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'Health Care Without Walls' talk underscores robust suite of community health initiatives

January 22, 2019

Community-based care embedded in ASU College of Nursing and Health Innovation's curriculum and research

Community-based care is ASU nursing Professor Gerri Lamb’s jam.

Straight out of college, she became a visiting nurse in New York City, where her conviction in the health care approach was solidified.

“In the visiting-nurse service, everything takes place in the community,” Lamb said. “You visit people in their homes, and you see how most of health care happens in the home and the community. For me, it was the beginning of a very deep belief that that’s where health care needed to be delivered.”

It should come as no surprise, then, that when Lamb found herself in the audience at a 2018 conference, the words of Susan DentzerIn addition to serving as president and CEO of the Network for Excellence in Health Innovation, Susan Dentzer is the editor-in-chief of Health Affairs, a premier health policy journal., president and CEO of the Network for Excellence in Health Innovation (NEHI), describing an actual plan to shift the axis of the American health care system into community settings had her rapt.

“We’ve been saying health care will move out of the hospital and into the community for years,” Lamb said. “Susan Dentzer is serious about it. She has the vision — and the detail with real-world examples. Imagine making health care more accessible using all kinds of technology from telemedicine to AI to drones.”

Lamb pounced on the opportunity and invited Dentzer to share that vision with students at Arizona State University’s College of Nursing and Health Innovation.

Health Care Without Walls: What It Means for Practice, Education and Training” will take place at 3 p.m. Friday at the Health North Auditorium on ASU’s Downtown Phoenix campus. Presented by ASU’s Center for Advancing Interprofessional Practice, Education and Research (CAIPER), the event is free and open the public; registration is required.

man and woman talking to audience members at community health event
From left: Study participant Jennifer Hernandez; Allison Williams, program manager of research at the Center for Health Promotion and Disease Prevention; and Associate Professor Gabriel Shaibi talk with a community member during an event to discuss the results of their community-based diabetes intervention on the Downtown Phoenix campus on March 15, 2018. Photo by Deanna Dent/ASU Now

As Lamb said, the need for a shift to community-based care isn’t news to those in the field — least of all those preparing students for the future of health care at the College of Nursing and Health Innovation.

“We’ve been predicting that things are moving to the community probably for over 20 years, and we’re seeing it happening now,” said Associate Dean and Clinical Professor Katherine Kenny.

Appropriately, the philosophy is already deeply embedded in the college’s curriculum. College of Nursing and Health Innovation students accumulate 1,000 hours of clinical preparation over two years during their undergraduate years. While some of those hours are gained in more traditional acute-care settings, they also include practical experience in the community providing care at homeless shelters, federal health clinics and other such facilities that cater to underserved populations.

Doctor of nursing students accumulate their 1,000 hours over the course of a program that involves hands-on care for patients living at home, receiving care at federally funded clinics or living in rural areas. And students on the integrative health degree track focus on treating each patient holistically, learning firsthand from community health care professionals as varied as acupuncturists to counselors.

“The U.S. is looking at the health of other countries compared to ours and realizing that community-based care, including health promotion and prevention, is really where our health system should be moving to, knowing there will always be chronic diseases and other health issues that require acute care and hospitalization,” Kenny said.

man talking and pointing to notes on a whiteboard while a woman listens
Erin Washbon meets with the director of the HEALab, Rick Hall, at the September 2017 soft launch of the entrepreneurial space. The startup incubator is geared toward health and wellness students on the Downtown Phoenix campus but is open to students of any major, as well as faculty, staff, alumni and the general public. Photo by Anya Magnuson/ASU Now

Beginning this year, the college is floating an ambitious goal for every one of their students to have an interprofessional community-based experience during their education. And there’s certainly no shortage of opportunities.

The Student Health Outreach for Wellness (SHOW) initiative is the perfect example. The tri-university, student-run service-learning program serves such vulnerable populations as those experiencing homelessness, those from low-income communities and those recovering from substance use.

With an emphasis on interprofessional health care delivery, SHOW welcomes students from all disciplines — including nursing, psychology and social work — to provide more holistic care to patients.

On the research side of things, the projects coming out of the College of Nursing and Health Innovation share cross-disciplinary and community-focused commitments. They run the gamut from diabetes interventions that partner with the local YMCA to music-based interprofessional interventions for aging adults.

“What I see a lot of folks doing across ASU is working together to understand a problem or phenomena, and then designing interventions to address those problems and challenges,” said David Coon, College of Nursing and Health Innovation associate dean of research. “They’re working together to make change by transforming society, breaking down the walls of where health care is delivered.

“Many times,” he added, “that takes both innovation and entrepreneurship.”

To that end, the HEALab (Health Entrepreneurship Accelerator Lab) was launched in September 2017 to serve as an incubator for health- and wellness-centric businesses and products.

“What Susan Dentzer is talking about is closely aligned with our priorities at ASU,” Lamb said. “The message of health care without walls is about social embeddedness, research that is relevant to the community and the application of innovation and technology; it’s really transformative and has huge implications for how we educate students, how we collaborate with clinical partners and how we use technology across ASU.

“She’s connecting so many things we’re already doing and putting them together in a very doable, important model of health care for the future.”

Top photo: ASU doctoral student in advanced nursing practice Reena Pathak asks her patient questions during their morning meeting at the Student Health and Outreach Wellness clinic at Crossroads residential and outpatient substance-abuse treatment program in Phoenix. Photo by Deanna Dent/ASU Now

Emma Greguska

Reporter , ASU Now

(480) 965-9657

Reinforcement learning steps robotic prosthetics forward


January 18, 2019

Researchers from Arizona State University, North Carolina State University and the University of North Carolina have developed an intelligent system for “tuning” powered prosthetic knees, allowing users to walk comfortably with the prosthetic device in minutes rather than hours. The system is the first to rely solely on reinforcement learning to tune a robotic prosthesis.

Jennie Si, a professor in the School of Electrical, Computer and Energy Engineering in ASU’s Ira A. Fulton Schools of Engineering, co-authored a paper released this week in the journal IEEE Transactions on Cybernetics.   User with prosthetic knee Photo courtesy of North Carolina State University Download Full Image

Using the reinforcement learning framework, Si developed the algorithm that essentially “teaches” a prosthetic device to adapt to a user’s normal walking gait using data collected from a suite of sensors in the device and the person’s natural walking pattern.

Normally when someone receives a robotic prosthetic knee, a human practitioner works with them to modify a handful of parameters to specifically accommodate their walking gait. The process can take hours.

However, the new tuning system relies on a computer program that uses reinforcement learning to modify 12 control parameters that address prosthesis dynamics, such as joint stiffness, throughout the entire gait cycle. With this system, a person using a powered prosthetic knee can walk on a level surface in about 10 minutes.

“I recognized the unprecedented challenge of learning to control, in real time, a prosthetic device that is simultaneously affected by the human user. This is a co-adaptation problem that does not have a readily available solution from either classical control designs or the current, state-of-the-art reinforcement learning-controlled robots,” Si said.

She has been working on reinforcement learning from the dynamic system control perspective to account for sensor noise, interference from the environment and the demand of system safety and stability.

“A computer model adapts parameters on the device and compares the patient’s gait to the profile of a normal walking gait in real time,” said Helen Huang, co-author of the work and a professor in the Joint Department of Biomedical Engineering at NC State and UNC. “The model can tell which parameter settings improve performance and which settings impair performance. Using reinforcement learning, the computational model can quickly identify the set of parameters that allows the patient to walk normally. Existing approaches relying on trained clinicians can take half a day.”

While the work is currently done in a controlled, clinical setting, one goal would be to develop a wireless version of the system, which would allow users to continue fine-tuning the powered prosthesis parameters when being used in real-world environments.

“This work was done for scenarios in which a patient is walking on a level surface, but in principle, we could also develop reinforcement learning controllers for situations such as ascending or descending stairs,” Si said.

Huang says researchers hope to make the process even more efficient.

“For example, we think we may be able to improve the process by identifying combinations of parameters that are more or less likely to succeed and training the model to focus first on the most promising parameter settings.”

The researchers note that, while this work is promising, many questions need to be addressed before it is available for widespread use.

“The prosthesis tuning goal in this study is to meet normative knee motion in walking,” Huang explained. “We did not consider other gait performance, such as gait symmetry, or the user’s preference. As another example, we can use our tuning method to fine-tune the device outside of clinics and labs to make the system adaptive over time with the user’s need. However, we need to ensure the safety in real-world use since errors in control might lead to stumbling and falls. Additional testing is needed to show safety.”

If the system does prove to be effective and enter widespread use, it would likely reduce costs for prosthetic knee users by limiting the need to make clinical visits to work with practitioners.

Today three biomedical engineering doctoral students round out the research team — Xiang Gao at ASU and Yue Wen and Andrea Brandt at NC State and UNC.

Si and Huang met while Huang was a graduate student in the Fulton Schools, where she earned her master’s and doctorate degrees. The longtime collaborators plan to continue their high-impact work in this area. 

“We are thrilled to find out that our reinforcement learning control algorithm actually did learn to make the prosthetic device work as part of a human body in such an exciting applications setting,” Si said.

Matt Shipman, research communications lead at North Carolina State University, contributed to this story. 

Lanelle Strawder

Content Manager, Communications, Ira A. Fulton Schools of Engineering

480-727-5618

 
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Symposium considers how classical texts address contemporary social issues

January 16, 2019

More than 200 scholars, students and community members will gather for Race Before Race in Tempe this weekend

For many years, there existed among scholars of the medieval and Renaissance periods the old chestnut that those were the times before the concept of race existed.

We know better now, said Arizona State University English Professor Ayanna Thompson: “We’ve uncovered so much archival material to show that race did exist as a social issue back then.”

The title of an upcoming event hosted by the Arizona Center for Medieval and Renaissance Studies, for which Thompson serves as director, takes a playful jab at the outdated notion.

Race Before Race will bring together more than 200 scholars, students and community members from across the nation to ASU’s Tempe campus Friday and Saturday for a symposium that asks them to consider the study of race through the framework of classical texts.

“There’s a way in which having all these scholars together, talking through medieval and Renaissance texts and making them relevant to today is really, really powerful,” Thompson said.

The symposium will feature a dialogue between her and internationally renowned theater director Peter Sellars, in which they will consider the ways classical texts address contemporary issues.

Sellars, a recipient of the MacArthur “genius grant” fellowship, has staged plays internationally and collaborated with Nobel Prize-winning writer Toni Morrison.

“Peter Sellars is one of my favorite directors because he always forces his audience to dive headlong into the most challenging topics,” Thompson said.

Thompson talked to ASU Now about how Sellars does that and her thoughts on what medieval literature has to teach us about social issues today.

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Ayanna Thompson

Question: How did you become interested in medieval literature?

Answer: I’m interested in race studies, and it’s the time period in which the first major encounters with different cultures, religions and races were occurring on a mass scale. You can’t really understand how we think about race without going back to those origins of initial encounters and constructions of racial identity. It’s an extraordinary moment right now, because there’s a significant mass of medievalists of color and Renaissance scholars of color who are thinking along similar lines but never get to be in same room together. I initially thought of Race Before Race as a small event to bring these scholars together, but there are so many of them that what I imagined as an intimate dialogue will now be a public dialogue that includes students and community members from all over.

Q: Can you give an example of a classical work being employed to address a social issue in modern times?

A: In the wake of the Los Angeles uprising after the Rodney King beating, Peter Sellars staged a production of “The Merchant of Venice” on Venice Beach in California that made the audience think of race relations"The Merchant of Venice" is known for a famous speech on humanity. through a Shakespearean text. He also staged a production of “Othello,” a play that looks at what happens when black men are in positions of power, right after President Obama was elected. At the time, there was a national discourse around America being a post-racial society. Now, we all realize, “No, no, no, we’re not living in a post-racial society.” There’s so much we haven’t addressed yet.

Q: What are some contemporary works that owe something to classical texts in the way they address social issues?

A: I think there’s a lot in pop culture, for example, in rap songs, like when Jay-Z references “Hamlet” in his song “Marcy Me” on his album “4:44.” Maya Angelou always said she thought Shakespeare must have been a black woman. And Toni Morrison, who has worked with Peter Sellars, wrote a response play to “Othello” called “DesdemonaToni Morrison’s play "Desdemona" revolves around the title character’s relationship with the African nurse who raised her..” So there’s so much of that that swirls around, from visual art to music to theater to novels, in which classical texts are invoked as ways of thinking about contemporary issues, whether it be race, class, gender or ability. Classical texts end up being a common touchstone we can go back to. They often become a way to launch into the current moment in a more profound way.

Q: Are there any particular classical works that have especially salient lessons for today’s readers?

A: Yes, but it changes by the minute. I was just in London for an event for the Aspen InitiativeThe Aspen Initiative for Europe is a joint endeavor of the seven European Institutes that aims to pool the national resources and strengths of each partner around common values, shared ideas and policy proposals., and I led a session called “BrexitBrexit, a portmanteau of “Britain” and “exit,” refers to the impending withdrawal of the United Kingdom from the European Union. and the Bard” at the same time they were having the vote of confidenceOn Dec. 12, 2018, U.K. Prime Minister Theresa May won a vote of confidence, defeating an attempt by some of her party to oust her and install a new leader to take control of Brexit. with Theresa May. It was unbelievably profound because even though Shakespeare could not anticipate Brexit, his work has so much to say about how an English national identity was forged and what parts of that still work and what parts don’t. In reading plays like “Henry V” and “King Richard II” and “King Lear,” the participants couldn’t believe how prescient certain passages were.

 

Race Before Race

What: A two-day symposium that will bring together medieval and early modern race scholars who are seeking to push their fields in new archival, theoretical and practical directions.

When: 9 a.m.–5 p.m. Friday and Saturday, Jan. 18–19.

Where: Carson Ballroom in Old Main, on the ASU Tempe campus.

Admission: Free and open to the public. Registration is requested.

Details/registration: https://www.eventbrite.com/e/race-before-race-tickets-50368359118

Top photo: An ancient tome with miniature illustration, open inside a display case of the Austrian National Library in Vienna on May 20, 2017. Photo by Getty Images

 
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January 15, 2019

Researchers across ASU are helping people, robots and artificial intelligence collaborate more effectively, safely and ethically

When we think about robots, it’s usually in the context of their relationships with humans. Some are friendly, like Rosie the Robot from “The Jetsons” — a bizarre juxtaposition of futuristic technology and 1950s gender roles. Then there’s R2D2, whose impressive skills are punctuated with adorable beeps and chirps.

Some robots are destructive — like the Terminator, programmed to go back in time to kill. Or the Cylons from “Battlestar Galactica,” cybernetic beings that try to wipe out the entire human race.

It makes sense to consider robots in relation to humans, because robots are created by people, for people. Yet outside of movies and books, it’s easy to get caught up in advancing the technological prowess of robots without thinking about the human element. We need them to work with us, not against us, or even simply apart from us.

“Often when you start thinking about these technologies, the human kind of gets lost in the shuffle,” said Nancy Cooke, a professor of human systems engineering at Arizona State University’s Polytechnic School. “People need to be able to coexist with this technology.”

Helping people and technology collaborate well is no easy feat. That’s why researchers across ASU are teaming up to help people, robots and artificial intelligence work together seamlessly. 

Three people, in a lab, peer at a row of monitors. The caption reads: Nancy Cooke works with Aaron Bradbury (left) and Mustafa Demir on the Synthetic Teammate project. Photo courtesy of the Ira A. Fulton Schools of Engineering.
Nancy Cooke works with Aaron Bradbury (left) and Mustafa Demir on the Synthetic Teammate project. Photo courtesy of Ira A. Fulton Schools of Engineering

“One of the first things you worry about is team composition. I think it’s an important question to consider who’s doing what on the team,” Cooke said. “We need to make sure the robots are doing what they’re best suited for and the humans are doing what they’re best suited for. You have (robots) doing tasks that either the human doesn’t want to do, it’s too dangerous for the human to do, or that the AI or robot is more capable of doing.”

Cooke is a cognitive psychologist by training. She has spent years working to understand human teamwork and decision-making. Now she applies this expertise to human-technology teams as director of ASU’s Center for Human, Artificial Intelligence, and Robot Teaming (CHART), a unit of the Global Security Initiative.

CHART is providing much-needed research on coordinating teams of humans and synthetic agents. Their work involves everything from how these teams communicate verbally and nonverbally, to how to coordinate swarms of robots, to the legal and ethical implications of increasingly autonomous technology. To accomplish this, robotics engineers and computer scientists work closely with researchers from social sciences, law and even the arts.

What can human-robot teams do? There are lots of applications. Scientists can explore other planets through rovers that don’t need air and water to survive. Swarms of drones could carry out search-and-rescue missions in dangerous locations. Robots and artificial intelligence (AI) can assist human employees in automated warehouses, on construction sites or even in surgical suites.

Teaching teamwork

“One of the key aspects of being on a team is interacting with team members, and a lot of that on human teams happens by communicating in natural language, which is a bit of a sticking point for AI and robots,” Cooke said.

She is working on a study called the “synthetic teammate project,” in which AI (the synthetic teammate) works with two people to fly an unmanned aerial vehicle. The AI is the pilot, while the people serve as a sensor operator and navigator.

The AI, developed by the Air Force Research Laboratory, communicates with the people via text chat.

Two men operate a drone simulator in a lab. The caption reads: Mustafa Demir (left) and Aaron Bradbury fly a drone with assistance from a synthetic teammate in Nancy Cooke's lab. Photo courtesy of the Ira A. Fulton Schools of Engineering.
Mustafa Demir (left) and Aaron Bradbury fly a drone with assistance from a synthetic teammate in Nancy Cooke's lab. Photo courtesy of Ira A. Fulton Schools of Engineering.

“So far, the agent is doing better than I ever thought it would,” Cooke said. “The team can function pretty well with the agent as long as nothing goes wrong. As soon as things get tough or the team has to be a little adaptive, things start falling apart, because the agent isn’t a very good team member.”

Why not? For one thing, the AI doesn’t anticipate its teammates’ needs the way humans do. As a result, it doesn’t provide critical information until asked — it doesn’t give a “heads up.”

“The whole team kind of falls apart,” Cooke said. “The humans say, ‘OK, you aren’t going to give me any information proactively, I’m not going to give you any either.’ It’s everybody for themselves.”

A need for information is not the only thing people figure out intuitively. Imagine that you are encountering a new person. The person approaches you, looks you in the eye and reaches out his right hand.

Your brain interprets these actions as “handshake,” and you reach out your own arm in response. You do this without even thinking about it, but could you teach a robot to do it?

Heni Ben Amor, an assistant professor in the School of Computing, Informatics, and Decision Systems Engineering, is trying to do just that. He teaches robots how to interact with people physically by using machine learning. Machine learning is how computers and AI learn from data without being programmed.

“It’s really about understanding the other and their needs, maybe even before they are uttering them. For example, if my coworker needs a screwdriver, then I would probably pre-emptively pick one up and hand it over, especially if I see that it’s out of their range,” Ben Amor said.

Three men in a lab crowd around a robot clutching a ball. The caption reads: "I’m always having a blast with my students, coming up with crazy ideas,” says Heni Ben Amor (center), shown here with Yash Rathore (left) and Kevin Luck.
"I’m always having a blast with my students, coming up with crazy ideas,” says Heni Ben Amor (center), shown here with Yash Rathore (left) and Kevin Luck teaching a robot to throw a ball. Photo by Jessica Hochreiter/ASU

His team uses motion-capture cameras, like the one in an Xbox Kinect. It’s an inexpensive way to let the robot “see” the world. The robot observes two humans interacting with each other, playing table tennis or assembling a set of shelves, for instance. From this, it learns how to take on the role of one of the people — returning a serve or handing a screw to its partner.

“The interesting part is that no programming was involved in this,” Ben Amor noted. “All of it came from the data. If we wanted the robot to do something else, the only thing we need to do is go in there again and demonstrate something else. Instead of getting a PhD in robotics and learning programming, you can just show the movement and teach the robot.”

 

Designing droids

Lance Gharavi also works with the physical interactions between humans and robots, but he is not a roboticist. He is an experimental artist and professor in the School of Film, Dance and Theatre. He has been integrating live performance and digital technologies since the early '90s.

Several years ago, Gharavi was asked to create a performance with a robot in collaboration with Srikanth Saripalli, a former professor in ASU’s School of Earth and Space Exploration.

“I think one of my first questions was, ‘Can he juggle?’ And Sri said, ‘No.’ And I said, ‘Can he fail to juggle?’ And Sri said, ‘Yes, spectacularly!’ I said, ‘I can work with that,’” Gharavi said.

Gharavi’s team put together a piece called “YOU n.0,” which premiered at ASU’s Emerge event. Afterward, Saripalli told Gharavi that the collaboration had advanced his research and asked to continue the partnership.

“It was primarily about trying to understand the control structures and mechanisms for the Baxter robot platform,” explained Gharavi, referring to an industrial robot with an animated face created by Rethink Robotics. “They weren’t really sure how to work with it. My team created a means of interfacing with the robot so that we could operate it in a kind of improvisational environment and make it function.”

For example, the team created a system called “the mirror,” in which the robot would face a person and mirror that person’s movements.

“What we were interested in doing is creating a system where the robot could move like you, but not just mimicking you. So that you could potentially use the robot as, say, a dance partner,” Gharavi said.

His goal is to give robots some of the “movement grammar” that people have. Or to put it more simply, to make a robot move less robotically.

A portrait of a man, Lance Gharavi, lit dramatically.
“I have a pretty voracious curiosity. I’m interested in all kinds of things. I tend to like big ideas and big stories, which is one of the reasons I’m interested in science and religion and philosophy. Those are the places where we keep our biggest ideas and our biggest stories," Lance Gharavi said. Photo by Deanna Dent/ASU

“If we’re looking forward to a day when robots are ubiquitous, and interacting with robots is a common experience for us, what do we want those interactions to look like? That takes a degree of design,” he explained.

Such a future may also require people to adjust their perceptions and attitudes. Cooke’s team conducted an experiment in which they replaced the AI pilot with a person but told the other two teammates that they were working with a synthetic agent. She says they treated the pilot differently, giving more commands with less polite interaction.

“Everything we saw from how they were interacting indicated that they weren’t really ready to be on a team with a synthetic agent. They still wanted to control the computer, not work with it,” Cooke said.

In a twist on the experiment, the researchers inserted a human teamwork expert into the AI pilot role. This person subtly guided the other humans on the team, including asking for information if it wasn’t coming in at the right time. The collaboration was much more effective.

Cooke’s team continues to work with the Air Force Research Laboratory to improve the synthetic teammate and test it in increasingly difficult conditions. They want to explore everything from how a breakdown in comprehension affects team trust to what happens if the AI teammate gets hacked.

Assisting autonomy

Cooke is also collaborating with Spring Berman, associate director of CHART, on a small-scale autonomous vehicle test bed. As driverless-car technology advances, these vehicles will have to safely share the road with each other, human-driven cars, pedestrians and cyclists.

Some of the miniature robotic “cars” in the test bed will be remotely controlled by people, who will have a first-person view of what’s happening as if they are really driving a car. Other vehicles will operate autonomously. The team wants to explore a wide range of potential real-world scenarios.

A woman smiles, surrounded by small robots.
Spring Berman studies robot swarms. She often collaborates with scientists who study animals that work in groups, such as ants. In college she worked with a professor studying underwater glider vehicles. "She was looking at how fish school. I thought it was a really interesting concept to use principles from nature to design controllers for robots.” Photo by Jessica Hochreiter/ASU

“Autonomous vehicles will generally obey all the rules. Humans are a little more flexible. There’s also the issue of how do humans react to something that’s autonomous versus human-driven. How much do they trust the autonomous vehicle, and how does that vary across ages?” Berman asked.

She is an associate professor in the School for Engineering of Matter, Transport and Energy who primarily studies robot swarms. She says that CHART allows her to consider her technical work in a broader context.

“You’re so focused on proving that the swarm is going to do something that you design it to do. In reality, the robots will be operating in an uncertain environment that’s changing. There are things you can’t control, and that’s very different from a simulation or lab environment. That’s been eye-opening for me, because you’re so used to testing robot swarms in controlled scenarios. And then you think, ‘Well, this might actually be operating out in the world. How will we keep people safe? How are they going to benefit from this? What are the legal issues?’” Berman asked.

According to Ben Amor, robots still have a long way to go before they operate truly autonomously in a safe way. Currently, machine learning is mostly used in domains where making a mistake is not costly or dangerous. An example is a website that recommends products to buy based on your past choices.

A man manually manipulated a robot's arm. The caption reads: Heni Ben Amor works with a Baxter robot in his lab. Photo by Jessica Hochreiter.
Heni Ben Amor works with a Baxter robot in his lab. Photo by Jessica Hochreiter/ASU

Ben Amor notes that robots aren’t good at executing a series of interdependent actions yet. For instance, if a car turns left, it is now on a new street. Any decision it makes now will be dependent on that last decision.

“If you’re learning, that means you have to explore new things. We need to allow the robot to try things it’s never done before. But if you do that, then you also run the risk of doing things that adversely affect the human,” he said. “That’s probably the biggest problem we have right now in robotics.”

In his research, he is exploring how to ensure that this continual learning process is actually safe before conducting those kinds of experiments.

What it means to be human

If the idea of robots continually learning and acting autonomously is a bit unnerving to you, you are not alone. That is why, as ASU researchers work on perfecting the technology of robots and AI, they collaborate with humanities scholars and artists like Gharavi.

“We can’t go blithely forward, just making and creating, without giving some thought to the implications and ramifications of what we’re doing,” Gharavi said. “That’s part of what humanities people do, is think about these sorts of things.”

Gharavi is collaborating with Cooke and Berman on the autonomous vehicle test bed. His role is to create the environment that the cars will operate in, a city for robots that he calls “Robotopolis.”

The autonomous vehicle testbed at ASU. Lance Gharavi and his team will design a city around the vehicles. Photo courtesy of the Autonomous Collective Systems Laboratory.
The autonomous vehicle test bed at ASU. Lance Gharavi and his team will design a city around the vehicles. Photo courtesy of the Autonomous Collective Systems Laboratory

“What I and some designers I’m working with are creating will be something on the order of a large art installation, that will at once be a laboratory for research and experiments in robotics and also an artistic experience for people that come into the space — an occasion for meditation on technology and the future, and also history,” he explained.

Gharavi says what fascinates him about working with robotics and AI is the way it forces us to explore what it really means to be human.

“We understand robots as kind of the ultimate ‘other.’ Whatever they are, they are the opposite of human. They are objects that specifically lack those qualities that make us as humans special. At least that’s the way we have framed them,” he said.

“Through that juxtaposition, it’s a way of engaging with what it means to be alive, what it means to be sentient, what it means to be human. What it means to be human has always been up for debate and negotiation. Significant portions of the population of this country were once not considered humans. So the meaning of human has changed historically,” he continued.

Scholars in the arts, humanities and social sciences have a lot to offer scientists and engineers studying robotics. Cooke says ASU’s interdisciplinary approach to robotics and AI sets the university apart from others. It also brings its own set of challenges, just like human-robot collaboration.

“Again you have the communication problem. The language that people who do robotics speak is not necessarily the same kind of language that we speak when we’re talking about human interaction with the robots,” noted Cooke, who chaired a committee on the effectiveness of team science for a National Academies study.

“Multidisciplinary team science can be really challenging, but it also can be really rewarding,” she said about her work with CHART. “Now I feel like I’m living the dream.”

Written by Diane Boudreau. Top photo: A child interacts with a Baxter robot at ASU's Emerge festival. Photo by Tim Trumble

The Polytechnic School; the School of Computing, Informatics, and Decision Systems Engineering; and the School for Engineering of Matter, Transport and Energy are among the six schools in the Ira A. Fulton Schools of Engineering. The School of Film, Dance and Theatre is a unit of the Herberger Institute for Design and the ArtsHuman-AI-robot teaming projects at ASU are funded by the National Science Foundation, NASA, Office of Naval Research, Defense Advanced Research Projects Agency, Intel, Honda, Toyota and SRP.

Director , Knowledge Enterprise Development

480-965-7260

 
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Creating a carbon economy

January 10, 2019

It won't be an easy transition, but it's doable, say experts in policy, business and finance

Pull carbon out of the air, make money from it and save the human race.

Speeding up that process and creating a large-scale economic sea change was the topic of a panel hosted by Arizona State University on Thursday night at the Barrett & O'Connor Center in Washington, D.C.

A financier, a businessman, a policy expert and the inventor of a carbon-capture machine discussed the opportunities and obstacles involved in turning waste into capital at “Hacking for Carbon: Building an Innovation Pipeline for the New Carbon Economy.”

Their panel was part of a workshop, the goal of which was to consider how government, philanthropy and private capital can fund and de-risk a pipeline to create new technologies for the energy transition from hydrocarbons to renewable energy like solar and wind power.

Klaus Lackner has been thinking about how to manage carbon since the 1990s.

A physicist and environmental engineer at ASU, where he is the director of the Center for Negative Carbon Emissions, Lackner has built a machine that pulls carbon from the air.

“There’s no practical way to stop this in time,” Lackner said, referring to the predicted global rise in temperature. “We have to take it back. … We have to think about these technological fixes.”

Lackner pointed out the planet is beyond being repaired by planting trees, for instance. The problem is simply too huge.

“It is more challenging than most people think,” he said. “If you start getting serious about it, you see how big these numbers are. … What do we do with 17 tons of anything? The problem is fantastically large.”

However, he said, “the markets can figure this out.”

The money people at the table offered plenty of pathways toward creating a new market for carbon.

Carbon economy panel discuss ASU Washington DC
(From left) Tony Michaels, CEO of Midwestern BioAg; Sarah Kearney, founder of Prime Coalition; Bob Litterman, the Julie Ann Wrigley Global Institute of Sustainability board director; Erin Burns, associate director of policy at Carbon180; and Klaus Lackner, director of the Center for Negative Carbon Emissions at ASU, spoke at the “Hacking for Carbon” event at the ASU Barrett & O’Connor Center in Washington, D.C., on Thursday. Photo by William Brandt/LightWorks

For accelerating and bringing new tech like Lackner’s to scale, “the easiest case should be, ‘You’re going to make a lot of money doing something different,’” said Tony Michaels, the chief executive officer of Midwestern BioAg, a sustainable agriculture company that sells carbon-based fertilizer blends, livestock nutrients, seed and specialty crops. “What do you have to change about the fundamental business model?”

“What are those barriers, and what do you have to do to overcome those barriers?” said Michaels. “Don’t start with the innovation; start with the profit. … Get the creativity working on that.”

The goal is to help clean-tech companies become attractive to investors, said Sarah Kearney, the founder of Prime Coalition, a nonprofit that partners with philanthropists to invest charitable capital in companies that combat climate change, have a high likelihood of achieving commercial success and would otherwise have a difficult time raising sufficient financial support.

Kearney said a balance of philanthropic and fiduciary capital for initial investment into clean tech is the key to success.

“You want companies to graduate from needing the charitable support,” she said. “The risk is a scarlet letter. … Once you get a lot of the big-name reputable organizations, all of a sudden it becomes a club you want to be a part of.”

In the three quarters after the 2015 Paris climate talks, there was no investment in clean tech reported at all, Kearney said.

Policy needs to work in tandem with finance to get the private sector ready to take advantage of clean-tech markets, said Erin Burns, associate director of policy at Carbon180, a climate-focused nonprofit pushing technology that captures carbon-dioxide emissions and working to support its commercialization.

“We think the most pressing need is for a robust (research and development) program,” Burns said. “Right now, what we’re spending isn’t really enough.”

“Today I’d say we’re at square one, maybe square two,” Burns said. “How do we build the kind of ecosystem that allows these projects to be built at scale? … What are the policies we need to work through now? … Maybe it’s naïve, but we’re really optimistic.”

Can the damage be minimized?

“There’s a big difference between waiting 30 years and starting today,” Lackner said.

The discussion was hosted by Arizona State University’s Julie Ann Wrigley Global Institute of Sustainability in partnership with the National Council on Science and the Environment, the Security and Sustainability Forum and Carbon180.

Top photo: The direct-air carbon-capture machine at ASU's Polytechnic campus, a project of the Center for Negative Carbon Emissions. Photo by Ken Fagan/ASU Now 

Scott Seckel

Reporter , ASU Now

480-727-4502

ASU’s NASA-funded ‘Infiniscope’ program makes science accessible and interactive


January 10, 2019

Everyone can be an explorer — that’s the goal of Arizona State University’s NASA-funded digital teaching network, “Infiniscope.” This project is beginning its fourth year working with educators across the country and connecting them with cutting-edge Earth and space exploration experiences, funded by a $10.18 million grant from NASA’s Science Mission Directorate Science Activation Collective.

Infiniscope provides next-generation exploratory science activities and lessons designed to empower educators to collaborate, create and customize learning activities. The activities, which are powered by technology from Smart Sparrow, are unique in that they use NASA data and subject-matter experts, and they include adaptive feedback features for individual learners. Infiniscope makes the vastness of space and space exploration inviting, accessible and interactive for educators and learners of all ages. Credit: ASU Download Full Image

“Infiniscope is designed to take on two big challenges in using technology to teach science in schools,” explained astrobiologist Ariel Anbar, principal investigator of Infiniscope and President’s Professor with the School of Earth and Space Exploration. “How can we make amazing high-tech visualizations more useful to teachers and how do we empower teachers to be not just consumers, but creators, of digital learning experiences.”

To launch their fourth year of the program, the Infiniscope team has announced the members of the 2018-19 Education Advisory Board. This board represents a select team of educators who provide essential feedback on Infiniscope lessons, develop their own content tailored to their classroom and community and evaluate and review Infiniscope products.

“Learning how to integrate and develop my own lessons is the most impactful part of being on the board,” said returning board member Debbie Morgan, a science teacher at South Sevier High School in Richfield, Utah. “I created a lesson on the life cycle of stars and found the entire process very engaging. It provided me insight into how my students could better learn the concepts and how I could use the adaptive feedback features to help them be successful.”

 

Members represent a variety of states across the U.S. The majority of board members are educators in middle school and high school. The board also includes educators from libraries, after-school programs and science centers. Almost all members have more than 10 years of teaching experience. 

The official 2018-19 Infiniscope Advisory Board members include returning members Morgan, Alison Oswald-Keene, Diane Ripollone, Elizabeth Sebastian, Helen Coyle, John Dupuis, Maki Fullerton and Noelle Luccioni. New members are Angenette Planter, Argy Leyton, Celeste Payne, Christine Girtain, Christopher Mick, Brian R. Shmaefsky, Homero Sanjuanero, Jayna Ashlock, Jeanine Gelhaus, Jose Octavio Rivas Jr., Juliana Ciccarelli, Kara Four Bear, Katrina Madok, Lindsey S. Dahl, Luna Dara Kelondra, Meridith Mitchell, Natasha Rabinowitz, Rafael Trujillo, Sian Proctor and Srividhya Sundaram.

Ripollone, who teaches Earth science and robotics at Cardinal Gibbons High School in Raleigh, North Carolina, said that through this program she was able to review and test many lessons offered on the Infiniscope website. “This opportunity has given me a chance to collaborate with other teachers across the country.”

The current board will serve from November 2018 to October 2019 and will be evaluating one product from beginning to end every six months for a total of two per year. In addition, the board will participate in monthly discussion forums and work to engage their local community.

“Serving on the Infiniscope advisory board offered a fantastic collaborative experience with educators from a variety backgrounds and interests,” said board member Morgan. “It provided a way for us to network, share ideas and provide feedback that otherwise wouldn't have been possible or easy to orchestrate.”

Using Infiniscope in the classroom

Dupuis, a returning board member who teaches environmental science and biology at St. Thomas More Catholic High School in Lafayette, Louisiana, said that the most impactful part of the program has been creating “real-life” science work in the classroom.

One of the programs Dupuis used, for example, features scientists in the field explaining what they are working on.

“Students could then use virtual scientific instruments to take readings and collect data,” said Dupuis. “Even the tedious aspect of some of this work was very realistic for the students in a manner I have yet to see through a computer simulation.”

This year, he hopes to continue an ambitious plan to create a detailed virtual field trip focused on Louisiana’s coastal erosion and restoration efforts.

“Technology has been in the classroom for a few decades now,” said Dupuis. “But its presence has dramatically increased in the last five years or so with the increasing number of schools implementing one-to-one programs for their students. The activities and virtual field trips through Infiniscope are well planned, aligned to curriculum standards and give an immersive, real-world experience of the type I have not seen before in its predecessors.”

Returning board member Luccioni, who is a teacher at the Philadelphia Performing Arts Charter School, has also found the program to be beneficial to her students and provided a new way for her to teach science.

“By using adaptive pathways and tech-based experiences that provide instant gratification for students, misconceptions can be corrected early, increasing students' self-efficacy for science,” explained Luccioni.

New to Infiniscope in 2019

In 2019, Infiniscope will be implementing a communication and discussion forum, called "Hivespace" for participating teachers.

“We want to empower educators not just with NASA content, but with powerful technology to achieve the goals of the schools and communities they serve,” said Infiniscope community manager Jessica Swann. “Hivespace provides our network of educators a space to collaborate and explore beyond the content. It's a community of practice for educators of all kinds.”

Educators who are interested in serving on the board next year first need to join the Infiniscope teaching network. Invitations to apply will be sent to teaching network members this year with selections occurring in late summer 2019 for the 2019-20 academic year. 

“The Infiniscope Education Advisory Board members are an essential part of the success of Infiniscope, providing immediate feedback on how the experiences will work in both traditional and nontraditional settings,” said Anbar.

Karin Valentine

Media Relations & Marketing manager, School of Earth and Space Exploration

480-965-9345

 
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Health care policy wishes for 2019

January 9, 2019

ASU expert Swapna Reddy picks 5 areas for improvement in U.S. health law and policy this year

Health care will continue to be in the national spotlight in 2019, as uncertainty lingers about the future of the Affordable Care Act.

Despite regular attempts by politicians to amend or repeal aspects of the landmark health care legislation, it remains the law of the land, providing health care coverage to roughly 155,000 Arizonans and 8.5 million Americans.

As the country grapples with the best way to ensure the health and well-being of its citizens, ASU Now asked College of Health Solutions Assistant Professor Swapna Reddy to reflect on the state of health in America. She shared her top five health care wishes for the new year.

1. Decrease the prevalence of maternal mortality

"The U.S. has the highest rate of maternal mortality in the developed world — and African-American mothers are likely to have the worst outcomes — so we can do better for our women and mothers."

2. Reduce the rate of uninsured children in the United States

"If we say we care about American children — let's operationalize that through policies and action. The U.S. rate of uninsured children has risen for the first time in a decade, despite a strong economy," Reddy said. "This reflects deep inequities and dangerous implications from cuts to public programs experienced by the most vulnerable amongst us."

3. Place more emphasis on preventive health and well-being, especially as it relates to 'diseases of despair'

"Life expectancy has decreased in the U.S for the third year in a row, the only developed country to hold this record. This is largely due to a significant spike in opioid-related deaths and suicides."

4. Ensure and strengthen protections for people with pre-existing conditions and continue to expand access to care through Medicaid expansion

"The American people have spoken decisively that they do not want be discriminated against for insurance coverage based on pre-existing conditions. Let's listen to them and support policy solutions for affordable and comprehensive coverage."

5. Maintain herd immunity for preventable communicable diseases, especially in children

"Let's refocus on evidenced-based medicine to protect the health of all of our children and not turn back the clock on the spread of dangerous childhood illnesses. The U.S. is currently experiencing a rising sentiment in opposition to vaccination for preventable childhood communicable diseases — a dangerous trend, especially in 'hot spots' such as Phoenix that have amongst the highest rates of unvaccinated children in the U.S."

Protecting U.S. elections against attack: What does biology have to do with it?


January 9, 2019

Most of us think of cybersecurity and biology as distinct areas of study. To better understand how we might apply principles of immunology to developing safeguards against cyberattacks, researchers are looking to ways in which the immune system of humans and other mammals naturally combats pathogens.

In the first “Dialogues in Complexity” lecture at Arizona State University, national experts will present their insights related to this emerging field of study. “Protecting Against Bad Actors: From Election Security to Immunology” will explore how “bad actors” — whether they be pathogens or hackers — contribute to the disruptive forces in U.S. elections and our immune systems. Dialogues in Complexity, Protecting Against Bad Actors event flyer "Dialogues in Complexity, Protecting Against Bad Actors: From Election Security to Immunology” will be held Jan. 16 from 3-5:30 p.m. and will feature researchers prominent in the fields of cybersecurity and immunology. Download Full Image

At the Jan. 16 event, J. Alex Halderman of the University of Michigan will discuss cybersecurity and U.S. elections and Andrea Graham of Princeton University will discuss mammalian immunology. The event will take place from 3 to 5:30 p.m. at the Biodesign Institute Auditorium and is free and open to the public.

“The problem that the immune system solves for the body is roughly the same problem we would like cybersecurity systems to solve,” said Stephanie Forrest, director of the Biodesign Center for Biocomputing, Security and Society. Forrest is also a professor of computer science at the School of Computing, Informatics, and Decision Systems Engineering. Forrest and her team focus on the interconnectedness of biological systems and cybersecurity.

“Over the years, computer security has discovered willy-nilly many of the same ideas we see in biological systems,” Forrest said. “So the question is: Where do the parallels exist today, and how might we think about those parallels more deeply to understand new ideas for cybersecurity?”

“There should be general principles that govern what kinds of threats emerge and what kind of defenses evolve to protect against those threats. We need to ask ourselves: Are there general principles that govern malicious behaviors in systems? How do we defend against them?”

The lecture series is a result of a partnership between Forrest, Graham, Simon A. Levin and Ann Kinzig. Levin is the James S. McDonnell Distinguished University Professor at Princeton University, and the namesake of ASU’s Simon A. Levin Mathematical, Computational and Modeling Sciences Center. Ann Kinzig is a senior sustainability scientist with ASU’s Julie Ann Wrigley Global Institute of Sustainability and a professor in the School of Life Sciences.

Cybersecurity and U.S. elections

Halderman will describe how cyberattacks on U.S. voting infrastructure threaten the integrity of elections and stand to undermine confidence in democratic processes. He will also discuss recent efforts to defend against disruptions to U.S. voting, touching specifically on the cyberattacks that occurred in the 2016 presidential election and Congress’s decision to provide $380 million in funding to develop safeguards in the voting process.

Halderman has spearheaded numerous projects aimed at staving off cyberattacks that could threaten the voting process. After the 2016 election, he served as an adviser on recount initiatives in three states, and he testified in 2017 to the U.S. Senate Intelligence Committee regarding cybersecurity threats to the election process.

“Alex Halderman is one of very few people, especially in academia, who is deeply skilled and knowledgeable in technical cybersecurity issues and knowledgeable and interested in policy,” said Forrest. "His talk will highlight security issues related to our current election practices and offer suggestions for how they may be addressed."

Mammalian immunology systems

Graham will discuss mammalian immunology systems and the complex dynamics of host-parasite transmission. Graham specifically studies the driving forces of heterogeneity in hosts, parasites and disease, and with her research, she addresses how natural selection has changed host defense and parasite transmission.

“Graham’s talk will give an overview of both the promise and perils of mammalian immune defense systems,” Forrest said.

The main goal of the event is to expose the public to the important connections between biological and cyber defenses.

“I want the audience to see these topics in the same space, and to reinforce our public interest in securing our democracies,” Forrest said. In addition to the public event, a small group of researchers will convene to discuss “what is known about how biological systems defend themselves and the many cybersecurity methods that have been devised to protect computational systems,” according to Levin.

“We hope to identify commonalities, differences, gaps and outstanding questions, ultimately producing a unified understanding of how complex systems defend themselves against a variety of threats and perturbations,” he said.

ASU students or staff are urged to attend. RSVPs are encouraged as space is limited.

Gabrielle Hirneise

Assistant science writer , Biodesign Institute

480-433-4272

 
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Nobility for the environment

January 7, 2019

Oxford eco-critic Jonathan Bate takes up residence at ASU, elevating top-ranked humanities research

A prominent British biographer, broadcaster, eco-critic and Shakespearean is visiting Arizona State University this spring to elevate further the university’s already top-ranked humanities research.

From January to February 2019, Sir Jonathan Bate, professor and provost of Worcester College, Oxford University, is distinguished visiting professor in ASU’s Julie Ann Wrigley Global Institute of Sustainability. He is consulting on an emerging medical humanities project, delivering several lectures on themes of sustainability and wellness — both on and off the ASU campus — and co-teaching an eco-literature course with ASU English Professor Mark Lussier.

“The presence of an international leader in green thinking and applied humanities,” suggested Lussier, who helped arrange Bate’s visit, “confirms the growing awareness of ASU as a location for the application of humanities solutions to complicated problems facing our cities, countries and world.”

Ideas planted — and growing — at ASU

This is not the scholar’s first visit to ASU. In 2015, drawing from research for his award-winning biography of Ted Hughes, Bate considered whether the famed British poet was an “Eco-Warrior or Eco-Worrier?” for the Provost’s Distinguished Lecture Series. Bate also spoke at a 2015 sustainability event, which, in part, planted the seed for his current visiting professorship and associated lecture series.

“Here at ASU, we have learned from humanities scholars the importance of human thought, behavior, creativity and imagination in making real progress toward a desirable, sustainable future for everyone,” said Christopher Boone, dean and professor in the ASU School of Sustainability. “We look forward to working with, and learning from, Sir Jonathan Bate.”

The 2019 lecture series “How the Humanities Can Save the Planet” will discuss how humanities thought can help generate imaginative solutions to environmental concerns. Bate is set to deliver three addresses: “Paradise Lost,” ASU’s annual Environmental Humanities Initiative Distinguished Lecture, on Wednesday, Jan. 16, which will explore how “fall” myths are related to sustainability; “The End of the World As We Know It” on Tuesday, Feb. 5, which will address apocalypse narratives; and “Living Sustainably” on Wednesday, Feb. 20, which will argue for the importance of a humanities-science marriage in solving ecological crises.

 / Courtesy photo
Sir Jonathan Bate

Bate and his wife, Lady Paula Byrne — a biographer, novelist and founding director of ReLit: The Bibliotherapy Foundation — will also each deliver talks for ASU’s Institute for Humanities Research series, “Humanities Interventions in Medical Environments.”

Topics include “Literature and Mental Health: The Warwick MOOC and/as Community Outreach and Medical Intervention” (Bate on Jan. 30) and “Bibliotherapy: Poetry, Practical Applications and Health Care Environments” (Byrne on Feb. 12). Other speakers in the series are Alison Essary, an ASU clinical professor of health care delivery; Lussier of ASU English; and Dr. Daniel Hall-Flavian, medical director of the Centers for Medicine and the Humanities at Mayo Clinic.

Nurturing sustainability philosophies

Bate’s residency is borne out of ASU’s commitment to sustainability research and practice, as well as the university’s leadership in the fields of environmental and health care humanities.

Jeffrey Cohen, the dean of humanities in ASU’s College of Liberal Arts and Sciences, is among those whose work is situated in these cross-disciplinary fields. “What a thrill to have a pioneer of ecological approaches to the study of literature in residence with us this spring,” Cohen said. “Sir Jonathan Bate is exactly the kind of innovating polymath who will feel right at home at ASU.”

According to the National Science Foundation HERD survey, ASU ranks No. 4 in humanities research expenditures, ahead of Yale and Harvard. Specifically an international hub for environmental humanities research, ASU is the home of the Environmental Humanities Initiative directed by English professor Joni Adamson. Among other projects, the initiative helped establish the Humanities for the Environment network of global observatories.

Visiting scholar Bate was an “early adopter” of environmental humanities philosophies, reflected in two influential works of ecocriticism, “Romantic Ecology” (Routledge, 1991, Routledge Revival edition 2013) and “The Song of the Earth” (Picador/Harvard UP, 2000).

Sir Jonathan Bate speaks at ASU in 2015 / Photo by Bruce Matsunaga
Sir Jonathan Bate speaks at Old Main's Carson Ballroom during a visit to ASU in 2015. Photo by Bruce Matsunaga

Ecological principles and classical education

Bate has wide-ranging research interests not just in sustainability, but also in Shakespeare and Renaissance literature, Romanticism, biography and life-writing, contemporary poetry, visual culture and theater history.

A literary scholar at heart, Bate is a Fellow of both the British Academy and the Royal Society of Literature, as well as an Honorary Fellow of St Catharine’s College, Cambridge. Bate has served on the board of the Royal Shakespeare Company, broadcast for the BBC, written for the Guardian, London's Times and Telegraph, The New York Times, Wall Street Journal and Times Literary Supplement, and has held visiting posts at Yale and UCLA. In 2006, he was awarded a CBE in Queen Elizabeth II's 80th birthday honors for his services to higher education. He has been vice president (leading the humanities) of the British Academy.

In January 2015, Bate became the youngest person ever to be knighted for services to literary scholarship.

His creative works include “Being Shakespeare,” a one-man play for Simon Callow, which toured nationally and played at the Edinburgh Festival Fringe prior to three West End runs in London, as well as transfers to New York, Chicago and Trieste. He was consultant curator for the British Museum’s major Round Reading Room exhibition for the London 2012 Olympics Festival of Culture.

Bate will bring his considerable classical expertise to his and Lussier’s team-taught course, ENG 367: Environmental Issues in Literature and Film: Classic Texts & Contemporary Trends. The class curriculum will combine a revaluation of landmark works that helped define ecological thought (for example, Henry David Thoreau’s “Walden” and Rachel Carson’s “Silent Spring”) with exploration of emerging forms and theoretical models.

Bate’s residency is supported by ASU’s Julie Ann Wrigley Global Institute of Sustainability, College of Liberal Arts and Sciences, Department of English and Institute for Humanities Research.

Top photo: Sir Jonathan Bate's Jan. 16 lecture will explore how “fall” myths — like the biblical Adam and Eve story — are related to sustainability. Image: "Expulsion from the Garden of Eden" by Thomas Cole, 1828. Public domain image from Wikimedia Commons

Kristen LaRue-Sandler

communications specialist , Department of English

480-965-7611

 
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Connecting students to hospice and palliative care as career options through real-world experience

January 4, 2019

Transdisciplinary efforts at ASU focus on finding new treatment methods that benefit patients and inspire and protect caregivers

The World Health Organization estimates roughly 47 million people worldwide are currently living with dementia. By 2050, that number is expected to almost triple.

John O’Donnell, 77, of Sun City, Arizona, has been living with dementia for the past seven years.

For the last few months, Arizona State University health sciences undergraduate Arbella Yousif has been visiting him and his wife, Karen, once a week for a few hours as part of a recently introduced course on dementia at the College of Health Solutions.

During their visits, O’Donnell and Yousif play cards, work on puzzles, listen to music and go for walks. And every Monday, Yousif takes O’Donnell to his voice class.

You might call it a win-win-win situation: Yousif gets the uncommon experience of working directly with a dementia patient while still an undergrad, O’Donnell gets to engage with someone new and his wife gets much-needed time to take care of herself.

“My husband told me it’s so nice to have a young person around. Her energy and enthusiasm is just so great,” Karen said. “For a while, it really hasn’t been safe for me to leave him on his own. So this semester with Arbella here, I said, ‘OK, I’m going to get my physical, I’m going to go to the grocery store, I’m going to get all these things done.’

“I also think it’s really important that young people see that older people can deal with a diagnosis as serious as dementia and do it in a way where they still make the most of every day. Each person with dementia is different, and their dementia is different.”

Arbella Yousif and John odonnell
John O'Donnell and Arbella Yousif go for walk during one of the ASU student's weekly visits. Photo by Charlie Leight/ASU Now

Preparing caregivers for the future

The course instructor, ASU faculty associate Gillian Hamilton, said she developed “Intro to Dementia and Alzheimer’s Disease” to encourage college students to consider hospice and palliative care as career options.

“We’re finding it’s not very common; people aren’t that excited about it,” Hamilton said. And that’s unfortunate, considering the need to train the next generation of health care workers to meet the needs of such patients is great.  

“No matter what, they’re going to meet these people, and we want them to understand them and care about them,” Hamilton said. “And right now, there aren’t many chances for students to have direct care with those kinds of patients. So this is a chance for them to really spend time with a patient and their family. And it changes them.”

Throughout her time with O’Donnell, Yousif has learned to be patient and “bring joy into his life by just letting him be himself … and I slowly started learning who John really is. … He is a man with humor, knowledge and love in his heart for everyone who is around him.”

The most important lesson she learned, though, was that “everyone deserves to be treated equally and at high standards until their last day on this Earth.”

The merging of humanities and health care

Last semester, Hamilton, who also serves as administrative medical director of Hospice of the Valley, collaborated with ASU English Professor Mark Lussier and College of Health Solutions Clinical Professor Alison Essary to implement something called bibliotherapy in her dementia course.

Lussier describes bibliotherapy as the use of literature for therapeutic reasons — basically, reading aloud to a patient particular pieces of literature thought to ease stress. It’s one of the cornerstones of a project he and Essary embarked on in 2013 after a chance meeting at ASU President Michael Crow’s annual academic assembly.  

Despite the apparent disparity between their fields, they struck up a conversation about the potential of injecting humanities into health care.  

“That’s sort of typical for ASU,” Lussier mused. “’Hi, we’re in different fields but we have shared interests; let’s do this.’ And the more we talked, the more we realized there may be ways that the humanities can actually enter into certain spaces in medicine to help relieve stress for patients and help relieve burnout in the workforce.”

The pair attended a conference at the University of Oxford where they presented on narrative medicine“Narrative medicine” refers to a medical approach that utilizes people's narratives in clinical practice, research and education as a way to promote healing.. It was well-received, as was a similar presentation they gave the following year.

That’s when they decided to put their ideas to the test pedagogically and created a summer program in Florence, Italy, in which students explored medicine through the lenses of art and literature.

Based on the success of that program, Lussier and Essary introduced a cross-campus initiative at ASU over the past year to develop and launch a health humanities certificate, available through the Department of English and open to all students.

After the certificate launched, Lussier found himself back at Oxford, where he had a fellowship, and discovered scholars there were also looking into humanities-based interventions in health care, particularly bibliotherapy.  

Provost of Worcester College and Professor of English literature at Oxford Jonathan Bate and his wife, Paula Byrne, an internationally acclaimed literary biographer, had together co-edited the anthology “Stressed, Unstressed,” a collection of poems by writers such as Shakespeare, Emily Dickinson and W.B. Yeats considered well-suited for use as a tool to ease the mind. The poems can be used in diverse spaces, including medicine.

Essary and Daniel Hall-Flavin, director of Mayo Clinic Center for Humanities in Medicine, joined Lussier at Oxford, where a three-and-a-half-day “energetic exchange of ideas” among the scholars resulted in the creation of the Applied Humanities Alliance, a collaboration between ASU, Mayo Clinic, Hospice of the Valley and the ReLit Bibliotherapy Foundation in Oxford.

The alliance describes themselves as “an innovative think tank established to create actionable solutions for wicked problems in education, training and practice for caregivers in hospice and palliative care.”

Arbella Yousif and John odonnell
Arbella Yousif (shown with Sun City resident John O’Donnell) says the experience in ASU faculty associate Gillian Hamilton's class has had a major impact on her. She plans to apply for similar internships in her senior year. Photo by Charlie Leight/ASU Now

Good for the patient and the caregiver

And the future of health care does face some wicked problems.

“There is what we call the silver tsunami,” Essary said, referring to the potential health care crisis brought on by a large aging population. “And we have an insufficient number of health care workers to serve that population. So part of what we see as our role is engendering a kind of love and an interest in working with that population among our students.

“And also, because of the insufficient workforce and the demands on the current workforce, there’s a burnout epidemic. So we’re also trying to identify what type of scalable interventions can be implemented within this type of setting to offset those stressors, whether on an individual level or on an organizational level.”

The alliance’s one- to three-year goals include: training transdisciplinary undergraduate and graduate students through experiential opportunities; convening a team of physicians, health care professionals, scholars, patients and family members to identify evidence-based strategies to burnout; and designing and implementing web-based modules for both caregivers and patients in the core competencies of hospice and palliative care.

As part of the first goal, Lussier and Essary worked with Hamilton to incorporate bibliotherapy into her dementia course for the spring 2018 semester, utilizing the “Stressed, Unstressed” anthology.  

Hamilton thought it was particularly beneficial for the students because it “helps them look more closely at the patients and see them differently.”

During the fall semester, the alliance looked at the effectiveness of bibliotherapy on increasing empathy and relieving burnout when used by professional caregivers at Hospice of the Valley and Mayo Clinic Rochester. They measured it against applied mindfulness techniques. There was also a control group who received no intervention. Researchers are currently analyzing the results.

Lussier and Essary have received several grants to fund research and expansion of the alliance, including the Gonda Grant, an internal grant within Mayo Clinic’s system, and a seed grant awarded by the College of Health Solutions.  

Lussier envisions a future where patients are given a regimen that instructs them to “do this exercise, take this prescription and read these three pages.”

The hope is that the alliance serves as an infrastructure to research, educate and implement humanities-based interventions in medicine to reduce burnout and attract more people to the field.

Yousif had very little knowledge of dementia before taking Hamilton's course but now plans to enroll in an internship during her senior year just so she can get more experience in the area.

“This class has changed my life forever and that, I am sure of,” she said.

Top photo: Health sciences junior Arbella Yousif works on a word-search puzzle with Sun City resident John O’Donnell, who has early onset Parkinson’s disease and dementia. Photo by Charlie Leight/ASU Now

Emma Greguska

Reporter , ASU Now

(480) 965-9657

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