GIST Spring 2016 by Duke SSRI

gist SPRING 2016

THE SOCIAL SCIENCE MAGAZINE OF DUKE UNIVERSITY

RESEARCHERS HEAD TO SOUTH CAROLINA to learn more about the devastating impact of recent flooding

SPRING 2016

Contents

Research on the ReMo

Teaching Students How to Keep Their Brains Healthy and Improve Their Learning Abilities

Increasing The Power of Sensitive Data through Collaboration

Shaping the Classroom

Grad Students, Research and the PRDN A local student shows off her artwork during an EHD Bass Connections visit to her classroom. For the scoop, see Shaping the

Classroom on page 10.

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N E C H Y B A’ S N I C H E

Collaboration at SSRI Working together, sharing ideas and accomplishing great research Q: An EHD Bass Connections team took the ResearchMobile (ReMo) to South Carolina over winter break. Can anyone use the ReMo? A: The ResearchMobile has really been one of the hidden treasures at SSRI, and we’d love to make a push for it to be utilized more. It’s part of our Interdisciplinary Behavioral Research Center (IBRC), which is directed by Mark Leary. Mark and his team will work with anyone who is interested—it really is a very easy process, and you don’t have to already be affiliated with SSRI. The South Carolina excursion was a brilliant idea by Alexandra Cooper who directs our education and training programs, and it was the first time the ResearchMobile has left North Carolina. I hope that story opens people’s imaginations for how this resource could enhance research at Duke. It can be rapidly deployed but it can also be employed for research at schools or in outlying communities with people who ordinarily would not come to a research facility. The upcoming election, for instance, might provide fascinating ways of utilizing the ResearchMobile across the state, but it could even be used locally on different parts of the Duke Campus.

Q: Bass Connections teams are in public schools

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through neuroscience-based health curriculum and guiding professional development for classroom and ESL teachers. Why is it important that Duke undergraduates bring their research to local public schools? A: It’s one of those wonderful win-win scenarios that we love to find. So many Duke students are genuinely interested in contributing to the community, and, together with the faculty, they have enormous intellectual capital to employ. Our community has real needs in the education space, and so bringing those needs together with research and engagement at Duke can improve our community, enhance education at Duke and advance research all at the same time. The key to making it all work is to make sure that the schools themselves become real partners, and that is what these projects have so successfully accomplished.

Q: Wilkie Wilson and Dr. Cynthia Kuhn’s neuroscience Bass Connections team is an example of a social science and medical science collaboration, much like economist Joe Hotz and Dr. Kristin Newby’s partnership. What other kinds of collaborations between SSRI and the medical campus do you envision? A: The potential for increased collaboration between social science and medicine is almost limitless. With the Social Science Challenge and the Duke Colloquium on Data and Medicine, we are discovering areas for potential collaboration that we could not have envisioned at the outset. Through mechanisms like the Data+ program in iiD and the Bass Connections Program, we now have ready ways for students to become involved in emerging projects.

Q: For graduate students interested in data, what tools and resources are available at SSRI? A: The Protected Research Data Network—or PRDN—at SSRI is less than two years old, but we are already counting users in the hundreds. Many researchers—including undergraduates and graduate students—are finding it to be a convenient way to work with sensitive data in a secure way, and many data providers are seeing it as the most secure way for them to share data with researchers. Our staff, led by Rachel Franke, is eager to help anyone with sensitive data needs that can be accommodated in the PRDN. Our staff can also help researchers navigate the larger research computing infrastructure at Duke, and you can access that expertise by stopping by our help desk in the Connection at SSRI. It’s the place to get help with questions on research software and a variety of research methods. So lots of resources are available—just come to SSRI in Gross Hall and ask!

Tom Nechyba Director, SSRI

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F E AT U R E

RESEARCH ON THE

ReMo

Duke researchers head to South Carolina to learn more about the devastating impact of recent flooding

The research team (left to right): Libby Dotson, Anya Bali, Betsy Albright, Clara Wang, Alican Arcasoy, Connie Ma. (Not pictured: Alexandra Cooper, Maya Durvasula, Christopher Molthrop, and Noah Triplett.)

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G I S T • FA L L 2 0 1 5

from talking with people face-to-face, was much greater than if the team had stayed on campus and sent out questionnaires. The project became part of Bass Connections, which paid for the lab’s travel expenses and now enables the student researchers to analyze their data over the spring semester. Duke’s Social Science Research Institute acquired the mobile research lab, which the team that took it to South Carolina dubbed the “ReMo,” about six years ago through funds from the National Science Foundation. The research trip in December and January marked its first voyage across state lines. Picture an RV stocked with portable equipment useful to researchers— video cameras, heart-rate monitors, soundproof

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ess than three months after devastating floods washed over parts of South Carolina, Duke’s ResearchMobile trundled down to Columbia, one of the hardest-hit areas, and set up shop in the parking lot of a shuttered Piggly Wiggly. Eight Duke students and two faculty spent part of their winter break to sit down with locals in a cubicle in the upfitted RV and say, “Tell us about what happened and how it affected you.” What those field interviews yielded could be turned into policy decisions and steps to reduce the risk of such events and minimize their effects on the community as a whole. The quality of the information the researchers learned by being at the site of the disaster, and

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experienced researcher Elizabeth Albright, assistant professor of the practice of environmental science and policy methods at the Nicholas School of the Environment, who was principal investigator of the project. “Many of the participants lost nearly everything they owned in the flood,” she said, “yet they wanted to talk with us, they wanted their story to be told.” Some, still working through FEMA claims and unable to return to their homes, felt forgotten after the floods moved out of the crisis news cycle. Cooper added, “A lot of people commented that we were the first group to ask them what it had been like, what happened to you, in a way that wasn’t about collecting numbers, about property damage.” The research uncovered surprising gaps, such as the extent to which government-organized

assistance is centered on insurance. “Insurance helps people who already had something,” Cooper said. “But if you don’t have things that have much market value before the flood, insurance won’t help after the flood in replacing what you lost.” Because of the way the flood unfolded—a breach of a dam maintained by a homeowners association causing another dam to breach farther downstream—people who weren’t normally in areas prone to flooding were unexpectedly in the path of a flood. This pointed to deeper policy issues of how to ensure that a dam maintained by an HOA is adequate for the risk of flooding. The researchers heard from people with nearly identical homes harmed in the same way who had gotten very different advice from different contractors on how to repair the damage. Cooper said that residents told her few local

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cubicles and a coloring table to entertain children brought by interview participants. Alexandra Cooper, SSRI’s associate director for education, admits that before she went on the flood research trip, she was skeptical about the need for such a fancy rig. Just set up a table and umbrella and sit and talk with people, she thought. But almost as soon as she arrived in South Carolina, she became a convert. First, there was the unseasonably cold weather. People are less inclined to sit outside and take a survey if their fingers are numb. “Having a heated ResearchMobile is nice,” Cooper said. And the sheer size of the vehicle adds legitimacy to the research. “It sends a clear message to the community that we care about the topic. We’ve devoted effort to getting down here. It says: If you think our research topic is something we should find out about, come talk to us.” The novelty of ReMo helped recruit subjects, too, said Connie Ma, a graduate student in public policy who spent the week after New Year’s interviewing flood victims in the mobile lab. A few days after ReMo arrived, a local news station sent out a TV crew to see what was going on. “We never would have gotten that kind of coverage if we had been located in a building on the USC campus,” she said. As word spread among community members of the Duke team wanting to talk about flood experiences, more and more people ventured in. Anya Bali, a freshman at Duke interested in the social sciences who is from South Carolina, signed on to the project to acquire some hands-on experience in collecting qualitative data. “The flood was personal for me,” she said. “I wanted to learn how people were responding to the floods, outside of the context of what my friends told me.” Bali was surprised that more than a hundred people braved the cold to talk about how the disaster affected them. “I didn’t think people would want to talk about their personal experience and the losses they faced,” she said. “But they were all very eager to share their stories.” The response from the public surprised even

contractors had extensive experience with flood damage. “Residents didn’t have any good way to assess who knew what they were talking about.” Even residents who did not lose their homes still suffered from the flood. Schools were closed for a week, and then had delayed openings for weeks after that. Parents who had to go to work suddenly had to find and likely pay for temporary childcare. While some businesses were working around the clock—such as a store that rented generators—other businesses, like restaurants, were closed. Their employees then didn’t get paid, and families who relied on those paychecks had to scramble. “We got a sense of the many different impacts an event like this can have across a wide range of socioeconomic groups,” Cooper said. The student researchers learned firsthand the complexities across all stages of field research. First, the logistics—finding a visible spot for

the ReMo and obtaining permission to park there for a week; acquiring a wireless hotspot so participants could complete the survey on an iPad; rigging up a clear shower curtain liner as a windbreaker over the doorway, because shutting ReMo’s door might discourage walk-in participants. Then, recruiting participants, which initially meant stapling fliers to telephone poles. Finally, the questionnaire itself: Each student got to include a question pertinent to his or her research, and crafting the language was challenging. “We had things like, ‘flood-plain zoning,” Ma said. “People weren’t sure what that meant, let alone have an opinion on whether the city should do a better job of it.” Now in the data-analysis phase, the students are learning NVivo, a software program valuable for many social science researchers, and cleaning and recoding the data. Albright plans to follow

up with study participants at six months and a year. “Extreme flood events have occurred across several regions,” she said, “and it is important that we learn from these events.” Any Duke researcher interested in using the ResearchMobile should contact SSRI. “It’s a great tool,” Cooper said, “but not if it’s parked at Duke and not in use.”

The ReMo on site in Columbia, SC; A reporter from Columbia’s WLTX interviews Anya Bali, Duke freshman and South Carolina native; Posters taped to the ReMo attracted curious Columbia residents and potential survey participants; Canal breach in downtown Columbia, as seen from Coble Plaza at Riverfront Park.

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TEACHING STUDENTS HOW TO KEEP THEIR

BRAINS healthy improve and their learning abilities

alk into a 9th-grade honors health class at Wakefield High School in Raleigh, and you might think you’ve stepped into a freshman biology class at any local university. These high schoolers are learning the ins-andouts of the brain down to the neuron level— details the average 14- or 15-year-old likely doesn’t know. But, it was a chance meeting between investigators and the former head of North Carolina’s Healthful Living public schools program that made this type of instruction possible. The collaboration’s result: the idea of a high school curriculum that teaches students how to keep their

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brains healthy and improve their learning abilities. Known as the Translating Neuroscience into Education: a Neuroscience-Based Health Curriculum for North Carolina 9th-Grade Students—and a 2016-17 Bass Connections grantee—this project is integrated into Wakefield’s required-for-graduation health class. It was a ready-made testing ground. “All of a sudden, we had a vector for delivering the information that we think is critical because it teaches kids to use their brains,” said Wilkie Wilson, Ph.D., research professor of prevention science. “We have to teach them how to use what they came to school to use—we’re not doing that right now.”

Alongside instructing students how to better care for their brain, he said, this course exposes them to the growing trend of STEM (science, technology, engineering, and mathematics) education. Prompting the next generation of physician-scientists is a secondary goal. The Course Most students don’t know their brains are still growing and can be permanently damaged by alcohol and drug experimentation, Wilson said. That’s where this course—targeting honors level, college-bound high school freshman—comes in. The curriculum, tested with 150 students with five, 90-minute lessons in three classes, discusses

the brain’s role in supporting life and physical neuroscience curriculum, Wilson said. But, with performance, the fundamental neuroscience of more time and greater funding, the investigators motivation and learning, the critical role of brain plan to provide the same level of training—if health in brain function, and brain performance- not more—to all teachers who will be involved. inhibiting substance abuse. “Teachers need to know how to address Students also learn simple, day-to-day steps questions students have and further extend the they can take to augment their brain’s health, curriculum to make it their own,” he said. said Cynthia Kuhn, Ph.D., pharmacology, Once teachers are properly trained and cancer biology, psychiatry and behavioral sciences professor. For example, getting enough sleep, exercising adequately, eating breakfast can improve cognitive function. Teachers delivering the curriculum participated in three training days to learn brain basics, such as how nerve cells control behavior and learning. The pilot year has revealed challenges, however, Kuhn said. The largest has been translating neuroscience information and making it accessible to all levels of age and education. “Translating from Ph.D. Cynthia Kuhn and Wilkie Wilson discuss their research.

There’s a huge unmet interest the Duke students have in teaching and connecting with the high school students in an academic way.

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level, down to skilled teacher, down to students who are ready to take hold of this level of information has been complicated,” she said. “We must rethink how to present information. These are complicated concepts on how different parts of the brain work and coordinate.” Extended funding, she said, will help project leaders make the curriculum accessible to students at all levels, not just those in honors classes. Despite underlying interest in the brain, she said, some students have pushed back, saying the curriculum is too demanding for what has traditionally been a physical education class. Teacher Training So far, only health teachers involved in pilot testing have been trained to deliver the

comfortable in their abilities to adequately answer thoughtful questions from students, it will be easier to implement the curriculum across the state and, potentially, the nation. Bass Connections From the outset, this project has been a University-Medical Center collaboration, bringing together leaders from both sides to design a curriculum that can best address unmet health education needs in North Carolina. “This collaboration has been nothing but a win-win with Dr. Kuhn on the medical side and me in the middle,” Wilson said. “The medical part is the key element to providing sciencebased, powerful rationales for engaging in healthy behaviors.”

And, Duke students selected to participate through Bass Connections will partner with teachers, providing in-person and online professional development assistance. During the process, they’ll learn to translate high-level science into a high school curriculum, train nonscientists to deliver the information, and evaluate performance and outcomes to determine whether the program is effective. The project is unique because it provides an avenue for Duke students to engage younger individuals with neuroscience information they previously didn’t have—all while meeting public school conventional health standards. “There’s a huge unmet interest the Duke students have in teaching and connecting with the high school students in an academic way,” she said. “Through Bass Connections, we have the capacity to address that desire in students.” In the course she teaches on drugs, Kuhn gives her students the choice between completing a group project or going into a classroom to share information about the brain. To date, 40 of 60 students have opted to work in the high schools. Ultimately, Kuhn said, the project should actively engage high school freshman, increasing their chances for academic success as they learn how their behavior directly affects their brain function and overall health. SSRI Involvement Getting high schools on board with allowing and implementing a neuroscience curriculum can be a tall task, Wilson said. And SSRI has been a valuable partner in supporting and sustaining this program. Without its resources, much of the work wouldn’t be possible, Wilson said. Kuhn agreed. SSRI tools have helped program leaders create a curriculum that fits the high school mold. Without this assistance, it would’ve been far more difficult to translate high-level neuroscience concepts into content that students at every level can grasp. “It’s been crucial to have a partner that can collect data on whether and what students are learning,” she said. “SSRI has the ability to navigate the bureaucracy to get us into the schools effectively. This support is critical.”

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Increasing The Power of Sensitive Data through

Collaboration

Professor Joe Hotz and Dr. Kristin Newby discuss their collaboration at the Edge in Bostock Library.

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and medical researchers alike share this challenge of data privacy and security and are shaping it now into an opportunity to collaborate. Fostering a Medical Data Community Last year, Economics Professor and Duke University Population Research Institute (DuPRI) scientist V. Joseph Hotz attended a town hall meeting as part of the Social Science Challenge. The Challenge, with funding from both SSRI and the Vice Provost for Research, brings together medical researchers and social scientists from across campus to discuss their research and the current academic climate. This now happens regularly in monthly dinners called the “Duke Colloquium on Data and Medicine.” Hosted by SSRI and organized in partnership with the Information Initiative at Duke (iiD)

and the Duke Translational Medicine Institute (DTMI), Colloquium members reflect a broad range of expertise from across the university and medical campus. Meetings are held monthly at the Edge in Bostock Library, and each includes several presentations by researchers from the campus and the medical sides of the university. The aim is to bring scholars together to innovate new methods while networking as an interdisciplinary community. Kristin Newby, M.D., gave one such presentation. Dr. Newby is principal investigator for the MURDOCK Study, co-director of the Duke Cardiac Care Unit and Professor of Medicine in Cardiology at the Duke University School of Medicine. In her day-to-day routine, she doesn’t typically cross paths with economists on campus.

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aining access to sensitive personal data for research purposes can prove to be a daunting, but necessary, task. With the wealth of information being gathered about our lives and our health, it’s not surprising that people are often hesitant to share access to their records. After all, recent estimates suggest that 60 to 80 percent of Social Security numbers have been compromised. The key to our identities, these numbers could unlock an unnerving amount of private information in the wrong hands. For researchers, however, this private information unlocks a treasure trove of data that can be used for improving our knowledge of our decision-making, health, finances and social behavior. So while the data are richer, and the benefits to using it are greater, access to it can be an obstacle. As two Duke experts discovered, social scientists

By design, however, she and economics Professor V. Joseph Hotz, crossed pathss at the initial Social Science Challenge town hall. Her presentation on the MURDOCK Study, also known as the Measurement to Understand the Reclassification of Disease of Cabarrus/ Kannapolis, struck a chord with Hotz. A longitudinal health study working to understand health and disease in a specific area of North Carolina, MURDOCK reflected similar challenges to those faced by Hotz with the longitudinal Add Health Parent Study. As principal investigator of the study alongside UNC Professor of Sociology Kathleen Mullan Harris, Hotz analyzes the social, behavioral and biological traits of parents of respondents in the ongoing National Longitudinal Study of Adolescent to Adult Health, also known as Add Health. The Add Health Parent Study research team was developing plans to ask parents in this study

Dr. Newby discusses her research.

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for permission to access various types of health, housing and earnings records. Getting consent for access to this kind of personal information was strikingly similar to the issue MURDOCK researchers faced with their need for consent to access electronic medical information and other personal information. “She gave a presentation,” said Hotz, “and I asked a follow up question.” “Out of that [conversation] grew this collaboration where there were mutual interests and needs around why people agree or don’t agree to participate or give their information to research,” Newby added. “I mentioned that we wanted to have a random sample, but we were having a really hard time getting people to agree, once we selected them, to participate. So it led to these

intersecting interests in understanding what motivates people to participate and consent to sharing sensitive information.”

translational population research with the Duke Translational Research Institute. “It’s a learning exercise for us to try and gain a better understanding of how our participants A Collaborative Effort feel about accessing those data and how we can The MURDOCK study relies on community improve the experience for them, so that they’re engagement for its research and has successfully more likely to engage with the study.” recruited over 12,000 participants from around Under the direction of Vladislav Slanchev, a Kannapolis and Cabarrus County. post-doctoral fellow on the Parent Study, the Meanwhile, the almost 5,000 parents being researchers will attempt to interview members interviewed in the Add Health Parent Study are of the MURDOCK Study and a sample of drawn from across the nation and are asked to individuals who expressed initial interest in participate in an extensive in-person interview. participating but ultimately did not enroll in For both studies, obtaining access to sensitive the Study. information represents an important component The group that expressed initial interest but of their research. Hotz’s Parent Study, for declined participating will not be asked to example, is asking parents to provide their reconsider their decision. Instead, Slanchev permission and identifying information for noted, the interviews will attempt to discover his research group to obtain data on diagnoses what the differences are between these two of health conditions and patient claims for groups in their privacy concerns and views on inpatient, outpatient, hospice and skilled the value of research studies like MURDOCK. Hopefully, the findings Ashley Dunham, from these interviews will Ph.D., M.S.P.H., stands on the begin to illuminate what steps of the Core researchers can do to improve Laboratory Building participant confidence. with David H. Murdock, founder of As Hotz explained, “Our the North Carolina challenge is to figure out Research Campus in Kannapolis, what it is that actually North Carolina, concerns people, and and namesake of what we can do to address Duke University’s MURDOCK Study. those concerns.” “We have the opportunity to improve the the research nursing facility services from the participants’ experience for both participants and researchers, current and future Medicare records. and make it smoother and more efficient and Doing so will reduce the need for additional successful,” Newby added. follow ups with participants, making the While the collaboration is still in its early research process smoother, more efficient and stages, Newby and Hotz agreed that it is exciting more cost effective. to be a part of interdisciplinary innovation But in order to achieve these gains for efforts on campus, particularly when it has the the research process, participants must first potential to affect ongoing research. feel comfortable providing such access to “It highlights the importance of the researchers. For Newby and Hotz, underinteractions that are beginning to grow between standing what determines whether participants the medical center campus and the main campus are willing to do so provides fertile ground at Duke,” Newby said. for discovery. “I think the importance of these kinds of “What we want to do is learn as much as opportunities is only increasing in the current we can about how participants feel, what environment. That’s what the Colloquium was their concerns are, and how to address those created for, and this is just one example of a concerns appropriately,” said Ashley Dunham success story of spurring these collaborations that who oversees all clinical operations for the we hope will be increasingly common.” MURDOCK Study as director of operations for

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he classroom is changing. According to the most recent Census, the Latino population in the U.S. grew 43 percent in the last 10 years, accounting for more than half of the nation’s growth during that time. What’s more, Latinos are the largest U.S. minority group, and more than 4.4 million students in public schools are English language learners. In North Carolina, this population growth has brought with it unique civic challenges and opportunities. Cultural differences and language barriers have been exacerbated by statewide cuts in education. While teachers receive intensive pre-service training, the majority of classroom teachers have not been afforded specialized training for English as a Second Language (ESL). For a demographic that faces a greater risk of dropping out, and a persistent achievement gap in math and reading, one Bass Connections in Education and Human Development research project team is creating a teacher professional development program to support teaching practices that increase language and literacy outcomes for Latino English learners. Supporting Teachers in Local Schools Classroom teachers have traditionally worked with ESL teachers to provide support for students through a pull-out model, with students pulled from the classroom for specialized language intervention. Although some local schools are using push-in or co-teaching models, teachers receive little instruction in how to form a professional collaboration with other teachers. For Leslie Babinski, assistant research professor in the Sanford School of Public Policy and associate director at the Center for Child and Family Policy, the pull-out model did not seem like an optimal use of teacher expertise— something especially concerning now that teachers in North Carolina are facing shortages, spending cuts and other drains on resources. “Students who were English learners and qualified for services were attending the regular classroom most of the day and then getting pulled out for specific instruction in English,” Babinski said. “Our idea was that you can leverage the work of what’s happening in the regular classroom

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Shaping

the Classroom Increasing language and literacy outcomes for Latino English Learners to support language learning, particularly in kindergarten, first and second grade because all students are language learners at that point, even native English speakers.” Babinski’s Bass Connections team, Promoting Academic Success for Latino English Learners in Elementary School, exists as part of a larger team of researchers from the University of Delaware and The University of North Carolina at Chapel Hill that’s known as Developing Consultation and Collaboration Skills (DCCS). DCCS emphasizes a collaborative approach to language intervention. With the input of educators and administrators, they designed a professional development program to assist the interaction and collaboration of ESL and classroom teachers. The demand is clear, and the aim is simple: to improve the classroom experience for high-need ESL students while supporting teachers professionally. Inspired by her early career work as a school psychologist, Babinski witnessed the transformation of that role as it became more integrated into the classroom. “I saw school psychology evolve from a pull-out service to children to one that was more inclusive in the regular classroom,” she said. “We realized that ESL teachers were still using a pull-out model and were kind of an untapped resource.”

Collaboration in the Classroom and at Duke The DCCS team has worked in four different school systems so far, including Orange County Schools, Chapel Hill Carrboro City Schools, Chatham County Schools and the Wake County Public School System. Durham Public Schools has expressed interest in partnering as well. And teachers as well as administrators have backed the program. “That’s really part of what makes it work, there’s administrator support and endorsement for the teachers to be able to interact in a professional way and we get really terrific feedback on our professional development,” Babinski said. “The skills and the instructional approaches we’re teaching them are in line with what they already do. It’s just kind of enhancing it or putting some intentional focus on it that maybe they didn’t have before, and they seem to really enjoy having this collaborative relationship with each other.” Collaboration is embedded in the fabric of the program. Four undergraduates—Setonji Agosa, Libby Dotson, Hope Arcuri and Jessica Del Villar—form the Bass Connections team alongside Babinski and Carmen Sanchez, Ph.D., research analyst at the Center for Child and Family Policy at Duke.

A local teacher works with students on their literacy skills.

“Much of my undergraduate coursework has focused on the Latino or immigrant communities, which has aligned very well with this Bass Team,” she said. “It’s been very useful to take the knowledge that I’ve gained in the classroom and be able to see how it applies in the real work. I’ve been able to gain a better understanding of the Latino community in Durham and the issues that affect it, which has been very eye opening.”

Each of the team members has contributed so much to the team and we’ve all really pushed each other to think outside the box and improve our project. I would highly recommend students of different backgrounds join the team and use their personal knowledge to contribute to the project’s growth.

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Each participant brings a unique perspective to the team. Agosa, a sophomore studying public policy and education, has hopes of one day working at the New York Department of Education. Dotson, also a sophomore, is majoring in both international comparative studies and cultural anthropology with a minor in environmental science. A public policy, global health and education student, Arcuri has extensive experience volunteering with the Latino community. She worked at an ESL center throughout high school and, once at Duke, continued her work with the community through an adult ESL tutoring service and ESL third grade tutoring in Durham. Del Villar, a senior, has also worked with the Latino community in Durham. A sociology major with a minor in cultural anthropology and a certificate in Latino Studies in the Global

South, her interests in educational programming are especially aligned with the mission of the Bass Connections team. “Bringing a variety of backgrounds together has provided a well-rounded perspective in terms of conducting research and working with the community,” Del Villar said. “Each of the team members has contributed so much to the team and we’ve all really pushed each other to think outside the box and improve our project. I would highly recommend students of different backgrounds join the team and use their personal knowledge to contribute to the project’s growth.” While the aim of the project is to improve the educational experiences of Latino English learners in the surrounding public schools, Del Villar acknowledged that the team’s work has also enriched her experience at Duke.

Fostering a Research Team Making it all happen in a 15 week semester, or even over the course of the academic year, can be one of their biggest challenges, but undergraduate involvement has proven an excellent opportunity for deeper engagement with the research community at Duke. In terms of development of skills, Babinski highlights a session with Alexandra Cooper, associate director for education at SSRI, on survey development last semester that was particularly helpful for the team’s development of questionnaires for parents. They also met with the Institutional Review Board to learn about that process. “I’m really excited about the overall Bass activities this semester which include focus groups with Latino parents and a survey of parents about their engagement in their children’s education.” “We’re really happy to have the opportunity to pull undergraduates in to be part of the research team,” Babinski said. “I think it’s an amazing opportunity for undergraduates to get first-hand knowledge of how research is conducted […] I think at a minimum they’re developing a new appreciation for what goes into research, what some of the challenges are, what the opportunities are and what the limits are.” When it comes to their impact outside of Duke, Babinski is proud of the work that her team is conducting in local schools. “It’s really rewarding. It’s really encouraging to see that people feel like they’re getting a lot out of it.”

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PROJECT 1

Grad Students, Research and the PRDN

Evaluating New Genetic Effects on Health and Aging from Longitudinal Data PI: ANATOLIY YASHIN Graduate Student: YELENA KERNOGITSKI Department: Biostatistics Can you explain your research project? Broadly, we’re interested in exploring genetic regulators of aging and health with a particular interest in cardiovascular issues. We have many datasets from various studies. Something I am wanting to learn more about is hereditability. How do you use the PRDN? Some of the programs I use in addition to R and Python are PLINK, Emacs and GCTA. Most of the programs we use are specific to genetics data. We recently moved our data to the PRDN and the transition has been smooth and intuitive. It’s very similar to the previous network we used. Tell us more… I was always interested in genetics generally, but wanted to find alternative ways of studying in this area. With a strong curiosity in statistics and computing, this project catered to all my interests. There’s a lot to learn, and lots of room for creativity. I appreciate that you can get data insights into genetics and our relationship between genetics and diseases outside of a lab environment.

top to bottom: Yelena Kernogitski Willem van den Boom Paul Eliason Dan Coroian Matthew Panhans

GIST • SPRING 2016

Is hemoglobin A1c a valid biomarker for surgical morbidity? PI: DAVID DUNSON Graduate Student: WILLEM VAN DEN BOOM Department: Statistical Science Can you explain your research project? It’s part of the Accenture and Duke University Analytics Research Program supported by a research grant from Accenture. Teams comprise around two undergraduates as independent study, graduate students and a PI. We call it variance modeling. The data are gathered from anesthesiology departments from almost half a million surgeries. The main data, from labs and Duke Hospital, contain measurements of vital signs in the operating room spanning about ten years. We’re looking at blood pressure levels, managing blood pressure variability in the operating room and looking at a biomarker correlated with blood glucose. We look at very specific subsets of the population because that’s one of the challenges that exists in the patient population; the ages differ hugely, there can be gender differences, racial differences, diabetic versus non-diabetic, obese versus not obese. There are a lot of variables that could have a huge effect on what you’re trying to investigate. How do you use the PRDN? The data is sensitive health data with locations and timestamps. Even though it’s de-identified, there are certain federal regulations on how it should be kept safe, and that’s where SSRI comes in. The data is stored with SSRI through the PRDN and we can log in and use the virtual machine. Tell us more… From a statistical modeling perspective it’s a really challenging problem. There are so many things to consider, so many things to try out. It’s very rich data that allows for a lot of new statistical methodology to be developed. The questions we’re trying to answer are very relevant, working with clinicians means it’s not just developing new statistics, it’s also communicating with clinicians and working with experts in other fields.

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Incentives and Competition in the Dialysis Industry

Strategies For Separation From Cardiopulmonary Bypass

Healthcare Exchanges, Utilization and Market Structure

PI: ALLAN COLLARD-WEXLER Graduate Student: PAUL ELIASON Department: Economics

PI: KRIS HAUSER Graduate Student: DAN COROIAN Department: Computer Science

PI: JUAN CARLOS SUAREZ SERRATO Graduate Student: MATTHEW PANHANS Department: Economics

Can you explain your research project? I look at how economic incentives influence providers’ choices. Healthcare is unique in economics because prices don’t play as much of a role, most people have insurance, or the government is paying for it. Since providers aren’t competing as much on price, we hope they’re competing on quality, but that’s difficult to identify through data. My focus is to look at the dialysis industry which has clear-cut procedure that’s fairly uniform and also has easy to measure capacity constraints.

Can you explain your research project? We’re interested in data-driven clinical decision-making support. Hospitals and medical facilities have an enormous amount of electronic medical record data that researchers can access and analyze. Our goal is to try to learn a system, using machine learning techniques, that can take a new patient and simulate the results of a certain set of potential actions. These results are based on what the data shows to be the results of those actions for similar patients. The system would then recommend what the best treatments are. We envision it as an automatic second opinion, something that can help the doctor process the wealth of information that is available on previous patient outcomes.

Can you explain your research project? States have begun putting together databases of medical claims that are processed in that state— it’s a new trend. They are requiring all payers from the insurance companies that are operating in the state to submit their claims to these databases. The first state to implement this system was Massachusetts and other states are following, including Colorado. I approached them and asked if this could be used to do research and they agreed to our use of the data.

How do you use the PRDN? [The PRDN] has various statistical software packages that I use, mostly SAS, STATA, MATLAB—that’s where I do all my coding and analysis. When I have results that I want to use, there’s a process that I have to go through to get the data out of the system. There is a folder where I put all the data I want to export from the system, I email one of the managers for permission, and then I get approval in about a day. It’s a very well managed process. When I was setting the project up, the provider had technical specifications for how the data had to be securely stored and I didn’t understand the technical aspects of the provider’s data use agreement. So I contacted the people at the PRDN and they were very helpful. Paul and Rachel helped me compose the application and explain the security measures that are in place with the PRDN. They were great. Tell us more… There’s this phrase that people throw around called “healthcare exceptionalism” because from an economics perspective healthcare doesn’t function like any other market. It’s really important since we spend a lot of our money on it. It’s worth my time and effort to try and pick apart some of the issues related to healthcare through an economics perspective.

How do you use the PRDN? The data we’re working with on the PRDN right now is very expansive. We’re looking at lab results, vital signs, medications administered, as well as categorical aspects of care like what procedures they were doing and what kind of outcome the patient experienced. It’s a matter of trying to take these heterogeneous sources of information and fit them all into some sort of box that we can use to make predictions. The data includes time series and event-based categorical data. We mostly work with Anaconda, which is a Python distribution that includes a lot of packages for scientific computing. We’re also integrating some use of R for different modeling and visualization tasks and pre-processing of data. The software itself is nothing too fancy; it’s mostly whatever can weave through that amount of data the fastest. Tell us more… The project appeals to me both because of the immense potential for positively impacting peoples’ lives through improving the way we utilize electronic medical record data, and also for the many technical challenges that attempting to create a ‘virtual doctor’s assistant’ from such data involves.

How do you use the PRDN? The data providers are very careful about releasing this data since it contains protected health information. They want to ensure security measures are being met to prevent any type of data breach. When I came to SSRI, it was impressive how easy it was. Staff members, including Paul and Rachel, were a great asset. They who know a lot about data networks and secure encryption and guided me through the process. The PRDN has been an incredible resource for us. Tell us more… This data contains medical claims of all the insurance companies operating, so you get a really broad picture of the market. Claims go back to 2009 and they’re continuing [data collection] through the present. You get a glimpse of what the healthcare markets looked like before the Affordable Care Act policies were implemented. There’s a whole lot of interesting stuff we’re looking at, like who the newly insured people are who are participating in these insurance exchanges. Are they healthy? Are they sick and just now able to get insurance? It matters for the long-term stability of these markets. We get to see which clinical services people are using and what impact these insurance exchanges are having on claims.

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CONNECTING SOCIAL SCIENTISTS TO DATA AND EXPERTISE IN THE MEDICAL FIELD. TOGETHER, WE CAN BUILD A LARGER INTERDISCIPLINARY COMMUNITY THAT CAN COMBINE EXPERTISE IN MEDICINE, SOCIAL, BEHAVIORAL AND POPULATION SCIENCE, AND DATA ANALYTICS TO ADVANCE KNOWLEDGE IN THIS IMPORTANT AREA.

Medical Data in the Social Sciences https://medicaldata.ssri.duke.edu/

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