October 12, 2009 • THE GAZETTE
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T E C H N O L O G Y
JHU brings virtual learning to Baltimore County schools By Kristi Marren
Applied Physics Laboratory
APPLIED PHYSICS LABORATORY
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oftware engineers at Johns Hopkins’ Applied Physics Laboratory, in collaboration with JHU’s Center for Technology in Education, have developed a prototype Virtual Learning Environment to provide Baltimore County students with a gaminglike experience to augment existing math and science curricula. The first of its kind in the nation, the VLE is located at Chesapeake High School in Essex, Md. It is deployed in a new facility modeled after a state-of-the-art 3-D visualization facility at APL, used for Department of Defense and NASA projects, called ARENA for Augmented Reality Environment at APL. Like the ARENA lab, the Virtual Learning facility at Chesapeake High School includes 10 high-definition 72-inch TV monitors arranged in two five-screen semicircles. Students will interface with what they see on screen using a custom-designed digital switch and touch-panel controller. Additionally, an adjoining classroom housing 30 workstations, each outfitted with three monitors, will run the same scenarios as the larger virtual facility so that lessons can be applied on an individual or team basis. The first 3-D virtual environment the students will experience is a geographically accurate terrain model of the area surrounding Mount St. Helens in Washington state.
Dave Peloff of JHU’s Center for Technology in Education, standing at left, and APL software engineers Jim Miller and Kevin Huber, seated at the controls of the Virtual Learning Environment, demonstrate the virtual tool’s capabilities to teachers, students and reporters during Baltimore County Public School Superintendent Joe Hairston’s annual address at Chesapeake High School in Essex, Md.
They’ll traverse the area in a “vehicle” that can morph from an aircraft to a car or boat, encountering learning challenges involving virtual characters, animals or other 3-D objects specific to the curriculum being addressed. The APL-developed software enables teachers to customize the learning modules by adding resources such as documents, Web sites, photos and videos.
“We’re providing a very compelling environment to excite students about math and science,” said Jim Miller, APL’s senior software engineer for the project. “It’s a different way for them to learn, and for teachers to present, math and science concepts.” Tim Frey, assistant supervisor of the APL group developing the Virtual Learning Environment prototype, said, “This is a unique
opportunity to work with other Johns Hopkins personnel and transition technology designed for the government to meet a critical educational need in our community, which reflects a larger educational crisis in our country. Studies have shown that U.S. students are lagging behind in math and science, and we hope this pilot program will capture and maintain students’ interest in these subjects and help expose them to careers in these fields as well,” he said. Although the tool will initially augment math and science curricula, the school also plans to use the Virtual Learning Environment for additional content areas, such as English and social studies courses. During the next year, APL will develop other virtual environments, such as the lunar South Pole. Future software developments will enable teams of students to simultaneously use the system, and will enable teachers to embed quizzes within the learning modules. The Virtual Learning Environment project grew out of a recently completed U.S. Department of Education “Star Schools” grant, initially awarded to Maryland Public Television, focused on the potential of gaming and simulation technologies to provide contextual, active and effective learning experiences. For this project, APL is responsible for software development to support deployment to Chesapeake High School’s VLE. JHU’s Center for Technology in Education is helping Chesapeake teachers develop curricula and scenarios for the prototype, and is training teachers to use the system.
Hispanic children rarely get top-notch care for brain tumors B y K at e r i n a P e s h e va
Johns Hopkins Medicine
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ispanic children diagnosed with brain tumors get high-quality treatment at hospitals that specialize in neurosurgery far less often than other children with the same condition, potentially compromising their immediate prognosis and long-term survival, according to research from Johns Hopkins published in October’s Pediatrics. More than a decade after the Institute of Medicine’s landmark report “Crossing the Quality Chasm,” the Johns Hopkins investigators say their findings detect persistent gaps in access to specialized care among certain patients, raising questions about how far across the chasm we have actually come. “What was shocking to us was the finding that, despite the push over the last decade to equalize access to high-quality care, gaps are still there, particularly among Hispanics, and, if anything, they may be getting even worse,” said lead investigator Raj Mukherjee, a postdoctoral fellow in the Department of Neurosurgery at the School of Medicine. Research has shown that patients treated at specialty hospitals that admit a high volume of patients with similar conditions fare better in the long and short term, investigators say. For example, studies show that patients undergoing brain surgeries in hospitals that perform the fewest neurosurgeries have up to 16 times the mortality rate of
Related Web sites Alfredo Quinones-Hinojosa:
www.hopkinsmedicine.org/hmn/ W07/feature1.cfm
www.nytimes.com/2008/05/13/ science/13conv.html/?_r=2
Raj Mukherjee:
http://commprojects/jhsph.edu/ sommerscholars/scholar_detail .cfm?f=Debraj&l=Mukherjee
patients treated in hospitals performing the highest number. “Given that brain tumors are the most common solid tumors in children, lack of access to specialized care simply means that thousands of pediatric patients are getting less-than-optimal treatment, putting them at risk for relapse and a host of neurological complications,” said pediatric neurosurgeon George Jallo, co-author on the study and director of Neurosurgery at Johns Hopkins Children’s Center. The study, which looked at 4,421 children with brain tumors over the span of 18 years, found that access was worst among Hispanics, those of lower socioeconomic status and those living in areas with higher immigrant population and with few neurosurgeons. Insurance did not play a role in determining where a patient was treated, the researchers found. The Johns Hopkins team linked two databases—one detailing hospital and patient information and another with demographic and environmental information—elucidating in a novel way the impact of such factors as ethnicity and proportion of foreign-born people in the county of residence. Overall, only 37 percent of the patients in the study who should have been treated at a high-volume hospital had surgeries in such institutions. Hispanics consistently fared worse than the others. Even when adjusting for factors that may affect access to care, such as socioeconomic status and health insurance, Hispanic children still got specialized care at one-third the rate of other children, the team found. “If you’re a Hispanic child diagnosed with a brain tumor, you’re far less likely to get the best possible treatment, and this is concerning in and of itself, but there’s another looming threat emerging from our findings,” said senior investigator Alfredo Quinones-Hinojosa, an associate professor of neurosurgery and oncology. “Hispanics will make up 25 percent of this country’s population by the year 2050, so unless we do something about this, it looks like in the next few decades a quarter of our population may end up getting substandard care. “Our findings are yet another reminder that we are at a unique crossroad in history as
we try to restructure our health care system, and we have been given a chance to reduce, perhaps even eliminate, these inequalities once and for all,” Quinones said. Researchers said that pinpointing the exact factors that determine who gets care and where they get it requires carefully designed studies that examine individual patient decision making, as well as systemic
factors such as insurance and possible institutional bias in patient selection. The research was funded in part by the Howard Hughes Medical Institute, the Children’s Cancer Foundation and the Johns Hopkins Center for Innovative Medicine. Co-investigators in the study are Thomas Kosztowski, Hasan Zaidi, Benjamin Carson and David Chang.
Countries slow to use lifesaving diarrhea treatments for children
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espite evidence that low-cost diarrhea treatments such as lower osmolarity oral rehydration salts, or ORS, and zinc supplements could drastically reduce the number of deaths among children, little progress has been made in implementing these lifesaving techniques, according to researchers at the Johns Hopkins Bloomberg School of Public Health. Examining the implementation of current treatment guidelines, the researchers found that few countries are equipped to quickly adapt policies and that many struggle to develop and maintain the recommended supplies. The analysis is featured in the October issue of Bulletin of the World Health Organization. “Low osmolarity ORS and zinc are inexpensive, safe and easy to use, and have the potential to dramatically lower diarrhea morbidity and mortality,” said Robert Black, chair and Edgar Berman Professor of International Health at the Bloomberg School and co-author of the article. “Many countries have changed diarrhea management policies to include low osmolarity ORS and zinc, but there is a significant gap between policy change and effective program implementation, leaving few children treated appropriately. In many countries, adopting child health policies is complex, and the registration and importation of zinc supplements require input from drug regulatory agencies
and procurement officials, making it difficult to secure these necessary supplies.” Diarrhea remains the second leading cause of death among children globally, accounting for 18 percent of childhood deaths and 13 percent of all disability-adjusted life years. In 2004, the World Health Organization and UNICEF released a joint statement recommending countries switch to a lower osmolarity formulation ORS and introduce zinc supplements for 10 to 14 days to decrease diarrhea deaths among children. The recommendation came after scientific consensus that this treatment has the potential to reduce more than three-quarters of all diarrhea-associated deaths. Large-scale programs in Bangladesh and India have demonstrated that together the two treatments can decrease unnecessary use of antibiotics and reinvigorate community management of diarrhea while keeping costs low and saving lives. “Of 68 priority countries, very few have zinc widely available, and coverage within all countries is extremely limited,” said Christa Fischer Walker, lead author of the analysis and an assistant scientist with the Bloomberg School’s Department of International Health. “Ranked by leading global economists as one of the most cost-effective interventions for advancing human development, zinc supplementation in diarrhea management should be a top global health priority.” —Natalie Wood-Wright