Researcher ◆ Climber ◆ West Coaster
One discovers the light in darkness, that is what darkness is for; but everything in our lives depends on how we bear the light. It is necessary, while in darkness, to know that there is a light somewhere, to know that in oneself, waiting to be found, there is a light. ~ James Baldwin
“The real encounter
is a meeting
an interchange
that literally
turns us around.”
~ Otto Bollnow
You can find my work at The Art Box located Silk Purse Arts Centre, 1570 Argyle Ave, West Vancouver and at the The Birds: Annual Invitational 2025, Smith & Vallee International Art Gallery, WA (Group). View here.
“I find television very educating. Every time somebody turns on the set, I go into the other room and read a book.” ~ Groucho Marx
My family installed a Little Free Library in our community 11 years ago, and it has been an incredible experience ever since. Children of all ages stop by to pick up a book or two, and sometimes they even make special requests. This has shown me how important it is for each of us to contribute to promoting literacy in our neighborhood. Together, we can inspire a love for reading and make a lasting impact!
Read more on my experience.
Concussions can occur at any level of ice hockey. Incidence estimates of concussions in ice hockey vary, and optimal prevention strategies and return-to-play (RTP) considerations have remained in evolution. The authors performed a mixed-methods study with the aim of elucidating the landscape of concussion in ice hockey and catalyzing initiatives to standardize preventative mechanisms and RTP considerations.
The authors performed a five-part mixed-methods study that includes: 1) an analysis of the impact of concussions on games missed and income for National Hockey League (NHL) players using a publicly available database, 2) a systematic review of the incidence of concussion in ice hockey, 3) a systematic review of preventative strategies, 4) a systematic review of RTP, and 5) a policy review of documents from major governing bodies related to concussions in sports with a focus on ice hockey. The PubMed, Embase, and Scopus databases were used for the systematic reviews and focused on any level of hockey.
In the NHL, 689 players had 1054 concussions from the 2000–2001 to 2022–2023 seasons. A concussion led to a mean of 13.77 ± 19.23 (range 1–82) games missed during the same season. After cap hit per game data became available in 2008–2009, players missed 10,024 games due to 668 concussions (mean 15.13 ± 3.81 per concussion, range 8.81–22.60 per concussion), with a cap hit per game missed of $35,880.85 ± $25,010.48 (range $5792.68–$134,146.30). The total cap hit of all missed games was $385,960,790.00, equating to $577,635.91 per concussion and $25,724,052.70 per NHL season. On systematic review, the incidence of concussions was 0.54–1.18 per 1000 athlete-exposures. Prevention mechanisms involved education, behavioral and cognitive interventions, protective equipment, biomechanical studies, and policy/rule changes. Rules prohibiting body checking in youth players were most effective. Determination of RTP was variable. Concussion protocols from both North American governing bodies and two leagues mandated that a player suspected of having a concussion be removed from play and undergo a six-step RTP strategy. The 6th International Conference on Concussion in Sport recommended the use of mouthguards for children and adolescents and disallowing body checking for all children and most levels of adolescents.
Concussions in ice hockey lead to substantial missed time from play. The authors strongly encourage all hockey leagues to adopt and adhere to age-appropriate rules to limit hits to the head, increase compliance in wearing protective equipment, and utilize high-quality concussion protocols.
Learn more on Concussions in ice hockey: mixed methods study including assessment of concussions on games missed and cap hit among National Hockey League players, systematic review, and concussion protocol analysis via Journal of Neurosurgery.
Image of JT Miller and Filip Hronek. Wear your helmet during warm up Hronek… 🙂
Objective: To systematically assess literature examining the impact of being a gamer or participating in video-game-based training on surgical skills acquisition amongst medical students.
Background: Video games and surgical procedures share similar skills such as visuospatial abilities and hand-eye coordination; therefore, video games can be a valuable tool for surgical training amongst medical students. However, comprehensive, up-to-date systematic reviews are necessary to confirm.
Methods: A systematic literature search of PubMed, MEDLINE, and EMBASE was performed in April 2020 with no limits set on the date of publication. Observational and randomized controlled studies were included. Quality and bias were assessed using the Newcastle-Ottawa Scale for nonrandomized studies and the Grading of Recommendations Assessment, Development and Evaluation system for randomized studies.
Results: A total of 575 participants from 16 studies were included. The most common surgical skills tested were laparoscopy (n = 283, from 8 studies) and robotic surgery (n = 199, from 5 studies). A history of gaming and video-game-based training were associated with improved metrics in robotic surgery and laparoscopy, respectively. Neither was beneficial in arthroscopy or bronchoscopy. Studies using the Wii U and Underground reported significant improvement in overall laparoscopic performance.
Conclusion: Video games demonstrate potential as adjunctive training in surgical skill education, with a history of gaming and video-game-based training being beneficial in robotic surgery and laparoscopy, respectively. Methodological heterogeneity amongst included studies limit the ability to make conclusive decisions; thus, future studies with long-term follow-up, larger sample sizes, outcomes stratified by video-game characteristics, and up-to-date technology are necessary.
Read more on Can video games enhance surgical skills acquisition for medical students? A systematic review via Surgery.
“Background and Study Aim. Attention and concentration, fundamental psychological skills, are crucial in situations where the opponent moves rapidly and incessantly. Reaction time is also of paramount importance in winning a game in fencing, which requires both offensive and defensive actions. Understanding the factors that affect reaction time is essential for improving performance. This study aimed to investigate the impact of disruptions in attention and concentration on reaction time in fencing.
Material and Methods. Thirty-four healthy male and female fencers participated in two testing sessions. In the initial session, participants filled out a personal information form and took the d2 Attention Test to determine their attention levels. They also completed items representing the concentration disruption subscale of the Sport Anxiety Scale-2 (SAS-2) to measure concentration levels. In the second session, participants underwent the Favero Electronic Fencing Target (EFT-1) test to measure their reaction times. To analyze the obtained data, SPSS 20 was used. The Pearson correlation coefficient between attention, concentration disruption, and participants’ reaction times was calculated. Then, linear regression analysis was employed to test whether attention and concentration scores could predict the reaction times.
Results. The findings indicated that there is a significant positive relationship between E (r = .603, p < .01), E% (r = .628, p < .01), E1 (r = .584, p < .01), E2 (r = .533, p < .01), and reaction time. Additionally, a significant negative relationship was revealed between concentration performance and reaction times (r = -.456, p < .01). A significant positive correlation was observed between fencers’ concentration disruption and reaction times (r = .416, p < .05).
Conclusions. Our study results emphasize the importance of attention and concentration in disciplines that require quick reactions. These cognitive factors need to be considered in the development of sports performance.”
Read more on the Examining the effects of attention and concentration levels on reaction time in fencing via Physical Education of Students.
“Generative artificial intelligence (AI) models are increasingly utilized for medical applications. We tested whether such models are prone to human-like cognitive biases when offering medical recommendations. We explored the performance of OpenAI generative pretrained transformer (GPT)-4 and Google Gemini-1.0-Pro with clinical cases that involved 10 cognitive biases and system prompts that created synthetic clinician respondents.
Medical recommendations from generative AI were compared with strict axioms of rationality and prior results from clinicians. We found that significant discrepancies were apparent for most biases. For example, surgery was recommended more frequently for lung cancer when framed in survival rather than mortality statistics (framing effect: 75% vs. 12%; P<0.001). Similarly, pulmonary embolism was more likely to be listed in the differential diagnoses if the opening sentence mentioned hemoptysis rather than chronic obstructive pulmonary disease (primacy effect: 100% vs. 26%; P<0.001). In addition, the same emergency department treatment was more likely to be rated as inappropriate if the patient subsequently died rather than recovered (hindsight bias: 85% vs. 0%; P<0.001). One exception was base-rate neglect that showed no bias when interpreting a positive viral screening test (correction for false positives: 94% vs. 93%; P=0.431).
The extent of these biases varied minimally with the characteristics of synthetic respondents, was generally larger than observed in prior research with practicing clinicians, and differed between generative AI models. We suggest that generative AI models display human-like cognitive biases and that the magnitude of bias can be larger than observed in practicing clinicians.”
More on Cognitive Biases & Artificial Intelligence via NEJM AI.
“The state of childhood in Canada has reached a breaking point. The seventh annual Raising Canada report, released today, finds that the top 10 threats to childhood are escalating, with children’s quality of life in Canada demonstrably worsening. The report includes an urgent call for policymakers to address and overcome these pressing issues. It also calls on community leaders to recognize the value of youth engagement as a critical element of creating and implementing solutions to complex social issues.
The annual Raising Canada report is published by Children First Canada, based on research conducted by the University of Calgary and McGill University. Researchers compiled existing data and conducted interviews with youth, parents and other subject matter experts. It comes as Canada ranks 66th out of 194 countries on the global Kids Rights Index.
Among the startling findings:
This year’s report also highlights several cross-cutting themes, including the influence of technology on children and adolescents. Researchers note that digital platforms have made it easier to create and share messages of hate, discrimination, and cyberbullying, which adversely impact mental health, physical activity, and the risk of violence and abuse. Evidence also concludes that the negative effects of technology on mental health have intensified since the onset of the pandemic, with the RCMP warning that victims face extreme outcomes of sextortion, including self-harm or suicide.
“Children today are facing unprecedented threats—from rising poverty and mental health crises to violence in their homes and online. Parents are struggling to offer their children a better way of life than they had,” says Sara Austin, Founder and CEO of Children First Canada. “Canada’s kids deserve better—a better childhood and a brighter future, and their survival and ability to thrive depend on the choices we make today. We must act with urgency and conviction to turn this around.”
Read more on New Report Reveals Record Increases in Violence, Poverty, Mental Health Issues and Sexploitation Among Canada’s Kids (2024) via Children First Canada.
Causation vs. Correlation: The Coffee and Baby Sleep Saga
Imagine you’re on your 24-hour call shift and you notice a strange trend: the nights you chug coffee after dinner, the clinic’s tiniest patients—babies—seem to cry more. Hmm, you think, “Does my coffee cause baby insomnia?”
Before you start banning coffee on call, let’s unpack two key concepts:
1️⃣ Correlation: This is when two things happen together. In this case, your coffee habit and baby tears seem to rise in tandem. Coincidence? Maybe. Correlation is like spotting two family members wearing plaid shirts at the same time—they’re connected somehow, but you can’t be sure it’s because they planned it.
2️⃣ Causation: This is when one thing directly causes another. If your coffee somehow made its way into those babies’ milk bottles, then you’d have causation.
Here’s the twist: just because two things are correlated doesn’t mean one causes the other. Maybe babies are just naturally fussier on stormy nights, and you drink coffee to power through those wild weather calls. The real culprit could be thunderclouds, not caffeine.
Key Takeaway: Don’t jump to conclusions! Always dig deeper, just like when a patient’s mysterious rash pops up. Is it an allergy (causation) or coincidence?
Background: In Canada, many patients face substantial out-of-pocket costs for prescription medication, which may affect their ability to take their medications as prescribed. We sought to conduct a comprehensive analysis of the burden and predictors of cost-related nonadherence in Canada.
Methods: Using pooled data from the 2015, 2016, 2018, 2019, and 2020 iterations of the Canadian Community Health Survey, we calculated weighted population estimates of the burden of cost-related nonadherence in the preceding 12 months and used logistic regression models to measure the association of 15 demographic, health, and health system predictors of cost-related nonadherence overall and stratified by sex.
Results: We included 223 085 respondents. We found that 4.9% of respondents aged 12 years or older reported cost-related nonadherence. Those who self-identified as female, belonging to a racial or ethnic minority group, or bisexual, pansexual, or questioning were more likely to report cost-related nonadherence. Younger age, higher disease burden, poorer health, non-employer prescription drug coverage, and not living in the province of Quebec were associated with cost-related nonadherence.
Interpretation: Our nationally representative findings reveal inequities that disproportionally affect marginalized people at the intersections of sex, race, age, and disability, and vary by province. This foundational understanding of the state of cost-related nonadherence may be used to inform potential expansion of public drug coverage eligibility, premiums, and cost-sharing policies that address financial barriers to medication adherence.
Predictors of cost-related medication nonadherence in Canada: a repeated cross-sectional analysis of the Canadian Community Health Survey via CMAJ.
JACQUELINE P. ASHBY 