What Side Effects?

"We contend that the [U.S.] Food and Drug Administration [FDA] -- in regulating direct-to-consumer advertisements to list side effects that range from the serious, such as stroke and thoughts of suicide, to those less serious, such as dry mouth and headache -- have diluted consumers' judgements of the overall severity of the drugs' side effects."
Researchers, new DTC study

"For professional advertisers, the idea that long disclosures will work is ridiculous."
"Good advertising has short, simple messages that people can understand and act on. These long messages we've seen in DTC [direct-to-consumer] is a broken regulation that needs to be fixed quickly."
John Kamp, head, Coalition for Healthcare Communication

"All drugs, whether prescription or over-the-counter, can have side effects. Side effects can range from headaches and upset stomach to those more serious such as liver or kidney injury, heart problems, or even death. Some side effects can be predicted in some people based on what occurred during the drug’s testing, but some rare events occur unexpectedly when many more people take the drug after it is approved."
U.S. Food & Drug Administration

Well-intentioned it may have been for the U.S. FDA to require the pharmaceutical industry to list all the potential side-effects that might be encountered as a by-product of a particular drug's use, but it seems that unintentionally their inclusion in television advertising might have a lulling effect in the minds of viewers. Too much detail, too much content may lead the potential consumer to the belief that divulging all in this manner provides some kind of assurance that there is nothing to be concerned about.

In other countries such as Canada, DTC advertising is not permissible by law, although the law is rarely enforced through Health Canada. Still, if prescription products are advertised they are done so in a manner that fails to link the drugs with the cause of their use, as a means of getting around the prohibition. DTC advertising in Canada is a muted affair, barely noticeable, in comparison to the loud and garish prominence of DTC pharmaceutical advertising commonly seen in the United States.

The FDA doubtless felt it was aiding the consuming public in requiring pharmaceutical companies to list all possible side-effects of drugs. Their purpose was to alert consumers to all and any potential risks in drug use. Unfortunately, it seems people have no wish to be alerted. Research has indicated that people have a tendency to pay little attention to the most serious side effects and instead they focus on the purported benefits of the drug, a newly-published study points out.

Researchers must have felt incredulous at their own results; instead of creating a cautionary atmosphere with the revelations of possible side-effects in drug use, the drugs have become a more marketable commodity, with increased sales resulting from the situation, according to researchers whose study was published in Nature Human Behaviour. Six experiments were operated by the researchers with over 3,000 participants in the United States.

The purpose of the study was to test whether the provision of this information highlighting major and minor side effects reached its purpose to increase awareness; instead it was found to reduce overall perception of the severity of side effects. The United States represents one of two countries permitting this type of prescription drugs promotion [along with New Zealand]. Critics point out that all too often advertisements promote new, higher-priced medicines, encouraging consumers to seek unecessary prescriptions.

The American Medical Association unsuccessfully campaigned to ban direct-to-consumer advertising two years ago. Three years ago the FDA launched a study of its own in hopes of determining whether the long list of potential risks could lower consumer understanding, minimize important risk data, and cause some people to potentially skip medicines, fearing side effects. The pharmaceutical industry had its own concerns over advertising requirements feeling consumers could react unfavourably to drugs listing side effects.

They now doubtless feel relief that the new research posits that some consumers may tune out these warnings in large part. Whatever the Food and Drug Inspection Agency determined from its own study has not been released to the public, however.

"If FDA is keen that all side effects are listed, especially if certain ones impact a subsample of the population, then one route is to categorize the seriousness of these side effects by increasing the attention people afford to those side effects, such as 'heart attack and stroke' versus side effects such as 'headache and nausea'."
"We show that simply highlighting and providing larger red font to the more serious side effects, while keeping to normal black font to the less severe side effects, helps mitigate the problem."
Niro Sivanathan, lead author, associate professor of organizational behavior, London Business School

Required listing of drug side effects may be backfiring on FDA  -- The Boston Globe

Gender Variables in Sports Concussions

"There are several possible explanations [respecting why girls take longer than boys to recover from concussions]."
"Boys have a greater neck musculature than females. So, during the mechanism of injury that causes the concussion, girls' necks and heads may whiplash more than boys'. The greater these accelerations and decelerations [especially the rotational aspect], the greater the strain on the brain."
Dr. Roger Zemek, concussion specialist, Children's Hospital of Eastern Ontario, Ottawa

"In the twelve years I've been doing this [studying and treating concussions in children], you do see a bit of that bravado [typical of boys' behaviour], girls saying they can play through a concussion and not report the symptoms."
Dr. Kristian Goulet, concussion specialist, Children's Hospital of Eastern Ontario

"We have known for at least the last decade that females who participate in similar sports as males have higher rates of concussion."

"Boys and girls likely have different recovery courses, but we have to treat each concussion individually."

"Adult coaches need to create an environment and culture for their players that stresses that a concussion is an important injury to not downplay and encourage the reporting of symptoms."

Dr. Mark Halstead, director of the Sports Concussion Clinic at St. Louis Children’s Hospital

Credit: Image Source Getty Images

"More females had preexisting migraines and mental illness which may be very important and more so than inherent biological differences."

"Larger studies that specifically examine sex biology are needed to understand the effect of sex on recovery trajectory after concussion."

Dr. Monica Vavilala, director, Harborview Injury Prevention and Research Center (HIPRC), University of Washington, Seattle

"First and foremost, the current findings highlight the importance of seeking proper care following a concussion."

"There are a lot of treatment interventions from behavioral management to vestibular and vision therapy that help athletes recover from concussions. "
"However, a large number - estimates are as high as 55 to 60 percent - of young athletes with concussions do not receive clinical care beyond the initial diagnosis."

Anthony Kontos, research director, Sports Medicine Concussion Program, University of Pittsburgh 

Photo: Consumer Reports

A study was published in the Journal of the American Medical Association (JAMA) in 2016 of which Dr. Zemek was the lead researcher. This was a comprehensive bit of research where over three thousand children, both boys and girls between the ages of five and 18 were part of the study, although over 8,000 children had been screened to gather data from five centres. Girls were involved in close to half of the concussions studied. The study concluded that girls and boys experience concussion rates matching the sport involved.

Other studies predating this one were cited along with the data gleaned for this study, all concluding that girls are at a much higher risk in lengthier recovery time than are boys. They are consequently more susceptible to post-concussion syndrome that takes a longer period of time to surmount. Basically it is a matter of anatomical and physiological differences between the genders, although it was also postulated by Dr. Zemek and other researchers as well, that hormone-specific differences could also factor into the duration and intensity of concussions.

Historically, however, females are also recognized as being more open about symptoms of physical harm and stress, reporting when physical contact of a violent nature has resulted in injury. Boys, on the other hand, tend to downplay injury, unwilling to appear to their peers as unable to take a knock. That kind of reaction and suppression of injury is also typical of the masculine character, the stiff upper lip to prove you're a 'man', and can 'take it'. Things are changing, however, in the world of sports with the growing awareness of the serious harm done by suffering concussions.

Data out of a 2015 study published in the British Journal of Sports Medicine pointed out higher rates of concussions for females playing soccer, and alternately, higher concussion rates for males in lacrosse and basketball. Scientific American earlier in the month highlighted a report revolving around a study of over 200 boys and girls in middle and high school in the U.S. The 110 boys and 102 girls had suffered their first concussions playing football, field hockey and wrestling.

The average recovery time from concussions for the boys in the study turned out to be eleven days, while the girls required 28 days for recovery. At a presentation for a symposium by the Concussion Legacy Foundation and the University of Ottawa brain and mind research institute, Dr. Zemek spoke of a prototypical case of concussion where he presented a hypothetical 14-year-old girl in a soccer collision who recalls what had occurred, didn't lose consciousness and didn't suffer amnesia.

"She was unsteady on her feet when evaluated. She was slow to answer questions. She has a headache, and feels foggy", he went on of the imaginary girl's first bout with a concussion with a background of never having suffered migraine headaches. The purpose of the example was to emphasize that what might at first reckoning appear to be a low-risk situation -- no concussion history, no loss of consciousness -- might in fact reflect someone at high risk for lingering concussion symptoms.

About one thousand concussion cases are seen and treated annually at the Children's Hospital of Eastern Ontario, a number that has quadrupled over the past ten years, as a result of increased public awareness of the prevalence and danger of concussions, all the more so if they're simply dismissed out of hand. From 2011 forward the number of reported instances of concussion doubled in the following year. And according to Dr. Zemek, one in five Canadians have had, or will suffer a concussive event.

"It wasn't necessarily a change in diagnosis, or a change in how we code it when we present to the emergency department. It was because of a high profile person -- and I think most of us in Canada know who that is [Sidney Crosby], and he missed the playoffs that year because of a concussion. The silver lining? His injury impacted awareness", concluded Dr. Zemek.

Entrepreneurial Vulnerabilities

"We all know that the tech profession tears you away from family far too much."
Chris Albinson, managing director, Panorama Capital

"The majority of the time, patients with bipolar disorder will be in  he depressive phase, not the manic."
"We also look for evidence of atypical behaviour [in diagnosing the condition]."
"A true bipolar condition affects patients' ability to function well on the job."
"I would also look for changes in moods that occur in distinct phases during the year, not a day-to-day thing."
Dr. Sanjay Aro, psychiatrist, clinical leader in cognitive behavioural therapy, The Royal Ottawa

  ‘What began as a journey for work-life balance has descended into the rat race most were aiming to avoid.’ Photograph: Maximilian Weinzierl/Alamy

It's fairly well accepted that people who work in IT are very often more reclusive temperamentally, inclined to introversion as a personal characteristic, though obviously not everyone falls into that type of category, just as not everyone who becomes a leader in innovative IT technology will end up in a struggle with psychological imbalance in their lives, through an innate propensity brought closer to the surface by the very stressors that they must surmount in their efforts to succeed in a crowded field of other like entrepreneurs, all anxious to become the next big success story through the genius of their vision and accomplishments.

Sheer dogged devotion to interpreting a problem in a way others fail to recognize, and adapting one's technical abilities to introduce new concepts advancing technology to bring the world of the Internet and Artificial Intelligence to a new gradient in its steeply rising capabilities takes exhaustive effort and a firm belief in one's own capacity to visualize and develop solutions evading others. That firm belief leads to a sense of inner invincibility, a requirement for success. These are entrepreneurs whose case studies of success in their field set them apart and above their colleagues.

Perhaps it shouldn't be surprising that according to a psychiatrist working out of the University of California San Francisco School of Medicine, one in two entrepreneurs in IT reflect a lifetime of coping with at least one mental health condition. But that's not all that Dr. Michael Freeman, in his study -- Are Entrepreneurs Touched with Fire -- concludes. His survey of 242 entrepreneurs alongside 93 non-entrepreneurs of similar age revealed that 32 percent struggle with multiple mental health conditions.

Of those surveyed, 30 percent of the entrepreneurs under survey had their experiences with depression, while half that number, 15 percent of the control group, had similar experiences with depression. Moreover, 11 percent of the entrepreneurs reported bipolar disorder, while only one percent of the non-entrepreneurs allowed to having bipolar disorder. So are people who become entrepreneurs inclined through predisposition to mental disorders, or is exposure to the high-tech industry responsible for leading them toward mental illness?

One-time Intel chief executive Andy Grove touched on this issue when he wrote his opinion that in the industry of high-tech "only the paranoid survive", the rigours and expectations, disappointments and mental stresses that come with the territory. It takes a special kind of self-confidence in one's ability and foresight and capability to produce that essential break-through to ensure that a startup succeeds -- where so many fail and are soon forgotten, falling by the wayside. Alternately, struggle to exist among competitors doing the same, while a minuscule number make the grade and the big time.

The very pressures creating psychic highs and lows are dramatic and veer between being emotionally fulfilling when they succeed -- and devastating when failure occurs. When equity investment becomes a reality alongside recognition and the influx of orders, it's stimulating and supreme validation. But when deals fall through and orders begin to dry up spelling the inexorability of oblivion, the low that's felt is as mind-boggling in the wrong direction as its opposite of exaltation.

All of these signals and manifestations taking place in the human brain, an instrument of unimaginable power yet also when the wrong/right conditions are present, a delicate instrument whose equilibrium can fail catastrophically, compromise normalcy.

"Most people in startups feel they have nowhere to turn and nobody to talk to, they feel isolated. Even with all the love in the world, their close friends and family “just don’t get it” and struggle to understand their motivations. They often bottle up their mental battles and the pressure can lead to stress, anxiety and depression."
"Startups can be a lonely place, where guidance is rare. New entrepreneurs present a brave face; a reticence towards staff, investors and customers hides any mental torment and projects an air of certainty, an aura that they have it all worked out. Despite the inherent vulnerability in most young companies, it’s rare to see their true colours, we mainly see a poker face."
"Particularly in technology, the spirit of entrepreneurship is fast becoming one of toil, long hours and self-sacrifice. Angel investors, accelerators and venture capitalists (VCs) encourage startups to work harder, move faster and, in some cases, 'sleep faster'. The yardstick has seemingly become hours worked, who can leave the office the latest. What began as a journey for work-life balance has descended into the rat race most were aiming to avoid"
James Rutledge, The Guardian

A Man's Honour and Dignity in Portugal

"These references are merely intended to emphasize that society has always strongly condemned adultery by a woman and therefore sees the violence by a betrayed, vexed and humiliated man with some understanding."
"Now, adultery by a woman is a very serious attack on a man's honour and dignity. Societies exist where the adulterous woman is stoned to death."
"In the Bible, we can read that the adulterous woman should be punished with death."
Judges Neto de Moura and Maria Luisa Abrantes, Portugal

"[No one should] justify any kind of violence, in this case domestic violence, even in the case of adultery."
Rev. Manuel Barbosa, secretary, Portuguese Episcopal Conference

"[The verdict was] 'perplexing', 'revolting' [and violated the rights, freedoms and] dignity [of the woman]."
"Evoking the Bible does not combine with the rule of law in our country and discredits the judicial norms. [The decision could lead to] serious consequences [for Portuguese society, particularly for women]."
"It also conveys a message, especially to younger generations, of total impunity."
Women’s Union for Alternative and Response (UMAR), Portugal

"Is this an isolated case in the Portuguese courts?. Perhaps not, because sentences with discriminatory and abusive references arise sporadically."
"Even when she is a victim of aggression, harassment or sexual abuse, she [the woman] is often considered the cause of the crime. Either because she dresses provocatively, or because she fails in her role as a dedicated wife, or because she acts with ‘sexual disloyalty and immorality'."
"We know that there is much to be done to combat marital violence and gender inequality. But the courts, like the other organs of sovereignty, exist to promote justice and equality. Not to validate prejudice and discrimination."
Inês Cardoso, deputy director, Portuguese news outlet

The Bible: license for domestic violence in Portugal? (Pixabay)

An antiquated patriarchy, right out of the stone age of women as chattel, with no rights as a human being to free agency, whether or not she acts in a societally-approved manner or not, has condemned a Portuguese woman to accept the viciously violent acts perpetrated upon her by two men; one her former  husband, the second her former lover, each man outraged that the woman 'betrayed' them each singly and in so doing besmirched the honour of men collectively.

It is one thing for men to dally with women outside the marriage covenant; in so doing he would merely be exercising a male prerogative not to be tied down to matrimonial bonds inconveniencing his right as a male to sow his seed in fields other than those he legally farms. Men may act with impunity and still have the right of expectation that a woman they believe they own through marriage would never dare stray from the matrimonial bed.

One woman did, briefly having an affair with a man other than her husband. She had second thoughts about the affair however, and for reasons known only to herself decided that her dalliance of two months was time enough wasted, conveying to her lover that as far as she was concerned it was over. The man, infuriated at the woman's decision, informed her husband that his wife had cuckolded him, leading to a divorce.

The woman was free from the stranglehold that both men felt they should have over her independence, but the men conspired to teach the insolent woman that she would pay a grievous penalty for dishonouring her marriage vows to one, and abandoning her relationship with the other, when anyone in their right mind should be aware that it is the man who is allowed to stray and it is the man who decides when a relationship should be ended.

The woman was kidnapped by her former lover who held her immobile while her former husband viciously beat her with a nail-spiked club. Her entire body was thoroughly slashed in the process, with ample bruises to show for the assault, a process that gave balm to the honour-deprived men with the tender and outraged sensibilities. A brutal attack on a defenceless woman by two men whose sense of proprietary rights had been offended.

In the ensuing trial the former husband was given a suspended sentence of 15 months and a fine of $2,000, though a prosecutor felt he was deserving of a more appropriate punishment, asking an appeals court in Porto, Portugal for a prison sentence of three years and six months. The appeals judges would have none of it; they commiserated with the husband's "depressive state" caused by his wife's betrayal.

Citing a 1886 criminal law calling for a symbolic penalty against a husband who killed his adulterous wife, the two justices decided they completely understood the trauma caused to the husband by the wife's infidelity, that she deserved the punishment the two men meted out to her. Upholding the casual suspended sentence despite the nature of the assault, women's rights activists, legal experts and religious authorities all were unanimous in condemning the situation justifying domestic violence.

Court Rules Bible Justifies Domestic Abuse After Man Beats Ex-Wife (Image via Pixabay

Parkinson's Research

"We haven't fixed anything for many years for Parkinson's, so you have to be totally open to accepting that you are wrong with whatever ideas you push."
"If the theory is correct, it would mean Parkinson's could be triggered by an infection decades before motor symptoms actually develop."
"This [infection theory] would allow us to predict who may develop Parkinson's in later years. It would also provide hope for new treatments for this still incurable disease."
"[Progress will be made] because people are more willing to look at alternative hypotheses and test them."
"All you have to do is crack the door open and show something can be done that people thought couldn't be done."
Dr. Michael Schlossmacher, neurologist, senior researcher, Ottawa Hospital Research Institute

OttawaMedicine.ca

Dr. Schlossmacher, a professor of cellular and molecular medicine at the University of Ottawa, has fashioned his medical career as a pioneering researcher by viewing problems waiting to be solved through not relying on hypotheses and theories that have proven disappointing, but rather by making a concerted effort to approach seemingly intractable problems from an angle no one else has thought to take. His focus is angled toward improved treatment, or better yet, a cure for Parkinson's disease.

Because his experience led him to reject widely accepted beliefs as medical orthodoxy, he paved a way to thinking beyond them and pioneered another theory altogether, that Parkinson's disease could have its trigger through an infection that occurred decades earlier, only resulting in symptoms related to Parkinson's many years on. Some 110,000 Canadians are affected by Parkinson's, and his goal is to find the path toward a better treatment regimen, and ultimately discover a cure.

There is, at present, no cure on the near horizon for this chronic, progressive movement disorder. As for treatment to try to improve the quality of life for those diagnosed with Parkinson's, it has remained inflexibly constant. Dr. Schlossmacher compares the progress in understanding Parkinson's to the situation of Alzheimer's disease, which he explains is at least a decade further ahead than what pertains with Parkinson's.

The research currently underway that links Parkinson's to earlier-in-life exposure to infections is nowhere near as advanced as the understanding in Alzheimer's that it is caused by plaques and tangles in the brain, enabling researchers to focus on the development of effective treatments, based on this predominant theory generally accepted in medical research circles. But Dr. Schlossmacher and a colleague, Dr. Julianna Tomlinson are moving research forward.

Loss of the sense of smell, along with chronic constipation are held to be associated as symptoms of Parkinson's, linking to the infection theory which holds that some infections in the gut and the nose may be the cause of the immune system malfunctioning, where inflammation in the brain and allied damage of critical nerve cells results in Parkinson's disease.

Dr. Schlossmacher cites the researcher from Perth Australia, who went on to be awarded the Nobel prize in medicine for proving that peptic ulcers is caused by bacteria, and thus curable with antibiotics. Nobel laureate Barry Marshall was so convinced of his theory he ingested a petri dish of H.pylori, causing the growth of an ulcer, which he then cured with antibiotics, convincing skeptics that his theory was in the event, fact.

Ten Symptoms:

1. Tremors
2. Small handwriting
3. Loss of Smell
4. Trouble sleeping
5. Trouble moving or walking
6. Constipation
7. Soft or low voice
8. Face masking (troubled appearance)
9. Dizziness or fainting
10. Stooped or hunched over

Parkinson's Foundation

Mysterious Stigmata

"There was no obvious trigger for the bleeding, which could occur while she was asleep and during times of physical activity."
"During admission, we observed the discharge of blood-stained fluid from her face."
"[The diagnosis was hematohidrosis causing] spontaneous discharge of 'blood sweat'."
University of Florence researchers, Italy

"[Hematohidrosis was defined as] the occasional spontaneous oozing of arterial blood from the sweat glands [in 1895, by Hungarian dermatologist Mortiz Kaposi]."
"[Very few dermatologists have seen a case, absent from standard hematology textbooks] although two had witnessed bloody tears."
"After all the research that I've done, I am convinced of the plausibility and the possibility that it exists .... case reports start appearing in the 16th century, and quite distinct from anything to do with the crucifixion, or Christianity."
"There are mentions of the phenomenon as far back as Aristotle ... prior to the time of Jesus."
"Almost half the total output [case reports] from more than a century came in the last five years [published articles from 1880 to 2017]."
"The very fact that there are sporadic references to the phenomenon through time, scattered in many different places, tends to suggest to me that it must occur."
"A significant proportion of all the actual cases I could find have emerged in recent decades." 
Dr. Jacalyn Duffin, hematologist/medical historian, Queen's University, Kingston, Ontario

In an article published Monday in the Canadian Medical Association Journal, doctors in Florence, Italy, describe the case of a young woman with a history of spontaneous bleeding from her palms and face. (CMAJ)

Exceedingly rare, but noted on occasion throughout history, mentioned in the third century B.C. by the Greek philosopher Aristotle, who wrote of sweat which] either looked like, or really was, blood", the latest issue of the Canadian Medical Association Journal published a report of Italian doctors who examined a 21-year-old woman who for three years suffered spontaneous, 'self-limited' episodes of bleeding from her palms and her face, though her skin was perfectly normal.

When the bleeding manifested itself, each episode took place between one to five minutes of time, becoming more intense in nature when the young woman was under emotional stress. Frightened and embarrassed by the bleeding phenomenon she was undergoing she became depressed and anxious, and loathe to appear in public. When she was examined by researchers from the University of Florence they could detect nothing awry with her skin.

She had no cuts, no bruises, and a disorder of the sweat glands which was familiarly known to be the cause of "coloured sweat", chromhidrosis, was ruled out, leading doctors to diagnose a rare phenomenon called hematohidrosis. This is a mysterious presentation, with no known cause. Some have hypothesized that the capillary blood vessels rupture, which function to feed the sweat glands "causing them to exude blood" when conditions of extreme physical or emotional stress are present.

In 2009, a medical research team published a report in the Indian Journal of Dermatology where they stated that "Acute fear and intense mental contemplation are the most frequent causes [of the bleeding]." In their report they cite a handful of instances of prisoners about to be executed, exhibiting those very symptoms. Professor Duffin of Queen's University searched medical literature to discover the publication of 42 related articles dating from 1880 to 2017.

There were 28 new cases appearing in peer-reviewed journals representing close to half of the reports she had investigated, and they appeared between the years 2004 to 2017. In each of those new cases reported upon, tests that were conducted affirmed the presence of blood appearing through the skin of the people involved. In one of the early reports, a Swiss doctor reported a 12-year-old boy with a high fever sweated blood, in 1627.

Doctors could find no obvious trigger for the bleeding, and said tests showed the 21-year-old patient had normal blood count and blood-clotting functions. (CMAJ)

Tests conducted on the young woman mentioned in the report out of University of Florence revealed her blood count and blood-clotting functions to be  completely normal, leading the examining researchers to rule out "factitious disorder"; which is to say faking a syndrome of sweat-bleeding. Yet not everyone is convinced that the phenomenon is feasible and has occurred as reported, attributing a more medically acceptable cause to the episodes.

"I can say with clarity that I've never seen a case like this — ever."
"And I can say that I've seen some of the worst bleeding disorders, and I've never seen them sweat blood."
"I think this person has a very bizarre anatomical defect on a microscopic level that is resulting in this very unusual symptom."
Dr. Michelle Sholzberg, co-director, Hemophilia Comprehensive Care program, St. Michael's Hospital, Toronto

According to this medical specialist, the observed abnormality could conceivably originate in a dysfunction of the sweat ducts themselves.

Running Biomedical Trials, Saving Lives

"I was curious."
"This may sound odd, but as a medical student, it's quite interesting to go through the process of being very ill [as a result of taking part in an emerging therapy medical experiment]."
"It does help to create empathy for your [future] patients."
James M. Duggan, medical student, Oxford University

"These are great results."
"And challenge tests are a great way to short-circuit the process of proving it [this type of research] works."
"If we'd done this in the field, we would have had to follow children for three or four years."
Dr. Anita Zaidi, director of diarrheal diseases, Bill & Melinda Gates Foundation

"[I felt] happy to be doing something that could help millions of poor people who haven't got antibiotics."
"[During the worst part of the trial] you feel sorry for yourself and you say 'I;m never doing that again'."
"And then it's like childbirth -- you get amnesia, and you do it again. I've just signed up for a second trial."
Faye Frances, 42, psychiatric nurse

The student, pictured, says although she may come across as being 'unfazed' by the studies, she feels safe with knowledgeable staff who explain everything thoroughly beforehand / Siân Rogers via The Tab

Typhoid was deadly when it became an unstoppable epidemic in various points of human history relating to the aftermath of natural catastrophes, of wars and of famines, reflecting the time in human history and medicine before antibiotics came on the scene. Invariably during times of great social upheaval, poor sanitation and lack of adequate hygiene results, leading to opportunistic lice carrying the disease, typical of times of social chaos and upheaval.

The bacteria leading to the onset of typhus can remain dormant for years before affecting people and in that stage it is also transmissible to others. Before the advent of antibiotics, which now in use swiftly aids the body to recover from the disease, it is likely that the woman named 'Typhoid Mary', who was a cook in houses of the aristocracy and who also worked in a New York maternity hospital was able to infect people in the years 1900 to 1915, but was never herself ill.

Recently 100 residents of Oxford in England agreed to take part in a trial of a new vaccine for typhoid which can spread in food and water and kills close to 200,000 people annually, many of them African, Asian and Latin American young children. Those who survive may end up with perforated intestines, heart problems and/or other life-complications.

As it happened, the vaccine turned out to be successful, at 87 percent effectiveness, as the only vaccine that is also safe for use with infants. It is already being manufactured inexpensively and is in wide use in India. The trial was run by the Oxford Vaccine Group under the funding auspices of the Bill & Melinda Gates Foundation. There is hope that the vaccine will be endorsed shortly by the World Health Organization.

Salmonella Typhi bacterium (Sanofl Pasteur via Flickr creative commons)

Subjects who had agreed to be part of the trial, were given an experimental vaccine, after which they were deliberately infected with the pathogen to determine whether the vaccine succeeded in protecting them from the disease. This kind of trial can only be undertaken with illnesses such as cholera or malaria that respond rapidly to antibiotics, curing the individual in short order. Even so, those who agreed to participate were informed they would experience being miserably ill with typhoid fever for several days while the antibiotics established their curative function.

This being so, it is interesting that people would decide to take part in the trials, prepared to feel very unpleasant for a short duration while the vaccine performed its mission. Some people were very ill with high fevers, joint pains and headaches. These symptoms which tests clarified were those of typhoid led to the immediate application of antibiotics.

Just as the subjects themselves all reacted in various ways, presenting with a number of symptoms and combinations of symptoms, their reasons for participation varied, as well. Some were simply curious, others wanted to feel they had given of themselves for a good cause, and others yet were motivated by the money they would earn, about $4,000 in cash.

"This new vaccine could be a real game changer in tackling a disease that disproportionately affects both poor people and children."
"For the first time, we will be able to offer protection to children under two years of age, which will enable us to stem the tide of the disease in the countries where it claims the most lives."
"If we are going to make serious headway in tackling typhoid, we need to dramatically reduce the number of people suffering from and carrying the disease globally, which will in turn lead to fewer people being at risk of encountering the infection."
"This is a disease that only affects humans, and I believe that it will be possible for us to eradicate [it] one day. However, we’re currently losing ground as overuse of antibiotics is leading to the emergence of new resistant strains, which are spreading rapidly."
Professor Andrew Pollard, professor of Paediatric Infection and Immunity, University of Oxford -- Director of the Oxford Vaccine Group

Avoiding Islamophobia

"We're still waiting for a march against honour killings, child marriages, polygamy, sex slavery or female genital mutilation."
Ayaan Hirsi Ali and Asra Q. Nomania (Muslim Reform Movement)

"If one finds white male sexism intolerable, then one should find all male sexism just as intolerable. Excusing men of colour, Muslims, immigrants or men living in non-Western societies for bad behaviour toward women is an expression of the bigotry of low expectations."
"The result of this mindset is that Christianity is criticized for every misstep against women but Islam is protected from the glare of scrutiny."
Ayaan Hirsi Ali, ex-Muslim Somalian, writer, activist

"What I describe as a 'faux feminism' has arisen in the last 30 years, a postmodern and post-colonial feminism that passionately condemns Christianity and Judaism but dares not critique religiously supremacist Islam for this same reason."
"[Today's Western feminists] are too nervous about being called Islamophobes, racists or colonialists] to dedicate themselves to rescue of victims of rape from Islamic communities]."
"In recent years, I fear that the 'peace and love' crowd in the West has refused to understand how Islamism endangers Western values and lives, beginning with our commitment to women's rights and human rights. The Islamists who are beheading civilians, stoning Muslim women to death, jailing Muslim dissidents, and bombing civilians on every continent are now moving among us both in the East and in the West. While some feminist leaders and groups have come to publicize the atrocities against women in the Islamic world, they have not tied it to any feminist foreign policy. Women's studies programs should have been the first to sound the alarm. They do not. More than four decades after I was a virtual prisoner in Afghanistan, I realize how far the Western feminist movement has to go."
Phyllis Chesler, American feminist

Women wearing the Chador. Getty Images

The campaign by women fed up with their secondary, unentitled place in society engaged in a protracted campaign to shame society with the understanding that in institutionalizing a social contract that diminished the stature and the intelligence and opportunities of women, not only were women and their children suffering great harm, but society itself, like those it targeted, would never reach its full aspirational potential. Equal-pay legislation, marital rights, equal access to education, opening up politics and the professions to women has enabled Western societies to move forward and grow.

All of which have been a tremendous benefit to the societies which finally accepted equality for both genders in every aspect of social, political, and working life. Yet, since those victories were established, with feminists forever cautious that nothing occur to set back the advances that took so many years to accomplish, it is women in the West who have benefited, not women universally. There were overtures to some societies to improve the lives of women virtually held in bondage to patriarchal societies who were condemned for the strictures they placed on women's lives.

But the issue of women living under Shariah law in Islamic countries where it is traditional and a vital part of the culture to assert female inferiority to the place of men has been consistently and deliberately overlooked. Women who ascribe great value in the feminist ideal and the men who support them have hesitated to criticize those cultural practices that dominate and repress women. Ayaan Hirsi Ali, a fierce critic of Islam and Asra Q. Nomania, co-founder of the Muslim Reform Movement recently called upon western feminists to re-adjust their focus.

Noting the women's march across the United States decrying the ascension of a crude sex predator to the presidency of the United States, they declared their dissatisfaction, yet while bringing attention to a man whose exploits as a braggart and a bully has brought infamy to the office of the president, pay no attention whatever to the plight of women and girls living in Islamic societies, both abroad and within Western countries where the cultural and religious traditions that have kept women as disadvantage chattels were brought as baggage to be practised in the West.

Feminists, so swift to denounce Western men for not recognizing women as equals and respecting them for the same traits and capabilities that men gain respect for, have chosen to overlook the attitudes and behaviours of Muslim men. Are they regarded as underdogs and therefore to be pitied should they be deprived of "their last source of pride: their domination over their women"? For this is what Islam views as a man's 'honour', that complete control of a woman be exerted. Any Muslim woman's father, brother, uncle, husband, son or brother-in-law has explicit control over her, dominating her life as seen fit lest family honour be shamed.



Phyllis Chesler's feminism dates back to the 1960s and 70s, when she campaigned with the National Organization for Women and allied organizations with the understanding that they were meant to support women everywhere. That has changed. In lock-step with the emergence of Islam as a factor and a growing one by leaps and bounds in the world of the West thanks to rampant immigration and migration. Now, Western societies are aware of child marriages, of female genital mutilation, of social forces that ghettoize Muslim women, of honour killings taking place within Muslim communities.

The heart of Islam beats hard for the misogyny they feel is the correct social order of relations between the sexes; women are not to be trusted, and must be firmly held in place under the heavy fist of a man, and if she requires physical punishment to emphasize her obligations, that is readily arranged. At one time feminists organized rape-crisis counselling centres and helped to bring in new rape laws; even in India which has a long tradition of violence against women has brought in new rape laws though violence has scarcely abated, so engrained is it in the culture of male entitlement.

Now, Phyllis Chesler hopes to influence feminists of their moral duty to advance human rights to aid girls and women "who are being beaten, stalked and threatened with death by their own families because they refuse to veil or to marry their first cousin". She feels there is an obligation to erect shelters as havens from honour-based violence, all the cultural 'norms' of Islamic society imported with immigration to the West. To each thing there is a season and a time for everything....

Muslim women in Amsterdam, wearing different styles of veils

Politically Correct : Chiefly in Magnitudes of Utter Stupidity

A plan has been put forward to have the York Region District School Board remove this totem pole from in front of Summitview Public School in Whitchurch-Stouffville. The totem has stood there since 1974. - Mike Barrett/Metroland

"While initially constructed with positive intentions, our understanding of how cultural appropriation affects our leaning environments has developed significantly."
"The totem pole was created without consultation or involvement of members of Indigenous Nations, including members of the Indigenous Nations of the West Coast for which the totem pole is unique."
York Region District School Board

"At that time, there was less awareness to what appropriation was."
"The First Nation felt it was probably not done with any ill-intent. That's why we're not jumping up and down with our arms in the air."
"Everybody's just trying to do the right thing here."
Lauri Hoeg, Chippewas of Georgina Island, Band councillor

"Listen, I think we've engaged in some significant learning since the totem pole went up."
"The one big thing for me is around the spaces that we're creating in our schools."
"We're looking to engage in some learning, as a starting point."
Drew McNaughton, Summitview Public School Superintendent, Stouffville, Ontario

"It may not have originated as an Indigenous word, but the fact is that it [the word "chief"] is used as a slur in some cases, or in a negative way to describe Indigenous people."
"With that in mind, as it has become a slur in some cases, that's the decision the administration has made to be proactive on that [to henceforth disallow the use of the word chief in any context]."
Ryan Bird, spokesman, Toronto District School Board

"If that usage is going to genuinely hurt a group of people, then I would say yes, by all means, let's see if we can find an alternative."
"On the other hand, the word originated outside of the context of First Nations cultures ... and the First Nations associations that it has, I don't think are negative."
Mark Morton, University of Waterloo's Centre for Teaching Excellence

We are canting at a galloping pace toward the very last gap in touchy-feelly empathy and rejection of anything that might possibly be construed as cultural appropriation -- heaven forfend -- or (gasp!) perceptions of bigoted expressions aimed at Indigenous people or their culture. An elementary school in Ontario has decided in a righteous fit of sanctimony that a totem pole erected decades ago as an exercise in children understanding and respecting historical culture, was to be summarily removed from its place adjacent the school's front entrance.

In 1973 former teacher Bernadine Mumford began a project as part of a focus on Canadian history, in the process enthusing her grade 6 students and the project was begun, everyone happily contributing to the carving and erection of a distinct and complimentary facsimile of a traditional West Coast totem pole, in sympathetic recognition of the "great harm" done in the past to Indigenous peoples. "It bothered me that there was an implication it was racist", she latterly said, to a local newspaper.

However, the spectral reality of victimhood, real or perceived, raised its accusing head. She was informed that a complaint had been broached to the school board about the structure, that the York Region District School Board identified as "community-based concerns"; one individual lodging an impassioned complaint to demonstrate her/his commitment to upholding the human rights and dignity of First Nations by taking the initiative to demand the removal of a disrespectful object mocking tradition is all it would take.

People in positions of authority have raised their antennae over such complaints of purported racism and no one wants to defend themselves by pleading not guilty and in so doing proving to the skeptical ultra-sensitive that no harm was intended, rather a project was meant to convey empathy and recognition of past wrongs. The merest whiff of controversy serves to light a firecracker under the seat of anyone held to be publicly accountable, and they move with righteous indignation blazing firmly in their culpable breasts.

When the board consulted with representatives from the Chippewas of Georgina Island, a local First Nation, though the totem pole does not reflect their own traditions, the Chippewas gravely agreed: the totem pole must be removed as an affront to First Nation dignity. In the matter of removing the offensive word "chief" from usage in any context whatever to assuage the perception that it is a word recognized as an epithet-arrow aimed at aboriginal hearts, there is nothing to discuss; the deed is done.

What is most harrowing about all of this is the simple fact that these intellectual simpletons have the last word on the kind of education Canadian children are exposed to, manipulating and avoiding any measure of discomfort through controversy that might be experienced when totally absurd notions arise implicating normal interactions of language and intention for fear that something, somewhere will be certain to offend someone at some time.

This letter was sent home to parents of students at Summit View Public School in Whitchurch-Stouffville Sept. 29. - YRDSB letter

Be Advised :  Rough Road Ahead

"It will be essential for those tasked with [educating youth about Cannabinoid Hyperemesis Syndrome -- CHS] this massive undertaking to figure out what to say by engaging stakeholders, including the Canadian Association of Emergency Physicians, in order to shed some light on CHS."
"We need to find out how to say it and who should say it so youth will listen."
"And, this all needs to be done starting now; we are on a tight time frame, after all. July 1 [2018, when Marijuana possession becomes lawful in Canada] is coming up fast, and we aren't ready."
Dr. Jessica Ross, emergency physician, Ontario

In this Feb. 17, 2016 photo, plants grow at the home of Jeremy Nickle, in his backyard in Honolulu, Hawaii. (AP / Marina Riker)

Abdominal pain, nausea and intractable vomiting resulting from chronic, regular cannabis use is a condition with a name: Cannabinoid Hypermesis Syndrome. Some doctors are familiar with the symptoms to enable them to make an accurate diagnosis and proceed with appropriate treatment, which of necessity includes persuading teens that it is not in their best interests to smoke pot. And some physicians have never heard of CHS, much less are knowledgeable about its symptoms; ergo, no diagnosis will be made in identifying an ill teen accompanied by a worried parent.

Dr. Ross, on the other hand -- in her capacity as an emergency physician, once she had ascertained that the very sick young man who had been admitted to her hospital in the company of his frantic mother had no fever, no diarrhea, and hadn't recently been on a trip to the tropics -- was able to identify the symptoms and link it to the cause. Her questioning of the 14-year-old boy and his mother elicited few clues, but the light slowly began to dawn when Dr. Ross suggested that the boy's mother briefly withdraw. And then it was that the boy admitted that he is a casual imbiber of alcohol and a daily pot smoker.

At the ripe old age of 14, the tow-haired boy said he was actually a veteran pot user, had been smoking it daily for a full two years. Making Dr. Ross quite confident in diagnosing his symptoms. She ran a few tests and then informed her patient and his mother that his vomiting was a result "of all the pot you've been smoking". Dr. Ross is becoming fairly confident and comfortable about such diagnoses, even while she is fairly perturbed and definitely uncomfortable that the syndrome is on the increase.

That being so, she is more than slightly concerned at the impending legalization of recreational marijuana. All the more so that cannabis use in the youth of Canada is taken as a casual reality, with more young people using the drug than most parents are prepared to credit. Young people feel relaxed about their cannabis use -- after all, 'everybody does it' and whatever is popular is a must for youth who are otherwise engaged in proving how 'different' they are from everyone else.

Young people in grades 7 through to 12 in responding to surveys affirm that one in five have tried cannabis, with over one in ten using it in the past month, while the average age of initiation into the ritual use of pot appears to be 15 years of age. In the United States, Colorado legalized marijuana use and if a dependable example is sought, they can qualify as a model for avoidance given they experienced close to a doubling of CHS cases following liberalization.

Hazards such as dangerous dehydration can result from CHS, which also contributes to absenteeism from school and from the workplace, even if setting aside the effect it has on an already overburdened health care system with emergency departments seeing the same sufferer on multiple occasions. And diagnosis is often elusive, leading to needless and expensive tests and prescribed treatments after consultation, which bypass correct diagnosis until an accurate diagnosis finally occurs.

Despite which the belief persists among young people that marijuana use is pretty safe. Education for parents, their children and health-care practitioners must be dependably in place to inform all parties. Health Canada has made it a priority to educate about the health effects of  cannabis, particularly among the young, while the Canadian Pediatric Society and the Canadian Psychiatric Association have produced positions statements giving warning of  cannabis harms to youth.

Risks such as impaired brain development, increased prevalence of mental illness and diminished school performance as well as lifetime under-achievement are real potentials and people need to understand this to be fact, not fiction, as they would prefer to believe. All to the good; Dr. Ross applauds their efforts, yet on the other hand, wonders why mention of CHS in these documents is completely absent.

Cannabis use has become one of the most commonly abused drugs in the world. It is estimated that each year 2.6 million individuals in the USA become new users and most are younger than 19 years of age. Reports describe marijuana use as high as 40–50% in male Cyclic Vomiting Syndrome patients. It is this interest in cannabis in the World, coupled with recognition of a cyclic vomiting illness associated with its chronic use that beckons a review of the most current articles, as well as a contribution from our own experiences in this area. The similarities we have demonstrated for both cannibinoid hyperemesis syndrome and cyclic vomiting make the case that cannibinoid hyperemesis syndrome is a subset of patients who have the diagnoses of cyclic vomiting syndrome and the role of marijuana should always be considered in the diagnosis of CVS, particularly in males.

Mithun B. Pattathan, Reza A. Hejazi, and Richard W. McCallum  U.S.National Library of Medicine: National Institutes of Health: Published online 2012 Jun 29.

The Health Benefits of Exposure to Greenery

"We found that those who have more trees and vegetation around where they lived had an eight to 12 per cent reduced risk of dying compared to those who didn’t."
 "Holding all that constant [ambient pollution, population density, socio-economic conditions], if you live in a greener area, compared to a less greener area, there’s about a 10-per-cent reduced risk of dying."
"One thing that was kind of striking is that we found that those who were in the highest income bracket and those who had the highest levels of education were benefiting more from the exposure to greenness."
"If you take two people and everything else is more or less the same … their age, sex and city they live in and they both have the same amount of greenness around where they live, someone who is more affluent is getting a big boost to their risk of dying whereas people in the lowest income group were getting almost no benefit at all."
"Parks are important but I think this shows that it’s just as important to have trees on medians and along streets and sidewalks where people are going to have contact on a regular basis."
"If it's a really nice green area, it's sort of a pleasant spot, people are more inclined to go walking, even just walking their dog, not necessarily getting … intense physical exercise."
"Water is completely different from green space, but living on the water can be very relaxing and stress reducing."
Dr. Dan Crouse, Epidemiologist, Research Associate in Sociology, University of New Brunswick 

Saint John's Rockwood Park is one of Canada's largest urban parks at 890 hectares. (YouTube)

A new study just published in the latest issue of The Lancet Planetary Health, is intriguing for its findings, but it shouldn't surprise people who gravitate to the out-of-doors in their leisure time for the distinct purpose of immersing themselves in natural surroundings such as city parks or urban forests. Ten researchers from Canada and one based in the United States formed a team led by Dr. Crouse do determine the health effects of being surrounded by trees and other types of natural greenery.

They undertook an extended study of data encompassing 1.3 million people over an eleven-year time span in cities around Canada, in an effort to understand and determine how people benefit from being in green environments. What they discovered was what they might have expected, except that the rate of benefit far outdistanced their expectation.

Constant, direct exposure to a green environment, they concluded, had the effect of reducing mortality caused by cardiovascular and respiratory diseases by between 8 and 12 percent.

It's no mystery that when you're immersed in an atmosphere of green, growing flora it has a calming effect. That kind of exposure is pleasurable and mellow, tending to a feeling of peacefulness. At risk of appearing maudlin: "at one with the world". But the mechanical properties of plant life represent an invaluable attribute; they cleanse the air we breathe by taking in carbon dioxide and exuding oxygen.

Moreover, when we venture into natural settings, in a park, on a forest trail, we walk or bicycle, exercising ourselves.

Most people acknowledge that having a canine companion results in the feeling of responsibility to get that dog, large or small, out for its daily exercise, a requirement to ensure the dog remains healthy. What works for dogs works for people, and in the very same way; exercise benefits a dog's cardiovascular and respiratory system just as it does for humans. We feel better about ourselves walking among trees and shrubs, and our vital organs, our muscles and our brains benefit.

Statistics Canada's many yearly collections and outputs of data carefully gathered and computed into useful form provide statistics used by many lines of research enquiries as well as for businesses. In this instance, their statistics from 2001 also aided this study which used the long-form census to compare it to mortality data within Canada for the following 11 years; extracting that information helped the researchers gain their end result.

Taking into account, moreover, the aggregate number of trees, plants, shrubs and allied vegetation in a 250-metre proximity to peoples' homes enabled the research team to conclude estimates of daily exposure to living greenery and that exposure's impact on longevity. Interviews resulted in anecdotal accounts of the stress-relieving capacity in green exposure on peoples' minds.

Economics enters the picture when it was judged that those in lower-income brackets may have less leisure time, and less opportunity to immerse themselves in green surroundings.The element of continuous exposure to local parks or trees growing on a boulevard close to one's home which can be passed daily has its benefits, as opposed to once-weekly visiting a treed park.

Drug Trafficking Consequences

"We're trying to show that when we have the information, we're going to pursue the people providing this because it's causing death in our communities."
"We think it's a fairly well known fact that the ingestion of fentanyl can cause death. They are supplying something they know could cause death to the person purchasing it. That's where manslaughter comes in."
Det.Sgt.Brad Reynolds, South Simcoe Police Force

"My son didn't deserve to die, he didn't deserve for these people to sell him this sh-- and for me to wake up in the morning to find him dead."
"Shawny may have held a gun to his own head, but the people that sold it to him are the ones that pulled the trigger."
"He was going to work the next day, he had two little boys to live for. He was on the right path. My son turned to the wrong people and he's no longer here."
Denise Lane, Innisfil, Ontario

"The law is clear that you do incur a liability for death resulting from your distribution of a drug."
"That's because the mental state fault requirement for manslaughter is very low -- the objective foreseeability of bodily harm, not even death."
Alan Young, law professor, York University, Toronto

"Given that it's pretty notorious what fentanyl does to people, it seems to me like a logical progression [police laying manslaughter charges on drug traffickers]."
Kent Roach, law professor, University of Toronto

Fentanyl .. torontosun

A new, and perhaps predictable issue has raised its head; with the public now so well aware of the dangers inherent in the use of powerful opiates like fentanyl and carfentanil, more than proven by the seemingly unstoppable incidences of drug overdoses throughout North America caused by other drugs being doctored with the cheaper fentanyl and the introduction of both these potentially lethal drugs to the street trade, no one peddling the drugs can claim ignorance of its deadly effects.

In choosing to continue selling these drugs to people addicted to opiates, drug pushers are fairly directly responsible for the deaths that ultimately ensue. If and when they can be identified and linked to particular instances of drug overdose leading to death they can now expect that local police forces will be arresting and charging them with homicide. This is not a particularly shocking new revelation, after all.

The notorious case of actor John Belushi who died of a drug overdose appears to have been the breaking point when Cathy Smith was convicted of involuntary manslaughter in a plea deal when she was prosecuted for second-degree murder for injecting Belushi with heroin and cocaine that killed him.

The Supreme Court of Canada in 1993 upheld a manslaughter conviction against a man who provided and injected cocaine into a woman's arm with her consent, after which she went into cardiac arrest and choked to death on her vomit.

Two charges against fentanyl traffickers have been laid by Ontario Provincial Police, while an additional three other traffickers are under investigation for the same offence. According to an OPP spokesperson, it can be expected that such charges will be increasingly used as a deterrent and punishment for those who traffic the drugs in lock-step with the growing death rate due to overdoses.

Two fentanyl suppliers in two separate cases have had manslaughter charges brought against them in the past year in Edmonton, Alberta. In Brantford, Ontario, police charged a man with manslaughter for selling powdered fentanyl and cocaine in early September to a man who died of an overdose. While RCMP in that same month reacted after a man died from an overdose of carfentanil, by charging the man who provided the drug, with manslaughter.

However, in Vancouver where a full-flood fentanyl crisis continues to unfold, no manslaughter charges have been laid by police against fentanyl dealers. "This is a complex issue that our investigators have considered at length. I believe charges and convictions in this area are fairly rare, and are usually only successful when a unique set of circumstances and evidence exist for that particular case", explained Const.Jason Doucette.

This could reflect a police culture at variance with those in other parts of the country. And it could conceivably reflect that this is a less efficient police force, incapable of investigating the source of an ongoing proliferation of deadly drugs, linking specific dealers to deadly events in the aftermath of yet another tragedy.

Fentanyl patches. (Postmedia Network)