Tag Archives: teach

What depressed robots can teach us about mental health | Zachary Mainen

Depression seems a uniquely human way of suffering, but surprising new ways of thinking about it are coming from the field of artificial intelligence. Worldwide, over 350 million people have depression, and rates are climbing. The success of today’s generation of AI owes much to studies of the brain. Might AI return the favour and shed light on mental illness?

The central idea of computational neuroscience is that similar issues face any intelligent agent – human or artificial – and therefore call for similar sorts of solutions. Intelligence of any form is thought to depend on building a model of the world – a map of how things work that allows its owner to make predictions, plan and take actions to achieve its goals.

Setting the right degree of flexibility in learning is a critical problem for an intelligent system. A person’s model of the world is built up slowly over years of experience. Yet sometimes everything changes from one day to the next – if you move to a foreign country, for instance. This calls for much more flexibility than usual. In AI, a global parameter that controls how flexible a model is – how fast it changes – is called the “learning rate”.

Failure to adapt to adversity may be one of the main reasons why humans get depressed. For example, someone who becomes disabled due to a severe injury suddenly needs to learn to view themselves in a new way. A person who does so may thrive, while a person who fails to may become depressed.

The idea of a depressed AI seems odd, but machines could face similar problems. Imagine a robot with a hardware malfunction. Perhaps it needs to learn a new way of grasping information. If its learning rate is not high enough, it may lack the flexibility to change its algorithms. If severely damaged, it might even need to adopt new goals. If it fails to adapt it could give up and stop trying.

A “depressed” AI could be easily fixed by a supervisor boosting its learning rate. But imagine an AI sent light years away to another solar system. It would need to set its own learning rate, and this could go wrong.

One might think that the solution would be to keep flexibility high. But there is a cost to too much flexibility. If learning rate is too great, one is always forgetting what was previously learned and never accumulating knowledge. If goals are too flexible, an AI is rudderless, distracted by every new encounter.

The human brain’s equivalent of an AI’s key global variables is thought by computational psychiatrists to be several “neuromodulators”, including the dopamine and serotonin systems. There are only a handful of these highly privileged groups of cells and they broadcast their special chemical messages to almost the entire brain.

A line of studies from my laboratory and others suggest that the brain’s way of setting the learning rate involves the serotonin system. In the lab, if we teach a mouse a task with certain rules and then abruptly change them, serotonin neurons respond strongly. They seem to be broadcasting a signal of surprise: “Oops! Time to change the model.” Then, when serotonin is released in downstream brain areas, it can be seen in the laboratory to promote plasticity or rewiring, particularly to rework the circuitry of an outdated model.

Antidepressants are typically selective serotonin reuptake inhibitors (SSRIs), which boost the availability of serotonin in the brain. Antidepressants are naively depicted as “happiness pills”, but this research suggests that they actually work mainly by promoting brain plasticity. If true, getting out of depression starts with flexibility.

If these ideas are on the right track, susceptibility to depression is one of the costs of the ability to adapt to an ever-changing environment. Today’s AIs are learning machines, but highly specialised ones with no autonomy. As we take steps toward more flexible “general AI”, we can expect to learn more about how this can go wrong, with more lessons for understanding not only depression but also conditions such as schizophrenia.

For a human, to be depressed is not merely to have a problem with learning, but to experience profound suffering. That is why, above all else, it is a condition that deserves our attention. For a machine, what looks like depression may involve no suffering whatsoever. But that does not mean that we cannot learn from machines how human brains might go wrong.

Zachary Mainen is a neuroscientist whose research focuses on the brain mechanisms of decision-making

What depressed robots can teach us about mental health | Zachary Mainen

Depression seems a uniquely human way of suffering, but surprising new ways of thinking about it are coming from the field of artificial intelligence. Worldwide, over 350 million people have depression, and rates are climbing. The success of today’s generation of AI owes much to studies of the brain. Might AI return the favour and shed light on mental illness?

The central idea of computational neuroscience is that similar issues face any intelligent agent – human or artificial – and therefore call for similar sorts of solutions. Intelligence of any form is thought to depend on building a model of the world – a map of how things work that allows its owner to make predictions, plan and take actions to achieve its goals.

Setting the right degree of flexibility in learning is a critical problem for an intelligent system. A person’s model of the world is built up slowly over years of experience. Yet sometimes everything changes from one day to the next – if you move to a foreign country, for instance. This calls for much more flexibility than usual. In AI, a global parameter that controls how flexible a model is – how fast it changes – is called the “learning rate”.

Failure to adapt to adversity may be one of the main reasons why humans get depressed. For example, someone who becomes disabled due to a severe injury suddenly needs to learn to view themselves in a new way. A person who does so may thrive, while a person who fails to may become depressed.

The idea of a depressed AI seems odd, but machines could face similar problems. Imagine a robot with a hardware malfunction. Perhaps it needs to learn a new way of grasping information. If its learning rate is not high enough, it may lack the flexibility to change its algorithms. If severely damaged, it might even need to adopt new goals. If it fails to adapt it could give up and stop trying.

A “depressed” AI could be easily fixed by a supervisor boosting its learning rate. But imagine an AI sent light years away to another solar system. It would need to set its own learning rate, and this could go wrong.

One might think that the solution would be to keep flexibility high. But there is a cost to too much flexibility. If learning rate is too great, one is always forgetting what was previously learned and never accumulating knowledge. If goals are too flexible, an AI is rudderless, distracted by every new encounter.

The human brain’s equivalent of an AI’s key global variables is thought by computational psychiatrists to be several “neuromodulators”, including the dopamine and serotonin systems. There are only a handful of these highly privileged groups of cells and they broadcast their special chemical messages to almost the entire brain.

A line of studies from my laboratory and others suggest that the brain’s way of setting the learning rate involves the serotonin system. In the lab, if we teach a mouse a task with certain rules and then abruptly change them, serotonin neurons respond strongly. They seem to be broadcasting a signal of surprise: “Oops! Time to change the model.” Then, when serotonin is released in downstream brain areas, it can be seen in the laboratory to promote plasticity or rewiring, particularly to rework the circuitry of an outdated model.

Antidepressants are typically selective serotonin reuptake inhibitors (SSRIs), which boost the availability of serotonin in the brain. Antidepressants are naively depicted as “happiness pills”, but this research suggests that they actually work mainly by promoting brain plasticity. If true, getting out of depression starts with flexibility.

If these ideas are on the right track, susceptibility to depression is one of the costs of the ability to adapt to an ever-changing environment. Today’s AIs are learning machines, but highly specialised ones with no autonomy. As we take steps toward more flexible “general AI”, we can expect to learn more about how this can go wrong, with more lessons for understanding not only depression but also conditions such as schizophrenia.

For a human, to be depressed is not merely to have a problem with learning, but to experience profound suffering. That is why, above all else, it is a condition that deserves our attention. For a machine, what looks like depression may involve no suffering whatsoever. But that does not mean that we cannot learn from machines how human brains might go wrong.

Zachary Mainen is a neuroscientist whose research focuses on the brain mechanisms of decision-making

What depressed robots can teach us about mental health | Zachary Mainen

Depression seems a uniquely human way of suffering, but surprising new ways of thinking about it are coming from the field of artificial intelligence. Worldwide, over 350 million people have depression, and rates are climbing. The success of today’s generation of AI owes much to studies of the brain. Might AI return the favour and shed light on mental illness?

The central idea of computational neuroscience is that similar issues face any intelligent agent – human or artificial – and therefore call for similar sorts of solutions. Intelligence of any form is thought to depend on building a model of the world – a map of how things work that allows its owner to make predictions, plan and take actions to achieve its goals.

Setting the right degree of flexibility in learning is a critical problem for an intelligent system. A person’s model of the world is built up slowly over years of experience. Yet sometimes everything changes from one day to the next – if you move to a foreign country, for instance. This calls for much more flexibility than usual. In AI, a global parameter that controls how flexible a model is – how fast it changes – is called the “learning rate”.

Failure to adapt to adversity may be one of the main reasons why humans get depressed. For example, someone who becomes disabled due to a severe injury suddenly needs to learn to view themselves in a new way. A person who does so may thrive, while a person who fails to may become depressed.

The idea of a depressed AI seems odd, but machines could face similar problems. Imagine a robot with a hardware malfunction. Perhaps it needs to learn a new way of grasping information. If its learning rate is not high enough, it may lack the flexibility to change its algorithms. If severely damaged, it might even need to adopt new goals. If it fails to adapt it could give up and stop trying.

A “depressed” AI could be easily fixed by a supervisor boosting its learning rate. But imagine an AI sent light years away to another solar system. It would need to set its own learning rate, and this could go wrong.

One might think that the solution would be to keep flexibility high. But there is a cost to too much flexibility. If learning rate is too great, one is always forgetting what was previously learned and never accumulating knowledge. If goals are too flexible, an AI is rudderless, distracted by every new encounter.

The human brain’s equivalent of an AI’s key global variables is thought by computational psychiatrists to be several “neuromodulators”, including the dopamine and serotonin systems. There are only a handful of these highly privileged groups of cells and they broadcast their special chemical messages to almost the entire brain.

A line of studies from my laboratory and others suggest that the brain’s way of setting the learning rate involves the serotonin system. In the lab, if we teach a mouse a task with certain rules and then abruptly change them, serotonin neurons respond strongly. They seem to be broadcasting a signal of surprise: “Oops! Time to change the model.” Then, when serotonin is released in downstream brain areas, it can be seen in the laboratory to promote plasticity or rewiring, particularly to rework the circuitry of an outdated model.

Antidepressants are typically selective serotonin reuptake inhibitors (SSRIs), which boost the availability of serotonin in the brain. Antidepressants are naively depicted as “happiness pills”, but this research suggests that they actually work mainly by promoting brain plasticity. If true, getting out of depression starts with flexibility.

If these ideas are on the right track, susceptibility to depression is one of the costs of the ability to adapt to an ever-changing environment. Today’s AIs are learning machines, but highly specialised ones with no autonomy. As we take steps toward more flexible “general AI”, we can expect to learn more about how this can go wrong, with more lessons for understanding not only depression but also conditions such as schizophrenia.

For a human, to be depressed is not merely to have a problem with learning, but to experience profound suffering. That is why, above all else, it is a condition that deserves our attention. For a machine, what looks like depression may involve no suffering whatsoever. But that does not mean that we cannot learn from machines how human brains might go wrong.

Zachary Mainen is a neuroscientist whose research focuses on the brain mechanisms of decision-making

What can sci-fi teach us about the future of health? | Ara Darzi

In State of Wonder, the American writer Ann Patchett imagined the discovery made by a charismatic but despotic professor, Dr Annick Swenson, who travelled deep into the Amazon basin and found a tribe in which the women went on bearing children until the end of their lives. While their bodies aged as normal, their reproductive systems stayed daisy-fresh.

Membership Event: Ann Patchett in conversation

“This is the end of IVF. No more expense, no more shots that don’t work, no more donor eggs and surrogates. This is ovum in perpetuity, menstruation everlasting …”

A miracle fertility drug, taken in this case from the bark of an endemic jungle tree, is one of science’s most enduring dreams. Miniature robots designed to prowl the bloodstream when injected through a vein seeking out and destroying undesirable micro-organisms is another. And there are many darker visions of monsters, plagues and organ trading.

Dreaming is what we should be doing, in science, in medicine and in life. If we do not imagine the future, how can we invent (or prevent) it? That is why I welcome what is described as the world’s largest health science-fiction prize, which seeks to unlock an array of hypothetical futures.

“Writing the Future” is open to writers of any nationality who are asked to submit a story of up to 3,000 words about the state of health and healthcare in the UK in the year 2100. The winner, to be announced in October, will take home £10,000.

As director of the Institute of Global Health Innovation at Imperial College London, I spend a lot of time debating the future of medicine. But change is hard to predict, and it doesn’t help if you spend much of your time with healthcare insiders, as I do, trying to solve the problems created in the past.

So why not ask people more familiar with conjuring dreams to help us out? The aim with this prize, for which we have provided a small sum in sponsorship, is to attract outsiders who can bring a fresh perspective with a story that displays ingenuity and insight, as well as being a cracking good read.

Thinking about the state of our health 83 years from now is vital if we are to continue delivering the best possible care. Looking back 83 years to the 1930s, the NHS was yet to be founded and penicillin existed only on Alexander Fleming’s petri dish. Of every 1,000 babies born, 63 died in infancy. Yet just 40 years later, babies were being conceived in test tubes.


The big gains are likely to come from innovations in the general purpose technologies that have transformed our world

The health industry has actually been remarkably good at innovation. Some advances have been the result of technical wizardry, such as in-vitro fertilisation, organ transplants and CT scanning for cancer. Others have transformed the outlook for whole populations, such as antibiotics, vaccination, and the contraceptive pill.

Asked to think about future innovations in health, most people might mention a new HIV vaccine, a cure for Alzheimer’s disease – or a drug to confer long-lasting fertility. These would certainly be blockbuster gains for humanity but with the rising cost and diminishing returns from drug development, there are likely to be few such silver bullets in the next decade.

The big gains are likely to come from innovations in general-purpose technologies – smartphones, computing, bio-engineering – that have already transformed our world. Until 1998 there were no online bookstores. Yet today, Amazon has 40% of the books market. Until a dozen years ago few people banked online. Today 60% do. Mobile phones may play as significant a role in healthcare in this century as the stethoscope did in the last.

So what is next? We have made astonishing progress in the last eight decades. More of us survive childbirth and infancy, our lives are longer and there is more that medicine can do to help when we are sick.

We have made enormous strides against the major killers of the past such as smallpox, tuberculosis and diphtheria. The new challenge comes from the chronic conditions that blight so many lives in the modern world – diabetes, cancer and heart disease. Here, advances in genomic medicine could help us to identify individuals at risk and allow us to intervene earlier.

Entrants for Writing the Future may have very different visions of what is to come. Social enterprise Kaleidoscope Health and Care, which conceived the prize, has its own ideas about how to encourage innovative thinking in health.

Established in 2016 by Richard Taunt, a former civil servant and director of policy at the Health Foundation thinktank, its 10 staff include clinicians and managers who have seen the problems from the inside and want to “change the conversation” by attracting talent that can see beyond the limits of budgets and hospital walls.

One way they do this is by offering envelopes containing £100 in cash to selected individuals to spend in any way they like – on coffees, a lunch, or a train ticket – as long as it is in the cause of having an unexpected conversation about health and care that they can blog about afterwards.

We need innovative thinking in healthcare now more than ever. There is substantial interest in Writing the Future from leading science fiction writers around the world. We should all expect to be excited, enlightened and entertained.

Sesame Street introduces muppet with autism to teach children about disorder

Sesame Street is adding a new character to its ranks – a muppet called Julia, who has autism.

Julia, a four-year-old with bright orange hair, a pink dress and a favorite toy rabbit called Fluffster, will make her debut on 10 April in an episode called “Meet Julia”. She has already appeared in Sesame Street cartoons and books, but this will be her first appearance on the famous children’s show.

“We wanted to address autism in general because of the growing number of children who are diagnosed with autism spectrum disorder,” Sherrie Westin, EVP of global social impact and philanthropy at Sesame Workshop, the non-profit behind Sesame Street, told the Guardian.

“We felt that creating a character who was autistic would allow children to identify her but equally important, it would allow us to model for all children the differences and commonalities of a child with autism.

“It was an opportunity to help explain autism and to help increase awareness and understanding.”

On Monday, Sesame Street released a number of video clips featuring Julia. One shows her sitting at a table, painting with some of the other characters. Big Bird arrives and says hello to Julia, who carries on with her work rather than saying hello back.

Big Bird and Sesame Street stalwart Elmo appeared on CBS’s 60 minutes on 17 March, to talk with host Lesley Stahl. Big Bird told Stahl he had initially been perturbed by Julia’s lack of response.

“I thought that maybe she didn’t like me,” Big Bird said.

“We had to explain to Big Bird that Julia likes Big Bird,” Elmo said. “It’s just that Julia has autism. So sometimes it takes her a little longer to do things.”

[embedded content]
Sesame Street introduces Julia to the Associated Press.

Later in the episode – according to a clip seen by the Associated Press – Julia becomes distressed when a siren goes off.

“She needs to take a break,” the muppets’ human friend Alan calmly explains. Julia soon relaxes and the friends carry on playing.

Another video shows Elmo approaching Julia, who is playing with Fluffster on her own. Elmo sees that Julia is focused on her own activity and says: “We can play side by side, like we do sometimes.”

“There’s lots of ways to play,” Elmo tells the camera.

Julia’s introduction is part of an initiative: “Sesame Street and Autism: See Amazing in all Children”. Sesame Workshop said it consulted with more than 250 organizations and experts over a five-year period, ahead of unveiling the character.

Julia is played by puppeteer Stacey Gordon, who told the Associated Press her 13-year-old son also has autism.

“The ‘Meet Julia’ episode is something that I wish my son’s friends had been able to see when they were small,” Gordon said. “I remember him having meltdowns and his classmates not understanding how to react.”

What can this Peru slum teach the world about stopping the spread of TB?

For Jasmin Bueno, aged seven, and her brother Aaron, aged six, there is little that can make swallowing chemo-profilactic pills any less bitter. But the tablets they stoically gulp down daily during the next six months are the best protection they can get from contracting tuberculosis.

Just a sheet draped over a washing line separates their sleeping area from that of their 20-year-old brother, Jose, a tuberculosis sufferer. The whole family, their mother and an older sister with an infant baby, live in shack on a hill overlooking the sprawling Carabayllo slum. It is a tuberculosis hotspot where the overcrowded, poorly-ventilated and often damp homes provide a breeding ground for one of the world’s most ancient diseases, which recent research shows claims 1.8 million lives a year globally, not the 1.5 million it was previously thought.

Peru has the highest incidence per capita of tuberculosis in the Americas, including virulent multi-drug resistant (around 2,300 patients per year, 35% of all cases in the region) and extensively drug resistant (around 100 patients per year, 75% of all cases in the region) strains. Its reduction is slow at around 1.5% a year, just short of the global reduction of 1.65% annually, according to the World Health Organisation (WHO). The rate of reduction would need to increase to a 4-5% annually, in order to reach sustainable development goal target 3.3 – ending epidemics of tuberculosis and other infectious diseases by 2030.

The WHO admits this is an ambitious aim. It said in a statement last year: “While there has been significant progress in the fight against TB, with 43 million lives saved since 2000, the battle is only half-won: more than 4,000 people lose their lives each day to this leading infectious disease. Many of the communities that are most burdened by tuberculosis are those that are poor, vulnerable and marginalised.”


We go to the patients’ houses and we find the best way on ensuring they don’t abandon the treatment

Carmen Contreras​,​ Partners in Health

But as well as being one of the hotspots for the disease, Peru has some of the world’s highest cure rates for multi-drug resistant tuberculosis (MDR-TB) at 83% and the extremely drug resistant strain (XDR-TB) at 60%. The global reduction rate for MDR-TB is around 50% and is just 25% for XDR-TB.

“Search, treat, prevent – that’s our approach,” says Carmen Contreras of US-based charity Partners in Health. “We go to the patients’ houses and we find the best way on ensuring they don’t abandon the treatment.” The WHO’s End TB hands-on approach has been implemented since 2015 and it is reaping rewards in Peru.

Decades on the streets as a drug addict smoking unrefined cocaine left 56-year-old Francisco Verastegui’s health in ruins. He became HIV positive then found out he had tuberculosis. Now off the streets in a homeless shelter run by an evangelical church, Verastegui says he has cheated death more than once. “I’ve abandoned the treatment on several occasions in the past but I didn’t die so I know that God must have a purpose for my life,” he says, taking his daily dose of pills.

Francisco Verastegui


Francisco Verastegui is HIV positive and has TB after years living on the streets as a drug user. He now lives on a farm for homeless men on the outskirts of Lima. Photograph: Jorge de la Quintana

Partners in Heath works with several thousand patients in Peru and has seen the number of people who abandon treatment reduce from 7-8% to less than 1%. The secret of their success is training local health promoters in the community itself, says Leonid Lecca, the NGO’s director in Lima: “They come from the same community; they know who the coughers are, who has lost weight, who’s hiding because they have problems. They find those people who sometimes never reach the health services.”

The NGO’s aim for 2017 is zero deaths and zero abandonment of treatment. A quick and accurate diagnosis is key to achieving this. So Partners in Health built a state-of-art tuberculosis detection laboratory in an old shipping container in the heart of this deprived community. It’s been operating in Carabayllo, in northern Lima, since 2012.

The lab is the only one of its kind in Latin America and can make 25 diagnoses a day. This is a big boost for Peru’s strained healthcare services, says its head, Roger Calderon: “The diagnosis is very important because the patient often doesn’t know what’s wrong with them. A quick and opportune diagnosis is best way to control tuberculosis but the problem is not just a medical one, it’s a social one. While there’s poor and needy people, there will be tuberculosis.”

Taking patients like Julia Roque, 53, through the lengthy treatment for multi-drug resistant tuberculosis is part of the job for Contreras at Partners in Health as she strolls arm-in-arm with her patient. Roque caught MDR-TB while being treated in hospital for diabetes.

Recovery is arduous. She is too weak to continue her work as a street vendor and lack of money to support herself and her family is constant worry, says Roque. “To recover you have to be determined, strong and have plenty of willpower otherwise you won’t get better,” she says. “If you quit the treatment then only God will gather you up.”

Accompanying patients on the road to recovery with consistent moral support is how Peru is leading by example. Perhaps the rest of the world can follow in its footsteps to make a dent on the global epidemic.

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‘Just say death!’ Plays teach healthcare workers about end-of-life care

Seth Goodburn seemed fit and well until two weeks before he was diagnosed with pancreatic cancer. He died just 33 days after diagnosis, spending much of that short time in hospital. In the emotional whirlwind of coping with the poor prognosis his wife, Lesley, felt their hopes for Seth’s end-of-life care were sidelined by medical professionals trying to do their job.

“The NHS focuses on the medicine and trying to fix people even when that’s not possible,” she says. “A lot of the conversations and decisions that we might have made were overshadowed by dealing with what was the next medical treatment and intervention.”

There is an ongoing conversation in the medical profession about how to care for terminally ill patients, given that the profession’s instinct is to preserve life. The issue is just one of many being address by Brian Daniels, a playwright commissioned by the National Council for Palliative Care (NCPC) to tell stories such as Goodburn’s through plays, and help educate healthcare professionals about patients and families’ experiences of end-of-life care.

Homeward Bound, a play based on a series of letters Lesley Goodburn wrote, in the months after her husband’s death, to medical professionals involved in his care, launched NCPC’s national conference this year to an audience of 300 healthcare workers.

In addition, Daniels’ plays on early onset dementia and palliative care for those with disabilities, have been performed in hospitals, hospices, care homes and to general audiences across the country. Daniels says: “[They] take people out of their professional role for a minute to look at the family and human side of the people they’re dealing with.”

For Goodburn, that human aspect is key. She could not fault the professionalism of those involved in caring for her husband, but says poor communication could leave the couple feeling worse. “There were just so many things where people weren’t cruel or unkind or deliberately unthinking, but just didn’t really think about what it was like to be me and Seth. He went from being well and living a normal life to suddenly being told that he was dying.” She says, for example, a physiotherapist asked Seth to march on the spot as part of an assessment to see if he was able to go home, as he had previously wished, seemingly unaware that his condition had deteriorated and he was dying.

Don't leave me now


An actor in Don’t Leave Me Now. Photograph: NCPC

Claire Henry, chief executive of the NCPC, says plays such as Homeward Bound are designed to encourage medical professionals to reflect on the people going through this traumatic process. “We obviously work very closely with people who have experience and they tell us their stories. Some are good, some not so good. Healthcare professionals don’t go to work to do a bad job, but sometimes they don’t think of things that affect people in a broader sense.”

What impact does a play have that a lecture, for instance, cannot? Don’t Leave Me Now, another play by Daniels, about early onset dementia, was performed at St Gemma’s hospice in Leeds to an audience including nurses, housekeeping staff and workers from other local hospices. Dr Mike Stockton, its director of medicine and consultant in palliative medicine, says the play enabled them to see some of families’ and patients’ challenges through a different lens. “It’s sometimes hard to have a full understanding … of what people may be going through and the reasons behind their actions or the emotional challenges, adjustments or the resilience that people need.”

Lynn Cawley agrees. There was barely a dry eye at a performance at Morley Arts Festival in October of Bounce Back Boy, the powerful dramatisation of her adopted son, Josh’s, story. Josh was severely disabled following a serious head injury as a baby, and later adopted by Cawley. Despite pioneering medical treatment throughout Josh’s life, Cawley says he was denied admission as an inpatient to a local hospice because his needs were too complex, and died a difficult death at home. She is fighting to end what she describes as end of life discrimination against those with disabilities.

Cawley thinks a play is an effective way of communicating that message, and for getting people to think about palliative care more broadly. She says: “When it’s someone’s real life story, people put themselves in it [and] they might think of a patient that they know. We hope that it will change policy but also people’s attitudes.”

For Stockton, working in a hospice, the wider issue of how treatment is balanced with patient comfort is a daily consideration. He says the two can often be done together: “It is about having early, thorough, open, honest, transparent conversations with people about what they want.”

For Cawley, as a carer and mother who went through the palliative process, those open conversations about dying are key. “We even find it hard to say the word,” she says. “When we’re watching Casualty on a Saturday night and they’re trying to tell a relative that somebody is dying, but they won’t say the word dying or death, we’re just like – say death!”

Join the Healthcare Professionals Network to read more pieces like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views.

How a 3D clitoris will help teach French schoolchildren about sex

Paul Verlaine celebrated it in his 1889 poem Printemps as a “shining pink button”, but thanks to the sociomedical researcher Odile Fillod, French schoolchildren will now understand that it looks more like a hi-tech boomerang. Yes, the world’s first open-source, anatomically correct, printable 3D clitoris is here, and it will be used for sex education in French schools, from primary to secondary level, from September.

From Fillod’s sculpture, pupils will learn that the clitoris is made up of the same tissue as the penis. That it is divided into crura or legs, bulbs, foreskin and a head. That the only difference between a clitoris and a penis is that most of the female erectile tissue is internal – and that it’s often longer, at around 8 inches.

“It’s important that women have a mental image of what is actually happening in their body when they’re stimulated,” Paris-based Fillod says. “In understanding the key role of the clitoris, a woman can stop feeling shame, or [that she’s] abnormal if penile-vaginal intercourse doesn’t do the trick for her – given the anatomical data, that is the case for most women.”

“It’s also vital to know that the equivalent of a penis in a woman is not a vagina, it’s her clitoris. Women get erections when they’re excited, only you can’t see them because most of the clitoris is internal. I wanted to show that men and women are not fundamentally different.”

Fillod had been working with Toulouse-based V.Ideaux, creators of an anti-sexist web TV series, to create a modern sex education video when it struck her that the clitoris was never presented correctly in school textbooks. This catalysed her to develop her 3D model at the Fab Lab, of the Cité des Sciences et de L’Industrie in Paris.

Fillod’s 3D clit has come in the nick of time. This June, Haut Conseil à l’Egalité, a government body monitoring gender equality in public life, published a damning report on the state of sex ed in France. The report revealed that sex education is rife with sexism. Current official guidelines state that young boys are more “focused on genital sexuality”, while girls “attach more importance to love”.

Clitoris activism is hot in France right now. The feminist group Osez Le Féminisme has been vocal in combatting the silence around it since 2011. While in Nice, a group of sex-positive feminists, Les Infemmes, has created a “sensual counter culture” fanzine called L’Antisèche du Clito or The Idiot’s Guide to the Clit. There are funny drawings of “Punk Clit,” “Dracula Clit” and “Freud Clit”, as well as facts about the organ.

Meanwhile, jeweller Anne Larue has created a bronze clitoris pendant in conjunction with Les Infemmes artist Amandine Brûlée. “The clitoris has been the hidden, shameful organ for so long,” says Larue. “My necklace brings it to the light of day.” She reassures that the more timorous should not be worried about wearing it: “For the uninitiated, it looks like an octopus or a neolithic goddess.”

Related: Mystery of the female orgasm may be solved

The Australian doctor Helen O’Connell is often credited as being the first person to show the complete anatomy of the clitoris to the modern world in 1998. In fact that achievement belongs to LA-based activist-artist Suzann Gage, who realised, while looking for images of the clitoris to illustrate a book called A New View of a Woman’s Body in 1981, that her best information came from medical textbooks of the 1800s – when anatomical drawings were done from cadavers. So images of the clitoris might have existed for a long time but, on realising that it played no direct part in reproduction, the medical profession chose to ignore it.

Fillod has hopes that doctors as well as school teachers, will use her sculpture to learn – and teach – the truth about the female body. “France has the reputation for being sexually sophisticated, but often it’s about male sexuality.” However, she is optimistic about the future. “Understanding that they have an erectile system just like men, I think women will start to experiment more. They will understand that pleasure is not some magic that only a partner knows how to give.”

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If Euclid Played Video Video games This Is The App He’d Develop To Teach Geometry

There’s an easy way to discover geometry over the summer time. It is straightforward and enjoyable. Picture Euclidean geometry: the video game. If your encounter in high college geometry was something like mine, it probably sounds like torture. But games make learning entertaining.

These days, game and app developers are consistently creating a new sorts of studying components. But the way people discover hasn’t really altered. The ideal game makers understand that the point of digital understanding video games is not to change books, chalkboards, diagrams, or lectures, but rather, to supplement effectively worn techniques with new educating resources that weren’t feasible in the previous.

Take into account the function of Jean-Baptiste Huynh. He’s the guy who impressed so several folks with his ingeniously simple “DragonBox Algebra” app. By changing algebraic variables with cute photographs, he proved that even small kids could get fired up about Algebra. On regular, it took 41 minutes and 44 seconds for college students to master the standard operations of Algebra in the course of the Washington State Algebra Challenge employing the DragonBox App.

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Soon after I wrote about DragonBox Algebra, Huynh and I kept in touch. We’d speak occasionally, but rarely about video games. Generally we’d examine far more abstract philosophical ideas about the way humans discover. We share a certain skepticism about numerous of the educational norms that most folks take for granted. For illustration, I’m especially doubtful about the notion of grade levels–or that kids are only able to comprehend some ideas at particular ages.

As an alternative, I believe it has to do with the ways we existing and articulate understanding. At youthful ages, kids are not ready for algebra the way that we presently teach it. But they are definitely prepared for algebraic contemplating. DragonBox Algebra showed a lot of of us that if we present material differently, even tiny little ones can effortlessly find out far more playful methods of executing and articulating basic algebra.

Huynh’s been quietly establishing a new game that tackles an additional mathematical subject that is notoriously tough to teach: Geometric proofs. His newest game for iOS and Android is referred to as “DragonBox Components.” Taking its inspiration from Euclid’s “Elements,” the game teaches geometric proofs employing the very same foundational framework laid out by the ancient Greek mathematician.

My six yr previous has been taking part in DragonBox Factors for a couple of days he’s training Euclidean geometric proofs and he’s only in very first grade. Of program, he doesn’t comprehend what he’s doing–that is, he cannot articulate what he’s undertaking utilizing the language we normally educate in substantial college. No variables. No formulas. No symbolic algebraic language that designed in the medieval planet, but by some means has remained trendy considering that the 16th Century. But nonetheless, he’s finding out pure Euclidean geometry taught via an updated digital manipulative: shinier, faster, and far more efficient. Gamers find out and investigate geometry by means of a hands on encounter of trial and error. I hated geometry homework, but I’m enjoying the game.

Huynh reminds us, once once more, that game based mostly finding out is not so much about altering what we learn. Right after all, Euclid’s factors is 23 Centuries previous. Nevertheless, with the exception of one particular-on-1 tutoring, we’ve never been capable to give learners with as a lot instantaneous feedback as video games can. Plus, by playing the game, learners understand how cummulative mastery final results in leveling-up–an understanding that is not only motivating, but also empowering.

This classic painting by Raphael is beautiful, but it also reminds me how extended it has been since we’ve up to date the processes via which we educate Euclid:

A Greek mathematician performing a geometric c... A Greek mathematician performing a geometric construction with a compass, from The School of Athens by Raphael. (Photo credit score: Wikipedia)

DragonBox Aspects makes use of the exact same method as DragonBox Algebra, it relies on cute characters and video game super powers to educate ancient ideas. For illustration, a triangle monster with 3 horns is a equilateral triangle (horns are kind of angle shaped). But players want to demonstrate that a triangle has like angles ahead of the triangle monster will get his or her horns. My six yr previous calls this procedure “the horn-inator.” He searches for approaches to activate it. The only way, of course, is to display that the triangle has matching angles. Kids don’t recognize they are proving anything at all, they are just following the rules of the video game program.

Any person with youngsters knows that they can learn a complicated video game’s rule method very speedily. Heck, they all learn language ahead of they can even talk: vocabulary, syntax, etc. What we typically fail to remember is that many of the items we educate in college are daily programs articulated in distinct approaches. Euclidean geometry, for illustration, is the seemingly self-evident foundation of the way humans have come to believe about measurable area (keep in mind that this conception of area has only existed considering that Descartes imagined “Euclidean Space” and laid the groundwork for Newtonian physics. Euclid just articulated a mathematical method. But that’s a longer conversation). Often, by just articulating factors in diverse techniques, comprehension becomes easy.

DragonBox Factors is a enjoyable, whimsical game that basically borrows a program from Euclid. As with Huynh’s preceding game, the artwork is pristine, the music is sharp, and the controls operate seamlessly. If your kids (or you) liked DragonBox Algebra, they’ll also like DragonBox Components. It is accessible for Android and iOS ($ five.99).

Jordan Shapiro is writer of FREEPLAY: A Video Game Guide to Greatest Euphoric Bliss, and MindShift’s Guidebook To Games And Learning For info on Jordan’s upcoming books and events click right here.