils.

With adults, Etnier explores whether exercise can safeguard mental faculties of individuals at genetic risk for Alzheimer’s disease. In her study, 54 adults between ages 50 and 65 exercised three times weekly (walking and strength-training). They also completed cognitive evaluations at the study’s start, at four months, and at eight months. The evaluations included recalling words from a list of 15 words read aloud and a Stroop test, where a participant must say the color of ink a word is written in instead of reading the word itself.

Everyone benefited.

“Overall, the group showed improvement in cognition associated with physical activity. This suggests that even those with a genetic risk will receive the benefit,” Etnier says. “It’s very exciting to see how long-lasting these benefits are — could we, perhaps, delay the effects of Alzheimer’s so that someone will die of other causes?”

Her team is also analyzing participants’ blood samples to examine brain-derived neurotrophic growth factor, a protein that is simultaneously responsible for strengthening synapses in the brain and pruning those the brain no longer uses. If physical activity is increasing production of this protein, the researchers may have identified one of the pathways by which physical activity is affecting cognition.

It’s clear, though, she says, that not all exercise is created equal. There could be a sweet spot — an optimal duration and intensity that evokes the best response. Working with UNCG undergraduates, she found those factors do matter, as does the timing of exercise relative to a mental task.

Participating students reviewed a 15-word list and recited the words after three 30-minute sessions on the treadmill at low, medium, and maximum capacity. They then returned 24 hours later to repeat the same word list. The students repeated the activity as a whole five times. Based on their performance, Etnier found that moderate and maximal exercise offered the greatest short-term benefits, but maximum exertion prompted the best performance the next day.

Etnier found further evidence of the importance of timing when studying children in the second, fourth, and sixth grades. Her team tested students after they exerted their maximum effort to complete a one-mile run (fourth and sixth graders) or an eight-minute run (second graders). Half of the children tested reviewed a 15-word list before the run, and half reviewed the word list after the run. They returned and were tested on their word recall 24 hours later. Those who ran prior to hearing the list remembered more words than those who ran after.

“Historically, there have been teachers who were afraid that if students exert themselves highly that it would hurt their academic performance,” she says. “We found that they actually performed better when they ran just before being asked to memorize the words than when they didn’t.”

These findings, she says, support the inclusion of physical education sessions early within the school day.

ACL Injury — Female Hormones At Fault?

Researchers have known for decades that women are more likely than men to suffer injury to the anterior cruciate ligament (ACL) — the ligament responsible for stabilizing the knee during jumping, landing, pivoting, and changing speeds. But the reasons behind this difference are still fuzzy.

Dr. Sandra Shultz has been at the forefront of these investigations since the late 1990s, looking specifically at how hormones might affect knee laxity in women.

“We’ve learned that laxity varies greatly among men and women,” Shultz says. “Women naturally have greater laxity than men. That’s important because research shows that greater laxity increases the risk of injury.”

Laxity refers to the amount of existing ligament looseness. With knees, laxity impacts stability. People with greater laxity tend to land more stiffly, and the knee collapses inward. Injuries occur when the force of impact on the knee overwhelms what the ACL can handle — often, the ligament just isn’t strong enough.

Shultz is investigating the potential for hormones to influence that laxity. Past research has shown that more injuries occur during the first half of a woman’s menstrual cycle compared to the second. Shultz’s team hypothesized that the reason might lie in fluctuations in estrogen, progesterone, testosterone, and possibly relaxin, the hormone most responsible for ligament laxity during pregnancy.

To test these changes, the team gathered blood samples from female undergraduate students, measuring their knee laxity on the same days the samples were drawn. They then identified the days of minimum and maximum laxity in each female’s cycle. On those days, subjects were asked to perform a landing maneuver while the researchers measured their lower extremity movement patterns. As expected, on days of maximum laxity, subjects exhibited movement patterns that are associated with a higher risk for injury.

The researchers assessed each subject’s hormone levels and other blood markers on days of minimum and maximum laxity. What they found? Not only do hormone changes correlate with changes in observed laxity, they also correlate with changes in collagen metabolism — in a way that can alter the makeup and structural integrity of soft tissue. These changes most likely contribute to a structurally weaker ligament and render the knee less mechanically stable at certain times of the month.

Dr. Randy Schmitz, Shultz’s colleague, is also adding to what researchers know about ACL injury and recovery. He’s following women who’ve had surgery for ACL injury to observe how their knee cartilage changes in the six months post-operation. He wants to know whether those early changes can predict how the subjects will walk over time. Such knowledge could impact rehabilitation. Figuring out better ways to treat or possibly prevent ACL injuries in females is critical, Shultz says, because the impact is lifelong. The majority of ACL injuries happen between ages 14 and 15, and arthritis sets in within 10 years to 15 years. That means injured young women can have arthritic knees — and face a future of knee replacements — by age 30.

Having a greater understanding of the variability of who’s at risk will help Shultz and her team better understand who to target for intervention.

“These injuries add up to missed time in sports and activities and an increase in potential long-term complications,”Shultz says. “Ultimately, we want to understand what factors increase knee laxity, and then determine if laxity can be changed or not through prevention and strengthening, since some evidence suggests that more muscle mass around the knee is associated with less knee joint laxity.”

Taken together — and individually — the ongoing work inside labs led by Rhea, Etnier, Shultz, and Schmitz continues to move the needle in the right direction for what we know about healthy movement and how the human body and brain can help themselves. Over time, their investigations hold great promise for combatting and, potentially, preventing and conquering some of the most common causes of impaired motion that both men and women face.

To read the article at its original location: http://research.uncg.edu/wp-content/uploads/2015/12/onlinefall2015.pdf

December 9, 2015 Posted by | Education, Healthcare | , , , , , , , , , , , , , , , | Leave a comment

Medical Schools Develop Programs to Grow Primary Care Pipeline

Published in the November 2015 AAMC Reporter

By Whitney L.J. Howell

With a looming doctor shortage, several medical schools are launching programs and curricula to help encourage students to pursue primary care careers. The hope is that students will have more time to develop a career interest in disciplines such as family medicine, internal medicine, and general pediatrics.

According to an AAMC study released in March, the United States will face a shortage of up to 90,000 physicians by 2025, with a deficit of up to 31,000 primary care doctors. Much of the shortage can be attributed to a growing and aging population that will require more of both primary and specialty care.

“We know fewer trainees are going into [internal medicine], but we’ve been working to improve the lifestyle and reimbursement for [internal medicine] and, more broadly, primary care,” said Ann Nattinger, MD, general internal medicine (GIM) chief for the Medical College of Wisconsin (MCW). “But improving reimbursement and redesigning the field won’t do anything without students. We must have a pipeline of bright, motivated medical students and residents.”

Encouraging primary care

Rowan University Cooper Medical School opened doors to its first medical school class in 2011. Already, institution leaders are focusing on promoting primary care and augmenting the number of providers.

In July, Cooper received a $1.75 million grant from the Health Resources and Services Administration Primary Care Training and Enhancement program to bolster primary care training. According to Vice Dean Anne Reboli, MD, funding will support faculty development, as well as a new three-year, competency-based curriculum.

Within the curriculum, which will begin in 2016, students will train in patient-centered medical homes (PCMHs) with a variety of primary care providers.

“We’re convinced students need the ability to respect and understand the role of other providers,” Reboli said.

Cooper students also run a primary care clinic where they learn about barriers to care and provide services under faculty supervision. The clinic operates four days a week, and each student works three hours weekly.

At Duke University School of Medicine, students who are interested in primary care can enroll in the Primary Care Leadership Track (PCLT), which increases exposure to primary care. During clinical training, students follow the same patients throughout the year and complete coursework in health literacy and community engagement. Students who enroll in PCLT sign a letter of intent to pursue primary care and receive a scholarship of $10,000 annually. If students do not remain in primary care, the scholarship reverts to a loan.

Students at the Texas Tech University Health Sciences Center can choose to complete medical school in three years through the Family Medicine Accelerated Track (FMAT), enabling graduates to enter the workforce a year earlier and save a year of tuition. Students also receive scholarship support. The program leads directly to a family medicine residency at one of three Texas Tech programs in the state. According to FMAT reports, more than 90 percent of family medicine residents continue practicing in primary care.

In addition to efforts originating at individual medical schools, the Society for General Internal Medicine (SGIM) is encouraging more students to enter primary care with its ProudtobeGIM campaign, which launched in October. According to MCW’s Nattinger, a ProudtobeGIM’s project leader, the program aims to make primary care more attractive. Twenty medical schools applied for funding, and six were selected to create and test innovative methods to increase GIM interest among first- and second-year students.

“We want to learn what works with different kinds of students so we’re ensuring we can speak to a broad group of medical students across the country,” Nattinger said.

Medical speed dating

It is an exciting time for primary care, noted Paul O’Rourke, MD, MPH, GIM fellow at Johns Hopkins Medicine and ProudtobeGIM liaison. The Affordable Care Act, new payment models, and the advent of PCMHs provide opportunities for medical students to observe how primary care physicians are contributing to delivery reforms and make it vital to bolster the number of GIM doctors.

In a novel approach to expanding the physician pipeline, Johns Hopkins used a speed-dating model. On Oct. 30, students rotated through five groups of primary care providers—faculty and roughly 25 alumni community physicians—to discuss five topics: GIM clinical opportunities; GIM research; leadership, advocacy, and public health; medical education; and work-life balance. The event offered opportunities for interactive student-provider discussions about life as a primary care physician.

In addition, O’Rourke said, the school is designing a mentorship program to pair faculty and students with similar interests. Alongside three annual social events, students will have ongoing chances to learn from faculty, seeing how primary care providers can improve outcomes and lower costs.

“We’re passionate about GIM and feel honored to be in this position as the quarterbacks of patient care,” O’Rourke said. “We have a unique role to be there for patients during crises and minor ailments.”

November 21, 2015 Posted by | Education, Healthcare | , , , , , , , , , , , | Leave a comment

Partnership between WCU, hospitals could boost health care

Published on the Nov. 9, 2015, Carolina Public Press website

By Whitney L.J. Howell

Expanded, consistent health-care access could be around the corner for Western North Carolina if a formalized partnership between Western Carolina University and Harris Regional Hospital and Swain Community Hospital succeeds.

Announced in mid-October, and known as the Ascent Partnership, the initiative is designed to train additional nurse practitioners and create opportunities to engage the surrounding communities about wellness.

According to Doug Keskula, dean of the WCU College of Health and Human Sciences, the overall goal is to ensure North Carolina’s westernmost countries receive quality health care.

“We want to provide an exceptional educational experience for our students and future health-care professionals,” Keskula said. “We can’t do that without our partners.

“We launched discussions about how to build on our existing partnership to take things to the next level — how to better use the resources and expertise of each partner to improve the health of the community through education, service and research.”

Currently, those communities lack significant health-care services, Keskula said.

Based on Mountain Area Health Education Center data, roughly 20 percent of North Carolinians — nearly 2.2 million people — live in rural counties with limited health-care access. Statewide, 42 counties have physician shortages, meaning they have too few providers to meet patient needs. The shortfall includes all of Western North Carolina’s counties.

To address this need through the Ascent Partnership, Harris Regional and Swain Community Hospitals, which are part of Duke LifePoint Healthcare, will pay the roughly $26,000 cost for three students each to complete WCU’s two-year family nurse practitioner (FNP) program.

One student will receive the award during each of the next three years in return for a commitment to work in an area hospital for a yet-undetermined number of years. The award allows students to graduate debt-free, Keskula said, while having guaranteed employment.

The Ascent Partnership furthers a decades-long relationship, said Steve Heatherly, Harris Regional and Swain Community Hospitals’ chief executive officer. During that time, the WCU-hospital connection has spawned two university-based clinics that provide rehabilitation and primary-care services to area communities, as well as clinical training sites for WCU students.

Currently, Heatherly said, the counties immediately surrounding WCU — Jackson, Swain, Graham, and Macon — need six to eight primary-care practitioners. WCU’s nurse practitioner program graduates could fill those roles.

“If it takes two years to be trained, by four years from now, we will have used this investment and partnership with the university to put three, fully-trained primary-care practitioners to work in our communities,” he said.

“They will be able to reduce that provider shortage by one-third within five years.”

Each nurse practitioner, carrying a full patient load, can treat roughly 1,500-to-2,000 patients a year. After all three award recipients graduate, Heatherly said, they could potentially serve 4,500-to-6,000 people who currently don’t have health-care access, accounting for approximately 10 percent of the communities the partnership serves.

But, securing an appointment with a primary-care provider frequently isn’t the problem, said Melissa McKnight, health education specialist with the Jackson County Department of Public Health. Having extra nurse practitioners available to serve the community will be a benefit, she said, but it’s unlikely to address the real issues that limit access to care.

“When we surveyed our communities, we heard it’s not hard to get an appointment to see a provider,” she said.

“What’s difficult is having the transportation or financial resources to get to the provider.”

Additionally, she said, educating extra practitioners won’t reduce the area’s uninsured population. According to public health department data, in 2013, 29 percent of 18-to-65-year-olds in the area were uninsured — a rate higher than WNC and statewide averages.

At this point, specific methods for measuring the partnership’s success haven’t been identified, but Keskula said a key indicator will be whether the initiative bolsters the number of providers in the health-care workforce.

In the long run, Heatherly said, greater primary-care access could create benefits for patients. He anticipates the Ascent Partnership will lead to Western North Carolinians making fewer trips to the emergency room for primary-care services and more people controlling their diabetes.

Keskula said he hopes the program will prompt better eating habits and less smoking among the surrounding population.

“Most importantly, this is a commitment of two major employers in the area to continually seek ways to collaborate for the benefit of our communities,” Heatherly said.

“We both recognize that individually, we play important roles in maximizing the health and well-being of the communities we serve, and collectively, we can make an impact in a much greater way.”

To read the article at its original location: http://www.carolinapublicpress.org/23639/partnership-between-wcu-hospitals-could-boost-health-care

November 9, 2015 Posted by | Education, Healthcare | , , , , , , , , , | Leave a comment

Playing with the Mind: Tech Meets Neuroscience in the Future of Medical Education

Published in the October 2015 AAMC Reporter

By Whitney L.J. Howell

Neuroscientist Adam Gazzaley, MD, PhD, studies the neurons and regions of the brain associated with perception, attention, and memory, looking specifically at how distraction and multitasking can affect these abilities. His unique research combines functional magnetic resonance imaging (fMRI), electroencephalography (EEG), and transcranial magnetic and electrical stimulation to augment what we know about how changes in the aging brain can lead to cognitive decline. His current work focuses on neuroplasticity and how custom-designed video games can bolster cognitive abilities.

Gazzaley is a professor of neurology, physiology, and psychiatry at the University of California, San Francisco (UCSF), School of Medicine. He is the founding director of UCSF’s Neuroscience Imaging Center and directs the cognitive neuroscience Gazzaley Lab. In addition, he is co-founder and chief science adviser of Akili Interactive Labs, a company focused on developing therapeutic video games. He holds several patents, has authored more than 100 scientific articles, and has given more than 425 invited presentations globally. Gazzaley’s presentation at the AAMC’s 2015 Medical Education Meeting will focus on how medical education can use gaming and technology to enhance learning.

Reporter: Based on your research, what areas of cognition and memory do action video games touch? Do we know why?

Gazzaley: It depends on what type of game—even an action video game—that you’re talking about, as well as its intended impact. There are consumer games out there that were developed for entertainment purposes and sold as consumer products. And there is literature that emerged in 2002 in Nature by my friends and colleagues Daphne Bavelier, PhD, and Shawn Green, PhD, that showed action video games designed to be entertainment in the hands of young people who played them seemed to enhance their cognitive control abilities, including attention and working memory. That is the sort of research that has led to games like the one we built. [The game] was not designed as a primary entertainment tool, though that’s still important with a video game, but it was designed with the particular goal of boosting cognitive abilities. It has been shown, in older adults, to help cognitive control abilities that also are impacted by consumer games. We are continuing to explore a whole host of areas dealing with cognition.

What is it about action video games that led you to want to study how they help us understand cognitive function?

There was an impressive body of scientific literature that was published in the early 2000s showing that action video games improved cognitive ability of the young people who played them. Also, I have been creating tasks for the last decade to study the brain. I felt that building a video game could be thought of as an extension of that skill, although it’s a complex extension, for sure.

What are the challenges in using action video games for therapeutic interventions and formal educational programming to make positive cognition and memory changes? What can be done to overcome those roadblocks?

There are two major challenges to using action video games in this way. First, we have to build these games at a high level so they’re fun and engaging to play. They have to have all the critical elements of adaptivity and feedback that will lead to change. In addition, we must validate the games at a high level so we actually know if they are doing what we hope they will.

What significant changes do EEGs, MRIs, and other tests identify? And how would a person experience the impact of neural stimulation from video games? Are there benefits for people without cognitive deficits?

Those tools allow us to understand what is changing in the brain from both a structural and functional perspective. We can then associate them with the changes in cognition that we also record to understand the basic mechanisms of enhancement effects. People who play the action video games may actually notice the cognitive benefits in their real-life activities. But this seems to be more likely if the person started with a deficit. We’re not studying the impact on healthy individuals without deficits. We are optimistic, based on the pilot data, that we will have some ability to induce positive effects.

Many people are skeptical about the effect of action video gaming on mental processing. What issues do the games raise to challenge what you have seen in your research?

Many games seem to improve only performance without transfer to other aspects of cognition, which are not directly trained. We have had success with a couple of games and have published results showing that at least some degree of transfer can occur. We now are working to extend that to the next level. There are many factors involved that we still need to explore, such as new game mechanics, motivation factors, dosage, delivery schedule, as well as the basis for individual differences.

How do you envision action video gaming being used to enhance learning? In what ways can it best be used in medical education?

I am trying to determine through both game development and research if we can use these games to improve the brain’s basic information processing systems—attention, working memory, task switching, multitasking—and thus positively impact the learning process. Medical education involves a lot of memorization, but also high-level thinking and decision-making. It should benefit from a cognitive enhancement approach.

To read the article at its original location: https://www.aamc.org/newsroom/reporter/october2015/444954/spotlight.html

October 9, 2015 Posted by | Education, Healthcare | , , , , | Leave a comment

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