Category Archives: Education

The Lab: virtual worlds and support for Asperger’s

This story originally appeared over at The Metaverse Journal.

Over the past few months or I’ve followed the efforts of Dale Linegar and Stefan Schutt in establishing what is now known as The Lab. Dedicated to providing support and skills to 10-16 year olds with Asperger’s Syndrome, The Lab is already showing some great results. It’s one of those initiatives that deserves much more kudos and funding than it is currently receiving. You’ll understand why after reading the interview I conducted with the Lab’s co-founders.

David: First, a little about The Lab team. Can you give a snapshot of your backgrounds?

Stefan: For the last seven years I’ve been an educator and researcher at Victoria University, working with technology and young people and teaching multimedia. Before this I worked in the Internet industry during and after the dot com boom as a content editor, producer, web developer and interaction designer. I also set up Australia’s first Computer Clubhouse, a tech skills club for underprivileged kids in Fitzroy based on the model established by the MIT Media Lab in Boston. Before all this, I worked as a writer and played in bands.

Dale: I started working with Stefan at Victoria University (VU) in 2007, teaching in Creative Industries. He had a lot of faith in the virtual worlds work I was doing then, and we have collaborated on at least half a dozen projects together since. We work well together, our skills complement each other. I run a business called Oztron, which does work for VU, Monash School of Pharmacy, and a range of other clients – most involving research and education in virtual worlds.

David: So what specifically has let you to working in this area?

Stefan: We had taught multimedia students with Asperger’s at VU and they seemed to particularly enjoy working with technology, especially the virtual worlds activities Dale was running. This led to a trial with two teenagers in Gippsland funded by Optus Communities. The results were promising and from this we applied to VicHealth for a one-on-one research project to pilot different kinds of technologies with young people with disabilities and other disadvantages. This project found that one-on-one technical tutoring seemed to work particularly well with kids with Asperger’s, and this led to the setting up of The Lab.

Dale: I think after that there were a few factors involved with us deciding to give this a go. We had established through those projects that this approach could work, and that there was a need for it. Once you reach this stage you can either publish and hope that somebody will eventually read what you write and take action, or you can give it a go yourself. The amount of money involved wasn’t huge so we decided to do it ourselves. At this time I was also meeting one young boy with Asperger’s and his mother for regular mentoring at McDonalds, we initally started at the library but were told we were making too much noise. This wasn’t ideal, and it required a lot of travel time to deal with one person.

All of this coincided with my business needing a physical location to work on a few larger contracts. This has provided us with the space, the technology and the human resources required to run The Lab.

David: For those not in the know, how prevalent is Asperger’s amongst the teen population?

Stefan: For Autism Spectrum Disorders (ASD) in general (which includes Asperger’s Syndrome), estimates for Victoria ranged in 2006 from 27 per 10 000 to 54 per 10 000. The prevalence appears to be increasing rapidly and there is debate about whether this is due to increased rates of diagnosis or increasing numbers of people with ASD.

David: Onto The Lab: it’s only just really started in earnest, what’s the journey been like to get to this stage?

Dale: Fascinating and rewarding. It’s a simple idea but when you see the immediate impact it has on both the children and their parents it’s incredibly satisfying. The process actually started with myself and Stefan walking around Footscray knocking on doors asking about vacant office and retail spaces. After a few hours we had found a suitable space, and once it becomes real like that, it takes on a life of its own. It took around 5 months from that day until we opened the doors for kids.

Some simple tasks have turned out to be a nightmare, like getting connected to the internet, and other things which initially seemed complex, like getting somebody who could work with the parents on board, involving our technology mentors, and attracting the right young people, have worked out better than we dared imagine. The physical space The Lab is in is also Oztron’s office, and it has been designed to encourage collaboration. The kids are very comfortable there – it feels more like some kind of gaming den than an office or school.

Stefan’s role at Victoria University and our previous project work means that we have a wide support network, and we have drawn on that throughout the process for advice and support in the many areas we lack knowledge in.

David: So who is funding The Lab at present and is the funding relatively secure?

Stefan: The Lab is currently unfunded, or more accurately, indirectly funded through the virtual world software development projects Dale runs for a range of organisations, as well as small amounts of left over funding from previous VU projects. Funding may be forthcoming later in the year via a Cooperative Research Centre in youth, technology and wellbeing run by the Inspire Foundation that we’re part of – but this is yet to be fully discussed with the CRC. Until then, we’re looking for other funding sources.

David: What is the scope of activities The Lab is involved in?

Dale: We currently run one session a week for 3 hours for 8 kids, and more sessions during holidays for a wider audience. What we try to do is provide as many different technology platforms as possible for the young people, which they can use to explore their own interests. Our aim is not to lead the students, but to support them and encourage collaboration. We provide students with a laptop stand, keyboard, mouse, second monitor, and network connection. We have a local server which is currently running Minecraft and allows filesharing – the kids can also log into this and play together from home. Once the kids come in it’s a case of – ‘What do you want to do?’

One of the hit pieces of software so far has been Minecraft, and this has ended up serving as a social and creative outlet for the kids. For young people who need to learn about social interaction, this has been great, they need to co-operate and respect each others’ territory. Last week we introduced an Arduino, an open-source electronic hardware and software kit comprising of a circuit board that can be programmed to do specific things, starting with simple things like making flashing lights and musical instruments and going up to projects like complex sensor-based triggering and robots with avoidance detection. The Arduino proved to be very popular, and we have now ordered a few more kits. It’s a great way to introduce kids to programming because the payoff is immediate and satisfying.

We also have a separate room where Stefan and Trish (our parent co-ordinator) hold an informal gathering for the parents each week. This gives both the kids and parents a bit of personal space. They can chat about issues they are having over a cup of tea, and discuss possible avenues of support. Trish has just organised for a psychologist to attend every fortnight, and we also have other experts with an interest in the field dropping by to offer assistance.

David: You use OpenSim, Spore and Minecraft to name three virtual environments. Let’s talk OpenSim first: has it primarily been a cost issue that’s led to its use versus say Second Life, or has there been other advantages to OpenSim?

Dale: As a business we use Opensim for nearly all of our work at the moment including Pharmatopia for Monash and a construction world for Victoria University. Second Life doesn’t provide a space where where we have total control, and people of all ages can interact, so as educators we were forced to make the switch a couple of years ago now. Like many people out there I personally have a love/hate relationship with Second Life – I love the possibilities it has created, but I have issues with the way it has been managed and promoted.

David: So what exactly are you doing in OpenSim?

Dale: We haven’t really introduced it to the wider group at The Lab because we are waiting for that opportunity to present itself, it’s up to the kids. We will run our own Opensim world which will be available to the group only – the plan is to create 8 islands and the rest is up to them. Many of the young people with Asperger’s we have worked with over the past couple of years continue to use Second Life. One young lady is using Second Life to bring her characters to life. She has written an amazing story about a group of female superheroes, and drawn pictures, and is now using the virtual world to bring her characters into the third dimension.

Another young man we work with has his dream house in Second Life and is constantly renovating, he lives in rural Victoria so for him it’s a great escape. We have also used Comic Life quite a bit in the past and will probably introduce this to interested Lab participants at some stage.

David: A common criticism of OpenSim (and Second Life) is the initial learning curve: has that been a greater or lesser issue with the teens you’ve been working with?

Stefan: Yes and no. What surprised us in our last project is how much Second Life and OpenSim rely on text-based navigation. We’d always thought of them as visual interfaces until then, but as we found out when working with kids with very low literacy levels, so much of the navigation is achieved by typing in text, which can cause issues for some kids. For others, they’ve taken to it like ducks to water, especially the younger ones. We also wonder whether the ‘learning curve’ referred to is related only to the ‘end user’ or also the people running the activity (ie teachers and managers) – this is where a lot of the problems seem to arise in terms of access, web speeds, and associated lag, plus generational issues like people not used to navigating in 3d or navigating via arrow keys like, erm, me. I always get Dale to do the practical demos because I’m so unskilled at it!

David: Now onto Spore: how are you using it?

Dale: We only use the free creature creator, firstly because it’s free, and secondly because it’s all about being creative. It’s a great icebreaker, many of the young kids we work with have already played it, and it acts as a catalyst for communication. It also gets kids into a more creative frame of mind, to feel the pleasure of making something as opposed to getting stuck competing in other games.

David: And Minecraft?

Dale: It can appear to an outsider as one of those ‘click-click-click’ games but when the kids are playing on a server together it allow for some wonderful creativity and encourages communication and collaboration. One of our mentors has built his own computer in it and knows it backwards, and the kids respect this.

David: Has Minecraft been a bit of a revelation for the work you are doing? It sort of came out of nowhere and has caught on quickly.

Dale: It has been surprising how many of the kids enjoy it, I think every one of them has played it at some stage now, and there are regularly 5 or 6 of the kids on the server during our sessions. There is a lot to learn, so I see it as the group exploring a new territory together – in this case a virtual one. They feed off each other and go on journeys, learning things they might not learn alone.

David: Talking more broadly again now, what are the individual benefits and outcomes you’ve seen so far amongst the participants?

Stefan: One big factor so far seems to be the environment of The Lab – i.e. a space where young people with Asperger’s are not picked on (unlike school, where bullying is constant), where they’re accepted and where being a ‘geek’ is even cool, and where they are surrounded by other people like them – both other kids and the programmers who are a kind of role model. Also, where their parents aren’t hovering the whole time! They’re relaxed because they’re not pushed to do anything, or to interact if they don’t want to. They can sit happily at the screen without being bugged – but the expert advice is on hand whenever they request it.

Having said that though, the level of kid-to-kid interaction to date has been quite amazing – here we’re talking about kids who don’t have any friends at all in the outside world, but who are happily chatting away and playing with others, both in-world and in the physical space.

Another factor is the technology itself, and the presence of experts to whom they can look up and respect (they usually run rings around other adults when it comes to IT). Tied to this is the sense of possible future careers, and a way into the future. This is very powerful – already we’ve heard reports of one parent halving her child’s anxiety medication dose due to his reduced anxiety levels about his future.

David: Let’s talk research: is there an underlying research methodology being used for The Lab?

Stefan: We would classify our approach as ‘participatory action research’ – our focus is on hands-on outcomes driven by all stakeholders in collaboration, and implemented (and continuously improved) by all involved. It’s based on making a real difference to real people’s lives rather than sitting back as the researchers in the white coats. It’s proudly interventionist and practical, and has a strong element of social activism.

David: Are there specific research projects underway and if so can you give a brief overview of any?

Dale: The Lab is it! We may choose to work with others in the future to measure outcomes empirically – especially researchers who are experts in ASD (which we’re not)

David: What are the measures of success for you with The Lab?

Stefan: In the short term, happier kids, happier families, and a sense of progress amongst participants. We rely heavily on feedback from the kids and the parents. It will always be tough to measure our impact in a quantitative way as each of these young kids is so unique and we are only dealing with small numbers. It’s not like we can create a control group. But we are looking to work with experts in the Autism field who may be able to measure the effects on individuals and their families over time – this is where the Cooperative Research Centre, and its 70 or so partner organisations, will hopefully come in.

David: Are there any qualitative or quantitative outcomes you’re able to see already?

Stefan: Yes. We’ve already had remarkable email and verbal feedback from participants’ parents about their children’s improvement, only three weeks into the beginning of the program. We also have 20 plus kids on our waiting list. Other parents have been ringing us daily after finding out about The Lab. It seems to have really hit a nerve. As stated previously, we’d like to get other measures too, working with field experts.

David: Given the central use of virtual environments in the program, are there any plans to expand the program geographically?

Stefan: Currently The Lab has three interlocking elements that work together: participant socialisation, technical tuition and parental networking/support. Any of those three elements would be useful in themselves (for instance, we’re arranging for a software engineer to undertake private volunteer programming tuition with one of the kids on our waiting list), but the combination of the three is especially powerful. So we could run virtual programs, and they could be useful, but some of those three elements might be missed.

Dale: My feeling is that having personal contact is still important in modern society, in this case for both the kids and their parents. We hope to build online resources which can help people at home, but nothing beats a one-to-one conversation with somebody who knows what they are talking about. I hope that we can inspire other real-world institutions to become involved.

David: Getting out the crystal ball: what are you hoping The Lab has achieved a year from now?

Stefan: What we are striving for is an effective model that can be replicated in other places and can positively influence the way society thinks about these kids, particularly in the education system which seems to be manifestly unsuited to a group of young people who are very talented.

Dale: Currently so many of the young people and their parents simply have nowhere to turn – they are stuck between normal schools and special schools, neither of which meet their needs. These people have a lot to offer to society – we deal with kids who can program their own games, but aren’t able to attend school and are at risk of being disadvantaged their entire lives. I hope that we can help support people and organisations who are interested in adopting this type of model, and I hope we can expand and deal with more kids more regularly. We live in an age where we have the opportunity to use technology to create
positive social change, and we are enjoying every moment of it.

JVWR latest issue

The latest issue of the Journal of Virtual Worlds Research has been out for a few weeks now, and I’ve been meaning to posts a synopsis, so here’s exactly that for  the peer-reviewed articles in Volume 3, No.3, with some horribly abbreviated summaries of findings for those too lazy to read the articles or the abstracts themselves.

 Synthesizing Presence: A Multidisciplinary Review of the Literature

 A detailed cross-discipline review of research on presence. 97 citations were found across Mass Communnications, Human-Computer Interfaces, Education and Psychology. Findings: there are very different perspectives on the issue depnding on the discipline and that an agreed framework for understanding the area is needed to move forward.

Collecting conversations: three approaches to obtaining user-to-user communications data from virtual environments

A very interesting look at how one effectively captures user-to-user communications in a virtual world environment. There’s a focus on establishing accuracy and three methods of collecting data are assessed within a Japanese MMO, Uncharted Waters Online. Findings: All three approaches explored are statistically viable and the choice of method depends on the individual research.

Developing an Obesity Prevention Intervention in Virtual Worlds: The International Health Challenge in Second Life

 A detailed look at a Second Life-based health initiative tackling obesity. An in-world exercise program, health information and social support was provided with promising outcomes. Challenges and opportunities of the approach are outlined. Findings: Good participation occurred, there were challenges in recruitment and retention and technical hurdles with Second Life were a barrier to a number of potential participants. Further research is recommended on optimal in-world exercise programs to deliver physical world results.

———-

Aside from those three articles, there’s a group of research papers:

 Design Principles for Doing Business on Second Life: an immersive ethnographic study

 Virtual Assisted Self Interviewing (VASI): An Expansion of Survey Data Collection Methods to Virtual Worlds by Means of VDCI

 Third Places Take First Place in Second Life: Developing a Scale to Measure the ‘Stickiness’ of Virtual World Sites

Methodology of a Novel Virtual Phenomenology Interview Technique

It’s fair to say that the research being undertaken continues to grow, although I remain a little concerned at the level of research demonstrating detailed qualitative or quantitative outcomes. It’s happening, but unfortunately at this stage the industry is still very fragmented and disseminating that information is challenging. Journals like the JVWR are obviously helping in that regard.

Virtual International Day of the Midwife 2011

A collaboration between Griffith University (Australia), Otago Polytechnic (New Zealand) and the University of Canberra (Australia), the Virtual International Day of the Midwife is in its third year (2009 and 2010 proceedings links).

For more information or to express interest in presenting, check out the VIDM Wiki.

The call for expressions of interest is as follows:

*Call for Expressions of Interest*
The organising committee are now calling for Expressions of Interest (EOI)
to present at the VIDM eVent. While the EOI must be in English we welcome
presentations in other languages. We also welcome EOI from non-midwives and
midwifery students. Presenters need not be experienced in using electronic
media – members of the organising committee will be able to give support.
Please provide a short paragraph (no more than 150 words) describing your
presentation and the form it will take (for example a PowerPoint
presentation, live or email discussion, video, photographic slide show,
story-telling session). Please also include your status (eg midwife,
non-midwife, midwifery student), country of origin and language of
presentation. Your presentations or resources should;

– Have a clear aim or purpose
– Focus on maternity care or midwifery
– Be of interest to an international audience
– Be appropriate to the chosen media

If you would like to give a live presentation, please indicate what time and
time zone you are available in your EOI.

*Support for speakers*
Please note: We will be using the web-conferencing platform Elluminate. All
live sessions will be facilitated by an experienced online facilitator so
you will be supported at every stage.

*When and where to submit your EOI*
Please submit your EOI by 11th March 2011 by;

– Email to Sarah Stewart:
sarahstewart07(at)gmail.com
– Or add it to the VIDM wiki

– Or add to the VIDM Facebook page

Medical and nursing education: more media attention

One of the advantages of being a regular (daily) observer of virtual worlds news, is you get a fair idea of trends. One growth trend over recent months has been the interest in the health applications of virtual environments.

One of the better pieces of media coverage is one by the Wall Street Journal. It’s well worth the read for anyone after a useful overview of where things are up to. The article is also pretty well balanced, citing the limitations of the approach:

The online world isn’t perfect, though, as Carol Kilmon discovered. An associate professor of nursing at the University of Texas at Tyler, Dr. Kilmon wanted to train students to respond to emergencies such as a man in cardiac arrest or a boy having trouble breathing.

But in early testing, she has run into some hitches. Many students have older computers that can’t support the Second Life system, or live in rural areas with iffy Internet connections. And it takes them a long time simply to master moving around in the virtual world. “They’re not necessarily gamers,” Dr. Kilmon says. Still, she’s pressing ahead.

That sums up the challenges very nicely, but the last sentence is the crucial one. There are hundreds of health professionals who see the potential of immersive virtual worlds for health professional training. It’s those same people who will eventually help the technology become a key aspect of a comprehensive curriculum.

ME / CFS support in Second Life

In recent weeks, thanks to a health professional colleague, I became aware of a research project underway at Murdoch University, looking at the use of virtual worlds as a support mechanism for people with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). It’s an ARC funded, three-year project titled Isolation, illness and the Internet: Exploring the possibility of a second life for sufferers of ME.

Chief Investigator for the research is Kirsty Best, a lecturer in Communication and Media Studies. She kindly spent some time explaining the research project and providing some insight on the wider issues faced by those with ME/CFS. There is also a further viewpoint after the Q&A section from Alex, an Australian living with ME/CFS who has been taking part in the project.

DH: To start off, can I get you to tell me a little about yourself, your specific role at Murdoch and with this project?

KB: I’m a Senior Lecturer with the School of Media, Communication and Culture. I received an ARC Discovery grant last year – the project and the centre are the result of that grant but I am planning to keep it going after funding runs out.

DH: So the part we’re standing in now contains resources on ME/CFS?

KB: I have created some user-friendly resources about ME/CFS. They’re aimed both at people with ME, who end up having to do a LOT of research on their own due to ignorance of the illness, and the general public. We also have a calendar of what’s going on. Then over here I have some major ME/CFS websites that I have found the most useful and user-friendly, with various theories of the cause, various treatment protocols and also support groups.

DH: With the cause theories, how have you assessed their validity?

KB: That’s not my area of expertise, and it’s not about that. This is about giving people with a very misunderstood illness the resources they need to find out more, get support, and be heard. I’m not a scientist. Some of our members are very interested in the biochemistry, etc and in our mailing list and groups the discussions often end up talking about some of these things.

DH: Absolutely – but what I’m getting at is how do you determine that the information is clinically sound? Let’s say an illegitimate site popped up making incorrect claims that could cause harm – how do you screen that?

KB: I don’t screen that. There are a lot of competing theories out there. I am just providing links to the sites that provide the best summaries of what has been said so far. To be honest, VERY little scientific research is even conducted about ME/CFS

DH: Ok, that makes sense. I suppose what I’m getting at is some of the value add for virtual worlds and health can be to provide guidance on the evidence-base or to debunk incorrect information.

KB: That is not what my work is about. I am not looking into causes and effects. I have no training in that. I am looking to provide people with ways to overcome their social isolation using virtual media. This area is a very small part of what the centre is about.

DH: Can you tell me a little about the research you are conducting here?

KB: It’s ongoing. I’m interviewing people with ME/CFS from Canada and from Australia about how and whether computers and the Internet help to ease some of the isolation they experience due to their illness, getting them set up with an avatar, getting them oriented and then seeing if SL is a useful way of supplementing some of their other Internet-based activities or whether it is too hard.

DH: Can you give any details on the methodology you’re using in the research e.g. specific qualitative or quantitative methods?

KB: I have conducted the first round of interviews, we will be having focus groups then more interviews. It’s all qualitiative.

DH: So how large is the first group?

KB: Thee’s roughly forty people.

DH: Can you describe the experience of the interviews and activities to date?

KB: Some had to drop out because of the requirements of SL: they didn’t have broadband for instance, or a fast enough computer. Real accessibility issues. But to be honest, the most important accessibility issues for people with ME are not just about hardware or bandwidth. It’s an illness that affects all systems in the body, including cognitive, and so orientation and navigation become very problematic. I do a LOT of troubleshooting. But there are benefits people are experiencing as well. It’s a mixed bag. A series of tradeoffs. People really like the social interaction, but getting their heads around the technology is hard.

However I have to say that Second Life DOES give an experience that is unique, and that people like. At the last meeting, one of our members who hadn’t been able to make it in a while said that when she saw us standing there, she felt like running up and hugging us, if she knew how to do it! She said how it really made her feel like she knew these people, and since she is pretty much housebound, having the visuals and the voice, and the virtual environment really made a difference. I’m not sure it’s worth the tradeoffs for some people, but for some it definiitely is – it depends on people’s levels of dysfunction in relation to spatial orientation to a large extent.

DH: What made you choose CFS as the research topic? Was it a personal interest?

KB: I’m very passionate about it, yes. These people have the worst of all worlds. They have a devastating illness in terms of quality of life, they have very little support from the medical community, and have to do pretty much all the research themselves–which of course they don’t have the energy for. And they have very little support from their friends and family. In fact this comes up quite a lot, and people are CONSTANTLY saying how their friends and family don’t believe them. or don’t support them, or what have you. And so this place is somewhere they can actually be understood.

DH: Was there a specific event that led you to understand how hard it is for CFS sufferers?

KB: I have a close family member who has had ME/CFS for – it must be 12 or more years now. It prompted me to do a lot of research about the condition. Let’s just say that whenever I try to explain the condition, or this project to anyone, I experience it for myself. I get very defensive. People with cancer or MS don’t feel they are having to constantly justify their illness. It’s very draining. And I”m healthy! It’s FAR worse for them.

DH: In regards to lack of support from the medical community, why do you think that is?

KB: I have been involved with volunteering for an organization in Canada that was actually LAUGHED at by a doctor when they approached him to see if he would speak at an ME/CFS Awareness Day. I think it’s changing slowly though. But very slowly. The Canadian Consensus Definition is extremely important to this – all the other clinical definitions have been sorely lacking.

DH: So for you, what would be measures of success for you, for both the research and the support here more broadly?

KB: Well success for the research would be finding out in what ways virtual environments such as SL can help this marginalized community, despite their cognitive and spatial difficulties. Hopefully we will find out specifically what is working and what isn’t. We already take our members to Virtual Ability island, who have been very helpful. But there are still a lot of ways that the evironment is very challenging to people with ME/CFS, as I have said.

I’m not sure these can be overcome completely. I think part of it is intrinsic to technology itself. There will always be these black holes where the technology fails us, no matter how advanced it gets, because bugs and usability issues are eternal. And for someone with ME/CFS, these are magnified 5000 percent. So I guess success is simply finding ways of amelioriating these black holes, if we know what to look for. I don’t think this environment will ever be for everyone with ME/CFS, but for those it reaches, its impact can be profound. I would say that is success.

DH: You mentioned that ME/CFS sufferers can experience cynicism from some health professionals – if this research demonstrates outcomes as far as social support, could this make those cynics sit up and take notice as whether they ‘believe’ in ME or not, the results will speak for themselves and need to be acknowledged?

KB: It doesn’t prove anything about the nature or reality of ME however. Unfortunate but true. I think you only have to speak to these people and be around them for a while to understand. See them totally struggle with things we find complely simple and no big deal. So I think the only thing that will potentially change someone’s mind is if they were to come here and join us for a few weeks! However, I think it’s really a culture change that needs to go on in both broader society and in the health community.

As there are more and more individuals coming forward and publicising their experiences (in books, online, in other media), as there are more and more projects and support groups and spaces such as this one that are springing up, then the community and the illness can’t help but be noticed. At this point, the culture of cynicism will hopefully slip and be replaced. So I guess I see this is a tiny brick in the wall. I do want to use it as a way to generate awareness in the broader SL community at least. I would like to hold events here and so on. How many health professionals there are that use SL I don’t know!

DH: There are quite a few 😉  Could you forsee collaborative research in the future, with say allied health professionals, on the use of virtual worlds as a support mechanism?

KB: Oh yes, that would be great, but that’s not about changing anyone’s mind. Those health professionals would already be open to it. The people who don’t believe, you can’t really budge them. I hear this over and over again from our members. I believe it. However, as I said, it is changing slowly, so there are some people who would be more open in the first place. They would be the kind we could collaborate with. The “early adopters” so to speak.

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Alex’s perspective:

Firstly, due to my illness I frequently do not enjoy being on Second Life. This isn’t about fun, it’s about need. I am too sick to function in the real world, but Second Life gives me just that – a chance to interact with people and alleviate the worst affects of severe isolation, in combination with a sense of being in the world, albeit virtual. (I play open world RPGs for much the same sense of being in the world). SL still makes demands on my health, just not as much as real life. One of the big issues is preventing desocialisation – we can become so isolated that we no longer relate to other people. Second Life allows for avatar-to-avatar talks, which while it isn’t as good as real life it does have its benefits.

For the first time I have met another person with long term ME/CFS who has similar health to me. Most people involved in CFS support groups are female, so there are very few long term male patients, and it turns out our experiences are very similar in ways that differ from most of the ladies.

Of course, I am also a long-term advocate for scientific research into ME/CFS, and this is not the first study I have been in with respect to ME/CFS, although this is the most prolonged sociological study that I have been involved in. I don’t know where this is going, and there are risks, because ME/CFS is one of the diseases in which charity and support groups occasionally fail because everyone involved can be too sick to keep things running. I do wish the researchers success in their aims, and I do see potential for this to provide social support for people too sick to find it in real life.

One of the drawbacks we keep running into is a combination of technical problems and illness issues. Some of us can’t handle too many people/avatars being around, and this is aggravated by sound degradation issues when too many people are present, particularly since most of us have problems with adapting to new technology. One fix is being tested at the moment, breaking us into smaller groups, but we have to move far enough away so that SL doesn’t pick up our speech. Large crowds of avatars in any part of SL are likely to cause problems for many of us.

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You can see the project for yourself here, and I’ve also created a quick walk-through machinima as well:

Molecular visualisation

Erich Bremer is a computer and systems engineer who has created Monolith, “a molecular visualization system created to display molecular structures within the virtual world known as Second Life and allow real-time interaction with the displayed structures”. It pulls information from the Rutgers Protein Data Bank and creates that structure in Second Life, allowing people to discuss its composition.

Here’s a short movie of Monolith in action:

There’s a relatively long history of molecular constructs in Second Life, but this is one of the more nuanced ones to date. For anyone needing to learn about molecules, this is likely a very useful resource for group discussion. Bremer himself is up front about the fact there are higher definition models that can be found online, but none that allow for this level of interaction and ease of discussion. I know when I was struggling with ribosomes and T-Cells in my nursing degree, I would have loved this as a tool to use with fellow students.

Over to you: do you see this as a truly useful adjunct to other teaching methods related to molecules?

Second Lives Clinic: demonstrating autologous stem cell transplant in Crohn’s disease

In the past week I received a note from Kerri McCusker (SL: Kerri Macchi) about a project completed for the Serious Games and Virtual Worlds Team, University of Ulster in Northern Ireland. Second Lives sets out to demonstrate a more recent approach to dealing with Crohn’s disease: autologous stem cell transplant.

You can view the Second Life aspect for yourself, or the video below explains the project in its entirety. I’ve also appended a section of the in-world notecard explaining the stem cell transplant history in some detail.

It’s yet another example of simulation as a useful adjunct for wider learning experiences. The level of complexity of this simulation is more at the patient education level rather than as a health professional training mechanism, but with further evolution it could obviously achieve both aims. I certainly learned a lot more about newer treatment options for Crohn’s disease. Anyone who’s been involved in the care of an individual with the disease knows that anything that improves health outcomes is a highly desirable thing.

Appendix: Sample of information provided by Second Lives Clinic

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Welcome to Second Lives Medical Clinic.
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This virtual clinic is a showcase of the process of the autologous stem cell transplant in Crohn’s disease.

Cellular therapy with stem cells is revolutionizing the focus of treatment of many serious diseases. Replacing the cells of damaged tissue with other new cells from the same patient is already a reality. This is the basis of cellular therapy and regenerative medicine, the latest great advance in biomedicine. In this line, Hospital Clínic, Barcelona is leading the world in the application of an innovative cellular therapy that uses stem cells to treat Crohn’s disease, a chronic genetic disease that affects 1% of the population in Spain and which has considerable impact on the quality of life of the patients. The procedure is based on an autologous bone-marrow transplant (when patients receive a transplant of their own stem cells) and now constitutes a treatment option to cure an intestinal disease that sometimes does not successfully respond to drugs and requires highly complex surgery that does not provide a cure.

Hospital Clínic, Barcelona is one of the few hospitals in the world to apply this new therapeutic option for patients with Crohn’s disease, and it does so with the guarantee of success experienced in the US and Italy, where the technique has been tested with excellent results: in an average follow-up period of 6 years, 80% of transplant patients are in a phase of total remission of the disease and the remaining 20% have shown considerable improvement following the transplant, and are now responding favorably to drugs. Dr. Julián Panés and Dr. Elena Ricart over the Gastroenterology Department of Hospital Clínic, Barcelona are the driving force behind this therapy in Spain and began to implement regenerative cellular therapy in patients with Crohn’s disease in August 2008. To date, a total of 6 patients are benefiting from this new treatment. The transplant requires several weeks of admission to hospital before patients receive their own cells. The procedure is the same as that carried out in bone-morrow transplants to cure leukemia or myeloma.

Autologous Stem-Cell Transplant: Phases of the Procedure

When the case is detected (that does not respond to drugs or surgery), the patient undergoes an autologous stem-cell transplant, which is a bone-morrow transplant in which the immune system is reset to prevent it from attacking the intestinal flora. The process lasts approximately 2 months and consists of 6 phases:
1. Initial Chemotherapy (Cyclophosphamide + G-CSF). In this initial phase, the reduction of the number of leukocytes (immune-system cells) in the blood is induced in the patient.

2. Migration of Stem-Cells to the Blood. Following the previous immunosuppression, the organism reacts by releasing stem cells from the bone marrow into the blood; these are the cells which will later be used for the transplant.

3. Collection of Stem Cells by means of Apheresis. Apheresis is a technique that separates components of the blood. Here, the stem cells that previously migrated from the bone marrow are separated.

4. Cryopreservation of Stem Cells. When the stem cells have been collected by apheresis, they are frozen and preserved until ready for transplant.

5. Second Chemotherapy. In this phase, total leukopenia is induced; that is, the immune system is left devoid of leukocytes, ready to be reset with the stem-cell transplant.

6. Autologous Stem-Cell Transplant. The patient receives the transplant by means of transfusion with his or her own stem cells. The immune system is reset, leading to remission or reduction of the abnormal inflammatory process of Crohn’s disease.

Problem-based learning in Second Life: new resource

A comprehensive new resource has been released by the UK’s University of Derby and Aston University, Titled Best Practices in Virtual Worlds Teaching: A guide to using problem-based learning in Second Life, this 40+ page publication covers a lot of ground in an easy to understand way. It’s available as a free download of a little over 6MB in PDF format.

The pivotal section for me is the one on making problem-based learning work in Second Life, with the succinct message being:

The possibilities for education within Second Life are limitless and one must be careful not to use this resource for the sake of it. Any teaching resources provided within Second Life must be embedded within traditional learning methods and fulfil a direct need within the course. Simply using Second Life for the sake of it will require time and effort from students and staff that is unwarranted and provides no additional benefit. There must be a direct applicable benefit to the material contained within Second Life, so purpose-driven use is advised rather than speculative-use.

As I’ve mentioned previously, the documentation of teaching methods in virtual environments continues to improve, and this document provides a superb overview for those new to the approach. From a health viewpoint, some good examples of Psychology projects undertaken in Second Life are given.

Thanks to Virtual World Watch for the heads-up