Blog dedicated primarily to randomly selected news items; comments reflecting personal perceptions

Thursday, February 28, 2019

Construction Hazard

"Construction and opioids go really well together."
"At the beginning when I was using hydromorphone, I was better at my job. I was more consistent.  enjoyed working more because I felt good. Nothing mattered. Even if I was doing something I didn't want to do, if I was on opioids, it made no difference, you know?"
"I started to attribute me being good at my job with me being on drugs."
"I'd lost all my jobs. I'd lost my girlfriend. I could hardly get out of bed. I was ready to die. I felt like I had lost everything and lost my purpose and nothing mattered anymore. And I was broke, that didn't help. I just said yes. Against my instincts, I said yes, I'd go to treatment even though everything in my body said I couldn't do it."
"Start saying yes to people who can help you. I was, 'I got myself into t his on my own. I can get myself out.' But that's just so wrong and so misguided. I just decided I didn't want to do this alone any more. It's not a weakness to ask for help."
Logan Carroll, construction worker, Ottawa
‘I started to attribute me being good at my job with me being on drugs,” says Logan Carroll.  Jean Levac / Postmedia News

"It's just the nature of the jobs we do. Heavy-duty work that takes its toll on the body -- lifting, climbing -- heavy work that's prone to injury."
"Look at construction sites and see some of this happening. Construction work opportunities are usually short. Typically, our folks go to a job site, try to get as many hours as they can, then go on to the next job."
"Unfortunately, when they do get hurt on the job, they go to their family physician or an emergency clinic, grab something for pain, then go back to work."
"It's staggering when you look at the small provinces and see how quickly the numbers [of opioid deaths] are catching up to the larger provinces."
"What we noticed is we had one particular pharmacy where we had spent $1.8 million in one year just for one construction union in prescription fees. We said, 'This doesn't seem right. Something is wrong.' When we tracked it, we found it that it was for methadone."
"It's deemed a macho industry where guys don't talk about their pain and don't say that they're ailing. That could be seen as a weakness. I think that's really unfortunate."
Arlene Dunn, deputy director, Building Trades Union, Canada

"A lot of people are using opioids for physical pain, but a lot of people are also using them for psychological pain."
"Most Canadian workplaces that have substance abuse policies favour disciplinary measures rather than supportive measures. Instead of paying for treatment, they're actually disciplining them."
"We need to create an environment that fosters them [workers addicted to drugs] to be able to come out and say, 'I need help'."
"[Employers] should be able to say, 'Here is a four-week leave and we'll support you in that.' They shouldn't be forced to come into work. We don't do that with cancer. Why are we stigmatizing people struggling with mental illness?"
"The war on drugs is not working. We see that year after year. Problematic substance use is like any other disease and should be treated as a health concern and not treated as a criminal justice concern."
"We're not saying decriminalization is a silver bullet -- because there's a bunch of other recommendations we made. The other big one is invest in mental health services, increasing access to services so that people can see a psychologist when they need to. We know that untreated mental illness over time gets worse and worse."
Fardous Hosseiny, national director, research and public policy, Canadian Mental Health Association
Opioid overdoses still plaguing the trades
Journal of Commerce, ConstructConnect

The construction and extraction industry had the highest suicide rate of any profession surveyed, according to a 2015 study by the Centers for Disease Control. The study revealed 52.1 deaths per 100,000, a rate seen to be 200 percent steeper than the national average in the United States. Therapies like meditation have evidently proven effective at pain control, but it represents a type of intensive work and scheduling, taking infinitely more time and patience than the expedient of using a pill to dull pain.

Few workplace occupations, it turns out, appear to be as vulnerable to addictions to opioids -- including a prevalence of overdose deaths -- than the construction industry, including general labourers. It was found last fall that 55 percent of the overdose deaths in the province of British Columbia were of workers in the construction and transportation industry, according to a study by the B.C. Coroners Service.

Similarly a study undertaken in 2018 by the Massachusetts Department of Public Health concluded that construction workers there were six times likelier to die of opioid overdose than any other occupation, a trend seen throughout North America. Canada is staggering under a death toll resulting from its opioid epidemic, with Health Canada reporting over 9,000 Canadians dying from overdose between January 2016 and June 2018. British Columbia alone saw 1,489 deaths from illicit opioid overdose last year, the equivalent of four deaths daily.

The problem has become even deadlier with the emergence of fentanyl, the synthetic opioid attributed with a powerful strength one hundred times greater than heroin. Ms. Dunn of the Building Trades Union recognized the emerging problem with construction workers and opioid addiction fifteen years ago when high fees for methadone doled out daily at pharmacies as a prescribed regimen resulted in sky-high dispensing fees for her union.

Opioids like oxycodone proved a quick fix when injured trades workers and labourers visited their family doctors for relief from pain related to industry work. They want to return to work as quickly as possible to meet construction deadlines, working for long hours while in pain.

Labels: , , ,

Wednesday, February 27, 2019

Herd Immunity Through Vaccination

"Did you know your child can get measles by being in a room where a person with measles has been, even up to two hours after that person has left? Measles is very contagious, and it can be serious, especially for young children. Because measles is common in other parts of the world, unvaccinated people can get measles while traveling and bring it into the United States. Anyone who is not protected is at risk, so make sure to stay up to date on your child’s vaccines to minimize the risk of coming into contact with an imported case."
"Doctors recommend that your child get two doses of the MMR shot for best protection. Your child will need one dose at each of the following ages: 12 through 15 months and 4 through 6 years."
"Infants 6 to 11 months old should have one dose of the MMR shot before traveling abroad. Infants vaccinated before 12 months of age should be revaccinated on or after their first birthday with two doses, each dose separated by at least 28 days."
U.S. Centers for Disease Control and Prevention

"Vaccines are more effective than almost any other medicine we use on a daily basis. Most people will be protected by most of the vaccines they receive, and some vaccines in the routine UK schedule are almost 100% effective against some diseases. For example, after two doses of MMR vaccine up to 99% of individuals will be protected from catching measles. However, there will always be a small number of people who fail to make an immune response to a particular vaccine. If their body has not made an immune response, then those people remain vulnerable to the disease."
Oxford Vaccine Group, University of Oxford, Great Britain

"Some people assume that because diseases like polio have disappeared from the United States, it’s no longer necessary to vaccinate children against them. However, polio is still widespread in other parts of the world, and could easily begin re-infecting unprotected individuals if it were re-introduced to the country. Another example is measles, which has become rare in the United States: U.S. outbreaks of the disease have occurred when Americans traveling to countries where measles remains widespread brought the disease back with them. With adequate vaccination rates, most of these types of outbreaks can be prevented. But if vaccination rates drop, “imported” cases of preventable diseases can begin to spread again. In the early 2000s, for example, low vaccination rates in England allowed measles to become endemic once again after earlier vaccination rates had halted its continuous transmission in the country."
The History of Vaccines, College of Physicians of Pennsylvania
Polio Vaccinations
A crowd of people receives inactivated poliovirus vaccine in Protection, Kansas
March of Dimes Foundation
Those who hold fast to the belief that vaccines are dangerous and withhold them from their children are inadvertently turning their children into time bombs in the creation of an explosion of infectious diseases. An unvaccinated 11-year-old returning from a trip to Vietnam where he picked up the measles disease has been the vector for a measles outbreak in Western Canada. As a carrier of disease that child who was unvaccinated and thus vulnerable to picking up the infection became a weak link in an otherwise-protected population.

Aside from those who refuse vaccinations on grounds of believing them to be harmful and the cause of other diseases and health-adverse conditions refuted by science, there does exist an immune-compromised demographic that is so vulnerable they can be harmed to the point of death should they come in contact with an unvaccinated person in a day care setting, on a public bus or in a hospital ward. Infants are not to be vaccinated for the first few months of their lives; avoiding contact with the unvaccinated is critical for them.

People with compromised immune systems because of autoimmune diseases are also vulnerable since vaccines won't work for them, leaving them susceptible to infection. In most Western societies the aim is to ensure that over 90 percent of people have been immunized, creating a barrier to the transmission of infectious diseases and protecting the most vulnerable in society. This is known as "herd immunity". Once the rate of vaccination drops, infants and the immunosuppressed become more likely to come in contact with potential carriers of preventable infections.

Europe is at the present time considered the world centre for vaccine skepticism where in a 2016 survey up to 41 percent responding to a poll professed not to believe that vaccines are safe. The result has been outbreaks of preventable diseases where in the first six months of 2018, 41,000 Europeans were infected with measles, and 37 of them died of the disease. Many among the anti-vaxxers and the undecided believe that a disease such as measles poses no threat, yet one in five cases requires hospitalization and one in every 350 to 1,200 cases will be deadly.

Diphtheria was once the leading cause of childhood death in Canada. And in the United States 500 people annually were killed before the measles vaccine, and 48,000 others were hospitalized. The concern among health professionals is that even a deadly disease like poliomyelitis currently plaguing only small areas of Africa and Central Asia, could be re-introduced into North American schools and hospital wards. A single measles-infected person in 2015 after spending the day at Disneyland was the cause of an outbreak that left 147 people sick -- from Canada to Mexico -- to seven U.S. states.

Of 102 million doses of MMR (measles, mumps, rubella) vaccine administered between 2006 to 2017 in the United States, only 120 resulted in payouts from the National Vaccine Injury Compensation Program. Adverse effects, when they occur from a vaccination rarely go beyond rashes, fever or other mild allergic reactions. It is rare (one in a million) that a vaccine will cause a lifelong disability.

In Canada, there are calls for mandatory vaccination of children; 70 percent of people claim it should be a requirement, to enter the public school system. One estimate has it that it is 5,000 times more potentially dangerous to become infected with measles than to receive the measles vaccine.
Image result for measles vaccinations

Labels: , , , , ,

Tuesday, February 26, 2019

The Issue is the Tissue

Clayoquot Old Growth Forest    Photo: JSR
"Forests are too vital to flush away."
"None of their flagship at-home brands [Big Tissue manufacturers] contain recycled materials or alternative fibres, and each company misses other key commitments necessary to ensure their products do not come at the expense of the boreal forest."
Report: The Issue With Tissue

"The Canadian boreal forest is the largest intact forest in the world, holding immense value for Indigenous Peoples, species and the climate. It is home to over 600 Indigenous communities whose cultures have remained inextricably linked to the forest for millennia, and is habitat for iconic species like the boreal caribou, Canada lynx and American marten. In addition, the forest is critical in the fight against climate change, storing the carbon equivalent of nearly twice the world's recoverable oil reserves in its soil."
Natural Resources Defense Council, Eco Watch
  Marriott Basin   Photo: JSR
Canada's boreal forests are coming under threat as giant pulp and paper producers based in the United States, like Procter & Gamble, Georgia-Pacific and Kimberly Clark with their popular brands of toilet tissue their public relations machinery touts as 'soft' and 'strong' captivate the market. Brands like Charmin, Cottonelle, Brawny, Bounty, Kleenex, Angel Soft, Quilted Northern and Viva, familiar to anyone who shops for 'quality' products knows well.

Toilet tissue is regarded as a staple product everywhere and anywhere. Tissues produced from recyclable paper simply doesn't have the right luxury cachet. They do attract the environment-conscious hoping to be able to make a bit of a difference in personal responsibility to the environment by choosing brands that advertise their recycled products, but the finished product lacks the soft touch that consumers now demand.

We've come a long way since vegetable waste, lettuce leaves, corncob foliage, and pages torn out of mail-order catalogues were routinely used in outhouses. We're now accustomed to using the softest, gentlest tissues available in our bathrooms and won't hear of any products that fail to live up to those demanding standards. On the other hand, there are astonishing numbers involved in the use of such products.

The U.S. has a population of over 350-million people. Amazingly the use of toilet tissue by Americans is rated as close to three rolls weekly per person. Let that sink in. That kind of usage reflects nothing short of egregious waste, and a type of abuse of a natural resource, but a boon to the bottom line of the producers of the product where the industry can boast it receives $31-billion in revenues on an annual basis.

"We know that virgin fibre in tissue products is significantly preferred by consumers, and 'does the job' much more efficiently than recycled or non-wood products", states Damon Jones, vice-president, global communications at Procter & Gamble. So, in essence, the company is blameless where the waste and the rapacity of old growth forests for their pulp wood is concerned; they are simply filling a market demand in their niche.

Photo: JSR
Where recycled paper is used, he points out, is in the packaging and the inner cores; while, he stresses its wood fibre used in the manufacture of the tissue itself to consumers' preferred specifications, is sourced from responsibly-managed forests. Georgia-Pacific takes pains to point out that consumers look for softness and absorbency and those virtues can only be achieved with the use of virgin pulp. A spokeswoman added that the company she represents "takes steps to ensure that we are responsibly sourcing wood and wood fibre for our pulp, paper and wood products operations".

What has led Natural Resources Defense Council and, international non-profit environmental organizations which worked in tandem to produce the study to criticize manufacturers of tissue is the very issue of the monopolistic use of virgin fibre pulp, which is accessed for the most part from old boreal forests in Canada. Where their marketing campaigns have convinced consumers to use those very products which can only be produced from softwood (hardwoods are deciduous trees, softwoods are conifers).

On the other hand, if we're speaking responsibility, conservation and inattention, forestry sweeps culling old growth and specific natural resources irresponsibly is first and foremost the responsibility of the governments where forest sustainability is threatened, and in this instance it is the provincial and federal governments of Canada itself. Where stewardship of natural resources resides primarily and whose decision-making in agreeing to have its immense boreal forest system reduced should be first and foremost, in question....

Labels: , , , ,

Monday, February 25, 2019

Autoimmune Responses

"More than 80 diseases occur as a result of the immune system attacking the body’s own organs, tissues, and cells. Some of the more common autoimmune diseases include type 1 diabetes, rheumatoid arthritis, systemic lupus erythematosus, and inflammatory bowel disease."
"Although the causes of many autoimmune diseases remain unknown, a person’s genes in combination with infections and other environmental exposures are likely to play a significant role in disease development. Treatments are available for many autoimmune diseases, but cures have yet to be discovered."
"The chronic and debilitating nature of these diseases, which can lead to high medical costs and reduced quality of life, is a burden on patients and also affects their families and communities.
"Although researchers have made considerable progress in understanding how the immune system causes organ, tissue, and cell injury in autoimmune diseases, much remains to be learned. By supporting a broad range of basic, preclinical, and clinical research in autoimmune diseases, NIAID enhances understanding of the causes of these diseases, the genetic factors that make people susceptible to them, and the regulatory mechanisms that control the production of self-destructive antibodies."
National Instituttes of Allergies and Infectious Diseases, U.S.A.
Roughly 23.5 million people living in the United States are plagued with chronic conditions brought on from an autoimmune condition. And while their condition can be diagnosed as such and treatment recommended, whatever it was that caused the onset of that condition remains a mystery. Type 1 diabetes is included in that group of autoimmune diseases; something has caused the body's immune system to attack insulin-producing beta cells in the Islets of Langerhans. Scientists conjecture that a genetic predisposition to the disease is involved, and some environmental factor has set it off.

As with rheumatoid arthritis, multiple sclerosis, lupus, celiac disease, psoriasis, irritable bowel syndrome and Crohn's disease. These are the most well-known of the diseases that exemplify an autoimmune condition but they represent only the tip of the iceberg, so to speak, with another 80 conditions much less well-known. The mechanism involved in the immune system targeting its own healthy cells is mystifying but, according to the National Institutes of Health:
"...There is a growing consensus that autoimmune diseases likely result from interactions between genetic and environmental factors..." 

According to some studies, certain genes may predispose someone to particular autoimmune diseases, a conclusion bolstered by the reality that many of these diseases appear in a family as a common factor of inheritance. On the other hand, while people in a family grouping may all inherit the same gene that predisposes for a certain disease, this does not necessarily translate to everyone in that family grouping certain to be diagnosed with that disease's onset.

The gene is there, and can be likened to wood piled up into a neat bundle ready to be kindled into a bonfire as soon as a match is applied. In the human body with a genetic trait to predisposing toward onset of a familial malady, the conditions to enable the malady to flare into existence must be met. The predisposition will always be there, but if the trigger to arouse the body into a full-blown disease onset does not occur, neither will the disease. The key is both circumstances, opportunity and on the other hand, a healthy body resistant to onset.

Although there are no guarantees that leading a healthy lifestyle will in the end help to avoid disease onset, it does produce a healthier body, better able to cope with an autoimmune disease onset should one arise. There are studies that suggest that aiming for a healthy lifestyle may ensure the immune system remains balanced; less focus on leading a healthy lifestyle may result in the immune system overreacting; low vitamin D levels have been implicated as a risk factor for multiple sclerosis, for example.

Just as obesity has been linked to a number of autoimmune diseases, including Type 2 diabetes, multiple-sclerosis, rheumatoid arthritis and psoriasis. All manner of autoimmune flare-ups have also been attributed to stress and anxiety levels. Dietary choices can come into play in achieving a healthy outcome in any event; the right nutrients to maintain a healthy weight, manage stress, and to ensure that a good night's sleep is a regular event to prevent a flare-up of autoimmunity gone berserk.

The human gut is viewed as critical in reacting when allergic or toxic things enter our bodies; 70 percent of the immune system lies in and around the gut, identifying it as linked distinctly to the immune system. Eliminating foods that inflame the gut and limiting unnecessary medications that have the potential to alter the bacteria balance in the gut seems a good place to start. Along with that, selecting foods that have a positive impact on reducing inflammation.
Foods that may cause inflammation:
  • Sugar
  • Refine carbohydrates
  • Trans fats
  • Omega 6 fatty acids
  • Processed foods and meat
  • Alcohol
  • Caffeine
  • Artificial Sweeteners
  • Food dyes
salmon, avocado, olive oil, nuts - Choose Healthy Fats

Foods known to reduce inflammation:
  • Leafy greens
  • Fruits such as blueberries, strawberries and blackberries
  • Fatty fish, high in omega 3 fatty acids
  • Olive oil
  • Aocados
  • Nuts and seeds
  • Herbs and spices such as turmeric, cumin and garlic
  • Vitamin D

Labels: , , , , ,

Sunday, February 24, 2019

Extraordinary Gift-Giving

"Meth, until recently, has been largely seen inside North Korea as a kind of very powerful energy drug -- something like Red Bull, amplified." 
"[That very misconception underscores a] significant underestimation [within the country of the risks inherent in drug abuse]."

Andrei Lankov, North Korea expert, Kookmin University, Seoul, South Korea

"[Though illegal in the North it has obtained the cachet of legality] because officials take bribes to look the other way, and because the state indirectly benefits from a food chain of bribes that goes all the way to the top."
Justin Hastings, political scientist, University of Sydney, Australia

"For as long as drug use does not pose a challenge to the regime, but instead dulls the wills and minds of the North Korean people, the government tacitly allows it to go on."
Greg Scarlatoiu, executive director, Committee for Human Rights in North Korea, Washington
Kim Il Sung Square
Kim Il-sung Square on Lunar New Year’s Day, 2017   Wikimedia Commons
Mr. Scarlatoui from his vantage point in a Washington think tank observes that Kim Jong-un's regime was entirely focused on placing its state resources on what it deems are national priorities. Controlling the use of psychotropic drugs is not anywhere close to a priority. Not in an impoverished country where health care itself is not recognized as a national need to be fulfilled, and where people, under-serviced in that area, will take to self-medicating with mind-alterants.

On the other hand, what is recognized as top priorities that the government places all its attention on is self-evident from the news, sometimes hysterical, that comes out of the hermit kingdom. Its development of long-range missiles, its preoccupation with 'defence' enabling it to lob viral warning to its perceived enemies, most of its neighbours whom the North believes have collaborated with the United States to undermine North Korea's progress. And its nuclear program, which has long alarmed the world at large.

This month during celebrations of the Lunar New Year, North Koreans have been exchanging gifts to one another. Choosing to present to those they care about, crystal meth. Methamphetamine, viewed by the outside world as a health and addiction threat has become in North Korea a casual, oft-used recreational and health aid. A powerful stimulant it may be, but in North Korea it is seen as beneficial to the user, used as lightly as smoking a cigarette. Its harmful effects evidently completely ignored.

The drug was originally introduced to the Korean Peninsula during the colonization period by occupying Japan. And during the 1970s North Korean diplomats were arrested while abroad, charged with drug smuggling. By the 1990s North Korea began manufacturing its own meth for export not too long after it sponsored local opium cultivation and opiate production, according to a study conducted by University of Missouri political scientist Sheena Chestnut Greitens.

Which opened a vigorous trade opportunity for the drug to be shipped across the border to China, or transferred at sea to the hands of criminal organizations such as Chinese triads or the Japanese yakuza, until the mid-2000s when government-sponsored meth production declined, leaving a surplus of people with manufacturing skills who began selling their product to the local market.

Though North Koreans in the face of a chronic shortage in health care have taken to self-help with the use of opiates and amphetamine-like stimulants, the government denies any of its citizens produce or make use of methamphetamine. Crystal meth, called "pingdu" as a transliteration of the Chinese word for "ice-drug", is customarily given as a gift, a particularly popular custom among young North Koreans.
Image via Shutterstock (L); and Flickr user Zennie Abraham, CC licence 2.0 (R)

"Ice has become a best-selling holiday gift item. Most of the buyers are young people, even those still in middle school."
"They usually buy ice to snort together during holidays. They want to forget their harsh reality and enjoy themselves… Social stigmas surrounding drug use [have disappeared], so people now feel that something big is missing if they don’t have ice or opium prepared as a holiday gift."
DPRK Anonymous Source

Labels: , , ,

Saturday, February 23, 2019

Medical Science Illiteracy

"If you are somebody who has not always understood why a flu shot works one year and not the next, or why some vaccines appear to be more effective than others, there can be some confusion about the clarity of the science."
"We're also in an era now that has a higher propensity, and a  higher level of skepticism toward the so-called experts. It may be that what we're seeing is the reflection of people saying, 'Well, no, I don't think the science is quite clear, and just because it's science doesn't mean that it is by definition clear'. We see this in the climate science debate and other debates as well."
"It's not as though there is a strong civil liberty or a libertarian view that is coming through wholly on one side of the political spectrum or divide."
Shachi Kurl, executive director, Angus Reid Institute

"These aren't hard-core anti-vaxxers -- these are people who are being exposed to the [prevailing] misinformation and want to do the best for their kids, but feel conflicted, and feel that the data isn't certain."
"The science around vaccines isn't unclear -- the science is tremendously well established."
Timothy Caulfield, professor of health law and policy, University of Alberta
Vast majority of Canadians say vaccines should be mandatory for school aged kids
A new poll has rendered results through an Angus Reid Institute online survey, that a full one-third of Canadians question the science behind vaccines. Of those polled, 29 percent feel the science on vaccinations against deadly childhood infections isn't "quite clear", with skepticism rising with age, leaving 36 percent of Canadians over 55 with the impression that the science involved fails to be entirely convincing.

Another one-quarter of those polled, representing 26 percent, believe a "real risk of serious side effects" exists from vaccinations, despite such hugely respected health authorities as the U.S. Centers for Disease Control and Prevention stating that side effects from childhood vaccines, by and large, are minor in character, with serious reactions exceedingly rare, occurring in fewer than one in a million doses with diphtheria, pertussis and tetanus vaccine, as an example.

Of those polled, the majority, coming in at 74 percent, agree people who campaign against vaccines are "irresponsible", while seven in ten Canadians, irrespective of whether they have children at home, state their support of instituting mandatory immunization which would effectively remove a parent's right to opt out of a universal immunization program.

Twenty percent of parents with children under age 12 feel permission to immunize should remain the choice of the parents.

The issue also reflects political influences, with Conservatives twice as likely as Liberal or NDP voters agreeing choice should belong to parents. And despite that a third of Canadians state uncertainty of the science of vaccines they fail to go so far as to feel it's wrong or misleading, more likely unconvincing and possibly too confusing.

Strangely enough, hesitancy on the part of those questioned doesn't appear to reflect whether they feel vaccines are effective, with nine in ten in agreement that vaccines are indeed effective in reducing risk of diseases spreading, while 83 percent claim they would not hesitate to vaccinate their own children, and five percent adamantly refusing vaccination for their children.
The Public Health Agency of Canada has issued a statement aimed at reminding Canadians that measles is a serious and highly contagious disease and that getting vaccinated is the best protection.   Eric Risberg/AP / ASSOCIATED PRESS

Experts have reported a global resurgence of measles cases; an increase of 30 percent since 2015, directly attributable to the anti-vaccine rhetoric seen everywhere on social media. The result of this resistance is that one in ten children in Canada have not been vaccinated, so that 750,000 young Canadians are bereft of immunity against diphtheria, whooping cough, tetanus and measles.

What that means is that these children whose parents have denied them the protection of vaccination, become vulnerable to those diseases. Moreover, not only are these unvaccinated children in danger of falling victim to ill health and its complications, but in defeating the 'herd effect' aspirations of health authorities where sufficient numbers are vaccinated to slow down infectious transmission, they effectively place other children in danger.

As matters now stand, in Canada no parent can be forced to have a child vaccinated. Mandatory school entry laws require vaccination in Manitoba, Ontario and New Brunswick, yet all three permit non-medical exemptions on religious or conscientious grounds, and in Ontario, exemptions are on the rise. The response to which by almost a three-to-one margin, Canadians feel vaccinations should be mandatory, taking the choice away from parents.

Twenty-four per cent say vaccinations should be a parent’s choice rather than mandatory. Still from video, Global News

Labels: , , , , ,

Friday, February 22, 2019


"We got the idea that a really useful way to look at people's appearance might be to look at something like acne, because, turns out that acne affects people pretty randomly."
"And we thought that acne was a good vehicle for investigating this relationship [the link between physical appearance and education and labor market outcomes] because a lot of people get acne and it happens to everyone regardless of their socioeconomic status."
"We’re hesitant to say that we find iron-clad proof."
Erik Nesson, economics professor, Ball State University, Indiana

"[Basically, acne] is associated with reduced participation in sports clubs and increased participation in non-sports clubs, suggesting a possible shift from physical to intellectual pursuits."
"Knowledge of long-term benefits associated with having had acne has the potential to reduce teen suicides."
"Our findings are consistent with a mechanism where severe acne limits socialization so much as to affect long-term outcomes that may depend both on studying and on sociability."
"Skin problems are also associated with increases in cumulative overall high-school GPA [grade point average] and cumulative science high-school GPA, and we find some evidence that skin problems are related to cumulative mathematics and science high-school GPAs."
"Skin problems are not consistently related to earnings among the entire sample, but skin problems are positively related to personal earnings for women and white women."
U.S. study, adolescent acne outcomes

"Overall, this is an interesting study in that it suggests that what might be considered as a disadvantage when growing up ends up translating into positive outcomes later on in life."
"In this regard, the finding contrasts with similar studies which show that other kinds of disadvantages [being short or not beautiful] are typically linked to labour market penalties."
Vera Brencic, economics professor, University of Alberta
Many youth need to treat skin conditions such as acne, which can be exacerbated when pores on the surface of the skin become clogged.(Photo11: liza5450, Getty Images/iStockphoto)
 Teens plagued with skin-blemishing acne see no upside in their affliction and would do almost anything to find a miracle 'cure' for their acne. However, two American professors of economics put their heads together, scoured scholarly articles on acne -- and there are plenty of them -- and came to the conclusion that there's an upside for having acne, as long as the sufferer is patient and endures. Their study was published in the Journal of Human Capital in late 2018.

And they found, convincingly enough to write with a  high degree of confidence, that having acne in one's adolescent years was correlated with higher grade point averages alongside a higher likelihood of graduating from college and singularly for women, they detected through their study that evidence exists that having acne is associated with higher earning potentials for women.

There is a rational enough reasoning here, that teens with acne were uncomfortable with their appearance and preferred to shelter themselves from public view as much as possible, meaning they were less likely to socialize and likelier to spend that time on their studies. There you have it: problems with skin blemishes point to a more intellectually-flavoured lifestyle and that in turn equates with improved grades, more intensive academic studies and eventually, higher incomes.

That's the good news, and there was no way of ignoring the bad news, that acne strongly correlates with adolescent suicide; the detrimental effect of severe acne even while it seems that lighter bouts of occasional acne result in labour market success. If we're weighing quality of life as opposed to cessation of life, there's really no contest, is there?

The paper and its conclusion is considered one piece of a larger puzzle relating to work that explores how physical attractiveness matches with greater success in life outcomes, a well-studied phenomenon where it is recognized that comely people have a tendency to reach for greater success through their aspirational pursuits.

Professor Nesson partnered for this study with Hugo Mialon, both analyzing data collected by the Eunice Kennedy Shriver National Institute of Child Health and Human development where studies were run of adolescent development in waves from 1994-95. Information was available through that research relating to academic performance, perception of physical attractiveness, acne, and adding research that followed over the years, educational attainment and income.

Having acne through the adolescent years correlates with a 3.8 percent increase in chances of obtaining a bachelor's degree.
We use data from the National Longitudinal Study of Adolescent to Adult Health to investigate the association between having acne in middle to high school and subsequent educational and labor market outcomes. We find that having acne is strongly positively associated with overall grade point average in high school, grades in high-school English, history, math, and science, and the completion of a college degree. We also find evidence that acne is associated with higher personal labor market earnings for women. We further explore a possible channel through which acne may affect education and earnings.
Hugo M. Mialon
Emory University - Department of Economics
Erik Nesson
Ball State University - Department of Economics

Labels: , , , , ,

Thursday, February 21, 2019

Consulting the OR Black Box

"We want to understand things that we do well and understand things we don't do so well."
"[We need to] make sure that if we make mistakes in the operating room, these mistakes are no longer repeated."
"[The black box project found that when there were many people in the room, the number of] interoperative errors and adverse events [doubled]."
"It showed us that with a simple intervention — reducing the number of unnecessary people in the operating room — we were able to bring down ... the number of errors." 
"It improved the attitudes towards safety. Not only the doctors and nurses, but the entire OR team."
"The most common response I hear from my patients is, 'I can't believe this hasn't been done before'."

Teodor Grantcharov, professor of surgery, University of Toronto, staff surgeon, St. Michael's Hospital, Toronto
Three years ago, a Toronto hospital installed its first black box in an operating room. Now the doctor behind that project is bringing the devices to hospitals in Ottawa    (CBC)
"We don't want to wait for a complication to understand what happens. We want to systematically identify behavior at risk of complication."
"Every clinician comes to work every day to provide the best possible care for their patients. That's their number one goal. And so any opportunity to improve care is usually welcomed."
"[Twenty years ago] There was a lot of training on how to stitch a wound, how to insert a catheter, but almost nothing on non-technical skills such as teamwork."
"Today medical staff receive more training in these areas, but we don't know whether it's making a difference to patient outcomes."
"The goal [with the black box project] is to learn from our current practices and see what we can improve." 
Dr. Sylvain Boet, black box project lead researcher, anesthesiologist, The Ottawa Hospital 
Dr. Sylvain Boet. OTTwp
"The operating room is like a black box. We don't necessarily know what is going on inside as patients when we are under the knife and anesthesia."
"It [data derived from analyzing black boxes] is a good tool to help improve patient safety."
"I was really glad to learn The Ottawa Hospital is engaging in this sort of patient-oriented research strategy."
"The fact that as patients our voices were heard and we were respected gives us a sense of pride and we feel valued."
Maxime Le, patient adviser, The Ottawa Hospital
Maxime Le had heard about the black box initiative in Toronto, installed in several hospitals there, headed up by Dr. Teodor Grantcharov at St. Michael's Hospital. Mr. Le had studied health sciences and communications; his academic background has led to his keen interest in this new project whereby black boxes are being installed in hospital operating rooms, to be played back post-surgery and analyzed with respect to how that surgery was conducted, and what its outcome was, and whether changes of any kind would be beneficial to patient outcome.

Mr. Le had himself in recent years undergone three surgeries. After his experiences and with his background in health sciences, he felt a compulsion to contribute what he could to the hospital once it was brought to his attention that the hospital uses the advice of patient advisers. He made application to join a team of patient advisers for assistance in implementing the black box program.

Black box installed in operating room A black box has been installed in an operating room at the Ottawa Hospital with the goal of making surgery safer.

The program itself is derived in principle from the installation of black boxes on aircraft where a record of all critical aspects of the flight are to be found. After all aircraft incidents or accidents, incident researchers look for the location of the black box to unlock the secrets of whatever went wrong which led to an untoward incident, to determine whether the fault lay with the plane itself, with technical faults of any kind, or whether human error or/and extreme weather conditions played a role when things went awry.

The more data that is available, collected from any source to be examined after the fact, the better investigators are enabled to understand the circumstances involved and causation, and to recommend a way forward to improve performances for the future, be it air flight or operating room procedures. The black box collects data from cameras, audio recorders, along with vital signs exhibited by the patient and other critical information. In the case of the operating room black box the goal is to improve communication.

Seen as a key to operating room safety, communication and the part it plays in advancing a smooth performance while not traditionally emphasized in medical school training, communication is critical to success. So much so that research concludes teamwork [and my implication communication] is a factor in up to two-thirds of surgical complications. The research project with the installation of black boxes in operating rooms is meant to identify practices that may lead to complications.

Dr. Teodor Grantcharov is the creator of the OR black box
Dr. Teodor Grantcharov is the creator of the OR black box. It records nearly everything in the OR, including video of the surgical procedure, conversations among health-care workers, room temperature and decibel levels. (Photo by Yuri Markarov)

Labels: , ,

Wednesday, February 20, 2019

Risks of Underage Cannabis Use

"My study clearly shows that cannabis does not cause schizophrenia by itself. Rather, a genetic predisposition is necessary."
"It is highly likely, based on the results of this study and others, that cannabis use during adolescence through to age 25, when the brain is maturing and at its peak of growth in a genetically vulnerable individual, can initiate the onset of schizophrenia."
Dr. Lynn E. DeLisi, Harvard Medical School
Cannabis, also known as marijuana, is a product of the plant Cannabis Sativa.

"It has long been known that cannabis use can cause an acute psychotic episode in some individuals and recent epidemiologic studies suggest that frequent cannabis use in adolescents may lead to an acute psychosis that by itself develops into chronic schizophrenia. However, the majority of individuals who use cannabis do not develop a psychosis or schizophrenia. Thus, some additional mechanism must underlie the development of schizophrenia in those that are affected. If cannabis use can interact with an underlying genetic basis for the illness, changes in brain structure characteristic of patients with schizophrenia will be seen in those cannabis users who later develop schizophrenia. The brain changes may represent the genetic vulnerability for schizophrenia and be predictive of who develops the illness. Thus, Aim #1 (primary aim) of this proposal is to determine whether brain structural deviances in temporal and frontal lobes and their white matter connections will predict which cannabis users develop schizophrenia. To accomplish this we will evaluate consecutive admissions with a first psychotic episode subsequent to cannabis use admitted to two large NYC psychiatric emergency rooms. These patients will be compared with adolescent cannabis users who never had a psychotic episode, and age, sex, and social class matched non-cannabis using controls. The presence of brain structural anomalies, particularly those characteristic of patients with chronic schizophrenia psychoses will be determined by MRI scans. All cannabis using subjects will have a diagnostic follow-up evaluation one and two years subsequent to the first psychotic episode to determine who developed a diagnosis of schizophrenia or whether the initially non-psychotic individuals remained symptom-free." "Aim #2 of this proposal is to examine whether brain abnormalities among cannabis users with a first schizophrenic-like psychosis are associated with increased genetic risk for schizophrenia. This will be achieved by obtaining family information from reliable family informants. This study will ultimately have implications for early treatment strategies in adolescent cannabis users who are at high genetic-risk for psychosis and suggest early biological warning signs through MRI evaluations of individuals who have an acute psychosis following cannabis use."
Abstract:   Biological Prediction of Psychosis Susceptibility among Adolescent Cannabis Users     Harvard University, Boston, MA, United States

During the teenage years of brain development unneeded connections between brain cells in the prefrontal cortex are stripped away; this is the area that controls thinking and planning. This is also the region that becomes perturbed when psychotic conditions arise, a region rich in CBI (cannabinoid) receptors involved in pruning the brain, and which become engaged by the use of cannabis. The result is the potential for alterations to the pruning process to occur. leading to an increase in the risk of schizophrenia, according to recent research. 

Circumstantial evidence exists that a biological mechanism can be triggered with the use of cannabis, causing a psychotic disorder with a tendency to emerge in late adolescence or early adulthood, matched to a period of rapid brain development. There is a realization that an inherited genetic vulnerability is involved, since psychotic conditions tend to be genetically inherited as a familial trait. Studies suggest that people are likelier to experience paranoia with cannabis use when they are already at a heightened risk of psychosis.

A study conducted in 2014 found a heightened schizophrenia risk among those with a family history, irrespective of cannabis use, leading to the understanding that familial risk for psychotic disorders outweigh possible added effects of cannabis use. According to Dr. DeLisi of Harvard Medical School, it appears likely that cannabis use during adolescence to age 25 can have the effect of initiating schizophrenia onset. However, research that might finally settle the question is scarce since marijuana has been illegal for a long period of time.

With the legalization of marijuana, policy makers and physicians are increasingly aware of the potential dangers of recreational marijuana use given that experts make a distinction between the "new cannabis" strains that are legal and far more potent now available in edibles and vapes, as opposed to the old version which comes in as a much milder weed. T.H.C., the chemical producing marijuana's narcotic effect has been rising for the past three decades. But well before then, about 70 years ago the suspicion among doctors that a link existed between marijuana and psychosis in the young existed.

Other stimulants such as caffeine, nicotine, alcohol can also be viewed as a potential cause of psychosis and hallucinogenic effects when taken in excess, just like marijuana. The temporary disorientation with peculiar imagined sights and sounds, on occasion accompanied by paranoia are the symptoms of psychosis yet the vast majority of those who experience a psychotic episode fail to develop a persistent condition such as schizophrenia, characterized by episodes of psychosis recurring for years.

The debate now ongoing revolves around the distinction between correlation and causation where people with psychotic problems often use cannabis on a regular basis, but on the other hand what is as yet unclear is which came first, the habit of using cannabis or the psychosis. And, to date, insufficient evidence exists to define whether heavy cannabis use causes schizophrenia or other syndromes. This issue is quite aside from that of possible brain damage occurring with the constant use of marijuana by under-aged users.

The end result of studies and conclusions and alternating theories rests with the issue that everyone agrees with, that the regular use of the newer, high-potency cannabis may be regarded as a risk for youth who have a family history of psychosis. 


Labels: , , ,

Tuesday, February 19, 2019

Extraordinary in Flight, Exquisite to Behold

"[Hummingbirds offer] opportunities to explore the limits of physiology [as creatures with the  highest metabolic rate among vertebrates and their hovering specialization] the most expensive form of locomotion [in terms of energy expenditure] in nature."
"Everybody wants to replicate hummingbird flight [in the design of flying robots]." 
"What has kept me attached to them is their incredible personality. They are very bold."
"We understand hummingbirds' lives as being all about drinking efficiently from flowers, but then suddenly we see these weird morphologies - stiff bills, hooks and serrations like teeth - that don't make any sense in terms of nectar collection efficiency."
"Looking at these bizarre bill tips, you would never expect that they're from a hummingbird or that they would be useful to squeeze the tongue."
"Extracting nectar is what fuels their lives [as a result, they have developed] very flexible bills with very soft edges, soft, blunt bill tips that are concave, like a couple of spoons, that perfectly match the tongue to squeeze out the last drop of nectar. All of these traits make a good seal between the tongue tips that actually enhances the efficiency of nectar extraction."
Dr. Alejandro Rico-Guevara, researcher, University of California, Berkeley
A male long-billed hermit (Phaethornis longirostris) shows off his pointy beak, which he uses as a weapon during territorial disputes. (Photo by Maxime Aliaga)
A male long-billed hermit (Phaethornis longirostris) shows off his pointy beak, which he uses as a weapon during territorial disputes. (Photo by Maxime Aliaga)

Dr. Rico-Guevara studied birds under an academic supervisor -- his specialty as a budding ornithologist -- at the National University of Colombia. Under the supervision given him there he wrote an honors thesis on how hummingbirds hunt insects in supplementing their diet of pure sugar [nectar from flowers]. Finally, Dr. Rico-Guevara did his Ph.D. research with Margaret A. Rubega, biologist at the University of Connecticut.

Dr. Rubega had published a paper observing how hummingbirds bend their bills to capture insects. And when Dr. Rico-Guevara studied under Dr. Rubega he co-produced research findings with his supervisor on hummingbird tongues which entirely turned around the conventional thinking of how hummingbirds suck nectar up from tube-shaped flowers. It was assumed that the shape of the beak and the tongue worked to produce capillary action where liquid rises against gravity in response to mechanical forces.

However, the research undertaken by Drs. Rubega and Rico-Guevara demonstrated that the feeding method hummingbirds used was not at all as imagined, for as the forked tip of its tongue is withdrawn upward within the narrow bill, it traps nectar. And now, newer research findings by Dr. Rico Guevara and other researchers is highlighting the reality that those lovable, exquisitely fragile and outstandingly beautiful tiny birds are in fact, aggressive warriors.

The serrated teeth are designed to tug away rivals. Pic: UC, Berkeley
The teeth are designed to tug away rivals. Pic: UC, Berkeley

They produced a paper recently where they outlined evidence gathered through  high-speed video demonstrating how the deadly beaks of those minuscule birds become weapons in male-to-male hummingbird conflict where rival battles are fought in competition for female hummingbirds as mates. This demonstrates a part of natural selection -- sexual selection -- where the dominant force becomes the improvement of mating opportunities, and where the males use their bills to stab other males, to fence -- feinting, parrying, knocking another bird off its perch.

Some hummingbirds come equipped with hooked beaks and with serrations lining those beaks similar to teeth of a crocodile which are used to tear feathers, as with grippers. But fighting between hummingbirds is not strictly monopolized by males alone; females fight as well, but weaponized bills are restricted to only a few species.

"Males fight in claiming the most superior territories for mating. Their territories are about 25 square meters; the size in keeping with that of the birds exploiting a given territory and its food source for their survival.
"As a hummingbird inserts its bill into a flower, it still needs to stick its long tongue deeper inside to get at the nectar within. After the tongue fills with nectar, the bird retracts the tongue back inside the bill. Researchers already knew that to keep the nectar inside the beak, the hummingbird squeezes the tongue with the bill tips as it is extended for the next lick. That compresses and flattens the tongue on its way out, leaving the nectar inside the bill. The way in which the nectar is moved from the bill tip to where it can be swallowed remains unknown."
Dr. Alejandro Rico-Guevara
When a hummingbird inserts its bill into a flower, it still needs to stick its long tongue deeper inside to get at the nectar within. After the tongue fills with nectar, the bird retracts the tongue back inside the bill. Researchers already knew that to keep the nectar inside the beak, the hummingbird squeezes the tongue with the bill tips as it is extended for the next lick. That compresses and flattens the tongue on its way out, leaving the nectar inside the bill. The way in which the nectar is moved from the bill tip to where it can be swallowed remains unknown.

Read more at:

A sparkling violetear and a brown violetear display their elaborate neck side-feathers to intimidate each other and dissuade each other from using their weaponized bills, which feature teeth-like serrations and dagger-like tips.
Image: Cristian Irian, Finca Colibrí Gorriazul, Colombia

Labels: , ,

Monday, February 18, 2019

Hawaii's Kilauea Eruption Timeline

"[This eruption was] truly unprecedented in the modern record."
"Everybody’s chewing on all the great data collected from this eruption."
"That will go on for years and years."
Christina Neal, head scientist, U.S. Geological Survey’s Hawaiian Volcano Observatory, Big Island 

"There’s no reason why we should have expected there would be hydrothermal activity that would be alive within the first 100 days. This is actually life here!"
"[The discovery suggests] how volcanism can give rise to the chemical energy that can drive primitive microbial organisms and flower a whole ecosystem."
"[Studying how hydrothermal life forms near volcanoes that aren’t along tectonic boundaries on Earth could reveal a lot about other celestial bodies]. This is a better analog of what we expect to them to be like [but] it is what’s least studied."
Chris German, geologist, Woods Hole Oceanographic Institution, Falmouth, Mass. 

"[The findings were highly valuable for the monitoring of Kilauea]: Having very high resolution ground deformation measurements before, during and after eruption is exceptional, and will help us to understand how magma behaves in shallow settings better—and in the Kilauea plumbing system in particular."
Pete Rowley, volcanologist, University of Hull, United Kingdom
Kilauea Volcano
Lava from a Kilauea volcano fissure advances up a residential street in Leilani Estates, on Hawaii's Big Island, on May 27. Mario Tama/Getty Images
On April 30 of 2018 the collapse of the Pu'u 'O'o crater atop Kilauea volcano on Hawaii surprised geology scientists and vulcanologists all over the world as the eruption continued for months, producing the equivalent of 320,000 Olympic-size swimming pools of lava transforming the landscape and in the process destroying 700 homes. A detailed timeline of the volcano's destructive eruption, the worst in recorded history, has been published by the Geological Survey's Hawaiian Volcano Observatory.

The data coming out of that publication has enabled vulcanologists to gain a deep understanding of the most hazardous volcano in America. Further investigation may help uncover mysteries of similar volcanoes located world-wide. One of several active volcanoes on Hawaii, Kilauea has been erupting continuously since 1983. The new eruption sequence initiated and seen in May saw two focal points; one, a flank area known as the lower east rift zone where the surface of the volcano is splitting, and the second, to the west, at the Helema'uma'u crater at Kilauea's summit.

A working hypothesis is that a breakdown of a subterranean barrier allowed magma to flow toward the lower east rift zone, coinciding with the April collapse of the Pu'u 'O'o crater. The lava lake representing a persistent pool of bubbling lava within the crater began to drain from the summit of Halema'uma'u, cracks appearing in the rift zone. The following day, May 3, the flow of lava began, necessitating an evacuation of thousands of residents.

A magnitude 6.9 temblor saw increased seismic activity at the summit on May 4, under the volcano's southern flank, the largest in over 40 years, likely a result of magma pushing against the southern section of the volcano, causing a fault to slip. On May 15 and 17 major summit explosions were recorded, producing plumes 3,700 and 9,150 metres in height, activity once thought to be driven by groundwater reacting with draining magma. According to Dr. Neal, however, new data suggests escaping magmatic gas accounted for the explosions.

June 24 saw fissures appearing in the rift zone and rivers of lava flowing up to 100 cubic meters per second, carrying deeper magma -- since old, stagnant magma had already erupted. The deeper magma was more fluid and packed with dissolved gasses, all erupting at 1200 degrees Celsius, leading to incredibly high fountains of lava emerging from some fissures, up to 80 meters in height. The largest freshwater lake on Hawaii vaporized in 90 minutes, on June 2, and by July hot updrafts contributed to pyrocumulus clouds.

A suffocating vog was produced by sulfur dioxide emissions intermixed with water vapor. As lava met the Pacific Ocean a laze, a mixture of hydrochloric acid, glass particles and steam was produced. Suddenly, on August 4, volcanic activity declined but not before a great area of the island was covered with lava. By the time the Hawaii Volcanoes National Park opened again on September 22 35.5 square kilometers had been layered over by lava and 500 meters of vertical collapse had occurred at the summit.
Kilauea lava flows
 Kilauea’s eruption last summer, its largest in 200 years, gave scientists a front-row seat to the volcanic processes that power the planet. In this image from August 5, lava heated to 1000° Celsius pours into the Pacific Ocean, sending a mixture of volcanic gases and evaporated seawater into the air.

Labels: ,

()() Follow @rheytah Tweet