Gel, Wand, Belly, Ultrasound: The Moment Life As I Knew It Ended – Phillipa McGuinness


t’s late 2001 and Crown Princess Masako of Japan is having a baby. Her husband, Crown Prince Naruhito, is heir to the Chrysanthemum Throne, the world’s oldest hereditary monarchy. Sinking into its fourth recession in a decade, Japan hungers for good news and hopes Masako might have a boy. The Imperial Household Law of 1947 decreed that only men could assume the throne as emperor.

The doubleness of the term “confinement” – imprisonment and childbirth – seems especially apt for Masako. Though she lives secluded in a palace, she is such an object of scrutiny that she may as well reside in a glass cube at the centre of Shibuya crossing.

Nine months pregnant myself, I watch this fertility saga of a woman caught between medieval dynasties and 21st century celebrity unfold from Singapore, where we are living. It’s so humid there, I don’t feel as if I have a mini oven inside me; I am the oven. But, I think, at least I’m not going through this with millions of eyes upon me, like Princess Masako.

Looking back now, I would have given birth on the Shibuya crossing if doing so would have changed the outcome for my baby.

People always ask me if there were any warning signs. But everything seemed fine. A few days before Christmas I’d gone to the obstetrician, who measured the baby’s position and heartbeat, and my vitals. I lay down with a band around my enormous middle for 20 minutes and left with reassurances that everything was as normal as it could be. Not long till the baby came now.

Later, in a taxi on the way to the airport to meet my sister and her son, the baby seemed to be going berserk in utero. Super-active, in the way that books said sometimes babies behaved when they were getting ready to be born. And the way I remember Isabella being before I went into labour with her. Looking back, though, I wonder if what I was feeling were convulsions.

I woke the next morning crushed by tiredness. I wanted to sleep for a thousand years. I could hardly move. And I hadn’t felt the baby move. I lay in bed waiting for one of the kicks, usually like clockwork, but there was nothing. It was odd. Adam, my husband, said before he went to work – as anyone in that situation would because it nearly always is – “Don’t worry, I’m sure it’s fine.” All I could do was go back to sleep. I woke mid-morning. Still nothing. My sister gave sensible advice: ring the obstetrician, go to the hospital, get reassured, and then let’s do whatever we are doing today with the kids. But it was going to be the day life as I knew it ended.

We sisters and our children headed off, geared up for a quick scan at the Mount Elizabeth hospital, in and out and on our way. I was shown into one of the ultrasound rooms, all very matter-of-fact. A nurse I’d met before drew the short straw. Gel, wand, belly. Here we go. Nothing. She smiled and said the baby must be asleep so she would try a different position. Nothing. No more smiling as she tried and tried, the wand pressing into my belly from every angle. I could see my baby on the screen. I heard that zhoosh-ing sound but not the chugga chugga chugga of the heartbeat. The nurse went to get help.

I lay there alone, alone with the baby inside me, desperate. “Please please please baby, please move. If you’re ever going to kick again, do it now.” All was still. So still, this baby I had felt grow for nine months, had loved and couldn’t wait to meet. This would be the moment to pray, I remember thinking, as tears ran down my cheeks.

My obstetrician appeared. They had told me she was away but here she was. I felt a flicker of hope now that the big guns were here. She could fix this. But when I saw her face and the glazed look of her offsider, hope receded. She tried to find a heartbeat but there was no heartbeat in my body but my own.

Anyone who has had a baby, or has watched a baby being born, knows that the gap between life and death narrows throughout labour. Sometimes the gap is as thin as a membrane. The mother is alive, the baby is alive, but will both emerge alive? When women say the pain is killing them, they don’t mean it metaphorically. Babies are rushed for tests within minutes of emerging into the world – will they make it? Women haemorrhage to death after giving birth. These things aren’t confined to pre-modern times or the developing world. It’s not for nothing that the standard phrase of the joyous birth announcement is “mother and baby are both well”. Because often they aren’t.

Death was in me. In shock, I could barely form thoughts. Someone handed me tissues. How could this be?

I had to call Adam. You can never predict where you will be when you get the worst news of your life. It was lunchtime and he was at a busy crossing on Orchard Road, about to grab a sandwich with colleagues. I told him bluntly, as I would tell my poor parents a few hours later. “The baby is dead.” I hope I prefaced it with, “Sit down, prepare yourself, I have bad news.” But how else to say it?

Usually when a person is felled by bad news they don’t have to get up and run a marathon. But the business of giving birth had to happen. I could choose my starting time. The doctor said we could let labour start naturally but it might take days. Or I could be induced. That night. That’s what we chose.

We went home to pack. I chose the only outfit my baby would ever wear from a cupboard full of tiny baby clothes.

Mum told me later, or told one of my siblings who told me, that she thought I was going to die. That never occurred to me but I was in such a state that if a giant crater had opened up and swallowed central Singapore I wouldn’t have been surprised. I might have stepped towards one of the fissures.

Phillipa McGuinness
‘It has taken me 17 years to write this.’ Photograph: Mel Koutchavlis/Penguin Books

At the hospital they hooked me up to the drugs to induce labour. I sat up in bed and Adam and I watched Survivor. I remember thinking, through my hysteria, “I’ll show you a fucking survivor, you bandana-wearing, gruel-eating, mud-dwelling, wannabe-celebrity idiots. The tribe has spoken all right. I’ll vote you right off your island.”

On it went. The baby wouldn’t be born for 24 hours. Labour is long, whether your baby is alive or not. I ate winter melon soup served out of an actual winter melon. Hospital food is better in Singapore. Finally, they sent me to the labour ward. There was a band around my belly designed to measure my contractions and a baby’s heartbeat.

On the monitor you could see what was going on in all the other rooms of labouring women. Their babies all had heartbeats. They must have thought, “What the hell is going on in room six?” I would hear their babies crying when they were born.

Contractions kicked in on waves of pain. Some epidural magic meant I fell asleep. When I woke up there was a flurry because the baby was about to be born. I had to push. The baby emerged. It was Daniel. I didn’t know what to expect but he was perfect. I remember the doctor saying in her calm voice, he looks good, he has the right number of toes and fingers, he’s 3.5kg. The placenta looked OK. Everything about him was right. Except, in the most fundamental way of all, it wasn’t.

Then we were alone. The three of us. Adam and I held Daniel. We talked to him. His little lifeless body. But he was ours and we loved him. And then they took our son away. I don’t ever want to feel so sad again.

There was no social worker, no grief counsellor. Just us. That night, lying in my hospital bed with my husband next to me in a camp bed, my son somewhere in the hospital (in the morgue, I guess) and my daughter with her aunty and cousin in our apartment 500 metres away, my thoughts raced. They had offered me a sleeping tablet but for some reason I refused, thinking I had to remember. Bereft was the word that kept popping into my head. I am bereft. I lack what I most want. Death had come for my own child. But not for me. I wondered, why not?

The next morning I lied about the bodily functions I was supposed to have performed; we signed the discharge papers and walked out of the hospital. “But where’s the baby?” asked my little nephew when we arrived home. Some things are too hard to explain. Indeed, it has taken me 17 years to write this.

All life’s big events involve paperwork. Adam had to go to the police station; a person had died and it had to be reported. There was no box on the form that covered our situation. I don’t know about Singapore but now it is possible to get a birth certificate for a stillborn baby in Australia. We had to do something about a funeral or a burial, the demands of the rituals of death. Adam had to choose a coffin. I found myself staring into my wardrobe wondering what to wear to my son’s funeral. The cruel joke was that it had to be a maternity dress.

Adam and I went back to the hospital to meet the hearse and go out to Choa Chu Kang cemetery. We rode in the hearse, with Daniel in his tiny white coffin in the back. The driver said to us that the only good thing about babies’ funerals was that they are cheaper.

A young Sri Lankan priest met us, giggling and smiling because he was nervous. We were all out of our depth. Blah blah into the earth blah blah commend his spirit. Our small group stood around a tiny plot in the tropical cemetery. The miracle was that I remained upright. My body was wrecked. “My child is dead,” I thought, thinking it must be the saddest line in the saddest scene imaginable and wishing I wasn’t in it.

Flowers and messages had been arriving for days from family, friends and neighbours. Most of the blooms were white lilies, Lilium candidum, and I would happily never lay eyes on a single stem again. How I hate those flowers. One reason might be because they’re called Madonna lilies. Another might be because they are said to symbolise innocence restored to the soul of the departed after death. But mainly I hate them because our house was full of flowers for the worst reason. What should have been a celebration was mourning, raw and untrammelled. I didn’t know where it would take us. All I could smell was those flowers.

Friends in holiday mode read the email about Daniel we sent to everyone in the wrong order – after they’d wished us happy new year. For it was New Year’s Eve. Daniel had finished his year as a statistic: in Australia one in 135 births is a stillbirth – six babies a day – and the numbers are similar in Singapore. No cause was found for his death. But he wasn’t a statistic for us. 2001 was over but in all the years to follow we wouldn’t forget him.

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102 Brain-Based Learning Resources For, Well, Brain-Based Teaching – Sara Bass


Researchers in neuroscience, psychology and education are uncovering new information about how brains learn best at an unbelievable pace. We have more insight into the brain’s learning processes than at any other moment in history, and we are poised on the brink of a radical shift of how we think about education.

Researching the conditions that allow brains to learn most easily enables innovation and optimization for learners in formal and informal settings. There are countless applications for the findings of the new science of learning, including:

Deeper understanding of cognitive deficits and the unique circumstances that affect everyone’s learning capacity. More nuanced information about memory, cognition, and comprehension in various settings. Better understanding of motivation, metacognition, and what drives us to learn at all.

We are incredibly excited about all of the new knowledge being discovered by researchers examining the neurological and psychological underpinnings of learning and education systems, and we can’t wait to see what the future has in store.

The organizations, blogs, research labs, and brain-based learning providers below have diverse perspectives and an incredible range of information about the new science of learning, and we think every single one is worth checking out.

Cognitive Neuroscience & Learning Research

Cognitive neuroscience researchers are at the forefront of the new science of learning. Understanding the deep structures of the brain, how they react to sensory input, and how they store information is crucial for attaining a deeper understanding of how people learn.

MIT’s Department of Brain and Cognitive Sciences

MIT’s Department of Brain and Cognitive Sciences combines neuroscience, biology and psychology. They stud specific aspects of the brain and mind including learning and memory, neural and cognitive development, language and reasoning.

Stanford Cognitive and Systems Neuroscience Laboratory

Under the direction of Dr. Vinod Menon, the SCSNL investigates human cognition and learning. Based out of Stanford, they use advanced brain imaging techniques such as MRI, DTI, and EEGas well as behavioral, genetic, neural network modeling, and computational methods in their research.

Staglin IMHRO Center for Cognitive Neuroscience

The Staglin IMHRO Center for Cognitive Neuroscience is UCLA’s research center for inquiries into the neural underpinnings and phenotypic conditions that correlate with cognitive anomalies. The center is currently studying the neural bases of creativity, social communication, autism, schizophrenia, memory mechanisms, and many other brain functions, disorders, and conditions.

University of Cambridge Centre for Neuroscience in Education

The main research goal of the Centre is to establish the basic parameters of brain development and understand cognitive skills critical for education. They aim to understand how the brain functions and changes during the development of reading, math, and other subjects.

Midwest Brain & Learning Institute

The Midwest Brain and Learning Institute provides brain compatible learning experiences by bringing educators together with nationally recognized researchers and presenters. They share the latest in neuroscience research and how it impacts the understanding of learning and teaching.

Grisolano Center for Neurodevelopment Blog

The Grisolano Center for Neurodevelopment is a pediatric neuropsychology practice dedicated to helping children overcome challenges in learning and development to create a better life for them today and for the future. Through Neurodevelopmental, Psychotherapy and Cognitive Training & Rehabilitation services, their team is dedicated to understanding the brain functions that affect a child’s behavior and learning abilities, and provide therapy services that help to overcome cognitive issues so the child can thrive academically, socially and emotionally.

The Center believes that knowledge is power and that is why offers online resources for families, educators and legal professionals. Free downloads and checklists range from information and guides on Autism Spectrum Disorder, ADD/ADHD, Independent Educational Evaluations and Due Process Hearings.

Earli: Neuroscience and Education

The SIG brings together researchers from the fields of educational research, cognitive, and developmental psychology and neuroscience. A team of interdisciplinary people with training in each of these investigate human learning and development.

University of Texas at San Antonio’s (UTSA) Neurobiology Podcast: Neuroscientists Talk Shop

Neuroscientists Talk Shop is the University of Texas at San Antonio’s Neurobiology Podcast. They showcase the work and research of renowned neuroscientists and focus on their work in the field.

Gazzaley Lab

Research in the Gazzaley lab focuses on furthering the understanding of the neural mechanisms, alterations that occur in aging and neurological disease, and how one may intervene therapeutically. Their goal is to understand how a healthy brain functions and be aware of alterations that occur with normal aging and disease.

Developmental Cognitive Neuroscience

Developmental Cognitive Neuroscience is an interdisciplinary field devoted to understanding how children’s minds change as they grow up. Their lab specializes in studying a region of the brain known as prefrontal cortex and the cognitive abilities that depend on it.

Laboratory for Cognitive Neuroscience

Established in 1970, the Salk Institute’s Laboratory for Cognitive Neuroscience is dedicated to the study language and cognition. Their research is designed to increase our understanding of genetically based disorders and cognitive abilities.

UW Educational Neuroscience Lab

Educational Neuroscience is an emerging field that integrates findings from neuroscience with those from education and cognitive science. Their research examines the neural underpinnings of cognitive processes that are relevant for education and the roles of educational experiences.

Brain, Learning, Animation, and Movement Lab

This animation and movement lab helps teach motor memory, motor control, and even encourages healing after a brain injury. They function as a part of the Department of Neurology at Johns Hopkins Medicine.

PSLC DataShop

DataShop is the world’s largest repository of learning interaction data. Some of their topics include how to improve student learning, detect motivation, and predict student performance.

Cognitive Development Center

The goal in the Cognitive Development Center is to understand thinking and how it changes with development. They work with infants and children to explore the development of memory, language, problem-solving, and flexibility.

Center for Cognitive Neuroscience, Duke University

Since 1999, the Center for Cognitive Neuroscience has served as the central focus at Duke University for research, education, and training in psychological and neuroscience. Their research focuses on perception, attention, memory, language, emotion, decision making, social interaction, morality, motor control, executive function, and the evolution and development of mental processes.

Project on the Decade of the Brain

The Decade of the Brain was a designation for 1990-1999 by U.S. president George H. W. Bush as part of a larger effort involving the Library of Congress and the National Institute of Mental Health of the National Institutes of Health “to enhance public awareness of the benefits to be derived from brain research”. The initiative was conducted through a variety of activities including publications and programs aimed at introducing Members of Congress, their staffs, and the general public to cutting-edge research on the brain and encouraging public dialog on the ethical, philosophical, and humanistic implications of these emerging discoveries.

Centre for Mind and Brain in Educational and Social Contexts (M-BESC)

The Centre for Mind and Brain in Educational and Social Contexts (M-BESC) aims to develop the understanding of learning and interaction in educational and social contexts by drawing upon, and extending, concepts and techniques situated in the study of mind and brain, and then interrelating this understanding with insights about human interaction and learning derived from other perspectives.
OECD Centre for Educational Research and Innovation (CERI) – Brain and Learning

The Organisation for Economic Co-operation and Development (OECD) provides a forum in which governments can work together to share experiences and seek solutions to common problems. They work with governments to understand what drives economic, social and environmental change. They also measure productivity and global flows of trade and investment.

FMRIB Plasticity Group

The FMRIB Plasticity Group, associated with The University of Oxford Medical Sciences Division, is an integrative research group that uses advanced brain imaging techniques to monitor brain change. They also use training programs and brain stimulation to try to influence brain change.

Allen Institute for Brain Science

The vision of the Allen Institute is to decipher how information is coded and processed in the brain. They also work to accelerate the understanding of how the human brain works in health and disease.

UCL Institute of Cognitive Neuroscience

The ICN is an interdisciplinary research institute. Their group of scientists and doctors from many different disciplines study mental processes in the human brain, in health and disease, and in adults and children.

George Washington University Center for Applied Developmental Science and Neuroeducation

Situated within the nation’s Capital, The Center for Applied Developmental Science and Neuroeducation at The George Washington University’s Graduate School of Education and Human Development (GSEHD) seeks to develop scholar-leaders, increase research, encourage knowledge sharing, and contribute to local and national policy dialogue. GSEHD aims to be a hub for the application of research from the fields of neuroscience and health sciences to the education and development of children and youth with disabilities.


SEDL is a private, nonprofit education research, development, and dissemination corporation based in Austin, Texas. Their mission is to solve significant problems facing educational systems and communities to ensure a quality education for all learners.

University of Washington Institute for Learning & Brain Sciences

The Institute for Learning & Brain Sciences (I-LABS) is an interdisciplinary center dedicated to discovering the fundamental principles of human learning, with special emphasis on work that will enable all children from 0 to 5 to achieve their full potential.


Brain@Work is a research group focusing on the human brain and mind, specifically on neurocognition, learning and memory.

Arizona State University Learning Sciences Institute (LSI)

Arizona State University’s Learning Sciences Institute (LSI) focuses on the generation and dissemination of research on the core human enterprises of learning and education broadly defined. It aspires to be recognized as the leading creation place in the country where researchers, scholars, policy makers, and practitioners collaborate and

Center for Integrative and Cognitive Neuroscience at Vanderbilt University

The Center for Integrative & Cognitive Neuroscience fosters mutual effort and serendipity among groups of investigators across the Vanderbilt University campus to push back the last great frontier in modern science. The Center sustains programs of research to help explain how normal and abnormal behavior and cognition arise from the function of the brain.

Action Potential

Action Potential is a forum operated by neuroscience editors at Nature for the entire neuroscience community. They discuss major new and exciting developments and research currently going on in the world of neuroscience.

Reberlab: Cognitive Neuroscience of Learning and Memory

Reberlab studies the cognitive neuroscience of learning and memory at Northwestern University. Some of their current projects include working memory training and perceptual-motor skill learning.

Thinking about Thinking: Cognitive neuroscience blog

This is a blog about the field of cognitive science and the study of thinking. Topics include computational science, cognitive development, and more.

Brannon Lab

The Brannon Lab studies the development and evolution of numerical cognition. Based out of Duke University, their research and findings are useful for parents, teachers, and others interested in the way we learn.

The Neuroeducation Institute

The Neuroeducation Institute is a two-day opportunity for educators to come together to enhance their teaching through discoveries about the brain and the learning process. They provide educators with knowledge about brain function, memory and learning to equip educators with usable knowledge and practical strategies for the classroom.

Science of Learning Strategic Research Theme (SoL-SRT)

Learning Sciences Researchers at the University of Hong Kong are building interdisciplinary research teams to construct multilevel models and theories of learning that build on the current understanding and methodologies of education and other sciences. They develop research and development programs to advance research, policy and practice related to learning that incorporate cutting edge ideas and techniques from neural physiological, functional, cognitive and socio-affective approaches to learning research.

NeuroEducation Across the Lifespan Laborator

The NeuroEducation Across the Lifespan Lab’s mission is to reveal the brain networks underlying music and the arts, explore the near- and far-transfer of the skills underlying music and art learning, and investigate the benefits of music and arts in education and treatment.

Kim Lab

Kim Lab, located at the University of Colorado Boulder’s Institute of Cognitive Science, is a research lab that works to investigate the cognitive and neural mechanisms that allow humans to understand language. They use neuroimaging and behavioral experimental techniques with the aims of advancing basic science and guiding treatments for disordered language and reading.

The Concepts, Actions and Objects Lab

Using a diverse set of methods to explore the cognitive and neural basis of conceptual domains, the Concepts, Actions and Objects lab group studies the origins and organization of conceptual knowledge.

Special Research Initiative for a Science of Learning

The ARC is a legal agency that advises the Australian government on research matters. Beginning in 2012, started funding a new research center to investigate the complex issues of the human learning process. The center helps bring together cross-disciplinary researchers ranging from neuroscience and cognitive development to pedagogy and educational technology.

Center for Cognitive Neuroscience and Engineering (CENCE)

Located at the University of California’s Irvine campus, CENCE is a multidisciplinary research center that aims to understand the relation between cognitive abilities and neural systems through brain imaging, brain mapping, computational modeling, informatics and engineering techniques.

Learning Sciences Research Institute

The Learning Sciences Research Institute (LSRI) was created in 2007 and is a collaboration between international, national, and UIC-based researchers to improve educational opportunities and environments for an array of learners.

University of California, San Diego, Center for Brain and Cognition

The Center for Brain and Cognition (CBC) at the University of California, San Diego, under the directorship of V.S. Ramachandran, conducts research on the neural basis of perception, cognition, language, attention and memory (also called cognitive neuroscience or behavioral neurology). An additional focus is on neuro-rehabilitation.

Academic Publications
For anyone who can understand dense, academic language, there are plenty of fascinating research papers and academic essays about neuroscience, cognitive studies, and the underpinnings of the biological systems that enable us to learn.

Developmental Cognitive Neuroscience Open Access Journal

This journal is for cognitive, affective and social developmental neuroscience. They publish theoretical and research papers on cognitive brain development.

Cognitive Neuroscience Blog

Psychology Press Cognitive Neuroscience Blog publishes news and updates about featured products and notable authors who work in the area of neuroscience. Some of their products include cognitive learning textbooks, research methods, development psychology books, and more.

Pedagogy and the Human Sciences

Pedagogy and the Human Sciences peer-reviewed interactive online journal is a peer-reviewed interactive online journal devoted to the study of teaching and learning in psychology and related fields. Their goal is to promote reflection upon what it means to teach and learn in psychology and related fields.

Cognitive Neuroscience Weekly

This blog is targeted to enthusiastic students, cognitive neuroscientists, and others interested in cognitive neuroscience and highlights some recently published findings of interest. It works to share important and inspiring findings about the brain-mind relationships.

ERIC: Teacher Perceptions of NeuroEducation: A Mixed Methods Survey of Teachers in the United States

This article summarizes teacher perceptions of NeuroEducation. A survey was given to educators about this new development in education and it revealed that educators feel overwhelmingly positive and teachers in the United States are quite enthusiastic about the potential of NeuroEducation,

Mind, Brain, and Education Journal

This online scholarly journal is a great resource for any educator interested in how the science of the mind can be brought into the classroom. Some of their issues and articles are available for free online.

Journal of Cognitive Neuroscience

Published by the MIT Press, the Journal of Cognitive Neuroscience is a peer-reviewed academic journal for scientific research on cognitive neuroscience and the interaction between brain and behavior. It aims for a cross-discipline approach, covering research in neuroscience, neuropsychology, cognitive psychology, neurobiology, linguistics, computer science and philosophy.

Brain & Learning Blogs
Many researchers and others interested in learning and the brain share their findings or general thoughts on the science of learning through blogs. Some are casual and easy to understand, and some are more dense, but all are worth a look.

Brain PathWays Blog

The Brain PathWays Blog is advanced, practical neuroscience application for daily living. It combines 20 years of research and experience from Stephen Hager and Deanna Phelps, two authors and scientists who have been working in neuroscience for decades. Hager and Phelps have recently launched another website, Neuidentity, geared towards using their combined knowledge of the brain to help others succeed in work, education, and life.

Neuronet Learning Research Blog

NeuroNet is a research-based learning readiness program designed to help students develop fluency in essential reading, math, and handwriting skills. They focus on the concepts of practice, evaluation, and independence as key skills in learning.

Brain Rules

In Brain Rules, Dr. John Medina shares his lifelong interest in how the brain sciences might influence the way we teach our children. In each chapter, he describes a brain rule and what scientists know for sure about how our brains work and then offers transformative ideas for our daily lives.

The Science of Learning Blog

Scientific Learning applies proven research on how the brain learns to accelerate learning. Their blog focuses on research, educational skills, memory programs, brain development, and more.

Brainscape Blog

Brainscape is a web and mobile study platform that helps you learn things faster. Their blog also includes articles about managing stress, increasing memory, and more.

Brainblogger: Neuroscience

Brainblogger has a rich back catalogue of posts covering neuroscience and its implications for business, politics, and education. This is a great place to start for anyone looking for a casual read about neurscience in easily understood language.

Daniel Willingham: Science And Education Blog

Daniel Willingham earned his B.A. from Duke University in 1983 and his Ph.D. in Cognitive Psychology from Harvard University in 1990. His research focuses on the brain, the basis of learning and memory application, as well as cognitive psychology and K-16 education.

R.A.D. by Judy Willis M.D., M.Ed.

This website features the insights, publications, and presentation schedules pertaining to parent and teacher strategies to ignite student learning. Dr. Judy Willis is a board-certified neurologist in Santa Barbara, California and combines her 15 years as a practicing adult and child neurologist with her teacher education training and years of classroom experience.

BrainFacts is full of educator resources, brain basics, and information about diseases and disorders. It also offers accessible information about the function of neuroscience in society and how current research works to advance education and treatments.


Neuroeducation in Spokane applies both psychological and educational strategies to overcome these educational and learning challenges. Counselors stay informed of the latest developments in neuroscience and use this information to overcome the many, varied challenges to academic and personal progress.

The Whole Brain Blog

The Whole Brain Techniques focus on adult learners to improve productivity, creativity, teamwork, sales and other business results. Herrmann International solutions include facilitated classroom workshops, interactive online programming, on-the-job resources and a variety of tools and services designed to optimize individual, team and organizational effectiveness.

Brains: A Group Blog on Topics of Philosophy & The Science of Mind

This site serves a grouping point for various blogs about philosophy and the science of mind. It’s a great resource for anyone looking for a good variety of sources and information in the area of neuroscience.
Improve Your Learning and Memory.

This blog includes summaries of research reports that have practical application for everyday memory. It is written and maintained by a neuroscience researcher, author, and professor.

NeuroLogica Blog: Education

Dr. Novella is an academic clinical neurologist at Yale University School of Medicine. The NeuroLogicaBlog covers news and issues in neuroscience, but also general science, scientific skepticism, philosophy of science, critical thinking, and the intersection of science with the media and society.

Organizations & Societies

Learning centers, neuroscience societies, and other organizations bring together the many, many people worldwide who have dedicated themselves to the advancement of the science of learning and all its facets.

Society for Neuroscience

The Society for Neuroscience is the world’s largest organization of scientists and physicians devoted to understanding the brain and nervous system. Their members promote public information and general education about the nature, results, and implications of their research.

British Neuroscience Association

The British Neuroscience Association is the largest UK organization representing all aspects of neuroscience from many channels including whole animal behavior to neuroscience applications in the clinic. They aim to promote neuroscience research and advise on issues in neuroscience.

The Neuroeducation Institute

The Neuroeducation Institute is a two-day opportunity for educators to come together to enhance their teaching through discoveries about the brain and the learning process. They provide educators with knowledge about brain function, memory and learning to equip educators with usable knowledge and practical strategies for the classroom.

Pittsburgh Science of Learning Center for Robust Learning (PSLC)

This center uses cognitive theory and computational modeling to identify the instructional conditions that cause excellent conditions for student learning. The researchers study learning by conducting in vivo experiments in math, science and language courses.

Brain Leaders and Learners

This site contains practical tactics for teachers derived from Neuro Discoveries written up by Dr. Ellen Weber. Some topics include how to decrease stress to increase learning as well as how things like play, reading, and discussions lead to increased learning and memory.

Centre for Educational Neuroscience

The Centre for Educational Neuroscience works to create resources and education for educators and scientists invested in brain education. They have seminars, conferences, textbooks, workshops and training for those interested in neuroscience methods for education.

American Society for Training & Development: Brain-Based Learning Resources

Brain-based learning theory focuses on creating an opportunity in which attainment, retention, recall, and use of information is maximized. This concept incorporates the latest research on the brain and encourages application of findings to training and educational learning environments.

Cognitive Science Society

The Cognitive Science Society, Inc. brings together researchers from many fields who hold a common goal: understanding the nature of the human mind. They promote scientific interchange among researchers in disciplines comprising the field of Cognitive Science, including Artificial Intelligence, Linguistics, Anthropology, Psychology, Neuroscience, Philosophy, and Education.
Learning & the Brain

Learning and the Brain provides educational conferences, symposiums and one-day professional development training seminars on the latest research in neuroscience and psychology and their potential applications to education. Teachers, school administrators, psychologists, and clinicians have been attending these conferences for more than a decade to hear from leading researchers.

Cognitive Neuroscience Society (CNS)

The Cognitive Neuroscience Society is an international group of researchers devoted to “elucidating the biological underpinnings of mental processes.” The organization has a three-day annual conference to present a wide array of findings from neuroscientists all over the globe.

International Neuroethics Society

Neuroethics studies the social, legal, ethical and policy implications of advances in neuroscience. As more research is conducted on the brain, Neuroethics works to help the public understand the issues raised by this research and the powerful new tools being developed, including issues like privacy and safety.

Center for Learning in Informal and Formal Environments (LIFE)

IFE Center researchers represent a broad range of fields, including neurobiology, psychology, education, speech and hearing sciences, anthropology, and sociology and others. Their findings inform learning theories, influence educational practices, and affect technologies designed to enhance learning.

Spatial Intelligence and Learning Center (SILC)
The Spatial Intelligence and Learning Center brings together scientists and educators from many different institutions for the goal of understanding spatial learning and using that understanding to transform education. SILC participants include researchers from cognitive science, psychology, computer science, education, and neuroscience.

Brain, Neurosciences and Education

The mission of this organization is to promote an understanding of neuroscience research within the educational community. They encourage neuroscience research that has implications for educational practice and D85provide a forum for the issues and controversies within these fields.

International Mind, Brain and Education Society (IMBES)

The mission of IMBES is to facilitate cross-cultural collaboration in biology, education and the cognitive and developmental sciences. They work to improve knowledge and create and develop resources for scientists, practitioners, public policy makers, and the public.

General Brain-based Learning Resources
Brain-based learning takes the knowledge we have now about how people learn, and integrates it into educational environments, both formal and informal, to start creating a new paradigm of how education is conducted. These types of resources, and many more, are available online, often for free, for anyone who is passionate about the science of learning.

iBiology’s mission is to convey, in the form of open-access free videos, the excitement of modern biology and the process by which scientific discoveries are made. Their aim is to let you meet the leading scientists in biology, so that you can find out how they think about scientific questions and conduct their research, and can get a sense of their personalities, opinions and perspectives.

LearningRX Braintraining

LearningRx is a successful nationwide network of brain training centers. They focus on changing a student’s underlying ability to learn and read and train and strengthen cognitive skills.

Searching for the Mind: Neuronal Plasticity

Dr. Lieff is a specialist in the interface of psychiatry, neurology, and medicine. His blog focuses neuropsychiatry, neuroscience, psychopharmacology, geriatric psychiatry, and high technology in medicine.

TeachThought: Neuroscience

TeachThought is a great resource for teachers looking for information about common core, technology, and much more. They have a dedicated section to neuroscience and practical uses of how the science of learning can be applied in every classroom.

Midcourse Corrections: Neuroscience

This organization focuses on improving conferences, meetings, training and education. They have several dedicated articles about neuroscience and how understanding how the brain receives and translates information can improve learning.

eLearn Magazine: Neuroscience

eLearn Magazine is a source for information and perspective about education and technology. They offer teachers research, case studies, best practice tips, and other ideas for a successful classroom.

InformED: Neuroeducation: 25 Findings Over 25 Years

This site is full of useful articles on computer based learning. They also work to unearth the best study tips and trends in virtual education to collaborate with educators.

Brain Study

Dana is a PhD in Psychology from the University of Cambridge. Her blog focuses on the connection between brains and bodies, and other discoveries in psychology and brain science.

Dr. Kathie Nunley connects current psychological and neurological research to education. Her focus includes writing on the importance of sleep, play, and good nutrition for educational success.

Learning on the Move

This blog includes ways in which physical educators can purposefully plan lessons in order to capitalize on how the brain learns best. There are many resources for teachers to use with the brain compatible learning method.

Whole-Brain Living and Learning

Kathy Brown, M.Ed., is a Licensed Brain Gym Instructor and Consultant. Her most recent project has been the completion and launching of her book Educate Your Brain, through which she describes the basics of the Brain Gym program and how to create a healthy neural environment for learning.

BrightBrain Learning

BrightBrain Learning works to apply enthusiastic and sound teaching to not only make learning easier, but also enjoyable. They tutor students for the SAT, ACT, and other academic courses.

The Second Principle

This blog focuses on holistic learning and concepts like emotional and multiple intelligences and brain-based education. The goal is to help educators teach to a child’s strengths and benefit them as lifelong learners.

Neuroscience Education

This site contains everything you’ve ever wanted to know about neuroscience at the intersection of education. It includes brain quotes, milestones in neuroscience education, tips for increasing memory, brain facts, books about neuroscience and much more.

Brain-Targeted Teaching

Brain-Targeted Teaching designates six “brain targets” for the teaching and learning process and describes brain research that supports each stage. Things like learning evaluations and establishing a positive emotional climate are important in this process.

NIH Videocasting and Podcasting: Neuroscience Lectures

CIT broadcasts seminars, conferences and meetings to world-wide audiences over the Internet as a real-time streaming video. They have a collection of podcasts and lectures on neuroscience freely available in the archives.

Brain Fitness Strategies

Brain Fitness helps people achieve their educational goals through the latest advances in neuromuscular brain development and individualized coaching programs. They assist those with ADD/ADHD, anxiety, or memory problems and anyone else needing academic support.

Posit Science’s BrainHQ

BrainHQ is a place to exercise memory, attention, and more. It was built by a team of top neuroscientists, with exercises proven in dozens of published studies to create real and lasting improvements in brain function.

Jensen Learning’s Brainbased Learning Blog

Eric Jensen is a member of the prestigious invitation-only Society for Neuroscience and the New York Academy of Science. His blog is full of curriculum and other tools and resources for brain based teaching and learning.

Evidence Based Teacher Network

The Evidence Based Teacher Network (EBTN) is an independent network of teachers who wish to use evidence-based methods in classrooms and training. The aim of this website is simply to give teachers access to the evidence-based material already published and available.


ThInk is a blog about the brain, written by expert columnists from across the field of neuroscience and beyond. Its aim is to explore neuroscience in research, medicine, art and everyday life.

Inside the Brain

Inside the Brain is written by Professor William T. (Billy) O’Connor, an internationally recognized leader in both research and education in neuroscience. Billy’s interests encompass all aspects of brain research, including nerve circuitry in neurological and psychiatric disorders, such as Parkinson’s disease and schizophrenia. Other interests are the application of recent discoveries in neuroscience to more effective teaching and learning the brain science of learning.

Brain Power Initiative

The Brain Power Initiative is led by leading researchers, institutions and industry partners to create positive changes in early childhood development, education and lifelong learning. Their initiative works to translate the findings of neuroscience into the creation of media, education and programs that directly influence how the brain develops.

Big Ideas in Education: Neuro-Education

Deborah McCallum is an educator interested in neuro-education, technology, and learning. Some blog posts focus on how developments in neuroscience have improved outcomes for students with dyslexia, autism and other learning disabilities.

Talking about learning

This is a blog written by Alma Dzib Goodin. She uses the site as a sort of personal notebook where she shares her neurocognitive approach of learning from a theoretical and sometimes applied perspective, with the overall goal to improve learning.

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Fasting Diets May Raise Risk Of Diabetes, Researchers Warn – Robin McKie


Fasting every other day to lose weight could have damaging side effects. That is the conclusion of a group of scientists speaking this weekend at the European Society of Endocrinology’s annual meeting.

Their findings suggest that fasting-based diets may impair the action of sugar-regulating hormone insulin, and lead to increased risk of diabetes. Care should be taken before starting such programmes, say researchers.

Ana Bonassa, whose team from the University of São Paulo in Brazil carried out the study, said: “This is the first study to show that, despite weight loss, intermittent fasting diets may actually damage the pancreas and affect insulin function in normal healthy individuals, which could lead to diabetes and serious health issues.”

In recent years intermittent fasting diets have gained popularity. Participants fast for two days out of seven, or on alternate days. However, evidence of their success has been contradictory and there is debate among doctors about their potential to trigger harmful long-term effects.

Previous research has also shown that short-term fasting can produce molecules called free radicals, highly reactive chemicals that can cause damage to cells in the body and which may be associated with impaired organ function, cancer risk and accelerated ageing.

The São Paulo researchers examined the effects of fasting every other day on the bodyweight, free radical levels and insulin function of normal adult rats over three months. Although the rats’ bodyweight and food intake decreased as expected, the amount of fat tissue in their abdomen actually increased. In addition, cells of the pancreas that release insulin showed damage, while the presence of increased levels of free radicals and markers of insulin resistance were also detected.

The results also suggest that in the long-term harm may be caused and that more investigation is needed to assess how people may be affected, particularly those with existing metabolic issues.

“We should consider that overweight or obese people who opt for intermittent fasting diets may already have insulin resistance, so although this diet may lead to early, rapid weight loss, in the long-term there could be potentially serious damaging effects to their health, such as the development of type 2 diabetes,” added Bonassa.

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The Harsh Penalty for Willful Ignorance

In 1968, Lyndon Johnson announced he would not accept the nomination of his party for another term as president of the United States.

Lyndon Johnson (LBJ) suffered severe coronary artery occlusion. Conventional medicine had no safe treatment. LBJ knew that men in his family did not live much beyond 60 years.

In 1955, LBJ had the first of several heart attacks. Suffering chronic angina pain, LBJ declined to run for re-election at age 59 and died at 64.

Move forward a few decades and vast improvements occurred in prevention and treatment of heart disease. So much so that Bill Clinton, George W. Bush, and Dick Cheney were spared the fate of Lyndon Johnson.

In the years spanning 1980 to 2014, there was an astounding 50% decline in cardiovascular-related deaths.1 The reasons have a lot to do with what readers of this magazine practice every day to reduce their risk of atherosclerosis.

There have also been massive enhancements in coronary artery stenting and surgical bypass procedures. None of these interventions are perfect, but they’re better than enduring chronic chest pain, disability, and fatal heart attack, as LBJ and others suffered during his era.

But did Lyndon Johnson really have no effective treatment option in 1968? And are other former presidents following optimal coronary prevention strategies today?

Even a cursory review uncovers startling lapses by presidential cardiologists in initiating steps to prevent and reverse coronary artery blockage. This fate often befalls high-end individuals who get the “best” of conventional care, which inherently overlooks novel approaches to better treatments.

This tragedy persists today because many people are not utilizing affordable methods to identify their vascular risk factors in time.

President Dwight Eisenhower suffered his first heart attack in 1955. He had an ischemic stroke in 1957.

By the time of his death in 1969, Eisenhower suffered seven heart attacks, along with multiple diseases related to the unhealthy lifestyle of his era.2

Lyndon Johnson was 46 years old when his first heart attack struck in 1955. LBJ suffered angina pain until he succumbed to heart disease in 1973.3

In 1972, former president Harry Truman died from coronary artery disease,4 as did almost one million other Americans that year.

Back in those days, recovery from a heart attack was a slow and arduous process. Doctors recommended bed rest, no physical activity, and little in the way of dietary changes.

Was this vascular disease carnage necessary? A review of the published literature dating back to the 1940s reveals millions could have been spared…if only their doctors had bothered paying attention.5-7

Pioneer of Modern Cardiology

John Gofman, M.D., Ph.D., was a physicist turned medical doctor whose early work on radioactive isotopes resulted in his being recruited to work on The Manhattan Project to develop the first atomic bomb.

Dr. Gofman’s expertise on the biological effects of radiation caused him to take a controversial position. He documented how diagnostic X-rays are a cause of cancer and artery disease, something most in the medical establishment still refuse to accept.8-13

In 1947, Dr. Gofman began research that led him to conclude that cholesterol is a cause of atherosclerosis.6,7

Dr. Gofman and his colleagues were the first to show that specific fractions of cholesterol such as LDL (low-density lipoprotein) contribute to clogged arteries.14

In 1951, Dr. Gofman was involved in the publication of possibly the first book advocating low-fat/low-cholesterol diets to prevent heart disease.15

John Gofman was a Life Extension® member. I was privileged to have Dr. Gofman call me to express his gratitude for warning our readers about the dangers posed by radiation-emitting imaging devices (such as CT scans). Dr. Gofman regretted that so few physicians paid attention to his books, which documented higher cancer rates in those exposed to medical radiation.

So, in 1951, Dr. Gofman, a prestigious individual, promoted a book that revealed the role of diet and LDL cholesterol in arterial disease. Yet mainstream cardiology behaved as if this scientific evidence did not exist.

In 1959 and again in 1965, the FDA proclaimed it illegal for food makers to promote healthy diet as a way of preventing artery disease.16-18

First heart attack at age 46 (1955)

  • Chronic angina (chest) pain
  • Declined to run for re-election at age 59
  • More major heart attacks
  • Dead at age 64 (1973)

(Conventional Treatments Lacking)


Role of Nathan Pritikin

Nathan Pritikin was a millionaire inventor in areas as diverse as engineering, photography, and aeronautics.

In 1957, at age 40, Pritikin was diagnosed with severe coronary artery disease. Faced with a lifetime of ever-increasing disability, he pored over the scientific literature and formulated a diet and exercise program to treat his ailment.19 After nine years of trial and error, he had effectively treated himself.

Long before the medical establishment acknowledged the role of poor diets causing serious illness, Pritikin created a program using food and exercise as medicine.

Pritikin was an engineer…not a doctor. His revolutionary departure from the flawed theories of the 1950s caused him to become a public enemy of the medical establishment.

Despite many clinical successes, Nathan Pritikin was accused of being a charlatan. For much of the 1970s, Pritikin waged battles with government and private health agencies, as well as the American Medical Association.20,21 The establishment refused to accept that what one ate had anything to do with heart disease risk.

In 1987, the Journal of the American Medical Association announced a study that showed regression of atherosclerosis in the coronary arteries of humans who reduced their blood cholesterol by a similar degree as was accomplished using the Pritikin protocol.22

Had Dwight Eisenhower or Lyndon Johnson paid attention to published scientific studies linking poor diets to coronary artery disease, they could have been spared years of suffering and premature death.

Bill Clinton underwent procedures in 2004 and 2010 to reopen blocked coronary arteries. Surgical complication resulted in his being rehospitalized.

  1. 2004 – Coronary Bypass, Age 58
  2. 2010 – Coronary Stents, Age 63

(These procedures were not safely available to LBJ in the 1955-1973 era.)

Improved Heart Attack Prevention

We know far more now than what John Gofman and Nathan Pritikin uncovered more than 60 years ago.

Back in those early days, there were no well-known effective methods to lower vascular risk factors (such as elevated LDL) other than strict low-calorie/ultra low-fat diets. Few people of that era were willing to give up their bacon, butter, steak, and eggs, let alone start eating healthy vegetables and fruit.

Today we know that not all fats are dangerous. For instance, solid data supports the value of extra-virgin olive oil23-25 and omega-3 fatty acids in lowering cardiovascular risk and risk of dying from cardiovascular disease.26-29

In lieu of the ultra low-fat diet espoused by Nathan Pritikin, the preponderance of data indicates that following a Mediterranean-style diet is an effective and practical way to reduce one’s cardiovascular risks.30,31

What’s more, there is a new test that measures factors that oxidize LDL, and thus provides a better marker of correctable vascular risk than John Gofman’s discovery of LDL in the late 1940s.

Since our inception, Life Extension® has advised healthy people to keep their LDL (low-density lipoprotein) below 100 mg/dL. Those with pre-existing coronary artery disease should strive to push LDL below 70 mg/dL.

The medical community now concurs with our LDL guidelines. I’m pleased that we can now identify earlier stages of atherosclerosis using a blood test that measures apolipoprotein B.

I’m even more excited that we are able to add apolipoprotein B to our popular Male and Female Panels at no extra charge!

George W. Bush underwent aggressive diagnostics before his heart was damaged by a heart attack. According to a news report,

“He was more than 95 percent occluded. With a blockage like that in a main artery you’re supposed to die…”

2013 – Coronary Stent, Age 67

Danger of Elevated Apolipoprotein B

Apolipoprotein B is found on all non-HDL cholesterol particles, such as LDL and VLDL.

The higher the ApoB number the more dangerous the situation. Higher ApoB generally equates to a higher amount of glycated and oxidized LDL particles, which are initiators of dangerous arterial plaque.32

Having a higher ApoB (apolipoprotein B) level can be a stronger heart attack predictor than LDL cholesterol.33,34

Until recently, testing one’s blood for apolipoprotein B (ApoB) was expensive. Even today, commercial labs charge $150 for this test (ApoB) of vascular risk.

Dick Cheney survived multiple heart attacks and eventual heart failure. He is alive only because of technological advances.

  • 1988 – Coronary Bypass, Age 47
  • 2000 – Coronary Stents, Age 59
  • 2010 – Ventricular Assist, Age 69
  • 2012 – Heart Transplant, Age 71


Check Your Apolipoprotein B at No Added Cost!

Those with high apolipoprotein B blood levels are at greater risk for coronary artery disease.35

If an apolipoprotein B blood test comes back high, steps can be initiated to correct this.

The incredible news is that apolipoprotein B has been added to the Male and Female Blood Panels many of our supporters have done each year.

The addition of this vascular risk marker makes these comprehensive blood panels a greater value…at no additional cost!

1981: DHEA replacement

  • 1981: Homocysteine reduction
  • 1983: Low-dose aspirin
  • 1983: Coenzyme Q10
  • 1996: Public access to blood tests

We defied conventional “reference ranges” for glucose, LDL, and blood pressure, arguing that optimal ranges were far lower than mainstream medicine believed at the time.

How Blood Tests Are Saving Lives

Every day, we at Life Extension® receive calls from people asking what they should do to reduce their degenerative disease risks. My response is that we have no idea until we review their blood test results.

In many cases, blood test panels that new people submit consist of little more than measures of glucose, lipids and liver/kidney function. Omitted almost always are tests for C-reactive protein, DHEA, homocysteine and other controllable risk factors

To resolve this lack of data, we combined the most powerful indicators of heart attack/stroke risk into comprehensive Male and Female Blood Panels.

The retail price of having all these tests done can approach $900. We’ve been able to use our high volume to drive the cost of these popular panels down to $199 during our annual Lab Test Super Sale.

I’m proud of how we’ve added more tests to these panels over the years, such as 25-hydroxyvitamin D and hemoglobin A1c… without raising the price!

We sometimes find our supporters are taking too much vitamin D or DHEA and are able to suggest they reduce their dose. In other cases, we identify markers that predispose one to cancer, dementia, atherosclerosis, or kidney failure.

Once uncovered via comprehensive blood testing, most people are able to move these markers into safer ranges.

Turn back the clock just 54 years, and history reveals how the FDA and medical establishment ridiculed the notion that poor diets were a cause of artery disease.This medical ignorance resulted in the most famous political leaders of their day keeling over from heart attacks before the public’s eyes.

For example, Dwight Eisenhower smoked four packs of cigarettes a day until he quit in 1949. Combined with his high saturated-fat intake, he was at great cardiac risk. Here is what President Eisenhower ate the day of his first heart attack:36

  • Breakfast: sausage, bacon, mush, hotcakes
  • Lunch: hamburger with raw onion
  • Dinner: roast lamb

Heart attack and/or stroke claimed the lives of most of the presidents in the past century including Theodore Roosevelt, William Taft, Woodrow Wilson, Calvin Coolidge, Franklin Roosevelt, and Richard Nixon (hemorrhagic stroke).

Annual Lab Test Super Sale

The high cost and hassles of blood testing in conventional settings precludes many people from availing themselves of a proven preventive diagnostic.

We resolved this problem 22 years ago by enabling readers of this magazine to order low-cost blood tests direct, and then to visit a drawing station in their area at their convenience.

Results come back in less than a week and are emailed and mailed directly to you. If you have any questions, our Wellness Specialists are available to assist seven days/week at no charge.

Once a year, we discount prices of all blood tests. This serves as a convenient reminder to have one’s annual tests performed and save 50% in the process.

People often comment on the degree of variability in blood results that can occur over a year’s time. This variance can be a result of normal aging, use of a new drug, or lifestyle alteration.

In any case, gaining knowledge that a blood marker is out of balance enables corrective actions to be taken before serious illnesses manifest.

This year’s blood test sale expires on June 4th, 2018.

To order the new Male or Female Blood Panels (that now include ApoB) at the bargain price of $199, call 1-800-208-3444 (24 hours) or log on to:


I hope the historical data conveyed in this editorial enable readers to understand that atherosclerosis is a normal part of aging.

One reason heart attacks did not kill more people in years 1900-1944 is that average life expectancy during this period was only 55 years.

Now that people are living longer, they need to be vigilant in protecting against arterial occlusion, and it starts with comprehensive blood tests.

By: William Faloon


What Blocks Our Empathy In The Design Thinking Process?


Empathy is the foundation of the whole Design Thinking process. Putting ourselves in someone else’s shoes enhances our ability to receive and process information, which helps us understand how other people experience the world.

As a product designer, I know that empathy helps me to recognise the difficulties that people face, alongside their needs and desires, and that I can then use that knowledge to design the best solution for their challenges.

Being a product designer is exciting. I get to solve important problems and make people’s lives easier but, unfortunately, sometimes I get distracted – and so do most of us.

How many times do we find ourselves distracted in a project, and losing perspective on why and who we’re designing for? We all know that even the most successful projects have their high and low moments. How can we improve focus and create space for designers to challenge themselves and come up with their best work?

Why do we get Distracted?

I felt uncomfortable with my lack of empathy in some situations and decided to look into what’s blocking me and how I could solve it. Here are some common reasons I uncovered:

1.Solving a Different Problem

Are we solving the right problem? As a project progresses, it is not unusual for team or client problems to emerge: projects lack focus, expectations become difficult to manage, tasks duplicate… And it all creates inefficiency and frustration in the team, making the purpose of the work not as central as it should be.

2. The Test of Time

The longest project I’ve worked on lasted 12 months. That experience made me realize it’s not easy to make lengthy projects continuously interesting. Designer teams might get lost in the middle of endless files, tweaks and twists. That’s when they lose empathy and stop pushing the thinking.

3. Complex Problems

Designers are being asked to design for increasingly diverse users, cultures, and environments. These design challenges can be so wickedly complex that is difficult to develop or maintain empathy for the problem.

What can we do to Maintain Empathy?

There is no easy (or perhaps even “right”) solution for this problem, but I can share some of my conclusions and practical methods to help you through the tricky moments.

1. Engage With Your Team

When you’re… solving a different problem

In my experience, to build great products, we need to nurture a healthy and positive culture within the team. If you are not solving the right problem, and that’s getting you frustrated, stop and ask for help from your team. If we don’t empathize with our colleagues, how can we empathize with people we’re designing for?

Activity: Swap roles – Get someone from your team to swap roles or tasks with you.  The goal here is to understand and even gain compassion for each other, which can lead to useful behavioral changes.

2. Keep the Momentum Going

When you’re… facing the test of time

Empathy serves to inspire decisions in the early stages of a design process: it helps designers to develop the reasoning and feelings behind human behaviours. We gain insights into people’s needs, wants, feelings and thoughts, and why they demonstrate such behaviors.

Activity: Empathy is not a stage: you should extend the empathy activities whenever needed during the process. Product teams that consistently keep customer needs in mind are able to maintain and evolve their products. For me, design process should be summarised as: Define, Ideate, Prototype, Test – and Empathise above all these stages.

3. Try it Yourself

When you’re… solving truly complex problems

If a problem is too complex, try gaining personal insights into others’ experiences. Resonating with the user may be easiest when you’ve got a personal example at hand. For example, I worked on a project to improve customer experience during a fraud journey. There was an immediate connection between me and our target customer, as I had also gone through the experience of being defrauded. I could remember how it felt when I experienced the same problem and how painful it was. Designers empathise more when they hear or see customers in action. So, why not invite a customer to sit and work with the team?

Activity: Extra chair – Invite customers to sit with the team and participate not only in the definition stage of the project. For example, invite them to participate in a ideation session with the team.

What About Your Empathic Thinking?

As humans we’ve evolved to have a powerful sense of empathy, but we get preoccupied with other things all too often. If we find ways to guarantee that empathy is always present, we will think deeper, care more, and create better products and services for humans everywhere.

Time and money are barriers to applying these activities but, as designers, we have the power to explore and educate others in new ways of thinking. We cannot solve our problems with the same thinking we used when we created them – these are Albert Einstein’s words, not mine.

We can all agree Design Thinking without empathy doesn’t work. It’s a mindset that all designers should have and try to maintain and cultivate.

Have you faced similar problems in your work? I’d love to hear from you. If you’re working through a similar situation at the moment, feel free to try and include my suggested experiments to your design process and let me know how it goes. Let’s start a conversation.


Maintaining a Daily Rhythm Is Important For Mental Health,Study Suggests

Setting an alarm might be the only thing that helps you get up in the morning, but try setting one at night to remind you when it's time to go to bed. Click through our gallery for other tips for better sleep.

The study, published Tuesday in the journal The Lancet Psychiatry, looked at disruptions in the circadian rhythms — or daily sleep-wake cycles — of over 91,000 adults in the United Kingdom. It measured these disruptions using a device called an accelerometer that is worn on the wrist and measures one’s daily activity levels. The participants were taken from the UK Biobank, a large cohort of over half a million UK adults ages 37 to 73.
The researchers found that individuals with more circadian rhythm disruptions — defined as increased activity at night, decreased activity during the day or both — were significantly more likely to have symptoms consistent with bipolar disorder or major depression. They were also more likely to have decreased feelings of well-being and to have reduced cognitive functioning, based on a computer-generated reaction time test.
For all participants, activity levels were measured over a seven-day period in either 2013 or 2014, and mental health proxies such as mood and cognitive functioning were measured using an online mental health questionnaire that participants filled out in 2016 or 2017.
“It’s widely known that a good night’s sleep is a good thing for well-being and health. That’s not a big surprise,” said Dr. Daniel Smith, professor of psychiatry at the University of Glasgow and a leading author on the study. “But I think what’s less well-known and what comes out of this work is that not only is a good night’s sleep important, but having a regular rhythm of being active in daylight and inactive in darkness over time is important for mental well-being.”
The findings were found to be consistent even when controlling for a number of influential factors including age, sex, lifestyle, education and body mass index, according to Smith.
“I think one of the striking things that we found was just the consistency in the direction of our association across everything we looked at in terms of mental health,” Smith said.
Daily circadian rhythm is controlled by a collection of neurons in an area of the brain called the hypothalamus. The hypothalamus helps regulate a number of important behavioral and physiological functions such as body temperature, eating and drinking habits, emotional well-being and sleep, according to the National Institute of General Medical Sciences.
The findings are consistent with research indicating a link between sleep disruptions and mood disorders. A 2009 study, for example, showed that men who worked night shifts for four years or more were more likely to have anxiety and depression than those who work during the day.
However, the new study is the first to use objective measurements of daily activity and is among the largest of its kind, according to Aiden Doherty, senior research fellow at the University of Oxford, who was not involved in the research.
“This study is the first large-scale investigation of the association of objectively measured circadian rhythmicity with various mental health, well-being, personality and cognitive outcomes, with an unprecedented sample size of more than 90 000 participants,” Doherty wrote in an email.
“Previous studies have been very small (in just a few hundred people), or relied on self-report measures (asking people what they think they do). … However, this study used objective device-based measures in over 90,000 participants; and then linked this information to standard measures of mood disorders, subjective well-being, and cognitive function,” he added.
The findings have significant public health consequences, particularly for those who live in urban areas, where circadian rhythms are often disrupted due to artificial light, according to Smith.
“By 2030, two-thirds of the world’s population will be living in cities, and we know that living in an urban environment can be pretty toxic to your circadian system because of all the artificial light that you’re exposed to,” Smith said.
“So we need to think about ways to help people tune in to their natural rhythms of activity and sleeping more effectively. Hopefully, that will protect a lot of people from mood disorders.”
For those who struggle to maintain a consistent circadian rhythm, certain strategies — such as avoiding technology at night — have proven to be an important part of good sleep hygiene.
“Not using your phone late at night and having a regular pattern of sleeping is really important,” Smith said. “But equally important is a pattern of exposing yourself to sunshine and daylight in the morning and doing activity in the morning or midday so you can actually sleep properly.”
Based on the observational nature of the study, the researchers were unable to show causality, meaning it is unclear whether the sleep disturbances caused the mental health problems or vice versa.
“It’s a cross-sectional study, so we can’t say anything about cause and effect or what came first, the mood disorder or the circadian disruption,” said Kristen Knutson, associate professor of neurology at Northwestern’s Feinberg School of Medicine, who was not involved in the study.
“And it’s likely they affect each other in a circular fashion,” she added. The researchers also looked exclusively at adults between age 37 and 73, meaning the results may not apply to younger individuals, whose circadian rhythms are known to be different than those of older adults, according to Smith.
“The circadian system changes throughout life. If you’ve got kids, you know that very young kids tend to be nocturnal,” Smith said. “My suspicion is that we might observe even more pronounced effects in younger samples, but that hasn’t been done yet, to my knowledge.”
But the study adds more credence to the idea that sleep hygiene — including maintaining a consistent pattern of sleep and wake cycles — may be an important component of good mental health, according to Smith.
“It’s an exciting time for this kind of research because it’s beginning to have some real-world applications,” Smith said. “And from my point of view as a psychiatrist, I think it’s probably under-recognized in psychiatry how important healthy circadian function is, but it’s an area that we’re trying to develop.”

 May 15, 2018

Patient Engagement Is The Key To Bundled Payment Success

patient engagement

Over the last decade, the Center for Medicare and Medicaid Services (CMS) has created both mandatory and voluntary programs designed to move healthcare providers from fee-for-service payment models to those that are value-based. Some of the most well-known programs are bundled payments.

Bundled payments have proven challenging for providers to address, as oftentimes they are unsure where or how to start. The shift towards value-based programs like BPCI (voluntary bundled payment program) and CJR (mandatory bundled payment program) have become a dividing issue amongst healthcare executives as some doubt the programs will drive desired success. More often than not, forward-thinking and progressive providers are already positioning themselves for the future by putting into place the right processes and structures for success.

Common Challenges in Succeeding Under Bundled Payment Programs
The purpose of bundled payments is to promote high-quality care, and the system is meant to reward providers that care for patients during the entire care episode at a predetermined cost. Conversely, if a provider goes over the predetermined budget or target price, it is required to pay the difference back to CMS.

The challenge for providers is that bundled payments require more coordination that is tailored to individual patient preferences than traditional fee-for-service models. Scaling this type of care management is typically a new process that will require better reporting, communication, and engagement workflows. Additionally, many providers do not have consistent processes around communicating with patients prior to their arrival or after they have left the facility.

By capitating episode-based payments, providers across the care continuum must work more closely together to understand and act upon patient needs. From gathering patient outcomes information at the physician office to proactive rounds in a rehab facility, if processes are not efficient and systems don’t communicate with each other, there is a greater risk of poor patient outcomes and of losing money. So, the question is, how can healthcare providers realize success under bundled payments? The answer lies in creating efficient and consistent patient engagement programs.

Utilizing Patient Engagement Strategies to Maximize Bundled Payment Rewards

As with any value-based initiative, involving patients in their care is critical to success. This is especially true of bundled payments. Under most CJR and BPCI models, providers are accountable for the patient for the entire care episode, which can include up to 90-days post-discharge. To ensure success, patients should be engaged prior to their scheduled appointment, educated while in the facility, and contacted throughout their recovery.

With proactive engagement strategies such as pre-op education and post-op follow up, providers can identify and prevent potentially costly events such as an infection or a readmission. There are many engagement strategies that can help providers achieve bundled payment goals and KPIs. For example, programs like CJR require providers to collect patient-reported outcomes. To do this, providers can implement kiosks at physician offices or they can proactively reach out to patients via call or text to capture the information. Additionally, clinical follow-up calls or wearable fitness trackers can be used to monitor patients post-discharge and determine if patients are experiencing any issues.

To further engage patients in the hospital or post-acute healthcare facility, rounds are a great way to track progress and leverage best practices such as teach-back to help prepare patients for their transition home and recovery. The bottom line is that there are countless interaction points where providers can engage patients in their own care to lower costs, improve outcomes, and enhance experiences.

Achieving Success with Bundled Payments
Whether you are a believer in bundled payments or a vocal skeptic, putting the right processes and technologies in place to drive patient engagement is proving to have a positive impact. Several hospitals in the U.S. are already meeting bundled program KPIs (key performance indicators) such as reduced readmissions with effective patient engagement and scalable patient engagement processes are what can drive long-term success.

The hospitals leverage the patient information they have to deploy automated calls and text messages, cross-continuum care management, and point-of-care data collection. By using technology, the team is able to leverage one orthopedic care coordinator to manage the day-to-day workflow associated with all total hip and knee replacement patient episodes.

By implementing patient engagement processes that leverage technology for efficiency, providers are creating a better experience throughout the entire care episode, all while reducing the overall cost of care. It is evident that risk-based models are here to stay with the launch of new programs such are BPCI Advanced, which is set to go live this year. As CMS and commercial payers continue to leverage value-based payments, patient engagement will play a critical role in improving quality and driving financial success.

Photo: mathisworks, Getty Images

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John Banks Powell

John Banks Powell is the Vice President of Post-Acute Strategy at CipherHealth. Powell spearheads CipherHealth’s post-acute and bundled payment initiatives by partnering with providers across the care continuum who leverage CipherHealth’s patient engagement and care coordination solutions to meet quality initiatives. Powell holds a BA from the University of North Carolina at Chapel Hill, and a Masters degree from the Fuqua School of Business at Duke University.