Research Roundup

How we respond to daily stressors can weigh us down or help lift us up. That’s the concept that informs a training module developed for adolescents and tested successfully by Jeremy Jamieson, an associate professor of psychology, and colleagues at the University of Texas, Stanford, and the Google Empathy Lab.

Conventional thinking often equates stress with something “bad,” but Jamieson, who heads Rochester’s Social Stress Lab, says “stress is a normal and even defining feature of adolescence” that allows teens to acquire a wide variety of complicated social and intellectual skills as they transition to adulthood.

Described in the journal Nature, the 30-minute online training module is designed to help teens develop two synergistic mindsets: the idea that intelligence can be developed in response to a challenge and the idea that stress responses can fuel performance. Over the course of six double-blind, randomized experiments in both laboratory and field settings, young people in grades 8 to 12 and in college who completed the module showed improved psychological well-being and fewer indications of anxiety.

The researchers caution that the tool is designed to address anxiety and depression among teens stemming from world events, peer pressure, and academics rather than those whose stressors are the result of trauma or abuse.

Says Jamieson: “These combined messages got the teenagers in our studies to view stressors as things that could be overcome, rather than as something overwhelming and outside their control.”

—Sandra Knispel

Instant Skin Biopsies May Be on the Way

A Rochester engineering professor has developed a new imaging system that could dramatically speed up the process for diagnosing biopsies for some skin cancers.

In a pilot study summarized in JAMA Dermatology, Michael Giacomelli, an assistant professor of biomedical engineering and of optics, reported that the new system was able to make accurate diagnoses in minutes rather than the much longer processes that surgeons currently rely on.

For the study, the technology evaluated 15 biopsies of known nonmelanoma skin cancer—the most common type of human cancer—and was able to detect basal cell carcinoma with perfect accuracy and squamous cell carcinoma with high accuracy.

Currently, analyzing such biopsies requires a surgeon and a pathologist and often requires more than one visit by a patient.

Even when tissue is frozen for more rapid analysis, surgeons can wait more than an hour for the results to be sure they have completely removed a malignant tumor from a patient still on the operating table.

Giacomelli, who is also on the research faculty of the Wilmot Cancer Institute, is working with Sherrif Ibrahim, an associate professor of dermatology at the Medical Center, on a larger, follow-up study. Giacomelli predicts the system eventually will have applications for many types of diseases.

—Bob Marcotte

Can Early Intervention Reduce Developmental Gaps for Children with HIV?

A long-running research effort involving Medical Center scientists and Zambian colleagues is finding some help for children with HIV. In a new study involving a project in the African nation, Rochester scientists reported that children who received better nutrition and antiretroviral therapies are less likely to face the developmental risks often experienced by children who test positive for the virus.

“HIV remains a major global health burden and children who are exposed to the virus during childbirth are known to be at greater risk for neurocognitive and psychiatric problems, like depression, as they age,” says David Bearden, an assistant professor of neurology and pediatrics at the Medical Center and senior author of the study published in the Journal of Acquired Immune Deficiency Syndromes. “This research is an attempt to understand if these problems persist and become more pronounced over time, and whether we can predict who will do well cognitively and who will not.”

The study is the most recent example of a decades-long collaboration involving an international team of researchers in sub-Saharan Africa, a region with approximately 70 percent of global HIV cases. Since 1994, Gretchen Birbeck, the Edward A. and Alma Vollertsen Rykenboer Professor in Neurology at the Medical Center, has partnered with the government of Zambia and clinicians and researchers with the University Teaching Hospital (UTH) in the capital city of Lusaka to study neurological problems associated with infectious diseases like HIV and malaria.

The Neurology Research Office established by Birbeck on the main hospital campus serves as a hub for several National Institutes of Health–funded research and training programs which have increased collaborations between UTH and the Medical Center.

The new findings come from the HIV–Associated Neurocognitive Disorders in Zambia, or HANDZ, study, an ongoing longitudinal study that’s following a cohort of 600 HIV positive and negative Zambian children ages 8 to 18 for five years.

The research found that children who were malnourished or who suffered more severe cases of HIV infection did worse on the assessments that are tracked as part of the ongoing study.

—Mark Michaud

Theater + Theory: An Improvisational Approach to Address Vaccine Hesitancy

Researchers at the Medical Center have developed a program that combines improv theater techniques with personal coaching based on self-determination theory to help health care workers guide hesitant patients toward vaccination. Described in an essay for JAMA Arts and Medicine, the Theater for Vaccine Hesitancy program reported that nearly 80 percent of its health care worker participants felt more confident and equipped to improve their conversations with patients. Nearly 30 percent believed their patients got the COVID-19 vaccine as a result of the change in their conversational approach.

The program features one-hour workshops during which team members reenact poorly executed real-world conversations between a provider and a vaccine-hesitant patient. After a short discussion, the team plays the scene again, but allows health care workers in the audience the opportunity to step into the scene as the provider and change the conversation. The “forum theater” exercise was adapted from an improvisational theater program developed in the 1970s, called Theatre of the Oppressed. In 2017, members of the Department of Health Humanities and Bioethics started using the model to help health care workers and students know how to react to instances of racial, sexual, or gender bias or discrimination.

John Cullen, professor and director of diversity and inclusion at the University’s Clinical and Translational Science Institute and lead author of the article, says, “We knew that Theatre of the Oppressed was an extremely effective tool for practicing challenging conversations with patients, so we adapted it to help coach health care workers to engage in conversations about COVID vaccinations.”

While improvisation helps health care providers build the skill and muscle memory for facilitating sensitive conversations, the science of the new program is rooted in a widely accepted theory of human motivation developed in the 1980s by Rochester psychology professors Edward Deci and Richard Ryan. The research-based theory debunks the assumption that people are motivated most strongly by external rewards, finding instead that people are more likely to choose a behavior if it meets their psychological needs of competence, autonomy, and relatedness.

Says coauthor Holly Ann Russell, an associate professor in the Department of Family Medicine and in the Center for Community Health and Prevention: “External motivators like mandates or monetary incentives have not worked for all of our patients and in some cases actually increase mistrust of public health and health care systems. So, we wanted to coach frontline health care workers on how to tap into patients’ intrinsic motivation instead.”

—Susanne Pallo ’15M (PhD)

How Should Students Be Grouped for Learning?

Students may learn better when they’re grouped with those who are similarly skilled rather than in a randomly assigned group or placed with students with a range of skill levels. That’s according to a mathematical analysis developed by Chad Heatwole, a professor of neurology at the Medical Center and the director of Rochester’s Center for Health + Technology (CHeT) and colleagues.

In the journal Educational Practice and Theory, Heatwole, Peter Wiens from the University of Nevada, Las Vegas, and Christine Zizzi, a director at CHeT, published the results of their mathematical approach designed to evaluate grouping methods. The findings? When the end goal is improving learning for all individuals, the like-skilled grouping yielded better results than cross-sectional or random grouping.

Which strategy best serves individual students is the subject of “a historic and ongoing rigorous debate,” says Heatwole. “We showed that, mathematically speaking, grouping individuals with similar skill levels maximizes the total learning of all individuals collectively.”

According to Heatwole, the research has broad implications in education, as well as in economics, music, medicine, and sports.

—Lindsey Valich