Artykuły w czasopismach na temat „University of North Carolina at Chapel Hill. Student Health Service”

Background College students are at heightened risk for negative psychological outcomes due to COVID-19. We examined the prevalence of psychological distress and its association with social isolation among public university students in the southern United States. Methods A cross-sectional survey was emailed to all University of North Carolina-Chapel Hill students in June 2020 and was open for two weeks. Students self-reported if they were self-isolating none, some, most, or all of the time. Validated screening instruments were used to assess clinically significant symptoms of depression, loneliness, and increased perceived stress. The data was weighted to the complete student population. Results 7,012 completed surveys were included. Almost two-thirds (64%) of the students reported clinically significant depressive symptoms and 65% were categorized as lonely. An estimated 64% of students reported self-isolating most or all of the time. Compared to those self-isolating none of the time, students self-isolating some of the time were 1.78 (95% CI 1.37, 2.30) times as likely to report clinically significant depressive symptoms, and students self-isolating most or all of the time were 2.12 (95% CI 1.64, 2.74) and 2.27 (95% CI 1.75, 2.94) times as likely to report clinically significant depressive symptoms, respectively. Similar associations between self-isolation and loneliness and perceived stress were observed. Conclusions The prevalence of adverse mental health indicators among this sample of university students in June 2020 was exceptionally high. University responses to the COVID-19 pandemic should prioritize student mental health and prepare a range of support services to mitigate mental health consequences as the pandemic continues to evolve.

Abstract The Donald P. Kent Award lecture will feature an address by the 2022 Kent Award recipient Nancy R. Hooyman, PhD, FGSA, of the University of Washington. The Kent Award is given annually to a member of The Gerontological Society of America who best exemplifies the highest standards of professional leadership in gerontology through teaching, service, and interpretation of gerontology to the larger society. The Robert W. Kleemeier Award lecture will feature an address by the 2022 Kleemeier Award recipient Sheryl Zimmerman, PhD, FGSA, of the University of North Carolina at Chapel Hill. The Kleemeier Award is given annually to a member of The Gerontological Society of America in recognition for outstanding research in the field of gerontology.

Introduction: Primary care physicians serve on the front lines of care and provide comprehensive care to patients who may have difficulty accessing subspecialists. However, not enough students are entering residency in primary care fields to meet the primary care physician shortage. The authors sought to compare primary care match rates among graduates of medical schools in the state of North Carolina from 2014 to 2018. Methods: The 4 allopathic medical schools in the state of North Carolina were selected for this study: East Carolina University (ECU) Brody School of Medicine, University of North Carolina (UNC) Chapel Hill, Duke School of Medicine, and Wake Forest School of Medicine. Primary care specialties were defined as family medicine, internal medicine, pediatrics, and internal medicine/pediatrics. The proportion of students matching to a residency in any of these fields, and in each specific field, was compared across schools. Results: Over 2014-2018, 214 ECU Brody School of Medicine graduates, 386 UNC graduates, 165 Duke graduates, and 196 Wake Forest graduates matched to a primary care specialty. ECU had the highest proportion of its graduates match in a primary care specialty (53%, compared with 34% to 45% at other schools; P < .001), and was particularly distinguished by having the highest proportions of graduates match to residencies in family medicine (18%) and pediatrics (16%). Conclusion: During the study period of 2014-2018, the ECU Brody School of Medicine matched more medical students into primary care specialties than the other medical schools in the state. This school’s community-driven mission and rural location, among other characteristics facilitating sustained student commitment to primary care careers, can inform the development of new medical schools in the United States to overcome the primary care physician shortage.

There has been a steady increase in global health experiential opportunities offered within healthcare professional training programs and with this, a need to describe the process for learning. This article describes a model to contextualize global health learning for students who complete international advanced pharmacy practice experiences (APPEs). Students from University of North Carolina at Chapel Hill, Purdue University, and the University of Colorado completed a post-APPE survey which included open-ended questions about knowledge, skills, and attitudes one week after completing an international APPE. Students were also invited to participate in a focus group. All 81 students who participated in an international APPE completed the open-ended survey questions and 22 students participated in a focus group discussion. Qualitative data from both the survey and focus groups were coded in a two-cycle open coding process. Code mapping and analytic memo writing were analyzed to derive to a conceptual learning model. The Global Health Experience Learning Progression (GHELP) model was derived to describe the process of student learning while on global health experiences. This progression model has three constructs and incorporates learning from external and internal influences. The model describes how students can advance from cultural awareness to cultural sensitivity and describes how student pharmacists who participate in international experiential education develop global health knowledge, skills, and attitudes.

Abstract Objectives To assess the association between moving in with family during the COVID-19 pandemic and changes in food consumption among college students. Methods We conducted a cross-sectional analysis using data from 2,012 undergraduate and graduate students from the University of North Carolina at Chapel Hill who completed an online survey about how their food situation has been impacted during the COVID-19 pandemic. The survey data were collected in June and July of 2020 and the questionnaire asked about student experiences during the spring 2020 semester up to March 6 (pre-COVID-19), which was when the university went on Spring break and transitioned to remote learning thereafter, and after March 6 (during COVID-19). Changes in food consumption were assessed using questions adapted from the Nurse's Health Study COVID-19 Baseline Questionnaire. Students were asked if they moved in with family during the pandemic. We used multinomial logistic regression to assess the association between moving in with family during the COVID-19 pandemic and changes in consumption of certain types of foods. Models were adjusted for potential covariates and statistical significance was considered P &lt; .05. Results In adjusted models, moving in with family was associated with decreased consumption of frozen prepared meals (P &lt; .05), canned or frozen fruits (P &lt; .05), canned or frozen vegetables (P &lt; .05), whole grain foods (P &lt; .05) and increased consumption of sugary drinks (P &lt; .05), fresh fruits (P &lt; .01), fish and seafood (P &lt; .001), and red meat (P &lt; .001). There were no significant associations between moving home and consumption of fast foods; alcohol; sweetened foods like candies, brownies, ice creams, muffins, and cakes; snacks like popcorn and potato chips; and fresh vegetables (not including potatoes) in the adjusted models. Conclusions Where college students live may influence if and how the types of foods they consume changed during the COVID-19 pandemic. In our sample, changes in consumption of certain types of foods were associated with moving in with family. Funding Sources None

School-aged children experienced substantial challenges to health and well-being as a result of school-building closures due to the coronavirus disease 2019 pandemic. In hopes of supporting equitable and safe school reopening for every student across North Carolina (NC) and improving child health, researchers from Duke University and the University at North Carolina at Chapel Hill established the ABC Science Collaborative (ABCs) in July 2020. The ABCs collected data related to in-school severe acute respiratory syndrome coronavirus 2 transmission and adherence to mitigation strategies. These data were presented to NC government officials, including the NC Department of Health and Human Services, the NC Department of Public Instruction, and Democratic and Republican representatives from the NC General Assembly. These data-sharing practices led to the implementation of in-person school legislation in early 2021 in which in-person school access for every student was required, the full-time in-person reopening of NC public schools was supported, and weekly reporting to the ABCs of coronavirus disease 2019 infections from &gt;1 000 000 children and adults was required.

ABSTRACT First Person is a series of interviews with the first authors of a selection of papers published in Journal of Cell Science, helping early-career researchers promote themselves alongside their papers. Benjamin Roberts is first author on ‘ Characterization of lipoprotein lipase storage vesicles in 3T3-L1 adipocytes’, published in JCS. Benjamin conducted the research described in this article while a PhD student in Dr Saskia Neher's lab at University of North Carolina at Chapel Hill, NC, USA. He is now a postdoctoral fellow in the lab of Dr Prasanna Krishnan at Uniformed Services University of the Health Sciences, Bethesda, MD, USA, investigating regulated secretory trafficking and cargo sorting.

To ensure workforce readiness, graduate-level public health training programs must prepare students to collaborate with communities on improving public health practice and tools. The Council on Education for Public Health (CEPH) requires Master of Public Health (MPH) students to complete an Integrative Learning Experience (ILE) at the end of their program of study that yields a high-quality written product demonstrating synthesis of competencies. CEPH suggests written products ideally be “developed and delivered in a manner that is useful to external stakeholders, such as non-profit or governmental organizations.” However, there are limited examples of the ILE pedagogies and practices most likely to yield mutual benefit for students and community partners. To address this gap, we describe a community-led, year-long, group-based ILE for MPH students, called Capstone. This service-learning course aims to (1) increase capacity of students and partner organizations to address public health issues and promote health equity; (2) create new or improved public health resources, programs, services, and policies that promote health equity; (3) enhance student preparedness and marketability for careers in public health; and (4) strengthen campus-community partnerships. Since 2009, 127 Capstone teams affiliated with the Department of Health Behavior at the Gillings School of Global Public Health at The University of North Carolina at Chapel Hill have worked with seventy-nine partner organizations to provide over 103,000 h of in-kind service and produce 635 unique products or “deliverables.” This paper describes key promising practices of Capstone, specifically its staffing model; approach to project recruitment, selection, and matching; course format; and assignments. Using course evaluation data, we summarize student and community partner outcomes. Next, we share lessons learned from 13 years of program implementation and future directions for continuing to maximize student and community partner benefits. Finally, we provide recommendations for other programs interested in replicating the Capstone model.

Abstract Even as progress has been made in extending access to safe water and sanitation under the Sustainable Development Goals (SDGs), substantial disparities in water, sanitation, and hygiene (WASH) services persist in high-income countries around the world. These gaps in service occur disproportionately among historically marginalized, rural, informal, and Indigenous communities. This paper synthesizes results from a side session convened at the 2020 University of North Carolina, Chapel Hill, Water and Health conference focused on knowledge gaps, challenges, and approaches to achieve SDG 6 among marginalized communities in high-income countries. We provide approaches and next steps to advance sustainable WASH services in communities that have often been overlooked.

ABSTRACT University-established modalities to help undergraduate students navigate the path to medical school are often implemented toward the end of college or following graduation. This imposes cost and time burdens that may be contribute to the high rate of premedical attrition, especially for students who are members of a marginalized community. In the fall 2022 semester, an asynchronous, self-directed pre-health module was offered to biology majors at the University of North Carolina at Chapel Hill enrolled in a required introductory biology research skills course. The objective of the five-lesson intervention was to enhance student understanding of the path to becoming a successful applicant early in their college career. The module aimed to increase the accessibility of pre-health advising and was designed to be easily shared and adapted across various learning management systems. A pre- and post-module survey was administered to assess changes in students’ perceived understanding of and confidence for success on the pre-health track following completion of the course.

This poster summarizes three recent digitization projects at the WVU Herbarium. The NSF “Keys to the Cabinet” digitizing and georeferencing grant, targeting botanical specimens from across the southeastern U.S., concluded at the WVU Herbarium in June 2019. More than 92,000 plant collections in 223 families, 1314 genera and 4639 species from the 12-state region were imaged and uploaded to the SERNEC portal. With the end of this grant, the WVU Herbarium began work on two new projects. A multi-year U.S. Forest Service contract was funded to support student labor for invasive plant research. The initial semesters of this project involved transcribing label data from WVU Herbarium records worldwide for seven species. Current work is focused on images from the iDigBio portal: Arthraxon hispidus and Polygonum caespitosum are completed; Glechoma hederacea and Stellaria media are ongoing. The final project is a 3-year NSF Pteridophyte Collections Consortium grant. Funding is distributed among nine research centers to digitize fern herbarium specimens and fossils. The WVU Herbarium is participating through a data hub at the University of North Carolina, Chapel Hill. More than 8500 WVU Herbarium fern collections have been imaged and will be linked to specimen label information at the award website. These three projects demonstrate a sampling of digitization foci in taxonomy, floristics, and ecology.

Background Racial and ethnically diverse communities have higher mortality rates from chronic diseases. One approach to address health disparities and systemic racism in health care is through alterations in primary care workforce development via the One-Minute Preceptor (OMP) Teaching Method. The University of North Carolina at Chapel Hill created a modified OMP Model for Health Equity to address racial health disparities while teaching. This quality improvement (QI) project focuses on faculty confidence in discussing racial health disparities with learners using the modified OMP Model. Methods The QI project used a Plan-Do-Study-Act (PDSA) framework. Faculty participated in the Awareness, Reflection/Empowerment, and Action (AREA) survey, to assess level of engagement in addressing health disparities. Family Medicine (FM) residents completed a survey on current precepting practices of ethno-racial health disparities. Faculty were introduced to the modified OMP, followed by a two-month intervention period. Post-intervention surveys assessed the impact and identified faculty development opportunities. The intervention took place within a Family Medicine Residency Program, specifically during outpatient continuity clinics and the inpatient Family Medicine Hospital Service. Results Faculty engagement increased in areas of awareness and action and decreased in reflection/empowerment. Residents reported higher satisfaction with Ethno-Racial health disparities clinical teaching after the intervention. Qualitative data suggests discussions are not occurring as often as residents desire and depend on different factors; race/ethnicity of the patient, clinical situation, social determinants of health impacting care, time, and preceptor. Discussion The modified OMP for Health Equity intervention can be used to increase awareness and promote self-reflection and change. Conclusion The PDSA cycle framework for an intervention can improve faculty engagement addressing Ethnic-Racial health disparities.

Background Racial and ethnically diverse communities have higher mortality rates from chronic diseases. One approach to address health disparities and systemic racism in health care is through alterations in primary care workforce development via the One-Minute Preceptor (OMP) Teaching Method. The University of North Carolina at Chapel Hill created a modified OMP Model for Health Equity to address racial health disparities while teaching. This quality improvement (QI) project focuses on faculty confidence in discussing racial health disparities with learners using the modified OMP Model. Methods The QI project used a Plan-Do-Study-Act (PDSA) framework. Faculty participated in the Awareness, Reflection/Empowerment, and Action (AREA) survey, to assess level of engagement in addressing health disparities. Family Medicine (FM) residents completed a survey on current precepting practices of ethno-racial health disparities. Faculty were introduced to the modified OMP, followed by a two-month intervention period. Post-intervention surveys assessed the impact and identified faculty development opportunities. The intervention took place within a Family Medicine Residency Program, specifically during outpatient continuity clinics and the inpatient Family Medicine Hospital Service. Results Faculty engagement increased in areas of awareness and action and decreased in reflection/empowerment. Residents reported higher satisfaction with Ethno-Racial health disparities clinical teaching after the intervention. Qualitative data suggests discussions are not occurring as often as residents desire and depend on different factors; race/ethnicity of the patient, clinical situation, social determinants of health impacting care, time, and preceptor. Discussion The modified OMP for Health Equity intervention can be used to increase awareness and promote self-reflection and change. Conclusion The PDSA cycle framework for an intervention can improve faculty engagement addressing Ethnic-Racial health disparities.

ABSTRACT Introduction Cumulative low-level blast exposure during military training may be a significant occupational hazard, increasing the risk of poor long-term outcomes in brain function. US Public Law 116-92 section 717 mandates that US Department of Defense agencies document the blast exposure of each Service member to help inform later disability and health care decisions. However, which empirical measures of training blast exposure, such as the number of incidents, peak overpressure, or impulse, best inform changes in the neurobehavioral symptoms reflecting brain health have not been established. Materials and Methods This study was approved by the US Army Special Operations Command, the University of North Carolina at Chapel Hill, and the VA Puget Sound Health Care System. Using methods easily deployable across different organizational structures, this study sought to identify and measure candidate risk factors related to career occupational blast exposure predictive of changes in neurobehavioral symptom burden. Blast dosimetry-symptom relationships were first evaluated in mice and then tested in a military training environment. In mice, the righting time neurobehavioral response was measured after exposure to a repetitive low-level blast paradigm modeled after Special Operations training. In the military training environment, 23 trainees enrolled in a 6-week explosive breaching training course, 13 instructors, and 10 Service member controls without blast exposure participated in the study (46 total). All participants provided weekly Neurobehavioral Symptom Inventory (NSI) surveys. Peak blast overpressure, impulse, total number of blasts, Time in Low-Level Blast Occupation, and Time in Service were analyzed by Bayesian analysis of regression modeling to determine their probability of influence on the post-training symptoms reported by participants. Results We tested the hypothesis that cumulative measures of low-level blast exposure were predictive of changes in neurobehavioral symptoms. In mice, repetitive blast resulted in reduced righting times correlated with cumulative blast impulse. In Service members, peak blast overpressure, impulse, total number of blasts, Time in Low-Level Blast Occupation, and Time in Service all showed strong evidence of influence on NSI scores after blast exposure. However, only models including baseline NSI scores and cumulative blast impulse provided significant predictive value following validation. Conclusions These results indicate that measures of cumulative blast impulse may have utility in predicting changes in NSI scores. Such paired dosimetry-symptom measures are expected to be an important tool in safely guiding Service members’ occupational exposure and optimizing force readiness and lethality.

Abstract Background Human trafficking is a serious global challenge associated with a complex array of health inequities for individuals, families, and communities. Consequently, in addition to a conventional criminal justice approach, anti-trafficking scholars have increasingly called for a public health approach to address this global challenge. Such calls have emphasized that a comprehensive, robust, and social justice-informed public health strategy for anti-trafficking must include services to facilitate survivors’ HT exit and recovery, and to prevent their re-victimization. Fortunately, many community-based organizations and non-governmental organizations worldwide have heeded these calls and developed anti-trafficking programs for survivors. Unfortunately, despite the growing numbers of organizations providing anti-trafficking services, research concerning these programs’ effectiveness remains nascent overall, and even more scant when filtered through an equity focus. Methods To advance the field by developing guidance concerning how best to evaluate anti-human trafficking programs, an ongoing research project aims to conduct a mixed methods evaluability assessment of a prominent anti-trafficking program using a social justice framework. Guided by well-established evaluability assessment frameworks, the study activities include four sequential steps: (a) focusing the assessment, (b) developing the program theory and logic, (c) gathering feedback, and (d) applying the assessment findings. Activities will include qualitative interviews and focus groups, observations, and quantitative analysis of program data among others. Human subjects and ethical review for the evaluability assessment has been granted by the Office of Human Subjects Research at The University of North Carolina at Chapel Hill. Discussion Once completed, evaluability assessment results will provide evidence and products that have the potential to guide both evaluation research and service provision not only for the specific organization under study, but also for other anti-human trafficking programs worldwide. Findings will be developed into a variety of dissemination products tailored for both practice professionals and researchers. In the interim, this protocol manuscript offers research strategies and recommendations that can help inform the development of other studies in the developing field of anti-trafficking program evaluation research.

Problem definition: Physicians spend more than five hours a day working on Electronic Health Record (EHR) systems and more than an hour doing EHR tasks after the end of the workday. Numerous studies have identified the detrimental effects of excessive EHR use and after-hours work, including physician burnout, physician attrition, and appointment delays. However, EHR time is not purely an exogenous factor because it depends on physician usage behavior that could have important operational consequences. Interestingly, prior literature has not considered this topic rigorously. In this paper, we investigate how physicians’ workflow decisions on when to perform EHR tasks affect: (1) total time on EHR and (2) time spent after work. Methodology/results: Our data comprise around 150,000 appointments from 74 physicians from a large Academic Medical Center Family Medicine unit. Our data set contains detailed, process-level time stamps of appointment progression and EHR use. We find that the effect of working on EHR systems depends on whether the work is done before or after an appointment. Pre-appointment EHR work reduces total EHR workload and after-work hours spent on EHR. Post-appointment EHR work reduces after-work hours on EHR but increases total EHR time. We find that increasing idle time between appointments can encourage both pre- and post-appointment EHR work. Managerial implications: Our results not only help us understand the timing and structure of work on secondary tasks more generally but also will help healthcare administrators create EHR workflows and appointment schedules to reduce physician burnout associated with excessive EHR use. History: This paper has been accepted in the Manufacturing & Service Operations Management Frontiers in Operations Initiative. Funding: The research conducted for this paper received partial funding from the Center of Business for Health at the Kenan-Flagler Business School, University of North Carolina at Chapel Hill. Supplemental Material: The online appendix is available at https://doi.org/10.1287/msom.2023.0028 .

IntroductionNew digital technologies hold promise for equalising access to information and communication for the Deaf community. SMS technology, for example, has helped to equalise deaf peoples’ access to information and made it easier to communicate with both deaf and hearing people (Tane Akamatsu et al.; Power and Power; Power, Power, and Horstmanshof; Valentine and Skelton, "Changing", "Umbilical"; Harper). A wealth of anecdotal evidence and some recent academic work suggests that new media technology is also reshaping deaf peoples’ sense of local and global community (Breivik "Deaf"; Breivik, Deaf; Brueggeman). One focus of research on new media technologies has been on technologies used for point to point communication, including communication (and interpretation) via video (Tane Akamatsu et al.; Power and Power; Power, Power, and Horstmanshof). Another has been the use of multimedia technologies in formal educational setting for pedagogical purposes, particularly English language literacy (e.g. Marshall Gentry et al.; Tane Akamatsu et al.; Vogel et al.). An emphasis on the role of multimedia in deaf education is understandable, considering the on-going highly politicised contest over whether to educate young deaf people in a bilingual environment using a signed language (Swanwick & Gregory). However, the increasing significance of social and participatory media in the leisure time of Westerners suggests that such uses of Web 2.0 are also worth exploring. There have begun to be some academic accounts of the enthusiastic adoption of vlogging by sign language users (e.g. Leigh; Cavander and Ladner) and this paper seeks to add to this important work. Web 2.0 has been defined by its ability to, in Denise Woods’ word, “harness collective intelligence” (19.2) by providing opportunities for users to make, adapt, “mash up” and share text, photos and video. As well as its well-documented participatory possibilities (Bruns), its re-emphasis on visual (as opposed to textual) communication is of particular interest for Deaf communities. It has been suggested that deaf people are a ‘visual variety of the human race’ (Bahan), and the visually rich presents new opportunities for visually rich forms of communication, most importantly via signed languages. The central importance of signed languages for Deaf identity suggests that the visual aspects of interactive multimedia might offer possibilities of maintenance, enhancement and shifts in those identities (Hyde, Power and Lloyd). At the same time, the visual aspects of the Web 2.0 are often audio-visual, such that the increasingly rich resources of the net offer potential barriers as well as routes to inclusion and community (see Woods; Ellis; Cavander and Ladner). In particular, lack of captioning or use of Auslan in video resources emerges as a key limit to the accessibility of the visual Web to deaf users (Cahill and Hollier). In this paper we ask to what extent contemporary digital media might create moments of permeability in what Krentz has called “the hearing line, that invisible boundary separating deaf and hearing people”( 2)”. To provide tentative answers to these questions, this paper will explore the use of participatory digital media by a group of young Deaf people taking part in a small-scale digital moviemaking project in Sydney in 2009. The ProjectAs a starting point, the interdisciplinary research team conducted a video-making course for young deaf sign language users within the Department of Media, Music and Cultural Studies at Macquarie University. The research team was comprised of one deaf and four hearing researchers, with expertise in media and cultural studies, information technology, sign language linguistics/ deaf studies, and signed language interpreting. The course was advertised through the newsletter of partner organization the NSW Deaf Society, via a Sydney bilingual deaf school and through the dense electronic networks of Australian deaf people. The course attracted fourteen participants from NSW, Western Australia and Queensland ranging in age from 10 to 18. Twelve of the participants were male, and two female. While there was no aspiration to gather a representative group of young people, it is worth noting there was some diversity within the group: for example, one participant was a wheelchair user while another had in recent years moved to Sydney from Africa and had learned Auslan relatively recently. Students were taught a variety of storytelling techniques and video-making skills, and set loose in groups to devise, shoot and edit a number of short films. The results were shared amongst the class, posted on a private YouTube channel and made into a DVD which was distributed to participants.The classes were largely taught in Auslan by a deaf teacher, although two sessions were taught by (non-deaf) members of Macquarie faculty, including an AFI award winning director. Those sessions were interpreted into Auslan by a sign language interpreter. Participants were then allowed free creative time to shoot video in locations of their choice on campus, or to edit their footage in the computer lab. Formal teaching sessions lasted half of each day – in the afternoons, participants were free to use the facilities or participate in a range of structured activities. Participants were also interviewed in groups, and individually, and their participation in the project was observed by researchers. Our research interest was in what deaf young people would choose to do with Web 2.0 technologies, and most particularly the visually rich elements of participatory and social media, in a relatively unstructured environment. Importantly, our focus was not on evaluating the effectiveness of multimedia for teaching deaf young people, or the level of literacy deployed by deaf young people in using the applications. Rather we were interested to discover the kinds of stories participants chose to tell, the ways they used Web 2.0 applications and the modalities of communication they chose to use. Given that Auslan was the language of instruction of the course, would participants draw on the tradition of deaf jokes and storytelling and narrate stories to camera in Auslan? Would they use the format of the “mash-up”, drawing on found footage or photographs? Would they make more filmic movies using Auslan dialogue? How would they use captions and text in their movies: as subtitles for Auslan dialogue? As an alternative to signing? Or not at all? Our observations from the project point to the great significance of the visual dimensions of Web 2.0 for the deaf young people who participated in the project. Initially, this was evident in the kind of movies students chose to make. Only one group – three young people in their late teens which included both of the young women in the class - chose to make a dialogue heavy movie, a spoof of Charlie’s Angels, entitled Deaf Angels. This movie included long scenes of the Angels using Auslan to chat together, receiving instruction from “Charlie” in sign language via videophone and recruiting “extras”, again using Auslan, to sign a petition for Auslan to be made an official Australian language. In follow up interviews, one of the students involved in making this film commented “my clip is about making a political statement, while the other [students in the class] made theirs just for fun”. The next group of (three) films, all with the involvement of the youngest class member, included signed storytelling of a sort readily recognisable from signed videos on-line: direct address to camera, with the teller narrating but also taking on the roles of characters and presenting their dialogue directly via the sign language convention of “role shift” - also referred to as constructed action and constructed dialogue (Metzger). One of these movies was an interesting hybrid. The first half of the four minute film had two young actors staging a hold-up at a vending machine, with a subsequent chase and fight scene. Like most of the films made by participants in the class, it included only one line of signed dialogue, with the rest of the narrative told visually through action. However, at the end of the action sequence, with the victim safely dead, the narrative was then retold by one of the performers within a signed story, using conventions typically observed in signed storytelling - such as role shift, characterisation and spatial mapping (Mather & Winston; Rayman; Wilson).The remaining films similarly drew on action and horror genres with copious use of chase and fight scenes and melodramatic and sometimes quite beautiful climactic death tableaux. The movies included a story about revenging the death of a brother; a story about escaping from jail; a short story about a hippo eating a vet; a similar short comprised of stills showing a sequence of executions in the computer lab; and a ghost story. Notably, most of these movies contained very little dialogue – with only one or two lines of signed dialogue in each four to five minute video (with the exception of the gun handshape used in context to represent the object liberally throughout most films). The kinds of movies made by this limited group of people on this one occasion are suggestive. While participants drew on a number of genres and communication strategies in their film making, the researchers were surprised at how few of the movies drew on traditions of signed storytelling or jokes– particularly since the course was targeted at deaf sign language users and promoted as presented in Auslan. Consequently, our group of students were largely drawn from the small number of deaf schools in which Auslan is the main language of instruction – an exceptional circumstance in an Australian setting in which most deaf young people attend mainstream schools (Byrnes et al.; Power and Hyde). Looking across the Hearing LineWe can make sense of the creative choices made by the participants in the course in a number of ways. Although methods of captioning were briefly introduced during the course, iMovie (the package which participants were using) has limited captioning functionality. Indeed, one student, who was involved in making the only clip to include captioning which contextualised the narrative, commented in follow-up interviews that he would have liked more information about captioning. It’s also possible that the compressed nature of the course prevented participants from undertaking the time-consuming task of scripting and entering captions. As well as being the most fun approach to the projects, the use of visual story telling was probably the easiest. This was perhaps exacerbated by the lack of emphasis on scriptwriting (outside of structural elements and broad narrative sweeps) in the course. Greater emphasis on that aspect of film-making would have given participants a stronger foundational literacy for caption-based projectsDespite these qualifications, both the movies made by students and our observations suggest the significance of a shared visual culture in the use of the Web by these particular young people. During an afternoon when many of the students were away swimming, one student stayed in the lab to use the computers. Rather than working on a video project, he spent time trawling through YouTube for clips purporting to show ghost sightings and other paranormal phenomena. He drew these clips to the attention of one of the research team who was present in the lab, prompting a discussion about the believability of the ghosts and supernatural apparitions in the clips. While some of the clips included (uncaptioned) off-screen dialogue and commentary, this didn’t seem to be a barrier to this student’s enjoyment. Like many other sub-genres of YouTube clips – pranks, pratfalls, cute or alarmingly dangerous incidents involving children and animals – these supernatural videos as a genre rely very little on commentary or dialogue for their meaning – just as with the action films that other students drew on so heavily in their movie making. In an E-Tech paper entitled "The Cute Cat Theory of Digital Activism", Ethan Zuckerman suggests that “web 1.0 was invented to allow physicists to share research papers and web 2.0 was created to allow people to share pictures of cute cats”. This comment points out both the Web 2.0’s vast repository of entertaining material in the ‘funny video’genre which is visually based, dialogue free, entertaining material accessible to a wide range of people, including deaf sign language users. In the realm of leisure, at least, the visually rich resources of Web 2.0’s ubiquitous images and video materials may be creating a shared culture in which the line between hearing and deaf people’s entertainment activities is less clear than it may have been in the past. The ironic tone of Zuckerman’s observation, however, alerts us to the limits of a reliance on language-free materials as a route to accessibility. The kinds of videos that the participants in the course chose to make speaks to the limitations as well as resources offered by the visual Web. There is still a limited range of captioned material on You Tube. In interviews, both young people and their teachers emphasised the central importance of access to captioned video on-line, with the young people we interviewed strongly favouring captioned video over the inclusion on-screen of simultaneous signed interpretations of text. One participant who was a regular user of a range of on-line social networking commented that if she really liked the look of a particular movie which was uncaptioned, she would sometimes contact its maker and ask them to add captions to it. Interestingly, two student participants emphasised in interviews that signed video should also include captions so hearing people could have access to signed narratives. These students seemed to be drawing on ideas about “reverse discrimination”, but their concern reflected the approach of many of the student movies - using shared visual conventions that made their movies available to the widest possible audience. All the students were anxious that hearing people could understand their work, perhaps a consequence of the course’s location in the University as an overwhelmingly hearing environment. In this emphasis on captioning rather than sign as a route to making media accessible, we may be seeing a consequence of the emphasis Krentz describes as ubiquitous in deaf education “the desire to make the differences between deaf and hearing people recede” (16). Krentz suggests that his concept of the ‘hearing line’ “must be perpetually retested and re-examined. It reveals complex and shifting relationships between physical difference, cultural fabrication and identity” (7). The students’ movies and attitudes emphasised the reality of that complexity. Our research project explored how some young Deaf people attempted to create stories capable of crossing categories of deafness and ‘hearing-ness’… unstable (like other identity categories) while others constructed narratives that affirmed Deaf Culture or drew on the Deaf storytelling traditions. This is of particular interest in the Web 2.0 environment, given that its technologies are often lauded as having the politics of participation. The example of the Deaf Community asks reasonable questions about the validity of those claims, and it’s hard to escape the conclusion that there is still less than appropriate access and that some users are more equal than others.How do young people handle the continuing lack of material available to the on the Web? The answer repeatedly offered by our young male interviewees was ‘I can’t be bothered’. As distinct from “I can’t understand” or “I won’t go there” this answer, represented a disengagement from demands to identify your literacy levels, reveal your preferred means of communication; to rehearse arguments about questions of access or expose attempts to struggle to make sense of texts that fail to employ readily accessible means of communicating. Neither an admission of failure or a demand for change, CAN’T-BE-BOTHERED in this context offers a cool way out of an accessibility impasse. This easily-dismissed comment in interviews was confirmed in a whole-group discussions, when students came to a consensus that if when searching for video resources on the Net they found video that included neither signing nor captions, they would move on to find other more accessible resources. Even here, though, the ground continues to shift. YouTube recently announced that it was making its auto-captioning feature open to everybody - a machine generated system that whilst not perfect does attempt to make all YouTube videos accessible to deaf people. (Bertolucci).The importance of captioning of non-signed video is thrown into further significance by our observation from the course of the use of YouTube as a search engine by the participants. Many of the students when asked to research information on the Web bypassed text-based search engines and used the more visual results presented on YouTube directly. In research on deaf adolescents’ search strategies on the Internet, Smith points to the promise of graphical interfaces for deaf young people as a strategy for overcoming the English literacy difficulties experienced by many deaf young people (527). In the years since Smith’s research was undertaken, the graphical and audiovisual resources available on the Web have exploded and users are increasingly turning to these resources in their searches, providing new possibilities for Deaf users (see for instance Schonfeld; Fajardo et al.). Preliminary ConclusionsA number of recent writers have pointed out the ways that the internet has made everyday communication with government services, businesses, workmates and friends immeasurably easier for deaf people (Power, Power and Horstmanshof; Keating and Mirus; Valentine and Skelton, "Changing", "Umbilical"). The ready availability of information in a textual and graphical form on the Web, and ready access to direct contact with others on the move via SMS, has worked against what has been described as deaf peoples’ “information deprivation”, while everyday tasks – booking tickets, for example – are no longer a struggle to communicate face-to-face with hearing people (Valentine and Skelton, "Changing"; Bakken 169-70).The impacts of new technologies should not be seen in simple terms, however. Valentine and Skelton summarise: “the Internet is not producing either just positive or just negative outcomes for D/deaf people but rather is generating a complex set of paradoxical effects for different users” (Valentine and Skelton, "Umbilical" 12). They note, for example, that the ability, via text-based on-line social media to interact with other people on-line regardless of geographic location, hearing status or facility with sign language has been highly valued by some of their deaf respondents. They comment, however, that the fact that many deaf people, using the Internet, can “pass” minimises the need for hearing people in a phonocentric society to be aware of the diversity of ways communication can take place. They note, for example, that “few mainstream Websites demonstrate awareness of D/deaf peoples’ information and communication needs/preferences (eg. by incorporating sign language video clips)” ("Changing" 11). As such, many deaf people have an enhanced ability to interact with a range of others, but in a mode favoured by the dominant culture, a culture which is thus unchallenged by exposure to alternative strategies of communication. Our research, preliminary as it is, suggests a somewhat different take on these complex questions. The visually driven, image-rich approach taken to movie making, Web-searching and information sharing by our participants suggests the emergence of a certain kind of on-line culture which seems likely to be shared by deaf and hearing young people. However where Valentine and Skelton suggest deaf people, in order to participate on-line, are obliged to do so, on the terms of the hearing majority, the increasingly visual nature of Web 2.0 suggests that the terrain may be shifting – even if there is still some way to go.AcknowledgementsWe would like to thank Natalie Kull and Meg Stewart for their research assistance on this project, and participants in the course and members of the project’s steering group for their generosity with their time and ideas.ReferencesBahan, B. "Upon the Formation of a Visual Variety of the Human Race. In H-Dirksen L. Baumann (ed.), Open Your Eyes: Deaf Studies Talking. 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