Diminished reality glasses

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Technology and autism

Recently, two of my classmates gave a class presentation on the subject of autism, which included the following video on the subject of Carly, a child with autism, who uses technology to communicate for the first time.

Carly is able to express herself by typing on the computer. This is a huge breakthrough for her and her family, and I think it worked because typing is a very linear and discrete form of communication—that is, you only type one letter at a time. Typing abstracts away many of the difficulties of verbal conversation and can be accomplished without the same level of motor coordination and timing that writing with a pen requires.

What struck me in the video was when Carly was asked, “Why do autistic kids cover their ears, flap their hands, hum and rock?”

She answered, “It’s a way for us to drown out all sensory input that overloads us all at once. We create output to block out input. … Our brains are wired differently. We take in many sounds and conversations at once. I take over a thousand pictures of a person’s face when I look at them. That’s why we have a hard time looking at people.”

Google’s augmented reality glasses

Recently, Google published a video about Project Glass (which I’m pretty sure isn’t another of their April Fool’s jokes) and it gave me an idea.

The principle behind augmented reality glasses is that you can add context-relevant input to your visual experience of the world.

Diminished reality glasses

So here’s the idea: I think that this technology could be adapted to help children like Carly. In the Project Glass video, the glasses are used to add extra information to one’s already busy visual field. But imagine that we first filtered out most of the busyness of the visual world with darkened glasses (not too dark—she should still be able to walk properly). Then we could use the same glasses to give pixel-by-pixel control to Carly over what she sees. We could also include noise-cancelling headphones that play white noise.

Carly says that she takes “a thousand pictures” of a person’s face, and so she has a hard time making eye contact. A single image, icon or word could replace a person’s face when Carly meets someone.

I think the way that the augmented reality glasses are demoed in the video would be ill-suited to helping Carly, but I think that they could probably be adapted so that they only display the information that Carly wants to see at the time.

That said, I have no idea if this would work in real life.

BibTeX

@online{bgcarlisle2012-2803,
    title = {Diminished reality glasses},
    journaltitle = {The Grey Literature},
    author = {Benjamin Gregory Carlisle},
    address = {Montreal, Canada},
    date = 2012-04-7,
    url = {https://www.bgcarlisle.com/blog/2012/04/07/diminished-reality-glasses/}
}

MLA

Carlisle, Benjamin Gregory. "Diminished reality glasses" Web blog post. The Grey Literature. 07 Apr 2012. Web. 22 Nov 2017. <https://www.bgcarlisle.com/blog/2012/04/07/diminished-reality-glasses/>

APA

Carlisle, Benjamin Gregory. (2012, Apr 07). Diminished reality glasses [Web log post]. Retrieved from https://www.bgcarlisle.com/blog/2012/04/07/diminished-reality-glasses/


Obstetrics and Shakespeare

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Today was the last day of my rotation as a student nurse in obstetrics, and I have one regret from this semester that I think will haunt me for the rest of my life.

For those of you who don’t remember high school English class, in Macbeth, the title character learns early in the play that no one who is “of woman born can harm Macbeth,” which he takes to mean that he is invincible. Later on, Macduff reveals that he was “from his mother’s womb untimely ripp’d.” And then he kills Macbeth.

In January, I assumed that at some point over the course of this semester, I would have had the opportunity to refer to a child born by C-section as one “from his mother’s womb untimely ripp’d,” but it never happened. I even got to see a Caesarian birth from inside the operating room, but I didn’t think about it at the time.

Life slips away far too fast. If you’re not careful, all the opportunities you think you’ll have will pass you by.

BibTeX

@online{bgcarlisle2012-2767,
    title = {Obstetrics and Shakespeare},
    journaltitle = {The Grey Literature},
    author = {Benjamin Gregory Carlisle},
    address = {Montreal, Canada},
    date = 2012-03-26,
    url = {https://www.bgcarlisle.com/blog/2012/03/26/obstetrics-and-shakespeare/}
}

MLA

Carlisle, Benjamin Gregory. "Obstetrics and Shakespeare" Web blog post. The Grey Literature. 26 Mar 2012. Web. 22 Nov 2017. <https://www.bgcarlisle.com/blog/2012/03/26/obstetrics-and-shakespeare/>

APA

Carlisle, Benjamin Gregory. (2012, Mar 26). Obstetrics and Shakespeare [Web log post]. Retrieved from https://www.bgcarlisle.com/blog/2012/03/26/obstetrics-and-shakespeare/


Tricky exams for health practitioners

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A couple years ago, I read a story about a medical student who was tricked by his professor. In this story, the professor asked the student to assess a patient’s retina, and told the student that he should expect to see a certain pattern of blood vessels on the retina. The medical student examined the patient’s eye and agreed, claiming to have seen it as well. Much to the embarrassment of the medical student, the professor then revealed that he was examining a glass eye.

I’m scared to death of this sort of thing happening to me.

Today I had a mock exam in my physical assessment class. Because it’s an exam situation, we’ve been told that we’re supposed to expect a normal, healthy standardised patient (SP), and so if we’re nervous and can’t actually find a pulse, for example, we can just say a pulse rate that would be normal for a healthy adult. I happened to be randomly assigned to the head/ears/eyes/nose/throat scenario, and one part of this assessment is examination of the SP’s tonsils.

I looked inside my SP’s mouth with my penlight to look at his mouth, tongue, the insides of his cheeks and his tonsils. The tonsils are supposed to be just visible around the sides of the back of the throat, and sometimes they’re not visible at all. I couldn’t see the tonsils, but rather than just writing down “tonsils +1,” I took the tongue depressor out and asked, “Have you had your tonsils removed?”

I felt like I dodged a bullet when he said, “Yes, they were removed three years ago.”

BibTeX

@online{bgcarlisle2012-2743,
    title = {Tricky exams for health practitioners},
    journaltitle = {The Grey Literature},
    author = {Benjamin Gregory Carlisle},
    address = {Montreal, Canada},
    date = 2012-03-14,
    url = {https://www.bgcarlisle.com/blog/2012/03/14/tricky-exams-for-health-practitioners/}
}

MLA

Carlisle, Benjamin Gregory. "Tricky exams for health practitioners" Web blog post. The Grey Literature. 14 Mar 2012. Web. 22 Nov 2017. <https://www.bgcarlisle.com/blog/2012/03/14/tricky-exams-for-health-practitioners/>

APA

Carlisle, Benjamin Gregory. (2012, Mar 14). Tricky exams for health practitioners [Web log post]. Retrieved from https://www.bgcarlisle.com/blog/2012/03/14/tricky-exams-for-health-practitioners/


Pathology midterm results

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My pathology midterm was three weeks ago. I went to the exam feeling cautiously optimistic, but when I started talking to my classmates in the hall before the exam, my confidence was shaken. I wrote the exam in my usual way: I answered the questions as quickly as possible and then left before I had a chance to turn correct answers into wrong ones. I didn’t feel very good about my performance afterward. I felt a little bit better when a classmate mentioned that she also had a lot of 5’s in a row, but I still had no idea how I did, and I feared the worst. I mean I actually was afraid of receiving a failing mark.

Yesterday I finally decided to check my grade online. I did really well. Unexpectedly well. Suspiciously well.

This, on the one hand, is great news. Who doesn’t want a good result on a challenging exam? The only problem is that it was a multiple choice exam and so I don’t know whether I just happened to guess the correct answers, or if it wasn’t as difficult as I made it out to be in retrospect. I don’t know if I was adequately prepared, or if it was just a stroke of luck.

To be certain, there were a number of questions I wasn’t sure of, but then, because of the structure of the exam itself (it was multiple multiple choice) I was able to narrow down most questions I wasn’t sure of to two or three options.

I suppose in the big world of academic problems that I could be having, this one’s not so bad.

BibTeX

@online{bgcarlisle2012-2738,
    title = {Pathology midterm results},
    journaltitle = {The Grey Literature},
    author = {Benjamin Gregory Carlisle},
    address = {Montreal, Canada},
    date = 2012-03-7,
    url = {https://www.bgcarlisle.com/blog/2012/03/07/pathology-midterm-results/}
}

MLA

Carlisle, Benjamin Gregory. "Pathology midterm results" Web blog post. The Grey Literature. 07 Mar 2012. Web. 22 Nov 2017. <https://www.bgcarlisle.com/blog/2012/03/07/pathology-midterm-results/>

APA

Carlisle, Benjamin Gregory. (2012, Mar 07). Pathology midterm results [Web log post]. Retrieved from https://www.bgcarlisle.com/blog/2012/03/07/pathology-midterm-results/


It’s midterm week and what is wrong with Google Docs?

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It’s midterm week right now, so I’m behind in my blogging. Apologies! I promise I’ll write a whole lot more when I get back.

Google Docs preferences

Google Docs preferences

In the meantime, here’s a little bug I’ve found in Google Docs, and it’s one that has come up recently, because I have been actively using this feature, and I’m not sure how it broke.

Google Docs has a great feature: automatic substitution. When you type “(c)” and then hit the spacebar, Google Docs immediately changes your “(c)” into a “©” like magic! There was one substitution I was using all the time, namely, the “–>” into “→” substitution.

I specifically remember having used it in January extensively in my notes.

If anyone has a tip or a clue as to how to fix this, that would be appreciated. Google’s documentation is lacking. I’ve done a few searches, and found nothing helpful.

Failure to replace

Failure to replace

I’ve checked my Google Docs preferences (see previous image) and the other substitutions work fine, but no matter what I do, I can’t get it to change my “–>” into a “→”.

BibTeX

@online{bgcarlisle2012-2710,
    title = {It’s midterm week and what is wrong with Google Docs?},
    journaltitle = {The Grey Literature},
    author = {Benjamin Gregory Carlisle},
    address = {Montreal, Canada},
    date = 2012-02-15,
    url = {https://www.bgcarlisle.com/blog/2012/02/15/its-midterm-week-and-what-is-wrong-with-google-docs/}
}

MLA

Carlisle, Benjamin Gregory. "It’s midterm week and what is wrong with Google Docs?" Web blog post. The Grey Literature. 15 Feb 2012. Web. 22 Nov 2017. <https://www.bgcarlisle.com/blog/2012/02/15/its-midterm-week-and-what-is-wrong-with-google-docs/>

APA

Carlisle, Benjamin Gregory. (2012, Feb 15). It’s midterm week and what is wrong with Google Docs? [Web log post]. Retrieved from https://www.bgcarlisle.com/blog/2012/02/15/its-midterm-week-and-what-is-wrong-with-google-docs/


Weird thing to find in my readings for “Health and Physical Assessment”

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My textbook for “Health and Physical Assessment” is called Physical Examination and Health Assessment (first Canadian edition) by Carolyn Jarvis. I’ve only done two readings from it, and it’s mostly what I expect. Largely, it’s written in a very scientific tone. It’s a textbook about anatomy, some common forms of illness, and techniques on how to assess a patient.

What’s surprising is something I found right in the middle of chapter 18, (thorax and lungs). The author uses an emotive, almost poetic voice to describe the baby’s first breath:

Breath is life. When the newborn inhales the first breath, the lusty cry that follows reassures anxious parents that their baby is all right.

(Jarvis, C. Physical Examination and Health Assessment. First Canadian Edition. p. 442)

The chapter continues immediately afterward in its characteristic, professional manner for the rest of the chapter, as if nothing happened. I read it, and had to go back to make sure that I didn’t imagine it. I don’t even know what they’re trying to get at with the whole “breath is life” thing. It’s almost philosophical, but then there’s no content there.

Just weird, that’s all.

BibTeX

@online{bgcarlisle2012-2675,
    title = {Weird thing to find in my readings for “Health and Physical Assessment”},
    journaltitle = {The Grey Literature},
    author = {Benjamin Gregory Carlisle},
    address = {Montreal, Canada},
    date = 2012-01-18,
    url = {https://www.bgcarlisle.com/blog/2012/01/18/weird-thing-to-find-in-my-readings-for-health-and-physical-assessment/}
}

MLA

Carlisle, Benjamin Gregory. "Weird thing to find in my readings for “Health and Physical Assessment”" Web blog post. The Grey Literature. 18 Jan 2012. Web. 22 Nov 2017. <https://www.bgcarlisle.com/blog/2012/01/18/weird-thing-to-find-in-my-readings-for-health-and-physical-assessment/>

APA

Carlisle, Benjamin Gregory. (2012, Jan 18). Weird thing to find in my readings for “Health and Physical Assessment” [Web log post]. Retrieved from https://www.bgcarlisle.com/blog/2012/01/18/weird-thing-to-find-in-my-readings-for-health-and-physical-assessment/


Antibiotics and antivirals

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More and more often these days, I come across articles about new anti-viral drugs that look really promising. Further, I’m sure we’ve all read or heard about the phenomenon of antibiotic resistance—strains of bacteria who acquire the ability to survive treatment with antibiotics which would otherwise kill the bacteria and cure the patient.

Since the discovery of antibiotics, bacterial infections have been relatively easy to treat, whereas viral infections have been something that can’t be treated directly. The treatment for a bacterial infection is penicillin, but the treatment for the common cold is bed-rest.

What I find interesting about these developments is that we may be entering an age where this is reversed: Bacterial infections may become difficult or impossible to treat directly, while viral infections can be simply and easily cured with drugs.

BibTeX

@online{bgcarlisle2011-2590,
    title = {Antibiotics and antivirals},
    journaltitle = {The Grey Literature},
    author = {Benjamin Gregory Carlisle},
    address = {Montreal, Canada},
    date = 2011-12-22,
    url = {https://www.bgcarlisle.com/blog/2011/12/22/antibiotics-and-antivirals/}
}

MLA

Carlisle, Benjamin Gregory. "Antibiotics and antivirals" Web blog post. The Grey Literature. 22 Dec 2011. Web. 22 Nov 2017. <https://www.bgcarlisle.com/blog/2011/12/22/antibiotics-and-antivirals/>

APA

Carlisle, Benjamin Gregory. (2011, Dec 22). Antibiotics and antivirals [Web log post]. Retrieved from https://www.bgcarlisle.com/blog/2011/12/22/antibiotics-and-antivirals/


I made a doctor very angry at clinical last Friday

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Last Friday, I was assigned to give a patient his morning medications. I checked the chart to see who the patient’s nurse was, and I didn’t recognise the name. It was someone new. He was due for a dressing change that morning as well, and so my teacher told me to look out for someone I didn’t recognise to come and have a look at it—that person would likely be my patient’s nurse.

So when a woman without a name tag who was wearing a stethoscope around her neck came to inspect my patient’s dressing, I asked, “Oh! Are you his nurse?”

Her eyes narrowed to slits, and a flash of anger crossed her face.

“I’m his doctor,” she replied, deeply offended.

I avoided her for the rest of the day. Now that I think of it, after that interaction, I don’t think she wouldn’t have been such a great nurse anyway.

BibTeX

@online{bgcarlisle2011-2531,
    title = {I made a doctor very angry at clinical last Friday},
    journaltitle = {The Grey Literature},
    author = {Benjamin Gregory Carlisle},
    address = {Montreal, Canada},
    date = 2011-12-5,
    url = {https://www.bgcarlisle.com/blog/2011/12/05/i-made-a-doctor-very-angry-at-clinical-last-friday/}
}

MLA

Carlisle, Benjamin Gregory. "I made a doctor very angry at clinical last Friday" Web blog post. The Grey Literature. 05 Dec 2011. Web. 22 Nov 2017. <https://www.bgcarlisle.com/blog/2011/12/05/i-made-a-doctor-very-angry-at-clinical-last-friday/>

APA

Carlisle, Benjamin Gregory. (2011, Dec 05). I made a doctor very angry at clinical last Friday [Web log post]. Retrieved from https://www.bgcarlisle.com/blog/2011/12/05/i-made-a-doctor-very-angry-at-clinical-last-friday/


I will be clean-shaven this Movember

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“Movember” is the name of a movement that emphasises men’s health, specifically prostate cancer awareness during the month of November, by encouraging men to grow moustaches. There are two main reasons why I will be clean-shaven this November.

Screening for prostate cancer

When is it rational to be screened for a condition?

When is it rational to be screened for a condition?

The first major problem I have with Movember is the emphasis that is placed on prostate cancer screening for men—even men who are not in a high risk group for this type of cancer.

Not every test is completely reliable. Think about it this way: If you put a toothpick into something you baked and it comes out dry, it’s likely that your baking is done. But it’s also possible that you just poked the wrong part of your banana bread, and the rest of it is all gooey. If that happens, it’s called a “false positive” result for your test, or a “Type I error.”

This isn’t just a problem for bakers. It’s a problem with pretty much all medical tests (or any test at all for that matter) that there is a non-zero chance that you will get a false positive (“Type I error”) or a false negative (“Type II error”) result.

For prostate cancer, there are two methods of screening: a digital rectal exam (DRE) or a prostate-specific antigen test (PSA). The DRE is a physical examination of your rectum by palpation and the PSA is a chemical assay performed on a blood draw. Neither of these tests can be relied upon to give perfectly accurate results all the time.

The problem is that if a doctor finds what he takes to be evidence of a tumour growth in the prostate, he may order a biopsy of the prostate. This is an invasive, expensive, painful (and in the case of Type I errors, unnecessary) procedure that brings its own set of medical risks. A biopsy carries the risk of infection, for example.

Please examine the decision tree I have attached to this post. I have tried to make it as general as possible. If you wanted to be really rigorous, you would assign dollar values to each of the outcomes, and then for each of the branches off a probability node (a circle), calculate the probability of that branch. Then if you multiply the probability value of that branch and the dollar value of the outcome for that branch, and take the sum of all the branches, it will give you the value of that node. Repeat the process from right to left, until you come to a decision node (a square). The branch that carries the highest value as calculated using the algorithm I outlined is the decision that one has most reason to take.

I haven’t done the research to find out what the rates of Type I and II errors are for PSA tests, but they are pretty high, and you can see that if the probability of an inaccurate test result is high enough, and the consequences for having a bad test result are dire enough, that might give you reason to go without testing, provided you aren’t in a high risk group for prostate cancer. Further, a randomised control trial of men showed that there is no significant difference in mortality between a group of men who were screened for prostate cancer and those who weren’t. The evidence shows that prostate cancer screening doesn’t help reduce mortality.

If you are in a high risk group, like if there is a history of it in your family, and you are in a certain age range, then by all means, you should be tested for prostate cancer regularly—but don’t start encouraging young healthy men who are not at high risk for developing this sort of cancer to go looking for it. They may find more trouble than is actually there.

Emphasis on men’s health

The second major problem I have with Movember is their condescending and naive position on “men’s health” generally. Let’s consider a quote from the Movember Canada website:

Let’s face it – men are known to be a little more indifferent towards their health … The reasons for the poor state of men’s health in the Canada and around the world are numerous and complex and this is primarily due to a lack of awareness of the health issues men face. This can largely be attributed to the reluctance of men to openly discuss the subject, the old ‘it’ll be alright’ attitude. Men are less likely to schedule doctors’ appointments when they feel ill or to go for an annual physical, thereby denying them the chance of early detection and effective treatment of common diseases.

(From Men’s health—Movember Canada)

Movember Canada is stating here that it is “reluctance of men,” an “‘it’ll be all right’ attitude” and the general indifference toward issues of health that make men less likely to schedule a doctor’s appointment when they feel ill, or to make an appointment for a regular physical exam.

This is not the case. In Canada, men don’t schedule doctor’s appointments largely because they don’t have a doctor that they can call to make an appointment. I have been on my CLSC’s waiting list for a doctor for over a year now, and unless I go to the hospital or a walk-in clinic, I think it unlikely that I will see a doctor any time soon. This is not because I’m indifferent toward my health. This is because I don’t have a doctor.

It is not men being “too macho for doctors” that’s the problem. It’s that we as a country have made decisions regarding health care in Canada based on economics and politics that have brought about a doctor shortage. I hesitate to call it a “doctor shortage,” because the word “shortage” makes it sound like it was something unavoidable or unforeseeable—not something that was engineered and implemented as a matter of public policy.

The reason men aren’t seeing doctors in Canada is because we have chosen to limit our health care spending by decreasing the number of doctors in Canada who will order expensive tests and procedures. So don’t you dare turn around and chide men for failing to see a doctor regularly, when that is exactly what we have decided we want.

Is Movember all bad?

No probably not, and insofar as it is a fundraiser for prostate cancer research and survivor programmes, I think it is probably a good thing. That said, the message of Movember needs to be changed before I can support it.

BibTeX

@online{bgcarlisle2011-2408,
    title = {I will be clean-shaven this Movember},
    journaltitle = {The Grey Literature},
    author = {Benjamin Gregory Carlisle},
    address = {Montreal, Canada},
    date = 2011-11-1,
    url = {https://www.bgcarlisle.com/blog/2011/11/01/i-will-be-clean-shaven-this-movember/}
}

MLA

Carlisle, Benjamin Gregory. "I will be clean-shaven this Movember" Web blog post. The Grey Literature. 01 Nov 2011. Web. 22 Nov 2017. <https://www.bgcarlisle.com/blog/2011/11/01/i-will-be-clean-shaven-this-movember/>

APA

Carlisle, Benjamin Gregory. (2011, Nov 01). I will be clean-shaven this Movember [Web log post]. Retrieved from https://www.bgcarlisle.com/blog/2011/11/01/i-will-be-clean-shaven-this-movember/


But what do we call them?

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In school this year, we have spent a good deal of time talking about our relationship to our patients. Actually, that’s not true. We have actually spent more time talking about our relationship to our “clients.” It’s surprisingly difficult to find any reference to “patients” in our readings or texts.

There has apparently been a movement away from referring to someone as a patient, because of the meaning of the word, I suppose. In philosophy, the word “patient” is sometimes used in opposition to the word “agent.” For example, a moral agent is someone for whom her actions, character or the results of her actions are the proper subject of moral evaluation. By contrast, a moral patient is someone for whom her treatment by others is the proper subject of moral evaluation. (So a human being would be a moral patient. An inanimate object would not be a moral patient, since you can treat an inanimate object any way you please without it being even slightly wrong, as far as the object itself is concerned.)

If that is the way that we conceive of a patient—someone who is acted upon, then we make an implicit divide between “us nurses” (the agents) and “those patients” (the patients). On this conception, it is we who act upon the patient to bring about health. By labelling her a “patient,” we take away her agency.

I can understand this concern. This is why the language has changed. We now interact with “clients.” On this model, the client comes and uses the services of the nurse. I think this word is better than the word “consumer,” but only just. It has a very economic feel, I think. When I call someone my “client,” it sounds like I see them as someone with whom I am about to have a business transaction.

What’s funny about this is that I’ve had some instructors at McGill who disapprove of the word “patient,” and others who disapprove of the word “client.”

I’m tempted to just use the word “buddy.” E.g. “I’m going to give my buddy his meds.” It’s non-gendered, it doesn’t imply a lack of agency, and it doesn’t sound like I mainly have a business transaction in mind.

BibTeX

@online{bgcarlisle2011-2190,
    title = {But what do we call them?},
    journaltitle = {The Grey Literature},
    author = {Benjamin Gregory Carlisle},
    address = {Montreal, Canada},
    date = 2011-09-22,
    url = {https://www.bgcarlisle.com/blog/2011/09/22/but-what-do-we-call-them/}
}

MLA

Carlisle, Benjamin Gregory. "But what do we call them?" Web blog post. The Grey Literature. 22 Sep 2011. Web. 22 Nov 2017. <https://www.bgcarlisle.com/blog/2011/09/22/but-what-do-we-call-them/>

APA

Carlisle, Benjamin Gregory. (2011, Sep 22). But what do we call them? [Web log post]. Retrieved from https://www.bgcarlisle.com/blog/2011/09/22/but-what-do-we-call-them/


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