Awareness

Tuberculosis champions’ in Nunavut improve testing, treatment

A recent CBC News article reported that “Researchers have found a unique way to detect hidden cases of tuberculosis in Canada’s North, where the bacterial infection is still an important public health problem.

The rate of TB infections in Nunavut is 62 times the Canadian average, in part due to crowded housing conditions, poor nutrition and high smoking rates. TB primarily attacks the lungs and can be deadly without treatment.

Dr. Gonzalo Alvarez, a respirologist and scientist with the Ottawa Hospital Research Institute, used information about previous TB cases to target high-risk neighbourhoods in Iqaluit. The usual method of tracking the infection is to follow up with contacts of known cases.

Alvarez, and local community members and health officials then developed an awareness campaign, translating TB information into Inuktitut, the Inuit language, and producing videos that were shown at a community gathering.”

Read more on the article here.

WHO’s goal to eradicate tuberculosis draws attention to Canadian challenges

A recent Globe and Mail article published that the World Health Organization is ramping up its efforts to wipe out tuberculosis in countries with low rates of active TB by setting a goal of eradicating the disease by 2050 in 33 countries, including Canada.

Meeting that target will be a tall order for Canada, according to infectious disease experts in this country.

Although Canada has one of the lowest rates of active TB in the world, it faces some particular challenges in eliminating the disease – namely, the waves of immigrants and visitors it welcomes from countries where TB is endemic, and the slow but persistent increase in incidence rates among aboriginals, especially in Nunavut.

“One of the really big challenges in Canada is, from a TB standpoint, it almost looks like we are a low-incidence country fused with a high-incidence country,” said Kamran Khan, an infectious disease physician and TB specialist at St. Michael’s Hospital in Toronto.

Michael Gardam, the director of infection prevention and control at University Health Network in Toronto, said it was unlikely Canada would be able to meet the WHO goal.

“I think these [WHO] statements are important to focus people’s attention on it, but tuberculosis continues to cause problems and is continuing to become more and more drug resistant,” he said. “I think it’s naive to think that we’re going to be able to just eliminate this infection.”

Federal Health Minister Rona Ambrose unveiled a new approach to combatting TB in March of this year, one that focuses heavily on aboriginals and new Canadians.

The public health arm of the United Nations announced on Thursday its own new framework aimed at TB elimination, which WHO defines as fewer than one new case per million people per year, by 2050.

The agency has set a “pre-elimination” goal of fewer than 10 new cases per million by 2035 in low-incidence countries.

Canada already meets the pre-elimination target among non-aboriginals born in Canada, according to the Public Health Agency of Canada.

But over all, Canada is still wide of the mark.

Canada logged 1,685 new cases of active tuberculosis in 2012, the last year for which nationwide statistics are available. That works out to a rate of 4.8 new cases for every 100,000 people, a slight uptick from the two previous years, when the figure was 4.7. It also reflects a steady decrease since 2002, when the figure was 5.3 per 100,000.

For aboriginal and foreign-born Canadians, the figures are less encouraging.

The incidence rates for aboriginals increased from 22 new cases per 100,000 population in 2002 to 29.2 per 100,000 in 2012.

The problem has been particularly acute in Nunavut, which had 76 new cases in 2012. For the tiny territory, that works out to an incidence rate of 234.4 per 100,000. The figure was down from 2010 when 100 cases were logged during an outbreak.

“In a nutshell, the reason we have high rates of TB is to do with socioeconomic factors,” said Geraldine Osborne, the territory’s acting chief medical officer of health. “The determinants are the living conditions of people here: Overcrowded housing, high rates of smoking, poor nutrition. We have all the risk factors.”

In a bid to counteract those risk factors, the federal government contributed $800,000 to a research project in 2011-2012 that sent nurses and educators door-to-door in Iqaluit to test for latent TB, the dormant infection that produces no symptoms until a weakened immune system or other factors activate the disease.

Foreign-born Canadians accounted for two-thirds of all new active TB cases diagnosed in 2012. In Toronto, a magnet for new immigrants, between 90 and 95 per cent of new cases in the past three years have been found in people born elsewhere, with the top three countries of origin being Philippines, India, and China, according to Toronto Public Health.

But Canada’s success in tamping down rates overall could wind up being its downfall, Dr. Gardam warned.

“On paper, Canada is doing pretty well,” he said. “We have one of the lowest rates in the world … on the other hand, to be honest with you, we’re kind of coasting. We don’t have the same TB control programs that we used to have because as rates go down, people stop being interested in funding these sorts of things.”

Why laughing is healthy

A recent CNN article reported the health benefits of laughing:

A study presented at this year’s annual Experimental Biology conference finds that when people laugh, their brains are activated in the same way as when people are mindfully meditating.

The study, from researchers at Loma Linda University, measured the brain activity of 31 people when they watched a funny video and again when they watched a stressful video. Researchers measured activity in nine parts of the brain. What they noted was that during the funny videos, the viewers actually activated their entire brains, with high gamma wave activity, as measured by electroencephalography, or EEG.

EEG measures electrical activity along the scalp. “The electrical activity translates to neuroactivity,” said the lead researcher, Dr. Lee Berk. Gamma wave activity is associated with increased dopamine levels and putting the brain’s cognitive state at its most alert level.

Berk explained, “What we know is that gamma is found in every part of the brain and that it helps generate recall and reorganization.” That’s why, he said, after people meditate, they feel refreshed and are better positioned to solve problems.

Not only can laughing help increase your awareness, Berk thinks it is likely to have the health benefits of meditation, like reducing stress, blood pressure and pain.

Berk acknowledges that more research is needed about how laughing can actually benefit our health, but he is optimistic about an area of science that shows real correlation between the mind and body. “We are looking at the keyhole in the door – and the light is bright on the other side,” he said.

The bottom line, he says: “Humor is evidenced to have a therapeutic value.”

So next time your boss catches you watching a funny cat video, just tell her that you’re trying to be more productive.

Kids who sleep more cope better

A recent CNN article reported that extending children’s sleep opens the door to an effective, feasible way to improve health and performance. Sleepy school children make crabby classmates, while students who get plenty of sleep are better behaved, according to a new study published in the journal Pediatrics.

Gruber and his colleagues wanted to find out if the behavior of elementary school children was affected by how much sleep they got. The researchers, with the permission of parents, enrolled 34 students ages 7 to 11 in the study. These were healthy kids who didn’t have sleep problems or behavior or academic issues.

During one week of school, half the students were put to bed earlier than normal, averaging about 27 minutes more sleep a night. The other half stayed up later than their routine bedtime, losing about 54 minutes of shut-eye each evening.

The results

Teachers – who didn’t know the sleep status of the students – reported significant differences in how the children behaved and coped with everyday challenges. Students who were sleep-deprived not only seemed overly tired, but were more impulsive and irritable than their well-rested classmates. They were quick to cry, lose their tempers or get frustrated.

The children who got plenty of sleep had a better handle on their emotions and were more alert in class.

Sleep experts say these results make sense and provide more evidence about the importance of sleep.

“We know that sleep deprivation can affect memory, creativity, verbal creativity and even things like judgment and motivation and being (engaged) in the classroom,” explains Dr. Judith Owens, director of sleep medicine at Children’s National Medical Center in Washington. “When you’re sleepy, (being engaged) isn’t going to happen.”

And when children have trouble coping with day-to-day situations, Owens adds, this can affect a child’s relationship with teachers, as well as their success in school, social skills and the ability to get along with peers.

Tips for parents

So how do you know if your child is getting enough sleep? Children in elementary school generally need between 10 to 11 hours each evening, but no two children are alike. Parents should look for clues, experts say.

“Kids in this age range should not be sleepy during the day,” Owens says. “If the are falling asleep in the car or watching TV, that’s a red flag.”

Another way to gauge your child’s sleep need is to pay attention to how much they sleep during school vacations, when they’re sleeping without a time schedule. If they consistently sleep longer than on school nights, your child probably isn’t getting enough sleep.

Take action

Parents can take steps to get their children off to bed at a reasonable hour.

– About a half hour before bedtime, have your kids start winding down – put down the electronic devices, turn off the TV and shut down the computer
– Have a consistent bedtime and wake time and try to make this apply to the weekends as well
– Be good role models for your children. Go to bed at a reasonable time and talk to them about the importance of sleep

“Consider that (sleep) is one of the building blocks of your child’s health, well-being and academic success,” Owens says. “It’s equivalent to good nutrition, exercise and all the other things we try to foster and provide for our children. You’ve got to put sleep right up there at the top of the list.”

It’s allergy season and time for the survival tool essentials

Thanks in part to a seemingly never ending winter, Canadians are now contending with one of the worst allergy seasons in recent memory. Dubbed the ‘pollen vortex,’ seasonal allergy sufferers are in for a long summer thanks to the increased levels of pollen making their way through the air.

Millions of Canadians suffer from seasonal allergies, and according to a recent survey by Claritin, 1 in 7 Canadians described their or someone in their household’s allergies as severe. The survey also found that while 64 per cent said their allergies negatively affect their quality of life, 1 in 5 don’t seek relief at all.

If you’re part of the 80% looking for a way to relieve your allergy symptoms, here are some tools to keep in your seasonal allergy survival kit that may offer relief.

New Ways to Get Children to Take Their Medicines

Nearly two-thirds of children and adolescents with a chronic illness are prescribed medication, but at least half of those with prescriptions don’t take their medicine reliably, according to a study published in September 2013 in the journal Pediatrics. The problem can lead to emergency-room visits, hospitalizations and other “avoidable costs,” the report said.

Various studies have estimated that nonadherence to medication costs the U.S. health-care system from $100 billion to $289 billion a year. Research is lacking on the effects on overall pediatric costs specifically. But one recent study in patients with cystic fibrosis age 6 and older found that moderate and low adherence to medication increased annual health-care costs per patient by $8,493 and $14,211, respectively, compared with high adherence.

A number of big hospitals are now experimenting with ways to keep children on their medication, including such things as text-message reminders and electronic devices that monitor when a pill bottle is opened. But getting to the bottom of the problem can be more complex than with adult patients, requiring doctors to evaluate not just the child’s behavior but that of the parents, too.

“Some of the children who have adherence problems have other problems, too…difficult families, inconsistent supervision, depression,” says Denny Drotar, director of a center at Cincinnati Children’s Hospital Medical Center that researches ways to boost medication adherence.

Read more about this Wall Street Journal article here.

Let’s Put a Cap on Big Soda

A recent Huffington Post article highlights the health benefits of putting caps on big soda.

“This week, New York City and the beverage industry squared off in the state’s highest court over the proposed portion cap on soda and other sugary beverages. I wholeheartedly support this proposal, as health commissioner, as a physician, as a mother and as a New Yorker who has seen more and more neighbors fall victim to obesity and the deadly illnesses it causes.

The link between sugary drink consumption and obesity is irrefutable, as is the link between obesity and three major causes of death in New York: cancer, heart disease and diabetes. More than half of all adult New Yorkers and almost 40 percent of public school students are considered overweight or obese. Experts warn that unless we reverse obesity trends, today’s youth may have a shorter life expectancy than their parents.

Sugary drinks like sodas, sweet teas and so-called sports drinks, guzzled from enormous containers, deserve the lion’s share of the blame for obesity, and even the most vocal opponents of the portion cap proposal seem to agree that we’re drinking too much of the wrong stuff. Resetting the default size on these drinks to more reasonable portions is one way to stem the tide of obesity.

But reversing the trend isn’t as easy as it seems, especially when unhealthy food and beverages are so aggressively marketed. The industry spends roughly $2 billion each year promoting food and beverages to kids. Most of these products are unhealthy, and much of the marketing is directed toward lower-income communities of color, whose residents are disproportionally trapped in the grip of our city’s obesity epidemic.

In one area of the Bronx, sugary drink advertising accounted for 85 percent of all advertisements, and only 8 percent of ads for food and non-alcoholic drinks were for healthy products. Our research shows that sugary drink ads are more prevalent in Central Harlem than its neighbor to the south, the Upper West Side. Tour our city’s poorer communities, and it’s easy to see the hand of big soda at work: Struggling bodega owners, prompted by distributor incentives, plaster their windows, doors and awnings with sugary drink ads. Consumers are forced to wade through this sea of junk, while healthy options are practically invisible.

Nationally, black children and teens reported seeing almost twice as many ads for sugary drinks, thanks to clever advertising and promotion. These tactics, the marketing industry’s version of racial profiling, unfortunately are working. Health Department data show that New Yorkers who are poorer, black or Hispanic drink more sugary beverages than whites. And they pay for it with their bodies: Our black and Hispanic neighbors are nearly twice as likely to be obese and more than twice as likely to have diabetes as whites. Blacks disproportionally suffer the long-term effects of obesity, which is partly why they have a life expectancy at birth that is four years shorter than that of whites. National data paint a grim picture for our littlest New Yorkers: A Hispanic baby girl born today has more than a 50 percent chance of developing Type 2 diabetes in her lifetime. If she lives in a community targeted by big soda, she’ll have no trouble finding unhealthy beverages to consume to help make that prediction a reality.

No one’s health should be determined by their zip code, yet this is what is happening in our city. Without government action, big soda (both the portion size and the industry) will continue to harm our most vulnerable communities for generations to come.

Those who argue that the Board of Health overstepped its authority by proposing the portion cap are conveniently ignoring the fact that today’s epidemic is obesity, and the Board is acting within its right to use every weapon at its disposal to save lives and reduce suffering.

The portion cap rule is not perfect, nor will it serve as the magic bullet to solve our obesity crisis. The Health Department and its community-based partners need to continue to educate the public through media campaigns and other vehicles, encourage store owners to stock more healthy foods and drinks, and to make healthy choices easier to buy. But in order to win the fight against the obesity epidemic, limiting portions is an important and necessary first step toward improving the health of all residents, regardless of where they live. Putting the brakes on big soda also will send a powerful message to the industry: Don’t mess with New York. We all deserve better.”

PTSD: The latest neuroimaging technology could mean a breakthrough for Canada’s military

“Post-traumatic stress disorder is a significant issue in the Canadian military. According to a report from the Library of Parliament, one in 10 veterans released between 1998 and 2007 were diagnosed with PTSD. The figure rose to 24 per cent when other mental health illnesses were considered, including depression and bipolar disorder.

Treatment is offered to current and former soldiers, but the military’s mental health services are strained. When symptoms become chronic, soldiers and veterans often have trouble working and face higher risks of alcohol abuse, drug addiction, run-ins with the law and suicide.

Some recover, others are released from the military because they are no longer well enough to serve. Before legislative changes in 2006, these veterans received lifetime payments for their injuries – now they’re offered lump-sum awards.

The disorder is a disfigurement of sorts, but unlike clearly physical injuries such as tissue damage or lost limbs, doctors haven’t had the equipment to scan for PTSD.

Until now.”

Read more on this Globe and Mail article here.

You’re Putting On Your Bug Spray All Wrong

‘Tis the season for picnics, bonfires and camping, but along with the sunshine and fresh air come insects. Not only are they annoying and their bites often itchy, but many carry dangerous diseases.

Among a long list of mosquito and tick-borne diseases are Eastern equine encephalitis, St. Louis encephalitis, West Nile virus and Lyme disease. West Nile virus is one of the most common carried by mosquitos, and in 2012, West Nile was responsible for 5,674 illnesses and 286 deaths. The previous year, 24,364 people were infected with Lyme disease, which is carried by ticks.

Insect repellent is certainly a good way to ward off disease-carrying critters (if you’re concerned about what chemicals are in bug sprays, we have a visual explainer here), but there are some things you may be doing wrong that could minimize its efficacy.

Read more about the Huffington Post article’s on bug spray here.