Thursday, January 10, 2008

No fast -track for Montreal Medical Students

Montreal's two medical schools have thrown cold water on a proposal to fast-track the education of medical students to save money and help reduce the shortage of doctors.

An editorial in the latest issue of the Canadian Medical Association Journal recommends that the standard four-year curriculum be reduced by a year.

But officials at both McGill University and the Université de Montréal argue the proposal doesn't make sense in Quebec because many students in the province enroll in medical school straight out of CEGEP.

In the other provinces, most medical students already have an undergraduate degree in the sciences.

"CEGEP students have two years of schooling, and it doesn't make sense for them to then have only three years of medical education," said Raymond Lalande, vice-dean of undergraduate studies in the faculty of medicine at U de M.

He noted that 40 percent of U de M's medical students do not have an undergraduate degree, and at the Université de Sherbrooke, the proportion is 80 percent.

"We risk lowering the quality of medicine by doing this," Lalande added.

The editorial by three doctors observed that McMaster University in Hamilton, and the University of Calgary have for years offered three-year programs.

"Is this extra year necessary?" the editorial asked. "Training each medical student in Canada is costly both in time and money. Each student requires hundreds of hours of time from established family physicians, specialists and medical educators - time that otherwise could be spent on caring for patients."

By graduating students earlier, the editorial suggested, newly-trained doctors would be able to provide an additional year of care.

Joyce Pickering, associate dean of medical education at McGill, said any decision to shorten the school curriculum in Quebec would have to reflect the CEGEP system of junior colleges.

"We'd have to look at whether or not the rules would be different for students who come directly from CEGEP as opposed to students who have (an undergraduate) degree first."

At the U de M's medical school, students must study for 180 weeks. U de M medical students tend to score the highest overall marks in the country in year-end exams by the Medical Council of Canada.

In contrast, the programs at McMaster and Calgary are 130 weeks long - the minimum required to earn a medical degree. McGill's program lasts 160 weeks.

The Association of Faculties of Medicine of Canada, representing the country's 17 medical schools, is reviewing the standard curriculum in addition to the three-year proposal.

Its recommendations are due in 2009. If any decision is taken to reduce the curriculum by a year, it probably won't occur until five years from now, Pickering said, because of the lead time it takes to make changes of this nature.

Lalande said that the trend in medicine is to length the residencies of specialties like pediatrics and neurosurgery, not shorten them.

Before being being allowed to practise on their own, doctors must complete residency training in a hospital. For family medicine, it's two years. But for specializations, it's at least three years.

"Honestly, I can't see how three years of medical school, followed by a two-year residency in family medicine, is enough to train a family doctor to respond to all the needs of patients and an aging population," Lalande said.

"Any proposal to change the curriculum has to be made for pedagogical reasons. This proposal is being made for non-medical reasons."

The Quebec government has gradually increased enrollment in medical schools since 2003. Health Minister Philippe Couillard said the province will report a net increase of 1,200 doctors by 2012.

Source: The Gazette

Wednesday, January 9, 2008

Preventable death rate U.S.higher than Canada

Canada's health care system offers "excellent value for the money" says a British researcher who has studied preventable deaths in 19 industrialized nations.

The study, to be released today in Health Affairs, looks at "amenable mortality", deaths that would not have occurred if effective health care had been available.

Conditions that caused these deaths included bacterial infections, treatable cancers, diabetes, some cardiovascular disease and the complications of common surgical procedures. The study, which looked at figures from 2002-03, updated a similar report based on 1997-98 figures.
Its goal was to compare amenable deaths in the United States with 14 western European nations, plus Canada, Australia, New Zealand and Japan.

The study also tracked whether gaps in these countries had narrowed or widened. The figures were computed according to amenable deaths per 100,000 population under the age of 75.
In the first study, the researchers found that amenable deaths in the U.S. stood at 114.74 per 100,000 population, exceeded only by Ireland, Portugal, Finland and the United Kingdom.

In that time period, Canada's amenable mortality rate was 88.77, the seventh-lowest rate after France, Japan, Spain, Australia, Sweden and Italy.
In the most recent study, Canada's amenable death rate had dropped to 76.83, putting Canada sixth after France, Japan, Australia, Spain and Italy.

Meanwhile, amenable mortality rates in the U.S. have barely budged from 114.74 to 109.65 in 2002-03, taking the U.S. from 15th place to last place among the 19 countries.

"This study shows that Canada's health system has performed very well in its ability to prevent people from dying from treatable conditions," said Martin McKee, a researcher at the London School of Hygiene and Tropical Medicine, and co-author of the study.

"While everyone has to die from something, sometime, in an ideal world, no-one would die from the causes we have looked at, in the age groups we have included."

"Of course, we don't live in an ideal world," said McKee.
"However, the bottom line is that the Canadian health system delivers outcomes that are substantially better than those in its southern neighbour."

"More importantly, outcomes in Canada are improving more quickly than those in the U.S.," he said.
"Given that the U.S health care system is far more expensive, this suggests that Canadians are getting excellent value for money."

The researchers expect there will be further improvements in amenable mortality rates in industrialized countries, but the rate will slow down.

The most significant gains were made in the 1970s and 1980s, when drugs to treat common conditions such as hypertension became widely available, said McKee.
That raises questions about whether the U.S. will be able to narrow the gap between itself and countries with much lower amenable mortality rates, he said.

"Other research shows that many Americans are unable to afford the prescription drugs they need," said McKee.

"So, if some future administration can tackle this then we could see real improvements there." In countries like Canada, he expects the main gains will be less in amenable mortality and more the the quality of life, especially for older people.

Source: Ottawa Citizen

Saskatchewan wants better care for seniors

Saskatchewan Health will be exploring the grey matter of many groups to create a seniors' care strategy.

Health Minister Don McMorris wants to identify and address problems in current community-based care programs, from home care to facility care.

"The goal is to keep seniors at home as long as possible but we hear that there are some gaps in that process, so we want to ensure that those gaps are filled," he said.

"We'll be starting to work with the regional health authorities because they play a major role and also senior groups and all the parties that are involved to identify where are the breakdowns."

Dr. William Klassen, a retired physician and senior, applauds keeping seniors at home as long as possible. But he said the elderly often have special needs such as mobility problems, which require supports such as paratransit to be expanded to improve access to health-care services.

"Those who use paratransit say the services are very good but hard to get," he said.

"Timely access to physicians is important for all residents, but seniors often have chronic and acute diseases so they are more vulnerable," Klassen said.

"The health care and the independence of seniors face one issue that is unique to them and that is the changes that come with old age, that makes their health problems more difficult to diagnose and sometimes more difficult to manage," Klassen said.

"That's an area that geriatricians, a physician who is a specialist in dealing with old age, play a special part. Unfortunately our province has only one geriatrician and only one geriatric unit and that's in Saskatoon."

Read the full story here

Frustration builds up among Canadian family doctors

Faced with an aging population requiring increasingly complex care, overwhelmed Canadian doctors are feeling more and more frustrated by their inability to properly serve their patients' health needs, a national survey of physicians reports.

In the survey of more than 20,000 doctors and doctors-in-training from across the country, 75 per cent reported that inadequate funding of the health care system and an under-supply of physicians and other health professionals, along with paperwork and bureaucracy, are curtailing the amount and level of care they want to provide patients.

While that attitude was expressed by all the specialties, it is perhaps most pronounced among family physicians, simply because of their number and the nature of their practice, said Calvin Gutkin, executive director and CEO of the College of Family Physicians of Canada.

Almost half of Canada's roughly 60,000 doctors are family practitioners, and it's usually the specialty seen most often by patients, he said.

"I think the frustration remains related to just the capacity within the family medicine community to address all of the needs of the population," said Dr. Gutkin, whose organization conducts the triennial survey jointly with the Canadian Medical Association and the Royal College of Physicians and Surgeons of Canada.

"Physicians in most communities across the country are doing their best to try to see as many patients as they can," he said.

"But still many of them have had to ... limit the number of new patients they can take. And we have community after community with patients who are unable to access a family physician for themselves or for their families. "

Read the rest of the story here

A related story about Calgary doctors can be read in here

Tuesday, January 8, 2008

Unique mentorship program started in York Central Hospital

As part of building capacity at York Central Hospital in Richmond Hill, Ontario, a strategy was created to enhance the learning environment for staff, attract staff to the organization and reduce the significant turnover within the first year.

To this end a dynamic mentorship program, the first of its kind in Canada, was created supported by the Ministry of Health and Long-Term Care inter-professional education initiative and York Central Hospital (YCH) Foundation.

“The mentorship program has been extremely successful in recruiting and retaining staff nurses,” says Interim Professional Practice Leader Audrey Sheridan.

Many new graduates told us that they chose YCH over other hospitals because of the mentorship program.
It speaks volumes about the value the organization places on nursing, both experienced and new graduates. The mentorship program has truly been a catalyst for YCH, raising the bar for nursing education and clinical development across the organization.”

This multifaceted program includes a number of components including mentorship development; supernumerary time for mentor support of newly hired staff; extended program development support for both experienced and new graduate staff; clinical fellowships; specialty certifications; national certifications and degree support bursaries.

New hires (experienced and new graduates) spend their first three weeks on the job learning in a classroom environment. Content includes: Assessment and Management of Pain; Risk Prevention and Assessment and Management of Stage I-IV Pressure Ulcers; Screening and Caregiving Strategies for Delirium and Dementia; Fall Prevention; Vascular Access and Diabetes Management drawn from the Registered Nurses Association of Ontario’s (RNAO) Best Practice Guidelines (BPGs).

Following the in-class portion, new nursing hires are assigned mentors and begin working with them on their specific nursing services. Further development components related to relationships include: providing and receiving feedback, responding to emotionally charged situations, building trust and Patient Focused Care which was based on the RNAO’s BPGs for Client Centered Care, Therapeutic Relationships and Leadership.

Read the rest of the story here

Editor's opinion:

Mentorship is a key solution to transfer valuable knowledge in any kind of profession.
Recently, I came across a virtual community for health care Professionals that has a built-in mentorship program.
Health care professionals can share their knowledge in various ways on that community, such as on a forum and via private messaging.

It's called LinkHealthPro and is free to sign on. LinkHealthPro

Genetic mapping of Quebec commences

Efforts to create a genetic map of Quebec begin in earnest this month as researchers start recruiting people willing to offer up their bodies' blueprints.

The University of Montréal-driven project aims to sign up the first 400 people from Montreal, Monteregie and the Eastern Townships, with the aim of eventually collecting data on health and disease from just over 20,000 people.

The government-funded project is expected to create one of the largest data and biobanks in Quebec and will be made available to health researchers.

"The genome of each human being contains enormous quantities of information. The analysis of this information can increase our understanding of the underlying processes of health and disease," Dr. Claude Laberge, a geneticist and scientific director of the CARTaGENE project, said in a release.

The initial subjects, all between the ages of 40 and 69, will be selected at random using a list provided by the province's health insurance board.

Laberge says focusing on subjects in this age group means researchers know they will find that one-third are already coping with a variety of ailments including hypertension, cardiovascular diseases and arthritis.

Read the full story here

Monday, January 7, 2008

Insufficient warning dangerous drugs by Health Canada

Despite evidence indicating seniors are being prescribed potentially dangerous drugs, Health Canada says it can't do anything more to make its warnings about these medications more effective.

The department is responding to an investigation in December revealing that doctors continue to prescribe anti-psychotic drugs to seniors, despite Health Canada warnings in 2005 that the drugs increased the risk of heart attack, stroke and death.

The analyzed sales data for the drugs indicated that prescriptions increased from seven to 40 percent for a 24-month period after the warnings.

Dr. Marc Berthiaume, director of the Marketed Pharmaceuticals Division at Health Canada, said the department warns doctors and their patients about dangerous drugs through an increasing number of safety alerts such as letters, e-mails and its website.

"We have developed over the years different ways to increase our outreach of that safety information," he said.

But he acknowledges it is up to physicians to read the mailed material. "We cannot open the letter for them. We cannot make them read them."

He said that's because the department doesn't have the legal power to do anything more than publish warnings.

Terence Young, whose 15-year-old daughter Vanessa died seven years ago after taking the drug Prepulsid, said that is nonsense. "Health Canada claims their responsibility stops when the information gets into doctors' hands. I find that disingenuous on several levels.

"The safety warnings sent out to doctors simply don't work, and this was well established at the inquest into Vanessa's death."

Young said Health Canada is wrong to claim it has no legal authority to beef up health warnings, because the law makes it clear the minister's ultimate duty is to protect the safety of Canadians.

Michèle Brill-Edwards, a pediatrician and clinical pharmacologist and one of Health Canada's fiercest critics, agrees. "The minister has in the enabling legislation called the National Department of Health Act very broad powers for the protection of the public."

"I think Dr. Berthiaume is voicing the standard views of the department that seek to limit the department's responsibility for safety."

Although Health Canada refers to its drug alerts as risk communication, Brill-Edwards said that it's hard to call it communication when no one seems to be paying attention.

Source: CBC News

Related article:

Dangerous drugs still prescribed to seniors

Does Halifax get its own Mayo Clinic?

Liberal Leader Stephen McNeil's remonstrations in the legislature this month condemning a year-old memo from some Capital District Health Authority physicians proposing a new, doctor-driven, private-public, "Mayo Clinic-like" hospital facility in metro were an emblematic example of the sort of backward, stick-in-the-mud attitudes and reactionary, tunnel-vision thinking that keep Nova Scotia an underachieving backwater.

McNeil trotted out the customary boilerplate about defending the sacrosanct public health care system from the evils of profit motive or market accountability, trotting out the old FUD (Fear, Uncertainty and Doubt) about privatization of health care delivery leading to (horrors!) - two-tiered health care, with NDP leader Darrell Dexter chiming in with his labour-union constituency's pet trope about private hospitals and clinics supposedly luring doctors and nurses away from the public system.

The 2006 memo, reportedly authored and signed by Capital Health surgeon Robert Stone, lays out a concept for clinics or centres that "should not be staffed by 'unionized' personnel

It would focus on providing endoscopy; breast health services; prostate therapy; various other diagnostics; orthopedic surgery, other same-day surgeries, and executive preventive health - all procedures that do not require the facilities of a fully-equipped and staffed, acute-care surgical hospital.
For which there is a strong demand that isn't being met in a timely fashion by the current public system, and which helps keep waiting lists long for other, more complex surgeries and treatments.

It's just, plain inefficient and a misuse of scarce resources.

Read the full story here

Sunday, January 6, 2008

Physician becomes Prince Albert Citizen of the Year 2007

"She is a physician who has gone above and beyond the call of duty, especially in the advancement of the health of women of Prince Albert and northern Saskatche-wan ... I find it simply amazing that she delivered approximately 270 (babies) in Prince Albert this past year," Ajay Krishan, one of her nominators, wrote in a letter to The Prince Albert Kinsmen Club and the Daily Herald.

Dr. Lalita Malhotra has won Canada's highest civic accolade and counts the 2007 Prince Albert Citizen of the Year as one of her greatest honours.

Last Wednesday she was named the Prince Albert Citizen of the Year by The Prince Albert Kinsmen Club and the Daily Herald.

Malhotra was awarded the Order of Canada in 2006 and the Saskatchewan Order of Merit in 2001.
But this new honour is very important to Malhotra, who has called Prince Albert home for 32 years.
"This is the biggest honour Prince Albert can give me ... When your own community honours you like this, it is totally different. I am very touched, very emotional."

As an obstetrician, Malhotra is known in the province for delivering an stunning average of 250 babies a year.

"Every baby is a thrill and it keeps me going. I feel every child is a challenge to me and it is a learning experience every day. I have no intention of giving up."

Read the rest of the story here

Battle over language in Winnipeg's St. Boniface General Hospital

A language battle is brewing at one of Winnipeg's leading medical institutions.

Since October 14th, nursing jobs posted for the Woman and Child program at St. Boniface General Hospital list the ability to speak French as one of the qualifications.

That has some nurses worried the ability to speak French is taking priority over skill and experience, possibly putting patient care at risk.

"They've started hiring people into positions and taking French language qualifications over top of nursing experience," said nurse Tamara Burnham, a 14-year nursing veteran who works in the St. Boniface program that includes obstetrics and gynecology.

"With all the things going on in health care, to focus in on that doesn't make sense."

Manitoba Nurses Union Local 5 says it's gone to court to fight the French language requirement because it violates their collective agreement and common sense.

The nurses union went to court October 23rd after the Labour Board refused to hear the matter.
Their suit said the Labour Board erred when it refused to hear their complaint that the hospital committed an unfair labour practice by changing the conditions of employment and refusing to negotiate.

The hospital has a hard time filling all of its nursing shifts, never mind requiring that they're filled by French-speaking staff, said Burnham.

Burnham said she has never seen a francophone patient's treatment hampered because of a language barrier.
Most Franco-Manitobans can also speak English, she said.

"A very real problem, however, exists with the growing number of immigrants who speak neither official language," she said.

"If the hospital wanted to address a real language barrier, it would hire interpreters who speak languages like Urdu, Hindi and Mandarin," she said.
The hospital has volunteer interpreters who speak 60 languages but they're not always available when you need them, she said.

Burnham said she has seen women in labour unable to get pain medication because of a language barrier.

"You can't get informed consent because you don't know if they understand," said Burnham. "If it's a delivery, you can't stop a baby from coming," she said.

"Too bad they couldn't spend this much time and energy to have interpreters on call."

Union local president Debbie Mintz said the hospital hasn't done a demographic study of the patient population since the early 1990s, and doesn't know how the client population in Winnipeg has changed.

The hospital says it has to expand services in French.

"St. Boniface General Hospital has a government-conferred responsibility to actively offer and provide services in French to its patients, their families and the public," hospital spokeswoman Helene Vrignon wrote in a statement.

"To meet our legislated responsibility, a small number of staff in direct patient care positions must be bilingual French and English.
In fact, health services in the language of your choice is a basic component of quality of care."

Saturday, January 5, 2008

Violence in hospitals gets out of hand

Violence seems a part of life for those working on the front lines of this country's health care system.

The impact of workplace violence on the health care industry is enormous, exacting a heavy financial toll, according to a 2006 survey by the Workers' Compensation Board of British Columbia.

Facts in figures concerning violence against health care workers:

Injury claims

Nine percent of all B.C. health care workers' accepted claims are due to violence.

More than half of the accepted B.C. claims for health care workers are from nurses aides and licensed practical nurses.

One in five of the accepted B.C. claims for healthcare workers, due to violence in the workplace, is from registered nurses.

$24-million was spent from 2002 to 2006 in workers compensation claims involving violence against health-care workers, including physicians, nurses, care aides, pharmacists, housekeeping staff, technicians and administration.

162,934 days were lost in 2006 due to accepted claims of violence against health care workers in B.C.

Fourteen B.C. health workers were injured every week in 2006, as recorded in accepted violence claims.

Most often hurt workers' body parts in attacks

Arms, including wrists, fingers and elbows: 27 percent

Backs and shoulders: 25 percent

Head, including neck, face, eyes, ears and scalp: 14 percent

Violence against nurses in Canada:

A national survey of nearly 19,000 nurses done by the Canadian Institute for Health Information, Health Canada and Statistics Canada in 2005 found the following:

29.6 Percent of nurses working in hospital said they were physically assaulted by a patient over the past 12 months

49.6 Percent of nurses who worked in a long-term care facility, such as a nursing home, said they were physically assaulted by a patient over the past 12 months

43.6 Percent of male nurses have faced physical assaults, be they in hospital, nursing homes, a community health centre or other health care settings

27.9 Percent of female nurses have faced physical assaults in the same settings

46.3 Percent of nurses working in a hospital said they were emotionally abused by a patient over the past 12 months

48 Percent of nurses working in long-term care facilities, such as nursing homes, said they were emotionally abused by a patient in the past 12 months

54.3 Percent of male nurses have reported suffering emotional abuse over the past 12 months, be it in a hospital, nursing home, a community health centre or other health-care related settings

43 Percent of female nurses have reported suffering emotional abuse in the same settings

46.7 Percent of nurses under 35 reported they have been emotionally abused by a patient in the past 12 months

38.2 Percent of nurses over 55 reported they have been emotionally abused by a patient in the past 12 months

Friday, January 4, 2008

Tailor-made food supplements disputed by Science

From A to zinc, the choice is endless.
Should you choose single vitamins or a multivitamin? Or how about a special formula for stress, fitness, women, men or seniors?

Wouldn't it be great to know exactly which supplements are right for you?
That's what laboratories that specialize in 'body chemistry balancing' promise.
For several hundred dollars, they claim to identify vitamin and mineral deficiencies from a simple blood and urine test.

For David and Cheryl Solomon of Dollard des Ormeaux, nutritional testing takes the guesswork out of the perennial question of whether they're getting the proper vitamins.

Six months ago, the couple and their three sons, age 6 to 11, underwent testing by NutriChem, an Ottawa company founded by pharmacist Kent MacLeod that sells personalized nutritional supplements.

"The beauty of it is he'll customize the vitamin for the individual," said David Solomon, 38, who takes 20 capsules a day, containing vitamins, minerals, fish oils and amino acids.

Cheryl and the boys each take between seven and 10 capsules a day of custom-made supplements.

"This is not a jack-of-all-vitamins," said Solomon, an advertising manager for the Suburban newspaper.
"Until you get tested, you don't know what's right and what's wrong."

The family spends $1,000 a month on supplements. The initial test cost $600 per person.

"In the last few months I've been taking it, I feel fabulous," said Solomon, who used to suffer from chronic indigestion.

"Several doctors said, 'You're getting older. Your body is changing.' "

Solomon, who also takes prescription medication for his digestive problems, said the nutritional supplements have helped him digest food better and boosted his energy.

MacLeod provides personalized care that is sorely lacking in the health care system, according to Solomon, who regards the cost of the vitamins as a long-term investment in his health.

"It's about get in, get out as fast as possible," he said of mainstream medicine. "We wait until we break down before we take care of something."

"This is the future," said pharmacist MacLeod, who founded NutriChem in 1981 and now provides nutritional testing and supplements to 20,000 families around the world.
The company mails out kits for blood and urine samples, which customers return to Ottawa for testing.

Many people are vitamin-deficient because of poor diet or problems absorbing nutrients from food, said MacLeod, whose customers range from middle-aged women with depression to professional hockey players.

They hear about NutriChem from the Internet, referrals by alternative health practitioners and word of mouth.

"Ninety percent of the Canadian population is not getting one or more essential micronutrients," he said.
"There are people running around with no gas in the tank."

MacLeod got into the nutritional-supplement business 27 years ago by creating vitamin cocktails for children with Down syndrome.
He later expanded his practice to include children and adults with conditions from autism to depression, high-performance athletes and people simply seeking optimum health.

But experts dispute the claims of companies that perform nutritional testing......................

Read the full story here

Groundbreaking national health survey starting soon

In the next few days, a groundbreaking national health survey is planned to be starting in British Columbia.

The survey is initiated to discover what kinds of toxic chemicals are present in Canadians' bodies, as well as examining other health issues such as obesity and disease other diseases.
Nearly 700 residents in the province will be surveyed.

By the end of 2008, more than 5,000 Canadians between the ages of 6 and 79 will have been tested.
Participants must agree to a series of physical exams, fitness testing and blood and urine tests. They'll also be required to wear an activity monitor for seven days.

According to Jeanine Bustros, the director of the physical health measures division of Statistics Canada, the survey could have major significance for health policy, depending on the findings.

"This survey will allow us, for the first time, to have a benchmark," she said.

"To be able to measure: Are we getting better? Are we getting worse?, in terms of the levels of contaminants in the Canadian population."


StatsCan will put the findings together for Health Canada and Canada's Public Health Agency. The results will become the first-ever comprehensive health study that directly measures things like obesity, lung function, chronic disease and levels of toxic chemicals in the blood.

Individual health results will be , but will be provided to participants who request them, within weeks of testing.

Only Canadians who are contacted by Statistics Canada are eligible to participate.
The results of the survey are confidential and protected by privacy laws, but will be given to participants within weeks after testing on request.

Source: CBC News

Folic Acid should be used also BEFORE pregnancy

Health care professionals are urging women who could become pregnant to up their intake of folic acid.

A panel of experts from the Society of Obstetricians and Gynecologists of Canada and Toronto's Hospital for Sick Children, along with Health Canada say certain birth defects can be prevented if women who become pregnant are taking proper amounts of folic acid.
According to Health Canada, folic acid is important in the normal development of a baby's spine, brain and skull and can prevent defects such as spina bifida.

It is recommended that women take a supplement of 0.4 milligrams of folic acid daily, along with eating sufficient amounts of foods fortified with folic acid such as spinach, broccoli, corn, oranges, peas, beans and lentils.

The supplement should be taken at least three months prior to becoming pregnant and should continue to be taken through the first three months of pregnancy.

"Folic acid becomes critical near the end of the first month of pregnancy," said Heather McAvoy, public health nutritionist at the Prince Albert Parkland Health Region

"Often women don't even realize they are pregnant at this time so it's important to have already been taking the supplement."


McAvoy also pointed out that some women are at a higher risk of having a baby with a birth defect.

"If you have had neural tube defect pregnancy, or have a family history of that problem, or if you have diabetes, epilepsy or you are overweight, you should consult a doctor before planning a pregnancy,"

Source: P.A. Daily Herald

Thursday, January 3, 2008

Burnout drives many women out of medicine

Across all health care occupations, from nurses to pharmacists to dental technicians, roughly 80 percent of the workforce is female, according to Statistics Canada.

It's becoming increasingly common as more and more women pursue medical careers, and it's the latest twist on what may be the country's most critical health care issue: the doctor shortage.

But the physician population has always been male-dominated, and this influx of women will add fuel to the doctor crisis in Canada.
Female doctors commit fewer hours and fewer years to the medical system than males, and family duties are at least one reason why.

Despite their demanding careers, women are still given the bigger proportion of child care, housekeeping and elder care, but this pressure comes with a price.

"Burnout"drives many women out of medicine altogether, and with five million Canadians currently without a family doctor, things are only getting worse.

A 2005 survey found that just 23 percent of Canadians were able to see a physician the same day they needed one, placing this country last among the six studied, including the U.S., Britain and Australia.

Canada's doctor-patient ratio is among the worst of any industrialized nation: with just 2.2 physicians per thousand people, it ranks 24th out of 28 OECD countries, which iswell below the average of three.
Among the G8 countries, Canada even ranks dead last when it comes to physician supply.

Source: CNW Group

Editor's opinion:
"A conclusion could be that husbands of women that pursue medical careers, are not contributing to the household and child care sufficiently."

Major investments in Health Care in Calgary and Edmonton

The Alberta Cunstruction Magazine reports there's a lot of work to be done in the years to come.

For Health and Wellness for just the two regions, there’s more than $1.6 billion worth of work. For advanced education, there’s $250 million for Calgary and more than $400 million for Edmonton over the next four years.

A number of factors are driving the construction boom in health care facilities: an aging population, an increase in population in high-growth areas such as Fort McMurray, and a desire to keep Alberta on the leading edge in research, technology, and world-class facilities.

The Alberta government reports funding for Health and Wellness is up $1.3 billion (12.2 per cent) for the 2007–08 budget year.
Over the next three years, the Alberta government has slated $2.6 billion for health facilities, including $250 million to replace the Queen Elizabeth Hospital in Grande Prairie, $221 million to cover cost escalation on health projects that have already been approved, and $26.4 million for the Northern Lights Health Region to build infrastructure for health care providers in the regions and new community health clinics.
In addition, a helicopter platform will be added at the Northern Lights Regional Health Centre.

Money will also go towards 30 previously approved projects.
Those include construction of community health centres in Red Deer, Calgary, and Edmonton, as well as long-term care facilities in Red Deer, Edmonton, High Prairie, Vermilion, and Vegreville.

The new multi-use facilities will offer excellence in health care for patients and learning opportunities for post-secondary students.

For instance, the Edmonton Clinic, a partnership between Capital Health and University of Alberta, models itself after the Mayo Clinic, a one-stop shop that houses multiple clinics in one place.
Construction, expected to open in 2011 at a cost of $909 million, begins this year.

In Calgary, 2008 marks the first full year of work on the $1.25-billion South Health Campus. The campus will bring together wellness, health research and education on a 44-acre campus located at Deerfoot Trail and 196th Avenue SE.

The 160,000 sq.m health campus will consist of heath services, including surgery and operating rooms, pediatrics, obstetrics, mental heath, as well as emergency and outpatient services. It will also focus on wellness services and research and education. Phase I is scheduled to open in the spring of 2011.

Europeans tallest, North Americans smallest brains?

Recently, according to a study Europeans, The Dutch in particular, are now the tallest people in the World.

North Americans were always the tallest, but haven't grown since the last 25 years and are 2 inches shorter than their Dutch counterparts.

We're used to the notion of the United States as the world's dominant power, a land of untold resources, wealth and consumption.

And one reflection of this abundance is the fact that for most of the past 2 1/2 centuries, Americans have been literally the tallest people on the planet.
Feeding off the abundant wild game and rich agriculture of their vast new land, colonial Americans measured a full three inches taller than Europeans.

Not so any more.
Compared to Europeans, Americans have effectively shrunk.
Indeed, among all advanced industrial nations, Americans are now at the bottom end of the height scale.

And, no, it's not the influx of short Hispanics. The height pattern is the same for Americans even when the sample is limited to non-Hispanic, native-born Americans.

It seems to be a reflection of something more basic.
According to an influential paper in Social Science Quarterly last June by economic historians John Komlos and Benjamin Lauderdale, "height is indicative of how well the human organism thrives in its socioeconomic environment."

The relative shrinking of Americans on the world scene is perhaps then an indicator of something Americans are doing badly, not in Iraq, but right at home.

And that something should be of more than passing interest to Canadians as we continue, consciously and unconsciously, to shape our economic and social systems with the U.S. in mind.

Actually, Canada has traditionally been a blend of the U.S. and European approaches.
But in the last couple of decades, as we have focused increasingly on cutting taxes and have adopted the attitude that individuals must make it on their own in society, we've veered more closely to the U.S. model.

We tend to view the low-tax, low-spending U.S. model as simply the norm in the era of globalization. But in fact it is only the U.S. norm.

Europeans, particularly northern Europeans, have traditionally done things differently.
They have been imposing much higher taxes and delivering much more generous social programs that provide a striking array of benefits to every member of society.

Contrary to our impressions here in the West that globalization has fundamentally redesigned the world, the Europeans have stuck with their high-tax, high-spending model in the globalized era.

Read the full story here

Brampton Civic Hospital apologizes for cutting in wrong leg

The chief of staff at Brampton’s criticized Civic Hospital has now officially apologized to the 72-year-old Amar Kaur Brar, whose wrong leg got cut by a surgeon, her family says.

The doctor, who sliced open Amar Kaur Brar’s right leg when he should have cut into her left, has also expressed his regret.
The apologies came after the family filed a formal complaint with the Brampton Civic Hospital ombudsman over the incident.
Her 21-year-old granddaughter Kanwaljot Brar said it has left her formerly agile grandmother in serious pain and handicapped as she now has to recover from incisions on both legs, on top of a broken bone.

“Before the complaint they didn’t apologize. Now they have apologized,” she said. “They do the mistake and after they say sorry. That’s not good.”

A spokesperson at Brampton Civic was unable to confirm yesterday whether these verbal regrets were issued.
Despite requesting a new physician, Amar Kaur Brar was today back under the care of the surgeon who performed the procedure.

"The reduced holiday staffing levels at Brampton Civic made it impossible to have another doctor on the job," Kanwaljot Brar said.
“He’s taking care of her, but after the vacation is over another doctor will be given to her,”

The alleged mistake is the latest in a string of controversies that put Brampton Civic under fire since it opened its doors amid much fanfare last October.

Two patients have died and their families believe it was due to complications caused by long waits for proper care.
In November, Harnek Sindu, 52, perished of pancreatitis 10 days after waiting 12 hours for a bed when he presented with abdominal pain and only last month it was Amerjit Narwal, 42, who succumbed to a stroke.

Calling the two deaths “unacceptable,” Health Minister George Smitherman last week appointed a supervisor to assume control of William Osler Health Centre, the hospital network responsible for Brampton Civic.
A citizen’s group, billing itself as Bramptonians for Better Health Care, held a thousand-person protest last month and is now organizing a petition calling for more funding, better staffing levels and the opening of more beds at a hospital serving one of Canada’s fastest growing communities.

Group spokesman Rajinder Saini, who is also editor of Parvasi Weekly, called the latest incident “unbelievable.”
“It’s tragic, there is outrage in the community. They are losing confidence in the hospital.”

While the apologies were appreciated, Ms. Brar said they come as cold comfort to her grandmother, who arrived in Canada from India last summer and now remains hospitalized.

“She just started crying,” reported her granddaughter.
Mrs. Kaur Brar slipped and fell on the stairs on Christmas day, fracturing her left leg.

Related articles:

Brampton Civic Hospital operates on wrong leg

Brampton Civic hospital has cost $340 million more than planned

Brampton Civic Hospital under fire

Wednesday, January 2, 2008

Solution donor shortage right under nose of Canadian Blood Services

Earlier this week I reported that Canadian Blood Services needs more blood donors (click here to read the article)

The following article proofs that some solutions to that problem are right under their noses and it might be time to do something about the ancient rules and regulations for giving blood!

Namely, Some Canadian university groups are speaking out loud over what they feel are outdated and discriminatory screening practices for blood donors.

Several student groups and gay rights activists say they're particularly concerned about Canadian Blood Services' lifetime ban against blood donations from gay men.
Their concerns largely stem from sections of a lengthy questionnaire potential donors need to fill out.

Question No. 18 of the blood agency's questionnaire asks potential male donors if they have had sex with a man, even once since 1977.
If the answer is yes, even if the person has practiced safe sex and is in a monogamous relationship, they are instantly deemed ineligible to donate.

"It makes people believe that, yes, gay men are likely to have HIV, likely to have AIDS," Andrew Brett, advocacy and outreach co-ordinator at the University of Toronto's student union in Mississauga, told CBC News.
"It kind of makes it official, and it's like official discrimination."

The student federation doesn't condone banning blood drives on campuses. But Brett said some campuses have canceled their blood donor days.

Lorna Tessier, director of public relations with Canadian Blood Services in Ottawa, said she hasn't heard of any cancellations.

Canadian Blood Services said it's reliant on student donations.

"We are very dependent on being able to do blood donor clinics in universities," said Dr. Margaret Fearon, executive director of medical microbiology at the blood agency.
She said students are mistaken to see the policy as a gay rights issue.

"People who receive blood have a right to safe blood. People do not have a right to donate blood. It's a privilege, really."

Many countries are struggling with the issue, in addition to Canada.
In the U.S., a lifetime ban on men who have had homosexual encounters was upheld earlier this year, even though the American Red Cross recommended a change.

According to Tessier, Canadian Blood Services has begun research into whether more specific questions about risky behavior would be a better addition to the screening process.

Dr. Steven Klinman, senior medical advisor with the American Association of Blood Banks, said that a lifetime ban isn't necessary because HIV testing is so accurate now.
But he also said recent sex between men still presents a risk blood agencies can't ignore.

Source: CBC News

Related Article:

Canadian Blood Services needs 'New Blood', literally!

York University needs to improve Medical Education

Originally designed as a feeder school for the University of Toronto, York University has managed to break away, except when it comes to medical students who are still forced to leave after completing their undergraduate degrees.

According to York University’s mission statement: “We promise excellence in research and teaching in pure, applied and professional fields.”

Since York’s founding in 1959, however, a strong emphasis has been placed on the arts and fine arts, while future doctors have moved on to other schools for further education.

Canadian universities do not have enough medical schools to keep up with the growing need for professional doctors.
Only four medical schools have been created in Canada since 1959, and only one since 1968. During this same time, the population of Canada grew 178 percent from 18 million to 32 million.

According to the Canadian Medical Association Journal, the average general practitioner in Canada works 51.4 hours per week.
From 1979 to 2003, the average Canadian workweek dropped from over 34 hours per week to around 33 hours per week.

Despite doctors working over 50 hours per week, many Canadians still have a hard time trying to find family doctors and wait times at hospitals have increased dramatically.

Meanwhile, Canada has seen a reversal of the brain drain of the mid 1990s, which saw its peak with around 1.5 percent of Canadian doctors leaving Canada to work in the United States, according to the Canadian Institute for Health Information.

Fortunately, 2006 was the third year in a row that saw a brain gain, with 238 doctors returning from abroad and only 207 leaving.
This only represents 0.05 percent of Canada’s 62,307 practicing physicians, which is not nearly enough of an increase to significantly affect hospital wait times, overworked doctors or the lack of family physicians.

The average age of doctors in Canada continues to increase, reaching 49 in 2006, with only 23 percent of doctors in Canada being under 40 and 19 percent being over 60.
The need for young doctors has never been greater, and in order to fill this need Canada needs more medical schools.

Most of the schools York competes against, including the University of Toronto, McMaster University, the University of Western Ontario and the University of Ottawa, all have quality medical schools.

York has managed to compete with and often surpass the big established programs with its business and law faculties, now it needs to do the same with a medical school.

After all, shouldn’t an interdisciplinary university strive to give their students everything that is possible, instead of simply taking the easy route and sticking to what they know best?

Source: Excalibur

Alzheimer Society kicks-off Brain Health awareness campaign

This January, the Alzheimer Society is challenging all Canadians, young and old, to make brain health a personal commitment as it kicks off its nationwide awareness campaign, 'Heads Up for Healthier Brains!'

"In 2007 we helped people make the connection between healthy living and a healthy brain," says Scott Dudgeon, chief executive officer of the Alzheimer Society of Canada.
"Now we are asking Canadians to make the commitment to do the things that will help keep their brains healthy, things that can also help to reduce the risk of developing Alzheimer's disease."

Making the commitment is easy.
It can involve the entire family, and include activities such as challenging your brain, being socially active, choosing a healthy lifestyle, and protecting your head from injury.
It is never too soon, or too late, to make changes that will maintain or improve your brain health.

For people already living with Alzheimer's disease, these kinds of activities go a long way in improving quality of life, as well as delaying the progression of the disease.
"Across the globe, top scientists are continuing to focus their efforts on the prevention of Alzheimer's disease, and much of this research is happening right here in Canada," says Dr. Jack Diamond, scientific director of the Alzheimer Society of Canada.

"In just the last year we have learned so much more about the importance of a healthy lifestyle, and the need to keep your brain active."

The Alzheimer Society is making its own commitment to helping Canadians improve their brain health with the launch of BrainBooster, an online gym of challenging games and puzzles designed to increase mental performance.
The gym also features brain boosting recipes and simple exercises to get people moving.

Canadians can access the gym by visiting www.alzheimer.ca.
Once there, they can also sign up with their personal 'brain' pledge and enter the 'Puzzled about Alzheimer's Contest,' showcased in the Feb/Mar issue of Homemakers and Madame magazines, as well as their online sites.

Source: CNW Group

Tuesday, January 1, 2008

More Canadians should get tax-incentive to start exercising

If we look at the numbers according to Obesity Canada, a network of health care professionals, as many as 25% of all teens and 50% of all adults in Canada are overweight.

A staggering 10%-12% of adult Canadians are classified as obese, putting them at serious risk of heart attack, stroke and diabetes, to name but a few of the threats they are exposed to.
The leading factors in the 'obesity epidemic' are a poor diet and inactive lifestyles.

Therefore, a New Year's resolution of the Harper government should be to get more Canadians off their couches and start exercising.
In 2007, the Tories already made a great step in the good direction with the introduction of the Children's Fitness Tax Credit, which allows parents to claim on their income tax a portion of the fees they pay to enroll their kids in sports.

The government really needs to expand the program now and include everyone over the age of 16.
Rewarding people for joining health clubs or signing up for recreational sports programs is a simple, yet effective way to get more Canadians active in our increasingly sedentary society.

Over the years, governments leaned toward using the 'stick-approach' to improving our health, but shaming and hectoring people through nagging awareness campaigns, food labelling, tobacco-use restrictions and the like will only go so far.

Now it's time to start offering rewards to people for making healthy choices.

Allowing people to claim only a portion of activity fees on their taxes will be a safeguard against abusers simply buying a gym membership as a tax write-off and then never showing up, but it will still reward people genuinely trying to get healthier.

In the long run, all Canadians will benefit.
More people leading healthy lifestyles will ease pressure on our overburdened health care system.

Source: Winnipeg Sun

Canadian Blood Services needs 'New Blood', literally!

As we continue through the holiday season, there's one gift that's always in demand: blood.

About every minute, someone in Canada needs a blood transfusion.

It's disturbing to learn then that a sizable portion of the population can't donate needed blood or bone marrow because they don't speak English or French.

Apparently, Canadian Blood Services can't accept blood from these people because of concern over their inability to accurately answer sensitive questions about their health and lifestyle that could affect the safety of the blood supply.

The service says it doesn't have either the staff to translate applications or nurses who speak multiple languages.

In a province where more than a quarter of the residents don't speak English or French as a first language, it's a significant issue.

Especially since the best chance of finding a match for some products like bone marrow is within a recipient's own ethnic group.

We'd have thought Canadian Blood Services would try harder to accommodate our multi-racial and multi-lingual reality. The language barrier isn't one that can't be overcome.

As far as safety is concerned, while many questions asked of donors help to pre-screen blood, afterwards the blood itself is tested for hepatitis, AIDS and a variety of other diseases.

The existing pool of blood donors is becoming older and fewer.
If the Canadian Blood Service hopes to do its job in the future, it's going to have to make changes.

We need new blood, literally!

This year, in British Columbia , Canadian Blood Services will need to collect 1,200 red blood cells or platelet donations by January 4th to help meet hospital needs.

For all of Canada, call Canadian Blood Services at 1-888-2-DONATE (1-888-236-6283) for blood donor clinic information, eligibility information or to book an appointment.

Source: Chilliwack Times

Supervisor appointed in Brampton Civic Hospital

Ken White, former CEO at Trillium Health Centre in Mississauga, will at least spend the next six to nine months, coming up with an action plan to improve communication between the hospital and the community, ensure proper staffing and reduce wait times in the emergency ward.

Amid reports that a patient had the wrong leg operated on at Brampton Civic, Ontario's first public-private hospital, Health Minister George Smitherman has named the supervisor who will look into problems at the new facility.

"People in the community should expect more answers to the questions raised ... What we see here is evidence of the need to do better," Smitherman told a press conference at the Brampton site of the William Osler Health Centre yesterday.

Smitherman took the rare step of appointing a supervisor to restore public confidence in Brampton Civic after the deaths of Harnek Sidhu, 52, of pancreatitis and Amarjit Narwal, 42, of a stroke, sparked a huge community protest in early December.

Then, on Christmas Day, 72-year-old Amar Kaur Brar complained doctors cut open her right leg by mistake when she went to hospital for surgery on her fractured left leg.

Although he had been an investigator at Brampton Civic for about a year, helping it to ramp up to its opening on October 28th, White said he was "not at all familiar" with concerns raised by the community about a shortage of staff, unduly long waits in emergency and a lack of beds.

"It's very sad there's all kinds of these misadventures in health care happening across Canada," White told reporters in an interview after the press conference.

Smitherman blamed "mischief makers" and alluded to persistent negative media reports about problems at the hospital since it opened as being a factor in attracting staff to work at the centre.

Some of those reports have been "pretty far off the mark," he said.

Brampton Civic, which replaced Peel Memorial Hospital, "overnight gained 100 beds, which is unheard of in health care" today, said Smitherman.
However, he did acknowledge staffing challenges.

Source: The Star

This is a video from CBC News concerning the appointment of Ken White

Related Articles:

Brampton Civic Hospital operates on wrong leg

Brampton Civic hospital has cost $340 million more than planned

Brampton Civic Hospital under fire

Calgary moms and company owners recall gourmet baby food

A small company, run by two Calgary mothers is voluntarily recalling some of its gourmet baby food after the Canadian Food Inspection Agency warned the product could harm children with severe peanut allergies.

Some Baby Gourmet products may contain peanut protein or sulphites not mentioned on the label, said the warning issued last Monday.

The baby foods in question include organic Moroccan lamb with couscous, which might contain undeclared peanut protein, and seasonal fruit compote, which contains undeclared sulphites, said Garfield Balsom, a food safety and recall specialist with the food and inspection agency.

Peanuts are not used in any of the locally made foods, but the dried couscous could have come in contact with peanuts in the packing plant before being sent to Calgary, said Jennifer Broe, who launched the company with her sister two years ago.

So far, only one allergic reaction has been reported in connection to Baby Gourmet products. Calgary Health Region officials said Monday the patient suffered an allergic reaction caused by the peanut protein in the product. The patient was treated at a physician's office and did not require hospitalization.

The recall involves foods that were sold at the Calgary Farmer's Market and at Mise en Place in Lakeview Plaza. The products have only been distributed in Calgary.

There has been one reported illness associated with the products, which are common food allergens.

The recipes included in the recall will be discontinued until Baby Gourmet can finish a thorough investigation of all ingredients, said Broe.

"We make this food like it's for our own children. We will definitely take every precaution to look into the recipes and research all the ingredients to make sure everything is listed," she said.

Source: Canada.com

Happy New Year!!


A happy New Year to all the readers of my blog!

May 2008 be a healthy and prosperous year to all of you.