Virtual Town Research Articles

The Virtual City ParadigmTM for Testing Visuo-Spatial Memory, Executive Functions and Cognitive Strategies in Children With ADHD: A Feasibility Study.

Navigation is a complex process, requiring target localization, route planning or retrieval, and physical displacement. Executive functions (EFs) such as working memory, inhibition and planning are fundamental for succeeding in this complex activity and are often impaired in Attention Deficit and Hyperactivity Disorder (ADHD). Our aim was to analyze the feasibility of a new ecological navigation task, the Virtual City paradigm™ (VC™) to test visuo-spatial memory and EFs in children with ADHD. Visuo-spatial short and working memory, inhibition and planning skills were tested with standardized tasks. The VC™, a new paradigm developed by our group, used the Virtual CarpetTM technology, consisting of a virtual town with houses, streets and crossroads projected on the ground. It includes a motion capture system, tracking body movement in 3D in real time. In one condition, children were required to walk through the city and reach a sequence of houses. In the other, before walking, they had to plan the shortest path to reach the houses, inhibiting the prepotent response to start walking. The results show a good feasibility of the paradigm (feasibility checklist and ad hoc questionnaire), being ecological and motivating. VC™ measures of span positively correlated with visuo-spatial short and working memory measures, suggesting that VC™ heavily relies on efficient spatial memory. Individual subject analyses suggested that children with ADHD may approach this task differently from typically developing children. Larger samples of ADHD and healthy children may further explore the specific role of EFs and memory, potentially opening new avenues for intervention.

Exercise Is Medicine On Campus At Michigan Tech: Promoting Physical Activity During The Covid-19 Pandemic

During the COVID-19 pandemic, physical activity levels have decreased by ~30% and sitting time has increased by ~30%. Recent call to actions by the ACSM and Physiological Society have urged widespread promotion and implementation of physical activity to keep communities healthy. PURPOSE: To leverage Exercise is Medicine on Campus (EIM-OC) and promote healthy living behaviors in our rural community during the pandemic. Specifically, we aimed to: 1) assess current levels of physical activity in the community, 2) increase public awareness about staying physically active during the pandemic and 3) offer a community physical activity program. METHODS: A team of kinesiology and biology students (n = 10) led our EIM-OC initiative. Levels of physical activity in the community were assessed through an online survey. Public awareness about physical activity was promoted through an infographic, virtual town hall, and discussion with health care providers. A 10-wk physical activity program was delivered through ZOOM and social media and included live workouts (3x/wk) consisting of home-based activities (e.g., aerobic exercise, resistance exercise using common household items, yoga). RESULTS: Twenty-nine adults (51 ± 17 yrs, 28 ± 6BMI) completed the survey. Majority of adults (72%) reported they were less physically active during the pandemic and 45% indicated that they had been encouraged by a health professional to remain active. Our message of staying physically active during the pandemic was communicated through website, email, radio, newspaper, social media, and state health department. More than 35 guided workouts (30-60 min) were delivered to healthy adults and those with reduced mobility. The physical activity program was also expanded to create a University-wide physical education course (50 students, 1 credit). CONCLUSIONS: Adults in our rural community reported they were moving less and not well informed about the importance of physically activity during the pandemic. As local health departments are currently overburdened with managing COVID-19, it is imperative for exercise specialists to help facilitate and communicate the importance of physical activity. EIM-OC provided a robust platform for us to deliver critical physical activity resources and keep our community active during the COVID-19 pandemic.

Memory for spatio-temporal contextual details during the retrieval of naturalistic episodes

Episodic memory entails the storage of events together with their spatio-temporal context and retrieval comprises the subjective experience of a link between the person who remembers and the episode itself. We used an encoding procedure with mobile-phones to generate experimentally-controlled episodes in the real world: object-images were sent to the participants' phone, with encoding durations up to 3 weeks. In other groups of participants, the same objects were encoded during the exploration of a virtual town (45 min) or using a standard laboratory paradigm, with pairs of object/place-images presented in a sequence of unrelated trials (15 min). At retrieval, we tested subjective memory for the objects (remember/familiar) and memory for the context (place and time). We found that accurate and confident context-memory increased the likelihood of “remember” responses, in all encoding contexts. We also tested the participants' ability to judge the temporal-order of the encoded episodes. Using a model of temporal similarity, we demonstrate scale-invariant properties of order-retrieval, but also highlight the contribution of non-chronological factors. We conclude that the mechanisms governing episodic memory retrieval can operate across a wide range of spatio-temporal contexts and that the multi-dimensional nature of the episodic traces contributes to the subjective experience of retrieval.

Strategic Planning for the Chinese American Library Association

This report explored the Chinese American Librarians Association (CALA)’s strategic planning process for 2020-2025 during COVID-19. The paper introduced CALA’s mission statement, values, and discussed the importance of the strategic plan. A strategic planning task force was formed to create an opportunity for membership input in virtual town hall meetings and surveys. The authors presented a case study on the process of revising a strategic plan and discussed the implementation phases. The authors also shared the challenges and recommendations in organizing strategic planning for a library association.

COVID-19 vaccine acceptance among pregnant, breastfeeding, and nonpregnant reproductive-aged women

BACKGROUNDAlthough mass vaccination against COVID-19 may prove to be the most efficacious end to this deadly pandemic, there remain concern and indecision among the public toward vaccination. Because pregnant and reproductive-aged women account for a large proportion of the population with particular concerns regarding vaccination against COVID-19, this survey aimed at investigating their current attitudes and beliefs within our own institution.OBJECTIVEThis study aimed to understand vaccine acceptability among pregnant, nonpregnant, and breastfeeding respondents and elucidate factors associated with COVID-19 vaccine acceptance.STUDY DESIGNWe administered an anonymous online survey to all women (including patients, providers, and staff) at our institution assessing rates of acceptance of COVID-19 vaccination. Respondents were contacted in 1 of 3 ways: by email, advertisement flyers, and distribution of quick response codes at virtual town halls regarding the COVID-19 vaccine. Based on their responses, respondents were divided into 3 mutually exclusive groups: (1) nonpregnant respondents, (2) pregnant respondents, and (3) breastfeeding respondents. The primary outcome was acceptance of vaccination. Prevalence ratios were calculated to ascertain the independent effects of multiple patient-level factors on vaccine acceptability.RESULTSThe survey was administered from January 7, 2021, to January 29, 2021, with 1012 respondents of whom 466 (46.9%) identified as non-Hispanic White, 108 (10.9%) as non-Hispanic Black, 286 (28.8%) as Hispanic, and 82 (8.2%) as non-Hispanic Asian. The median age was 36 years (interquartile range, 25–47 years). Of all the respondents, 656 respondents (64.8%) were nonpregnant, 216 (21.3%) were pregnant, and 122 (12.1%) were breastfeeding. There was no difference in chronic comorbidities when evaluated as a composite variable (Table 1). A total of 390 respondents (39.2%) reported working in healthcare. Nonpregnant respondents were most likely to accept vaccination (457 respondents, 76.2%; P<.001) with breastfeeding respondents the second most likely (55.2%). Pregnant respondents had the lowest rate of vaccine acceptance (44.3%; P<.001). Prevalence ratios revealed all non-White races except for non-Hispanic Asian respondents, and Spanish-speaking respondents were less likely to accept vaccination (Table 3). Working in healthcare was not found to be associated with vaccine acceptance among our cohort.CONCLUSIONIn this survey study of only women at a single institution, pregnant respondents of non-White or non-Asian races were more likely to decline vaccination than nonpregnant and breastfeeding respondents. Working in healthcare was not associated with vaccine acceptance.

Vestibular cues improve landmark-based route navigation: A simulated driving study.

It is well established that humans use self-motion and landmark cues to successfully navigate their environment. Existing research has demonstrated a critical role of the vestibular system in supporting navigation across many species. However, less is known about how vestibular cues interact with landmarks to promote successful navigation in humans. In the present study, we used a motion simulator to manipulate the presence or absence of vestibular cues during a virtual navigation task. Participants learned routes to a target destination in three different landmark blocks in a virtual town: one with proximal landmarks, one with distal landmarks, and one with no landmarks present. Afterwards, they were tested on their ability to retrace the route and find the target destination. We observed a significant interaction between vestibular cues and proximal landmarks, demonstrating that the potential for vestibular cues to improve route navigation is dependent on landmarks that are present in the environment. In particular, vestibular cues significantly improved route navigation when proximal landmarks were present, but this was not significant when distal landmarks or no landmarks were present. Overall, our results indicate that landmarks play an important role in the successful incorporation of vestibular cues to human spatial navigation.

A Holistic Approach to Pathology Education During the Coronavirus Disease 2019 (COVID-19) Pandemic

A Holistic Approach to Pathology Education During the Coronavirus Disease 2019 (COVID-19) Pandemic

Cover Up This Face? The Principal Takes a Stand

This case was written for graduate students, specifically for individuals seeking school principal licensure. The COVID-19 pandemic has forced school organizations, particularly building and district leaders, to modify and alter the traditional educational model. School district leaders hosted virtual town hall meetings to receive community input to determine the safest option to deliver instruction to students. Educational leaders have endured challenges from stakeholder groups that pertain to students returning to campus amid a pandemic. Future school leaders can use this case to examine their knowledge of case law, student discipline, and navigating a complex scenario due to COVID-19.

Virtual Morris water maze: opportunities and challenges.

The ability to accurately recall locations and navigate our environment relies on multiple cognitive mechanisms. The behavioural and neural correlates of spatial navigation have been repeatedly examined using different types of mazes and tasks with animals. Accurate performances of many of these tasks have proven to depend on specific circuits and brain structures and some have become the standard test of memory in many disease models. With the introduction of virtual reality (VR) to neuroscience research, VR tasks have become a popular method of examining human spatial memory and navigation. However, the types of VR tasks used to examine navigation across laboratories appears to greatly differ, from open arena mazes and virtual towns to driving simulators. Here, we examined over 200 VR navigation papers, and found that the most popular task used is the virtual analogue of the Morris water maze (VWM). Although we highlight the many advantages of using the VWM task, there are also some major difficulties related to the widespread use of this behavioural method. Despite the task's popularity, we demonstrate an inconsistency of use- particularly with respect to the environmental setup and procedures. Using different versions of the virtual water maze makes replication of findings and comparison of results across researchers very difficult. We suggest the need for protocol and design standardisation, alongside other difficulties that need to be addressed, if the virtual water maze is to become the 'gold standard' for human spatial research similar to its animal counterpart.

Post-Training Sleep Modulates Topographical Relearning-Dependent Resting State Activity.

Continuation of experience-dependent neural activity during offline sleep and wakefulness episodes is a critical component of memory consolidation. Using functional magnetic resonance imaging (fMRI), offline consolidation effects have been evidenced probing behavioural and neurophysiological changes during memory retrieval, i.e., in the context of task practice. Resting state fMRI (rsfMRI) further allows investigating the offline evolution of recently learned information without the confounds of online task-related effects. We used rsfMRI to investigate sleep-related changes in seed-based resting functional connectivity (FC) and amplitude of low frequency fluctuations (ALFF) after spatial navigation learning and relearning. On Day 1, offline resting state activity was measured immediately before and after topographical learning in a virtual town. On Day 4, it was measured again before and after relearning in an extended version of the town. Navigation-related activity was also recorded during target retrieval, i.e., online. Participants spent the first post-training night under regular sleep (RS) or sleep deprivation (SD) conditions. Results evidence FC and ALFF changes in task-related neural networks, indicating the continuation of navigation-related activity in the resting state. Although post-training sleep did not modulate behavioural performance, connectivity analyses evidenced increased FC after post-training SD between navigation-related brain structures during relearning in the extended environment. These results suggest that memory traces were less efficiently consolidated after post-learning SD, eventually resulting in the use of compensatory brain resources to link previously stored spatial elements with the newly presented information.

Proceedings from an International Virtual Townhall: Reflecting on the COVID-19 Pandemic: Themes from Long-Term Care

Residents of long-term care (LTC) homes have suffered disproportionately during the COVID-19 pandemic, from the virus itself and often from the imposition of lockdown measures. Provincial Geriatrics Leadership Ontario, in collaboration with interRAI and the International Federation on Aging, hosted a virtual Town Hall on September 25, 2020. The purpose of this event was to bring together international perspectives from researchers, clinicians, and policy experts to address important themes potentially amenable to timely policy interventions. This article summarizes these themes and the ensuing discussions among 130 attendees from 5 continents. The disproportionate impact of the COVID-19 pandemic on frail residents of LTC homes reflects a systematic lack of equitable prioritization by health system decision makers around the world. The primary risk factors for an outbreak in an LTC home were outbreaks in the surrounding community, high staff and visitor traffic in large facilities, and crowding of residents in ageing buildings. Infection control measures must be prioritized in LTC homes, though care must be taken to protect frail and vulnerable residents from their overly blunt application that deprives residents from appropriate physical and psychosocial support. Staffing, in terms of overall numbers, training, and leadership skills, was inadequate. The built environment of LTC homes can be configured for both optimal resident well-being and infection control. Infection control and resident wellness need not be mutually exclusive. Improving outcomes for LTC residents requires more staffing with proper training and interprofessional leadership. All these initiatives must be underpinned by an effective quality assurance system based on standardized, comprehensive, accessible, and clinically relevant data, and which can support broad communities of practice capable of effecting real and meaningful change for frail older persons, wherever they chose to reside.

Report on 2020 Safe to Touch Consensus Conference on Hazardous Drug Surface Contamination.

The 2020 Safe to Touch Consensus Conference on Hazardous Drug Surface Contamination was convened in order to gather subject matter experts in the field of hazardous drug (HD) handling to develop consensus statements regarding surface contamination monitoring for adoption by stakeholders in the drug supply chain, policy, and healthcare arenas. The Safe to Touch conference convened virtually on September 22, 24, and 26, 2020. An expert panel of healthcare providers with experience in HD handling, monitoring, and research; pharmacy and nursing operations; and medication safety led the conference. An experienced audience of approximately 25 reaction panel members provided feedback to the panel via a preconference survey, during the conference, and at a postconference virtual town hall. Additionally, expert speakers presented on a range of issues, including the impact of HD surface contamination on health, current regulations and standards, surface contamination monitoring technologies, and variables impacting surface contamination testing. At the end of the conference, the expert panel developed 11 consensus statements and corresponding recommendations that should be widely disseminated in order to educate individuals regarding the impact of HD surface contamination and increase the scope of HD surface contamination monitoring. Institutions involved in the handling of HDs should set short- and long-term goals for implementation of applicable consensus statements.

Lessons learned from frontline skilled nursing facility staff regarding COVID-19 vaccine hesitancy.

BackgroundPresently a median of 37.5% of the U.S. skilled nursing facility (SNF) workforce has been vaccinated for COVID‐19. It is essential to understand vaccine hesitancy among SNF workers to inform vaccine campaigns going forward.ObjectiveTo describe the concerns raised among healthcare workers and staff from SNFs during town hall meetings.DesignSixty‐three SNFs from four corporations were invited to send Opinion Leaders, outspoken staff from nursing, nurse aid, dietary, housekeeping or recreational therapy, to attend a 1‐h virtual town hall meeting. Meetings used a similar format where the moderator solicited concerns that the attendees themselves had or had heard from others in the facility about the COVID‐19 vaccine. Physicians and moderators used personal stories to address concerns and reaffirmed positive emotions.SettingTwenty‐six video town hall meetings with SNF staff.ParticipantsHealthcare workers and staff, with physicians serving as content experts.MeasurementQuestions and comments about the COVID‐19 vaccines noted by physicians.ResultsOne hundred and ninety three staff from 50 facilities participated in 26 meetings between December 30, 2020 and January 15, 2021. Most staff reported getting information about the vaccine from friends or social media. Concerns about how rapidly the vaccines were developed and side effects, including infertility or pregnancy related concerns, were frequently raised. There were no differences in concerns raised by discipline. Questions about returning to prior activities after being vaccinated were common and offered the opportunity to build on positive emotions to reduce vaccine hesitancy.ConclusionsMisinformation about the COVID‐19 vaccine was widespread among SNF staff. Sharing positive emotions and stories may be more effective than sharing data when attempting to reduce vaccine hesitancy in SNF staff.

Essential and Expendable: Migrant Domestic Workers and the COVID-19 Pandemic.

In this article, we examine the effects of the COVID-19 pandemic on the labor conditions of domestic workers in the epicenter of the United States. We focus our analysis on the symbolic categorization of domestic work as “essential labor.” While domestic workers are lauded as heroes in public discourse, we argue that this symbolic recognition does not extend to material remuneration. Instead, we find that labor conditions better fit their categorization as expendable essential workers, meaning those whose essential labor is magnified during the pandemic but whose work remains materially undervalued. Data used in this article draw from observations of more than 30 hours of virtual town hall meetings on the pandemic hosted by migrant domestic worker advocacy groups in Los Angeles and New York.

Virtual family town hall: An innovative multi-family telehealth intervention during COVID-19

ABSTRACT The COVID-19 pandemic has posed unprecedented challenges to the U.S. mental healthcare system. Immediate action has been required to transform existing social work practice models to ensure uninterrupted delivery of essential mental health services. This paper describes how clinicians in a residential program, who offered an in-person multi-family education workshop, rapidly pivoted in the context of the pandemic to develop and implement an alternative and unique multi-family intervention model – a virtual family town hall. This innovative telehealth practice model serves as an exemplar of best practices amidst the COVID-19 pandemic as it prioritized health and safety, increased accessibility, and allowed clinicians to effectively respond to family members’ heightened informational needs.

Psychiatrists Discuss Impact of Racism Across Generations

Psychiatrists Discuss Impact of Racism Across Generations

Protecting perioperative patients and personnel in the era of COVID-19.

Protecting perioperative patients and personnel in the era of COVID-19.

Patient-centered communication: Collaborative learning and communication strategies for patient and healthcare providers in the new normal of COVID-19.

152 Background: Data from the National Cancer Institute’s Surveillance, Epidemiology &amp; End Results (SEER) program estimates in 2020 over 1.8 million new cancer diagnoses will occur. SEER data also indicates that over 15.5 million patients/survivors are currently living with a cancer diagnosis in the United States. Amid COVID-19, transitioning care beyond the clinic to minimize exposure for patients and healthcare providers is essential. Now more than ever, new and evolving ways to communicate openly and effectively are crucial for patients and their healthcare team. Methods: March-May 2020 the Raymond Foundation hosted nationwide virtual focus groups and town halls for cancer patients, survivors, and caregivers to gain a better understanding of how COVID-19 is affecting their cancer care, communication with their healthcare team, and shared decision-making. Primary goals included reaching patients in rural, urban, and community oncology settings to gain perspective from diverse populations. Results: 489 patients, survivors, and caregivers (54% female, 46% male) provided the following insights: 89% reported communication with their healthcare team had deteriorated since the pandemic; 94% indicated the need for increased communication with their healthcare team; 42% had a general knowledge of telehealth while 58% had little to no knowledge; 98% indicated they would like to learn more about telehealth options and would try this advanced class of service if offered by their healthcare team; 64% reported they were not able to accurately communicate treatment adverse effects leading to increased suffering; 96% reported increased isolation and fear of the unknown care landscape. Conclusions: Cancer patients realize the importance of patient-centered communication to facilitate a personalized dialogue to actively participate in their care. Empowering patients with the skills they require to comprehensively perceive telemedicine, virtual care, and remote monitoring will help minimize patient risk and provide an opportunity for patients to engage with their healthcare team throughout the care continuum. Implementing strategies to skillfully serve patients via telemedicine and teleconferencing may be the new normal as we virtually revive the classic house call.

Fostering Certainty in an Uncertain Era of Virtual Residency Interviews.

Fostering Certainty in an Uncertain Era of Virtual Residency Interviews.

Abstract PO-032: Patient-centered communication: Collaborative learning and communication strategies for patients and health care providers in the new normal of COVID-19

Abstract Background: Data from the National Cancer Institute’s Surveillance, Epidemiology &amp; End Results (SEER) program estimate that in 2020 over 1.8 million new cancer diagnoses will occur. SEER data also indicate that over 15.5 million patients/survivors are currently living with a cancer diagnosis in the United States. Amid COVID-19, transitioning care beyond the clinic to minimize exposure for patients and health care providers is essential. Now more than ever, new and evolving ways to communicate openly and effectively are crucial for patients and their health care team. Methods: In March-May, 2020, the Raymond Foundation hosted nationwide virtual focus groups and town halls for cancer patients, survivors, and caregivers to gain a better understanding of how COVID-19 is affecting their cancer care, communication with their health care team, and shared decision-making. Primary goals included reaching patients in rural, urban, and community oncology settings to gain perspective from diverse populations. Results: 489 patients, survivors, and caregivers (54% female, 46% male) provided the following insights: 89% reported communication with their health care team had deteriorated since the pandemic; 94% indicated the need for increased communication with their health care team; 42% had a general knowledge of telehealth while 58% had little to no knowledge; 98% indicated they would like to learn more about telehealth options and would try this advanced class of service if offered by their health care team; 64% reported they were not able to accurately communicate treatment adverse effects leading to increased suffering; and 96% reported increased isolation and fear of the unknown care landscape. Conclusion: Cancer patients realize the importance of patient-centered communication to facilitate a personalized dialogue to actively participate in their care. Empowering patients with the skills they require to comprehensively perceive telemedicine, virtual care, and remote monitoring will help minimize patient risk and provide an opportunity for patients to engage with their health care team throughout the care continuum. Implementing strategies to skillfully serve patients via telemedicine and teleconferencing may be the new normal as we virtually revive the classic house call. Citation Format: Martha Raymond, Margaret-Ann Simonetta. Patient-centered communication: Collaborative learning and communication strategies for patients and health care providers in the new normal of COVID-19 [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2020 Jul 20-22. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(18_Suppl):Abstract nr PO-032.