UPDATES

Roughly every very two weeks I will post an update on how the project is going. This will include updates in the study, things I've learned about the research process, and other relevant information.

Final Reflection

May

As the school year ends, my last post will be a final reflection of what I've learned, and how I feel the project went. Overall, my project was very successful. I got to see so much of the research process, and I've developed a much greater understanding for just how much time and effort goes into just one experiment. It was incredible to see how strong the relationship between our minds and our bodies is, and seeing that in a real-life experimental setting was amazing. Dealing with COVID protocols was definitely a challenge, but I do feel like I dealt with that well. I'm proud of how well I stayed on top of things and how much I pushed myself to continuously be learning during the process. I'm excited to keep learning more about this field in the future!

Interview With Dr. Kenneth Koch

As part of my project, I interviewed another expert in the field of health psychophysiology and gastroenterology: Dr. Kenneth Koch. Dr. Koch is a gastroenterologist in the Winston-Salem, NC, area, and both sees patients and does research. Dr. Koch has also done research with my dad, and the two of them have written several research articles together.

In our interview, I asked Dr. Koch a variety of questions about his experience in research and in medicine, both in a broader sense of what research is like and what his personal experience has been.

I first asked Dr. Koch how he became interested in gastroenterology and nausea. He explained how, after completing medical school at the University of Iowa, he was interested in the field of internal medicine. While studying this field during his residency at Penn State University, he was introduced to many different bodily systems and further specific specialties. He found the gastrointestinal system especially fascinating, since there are many parts to the system, and there are many functions that the system carries out. He added that there are many kinds procedures that gastroenterologists perform, and this also intrigued him. Because of his interest in the field, Dr. Koch then went on to do a fellowship in gastroenterology at the University of Florida. During his fellowship, he was introduced to the research aspect of medicine, and became interested in conducting research. After completing his fellowship, he moved his work back to Penn State University, where he met a psychology professor/researcher. The two began to conduct research together looking at the correlation between psychological stimuli and nausea. They were particularly interested in the electrogastrogram, and used the tool, which was not as widely used at the time, in much of their research.

When talking about his education and journey in this field, I asked Dr. Koch what his main takeaways were from the process. As a person very interested in pursuing a career in medicine, I was interested to see what someone who had gone through the whole process had to say about his experience. Dr. Koch explained to me how what you end up doing with your career might not be exactly what you planned, and that's perfectly okay. He added that he actually thought he was going to be a dentist for much of his life in high school and college, and actually attended dentistry school for a year before switching to medical school. He also explained that there are a lot of different pathways in the medical field, and many things you can do with a medical degree, so if you find what you're interested in, there's almost certainly a career in that field.

I then asked Dr. Koch about his experience in research and seeing patients in a clinical setting, and how they were both similar and different. He described his experience connecting his research to his patients, and how these two areas not only influence each other, but enhance each other. Doing research helps to understand the phenomena that affect his patients, and seeing patients sparks ideas for research questions and projects. Dr. Koch works in a tertiary medical center, meaning that he sees patients who have already seen multiple doctors who couldn't diagnose their problems. He explained that this makes him think everyday at work, and forces him to, as he put it, "learn beyond the textbook." He added that teaching has helped him a lot with both his research and seeing patients. Hearing students ask difficult questions about this field further sparks new ideas, and again forces him to think deeper about certain problems, and how they might be solved.

Finally, I asked Dr. Koch what keeps him interested in this field, even after studying gastroenterology for so long. He responded that maintaining curiosity within your field is crucial to not becoming stagnant in your research. He explained that when doing research, you have to constantly be looking for new angles and new questions, and this helps maintain a strong interest in the field. He also noted that the medical field in developing all the time, and the new technology and information available helps him find new areas of research to explore.

Talking with Dr. Koch was very eye-opening for me about how much there is to do in a research and medical career, and I am very appreciative for him giving his time to talk with me!

Taking External Factors Into Account

April

As we've settled into a steady flow of participants signing up for the experiment and the experiments being conducted, one thing I've noticed that is important to note in an experiment like this one is the impact of external factors on an experiment. These factors are usually rather unavoidable, since there are so many variables at play in any type of experiment, and there are exponentially more in an experiment with human subjects. In the lab we try and control as many things as possible to ensure the best result, but there are some that just can't be accounted for. Below are some that I've observed in this experiment.

In the first experiment that I helped to conduct, there was an interesting interaction between two of the participants in the study. For the experiment, the participants in the experimental group are given mental math problems to complete while in the rotating drum, and those in the control group are not. This is in an effort to see how adding psychological stimulation/stress impacts the nausea and other physiological symptoms. In the experiment that I was helping to conduct, the participant was assigned to the control group. However, he and his friend had both signed up for the experiment together, and since his friend had participated first, he had been informed of how the experiment went. If both of them had been in the same group, this might not have had any impact, but this was not the case. The participant's friend had been put in the experimental group, and proceeded to tell the other one all about how he had to do math problems while in the drum. This knowledge of the experimental group procedure may very well have had an impact on his symptoms, and at the very least introduced a new, unintended variable to the experiment. This is something that was unavoidable, but in a study looking specifically at psychological influences, is definitely something to consider.

This issue of when participants volunteer for the experiment is also an interesting factor. In talking with my dad, I learned that there are usually two waves of participants in a study on a college campus. Because participation in a research study is part of many science classes' requirements, there are usually two groups of people: those who participate at the beginning of the semester to get it out of the way, and those who wait until the last minute. This results in a lull in experimental participation towards the middle of the semester. To combat this, we've stopped offering as many participation times in the middle of the semester (where we are now), and we plan to make more times available towards the end of the semester, and with more flexible days and times (for example, holding experiments on the weekends.

A final thing we have to take into account is the type of person to sign up for a motion sickness/nausea study. To be in agreement with the IRB guidelines (and general common sense ethics), a brief description of the study has to be included when a participant decides to sign up or not. However, it can be reasonably inferred that this dissuades any potential participants with a history of severe motion sickness or nausea from signing up. This leads to a somewhat skewed participant pool, and results in experimental findings that might not always be reflective of an unskewed group of people. However, this can't be controlled, and so it's just another factor to be taken into consideration when drawing conclusions from this experiment.

Takeaways From Conducting My First Experiment

March

One of the main things that struck me when I helped to conduct the experiment was how we could predict the subjective symptoms just by looking at the physiological symptoms. The instance of this that really stood out to me was when the participant began to feel nausea. One of the physiological symptoms that we record is stomach activity, measured by the EGG (electrogastrogram). Normal stomach activity consists of about 3 cycles per minute, and for the first 6 or 7 minutes of the rotation period of the experiment, the EGG showed this rate. However, after this amount of time, we could see an increased number of cycles per minute, and the cycles were not evenly spaced or consistent. This kind of irregular stomach activity often results in the feeling of nausea, and sure enough, at the next interval during which we asked the participant his subjective symptoms, he reported feeling nauseous for the first time.

Before running the experiment, I knew there was a correlation between bodily functions and what we actually feel, but only after running the experiment did I realize how immediate it really is. This aspect of the research was so interesting to me, and I'm excited to see where other correlations present themselves in future experiments.

Conducting My First Experiment

March

Last week I helped to conduct my first experiment! The participant was part of the control group, so I didn't get to see the variable in question for this experiment in action, but it was very interesting nonetheless. I mostly just watched and observed how the experiment is run, but I did get to help record the skin conductance. The experiment is 25 minutes long: 8 minutes of a baseline period in the drum at the beginning (but no rotation) followed by 16 minutes in the drum while it's rotating (with one minute between the two periods). Every minute I had to record the measured skin conductance from a monitor on the desk.

When the participant first came in, we explained the whole experiment to him, making sure he had all of the information needed to decide whether to continue to take part in the study. We then gave him the consent form for him to sign, along with a participant questionnaire, which asks for simple demographic information and previous health issues. Then we had him fill out two surveys: one regarding how one perceives physical health symptoms and the other regarding stomach problems in the last 7 days. Then we put the participant in the rotating drum and began the experiment. In the drum there is a two way microphone system, and a camera. This is helpful because the drum in a separate room in the lab than the investigators are during the experiment, and the door between these two rooms in closed. After the 8 minutes of baseline period, we turned on the rotating drum. During this period of time we continued to record skin conductance, but we also asked the participant about his subjective symptoms. We asked him to rate from 0 to 10 his perception of vection (if he felt he was moving and the drum rotating around him was actually still), his dizziness, and his nausea. We also asked these questions at the end of the experiment. After the experiment, we gave him another survey about his subjective symptoms, and a final survey about his overall life experience with motion sickness. Although there were many details and procedures during the experiment, these are important to amass the most amount of data we can. After we conduct all of the experiments (we are hoping for about 50), we can look at all of these variables we collected and find patterns and correlations, which I expect is a fascinating process.

General Update

February

In the past couple of weeks, I've been able to help with more experiments, including one where the participant was in the experimental group. This added variable was interesting to explore.

Additionally, here is my official project summary that will be published for Signature Day:

The goal of this project was to explore the field of health psychophysiology from a variety of perspectives. To accomplish this, there are two parts to the project: assisting in an experiment at a local college exploring mind-body interactions, and learning about the research process as a whole. The experiment (of which I am officially a co-investigator) looks specifically at how psychological stress impacts the effect of a motion sickness stimulator on nausea felt by the participant. In this process, I’ve learned a lot about both objective and subjective measurements of physiological symptoms. To measure subjective symptoms, we ask a series of questions before, during, and after about current symptoms. For more objective symptoms, we use multiple tools such as an electrocardiogram (EKG) and an electrogastrogram (EGG). It’s been incredibly interesting to see how connected the “hard” data of physiological symptoms, like heart rate, is to the participant’s reports of feeling more subjective symptoms, like nausea. As for learning more about the research process as a whole, I’ve been able to look at almost all aspects of the process through both experience and other reading. I’ve completed the official ethics training for human subjects research, and I’ve read many articles about past studies pertaining to mind-body interactions, especially with regard to nausea. I’ve also helped to input data from past experiments, and I’ve been able to help conduct several actual trials of the experiment. All of these experiences have helped me accomplish my goal of learning about how the entire research process works, and it’s been a fascinating journey.

There aren't many new developments with my project. At this point we're almost ready to start collecting data, which is something I'm very excited for. There are several key steps in starting a research experiment. First is collecting all materials and testing them. We did this a few weeks ago by turning on all the equipment and testing it on ourselves (thankfully it all was still functioning, even after two years of no use because of COVID). Next is determining all of the surveys and forms we need to have for each participant, and printing each of these for all of the participants. For example, questionnaires pertaining to demographics of each participant, consent forms, and surveys more specific to the study, such as state-trait anxiety levels and a motion sickness questionnaire (MSQ) score. Lastly, we need to find viable participants for the study. One advantage of doing research in a college environment, and the professor I'm working with does, is that there are plenty of eager participants, making this stage of the preparation process relatively easy. Once these steps are completed, we can get started working on collecting data!

General Update

February

Tour of Lab Equipment

January

General Update

December

Because the semester at the college I'm working at has been wrapping up these past few weeks, I haven't been as active in the research process as I had been in past months. I've mainly been reading more articles pertaining to past experiments.

Reflecting on how my signature project has been going in the past 4 months, there are certainly some differences in how I thought the project would go. We haven't started collecting data yet, which is the main difference in how I thought it would go compared to how it's actually going. However, I hadn't anticipated how much I would be learning about nausea and the research process before the experiment started. Going through the IRB training and getting to read a good amount of research papers has definitely given me a better understanding of how the research process works. I now know the steps it takes to get an experiment approved, and what kinds of details need to be specified prior to running the experiment to ensure it runs smoothly. I also have learned quite a bit about taking measurements of physiological symptoms, and getting to see the equipment in action was so interesting.

Looking forward, we will start running the experiment once the spring semester at the college begins. The data collection will likely take the entire spring semester, since we plan on having 60 participants, and running the experiment takes about an hour for each participant. However, I think once we start running the experiment and getting into a schedule, it will go smoothly and relatively quickly. I am also looking forward to learning about the data analysis process. The data we collect in the spring semester will most likely be analyzed next year, but at the beginning of the year I had planned to learn the process and maybe help out with analyzing the data of a past experiment. Overall, the spring should bring new experiences both in and out of the lab, and I can't wait to get started.

First Time in the Lab

November

This month I was able to get into the lab for the first time! I learned all of the details of the physiological measurements we'll be taking, including how to put the equipment on another person and what the readings they produce mean. To test the equipment, and to get see what it looks like on a person, we put all of the equipment on my own body, and it was so amazing to see all of it in action. We take four physiological measurements: EKG, EGG, respiration, and skin conductivity. The EKG works through three electrodes: one on the subject's left shoulder, and one under each rib on the side of the body. The EGG also works through three electrodes: one just above the belly button, one at a 45 degree angle up and to the left from the first one, and a third on the right side of the body in line with the belly button. Respiration is measured using a band that goes around the midsection. Skin conductivity is measured through two sensors that go on the index and ring finger of the non-dominant hand, and one sensor sends a current in, and the other reads how much of that signal comes back out through the other finger. The purpose of this is to see how conducive your skin is, and when you sweat, your skin becomes conducive. The sensors are extremely sensitive, so much to the point that you can see immediate changes in monitor. For example, when I had the sensors on, my dad (the professor) startled me just by jumping, and you could see my skin conductivity spike very clearly on the monitor. As you can see, this is an excellent way to measure stress in a physiological way.

I also had the chance to sit in the rotating optokinetic drum while it was spinning, although only for a couple minutes. I can definitely confirm it causes dizziness and is a very weird sensation. I also was able to see the whole setup of the drum, and all the equipment inside it. For communication purposes, there is an intercom from the part of the lab where the investigators sit to the part of the lab where the drum is (they are two connected rooms separated by a door). There is also an intercom from the drum room to the investigator room, and this allows the investigators to hear everything going on in the drum. Additionally, there is a camera in the drum, so we can see the participant at all times. All of this equipments allows us to ensure the participant is still well and allows us to get a full picture of what is going on in the experiment.

I also was able to look at all of the forms and surveys we will be giving to each participant. Overall, I learned a lot about the experiment itself, but also how all of the equipment involved works, and this was very interesting to learn about.

Consent Form and IRB Application

October

This month I worked mostly on finishing the IRB Training, but I was also able to read over the Consent Form and IRB Application of the experiment I will be helping to conduct. The IRB Application contains all of the details of the study needed to get approval, and reading through all of the specifics of the study was helpful in terms of understanding exactly what I will be doing and why.

For the study we will have 60 participants ranging in ages 18-40: 30 in the control group, and 30 in the experimental group. Both groups will sit in the rotating optokinetic drum for 16 minutes, and we will ask them questions every 2 minutes pertaining to how they are feeling. The purpose of the study is to find what the effects of psychological stress are on nausea, so the participants in the experimental group will be asked to evaluate math problems mentally while sitting in the drum (they will be asked to subtract 7 from a randomly announced number). This will hopefully induce psychological stress, and we will be able to see how it affects the participants' nausea. The participants' nausea will be measured in two ways: subjectively and physiologically. For the subjective measurement, participants will be asked to rate their nausea before, after, and during the experiment. For the physiological measurement, we will be measuring heart rate, stomach activity, breathing, and skin conductance, using an EKG, EGG, a breathing monitor around the midsection, and sensors placed on the finger, respectively.

Another key aspect of the study is the effect of somatization on the levels of nausea the participants feel. Somatization is the level of correlation between psychological stimulants and physiological responses, and different people have different levels of this correlation. Some people, for example, might have a very powerful link between their mental state and their physical health, while others might not as much. All participants will be given a questionnaire to assess their somatization before the experiment, and how these data factor into the other variable (psychological stress) will be looked at as well.

The consent form is also a very important part of any study involving human participants. The consent form for the study outlines every step of the experiment, and emphasizes that at any point during the experiment the participant can stop, and there will be no repercussions for this. Because there is the possibility for discomfort with this study, it's imperative that the participants know exactly what will happen during the experiment, and are able to decline participation at any point.

Looking forward, the next steps are to get into the lab and start to learn how all of the equipment works, which I'm very excited for!

Institutional Review Board (IRB) Training

September

All research done on human subjects must be approved by an Institutional Review Board (IRB). In order to be a co-investigator in a study (which is what I will be), one must complete an IRB training course. The course covers ethical research practices, different IRB processes and regulations, details about different parts of the research process, etc. I completed this training over the course of the month of September, and here are some of my main takeaways...

Every institution where research is being conducted has its own Institutional Review Board. The IRB is made up of a variety of people, including both researchers and non-researchers. The IRB must approve all research projects done on human subjects, and all projects must be reviewed annually. The IRB reviews projects using several different sets of rules, one of which is the Belmont Report, which is a report published in 1879 outlining ethical research practices and guidelines for responsibly conducting research. The Belmont Report gives three main principles to focus on when doing research: Respect for Persons, Beneficence, and Justice. The first principle, Respect for Persons, focuses on ensuring consent is given by all participants, and maintained throughout the study. This includes giving all information about the experiment prior to gaining consent, ensuring comprehension of the details of the experiment, and making sure consent is voluntary. The second principle, Beneficence, tells researchers that maximizing benefits and minimizing risks while conducting research is critical. The third principle, Justice, focuses on the equitable selection of participants in order to make certain that some populations, for example the incarcerated or the mentally ill, are not used in experiments unfairly. The Belmont report was put together as a way to promote the well-being of research participants, and looked at many past cases where the safety of participants was compromised. Many policies around research today are structured around the topics discussed in the Belmont Report, and the IRB uses these policies and the Belmont Report itself in deciding whether studies can be approved.