Proceed with Caution and Awareness

"This perception of risk [surrounding the use of cannabis] is decreasing more rapidly among those with depression. Those with depression who perceive little or no risk associated with use [of cannabis] have a much higher prevalence of cannabis use, relative to those who perceive higher associated risks."
"There is some thinking that drug use is a form of self-medication of depression, or attempted self=medication of depressive symptoms."
"The prevalence of cannabis use among those with depression who perceived no risk associated with regular use was much higher than among those who perceived significant risk associated with use -- 39 percent versus 1.6 percent, respectively."
"With increasing legalization in the U.S., previous studies have shown that perception of risk associated with use is declining overall. The results of this study show that this decline is even more rapid among this vulnerable population: those with depression." 
"There is no evidence to suggest that cannabis use will ease depression symptoms, except temporarily, and there are data to suggest that cannabis use may worsen or prolong depression."
"Historically, patients in treatment/recovery from depression are advised to avoid cannabis use."
Dr.Renee Goodwin, psychiatric epidemiologist and clinical psychologist, Columbia University, New York city

Bustle

A new study had researchers examining data collected from almost 729,000 people between the ages of 12 and older from the period 2005 to 2017. Prior-month use of cannabis and depression that may have been experienced over the previous year were absorbed into the study. When it reached the final year, some 19 percent of those with depression reported some cannabis use in comparison with 8.7 percent of individuals with no recent history of depression.

Approximately 10.2 percent of those living with depression, and 5.7 percent of individuals not impacted by depression made use of cannabis, at the same time that the proportion of people with depression perceiving risky behaviour with the use of cannabis fell from 41 percent to 17 percent during the study period. A decline from 52 percent to 33 percent among those with no depression counterbalanced the results, according to the report published in the journal Addiction.

Among people aged 18 to 25 with depression, who were unmarried, male or black, usage was common with each of those groups coming in at around 23 percent. There was no focus in the study to determine how or whether depression could influence the frequency with which people used cannabis, nor their thoughts of the risk inherent in regular use of the drug.

Researchers relied throughout the study on participants truthfully reporting their cannabis use or symptoms of depression; there were no laboratory tests for drug use and nor were medical records examined to confirm the diagnosis of mental health. The study team noted as well that researchers were unable to link whether cannabis legalization could have impacted the number of those using the drug, or thoughts about its safety.

"As brain development is ongoing until at least age 25, and young persons with depression are especially vulnerable, this is a group who may need attention in terms of prevention and intervention."
"Depression is not generally a condition for which medicinal cannabis is prescribed, and it is not clear why recreational use would occur disproportionately among those with depression."
"It is conceivable that cannabis may be increasingly used in an attempt to self-medicate depression in states where it is legal for recreational use."

Sex and Unanticipated Consequences

"This is a cross-continent thing we've been observing over the past number of years."
Dr.Chris Sikora, medical officer of health, Alberta

"Each part of Canada is kind of experiencing its own version of the epidemic. Unfortunately, we have effective testing .. and yet we still have an epidemic."
"There's no reason why it shouldn't be able to go away."
"It's not very nimble [lack of data, reliance on test reports] in terms of understanding what's shifting on the ground."
"If people are only peeing in a cup then they're not getting tested for syphilis. We cannot let our foot off the gas in terms of managing this."
Nathan Lachowsky, public health professor, University of Victoria

"In the initial part of this outbreak, many of the cases ... were among gay and bisexual men. In the last two years or so there's been a definite shift to heterosexual persons."
"Meth is a very important component of what is happening."
"A recent rise in the use of smartphone-based dating applications, which make it easier to meet sex partners, has been linked to increased likelihood of risky sexual behaviours among people of all sexual orientations."
Dr. Ameet Singh, clinical professor, division of infectious diseases, University of Alberta

Patrick O'Byrne, a nurse practitioner at the Ottawa Public Health sexual health clinic, says syphilis is known as the great masquerader because it can look like other illnesses and can be so difficult to diagnose. Jean Levac / Postmedia News

Syphilis is making a comeback worldwide, and it is hitting some areas of Canada particularly hard. Syphilis has been known through historical accounts as a disease that struck some notable personages. It was also known by its ravages as a disease associated with facial deformities and dementia, left untreated. In 18th-century England one city had syphilis striking up to eight percent of its population. The first outbreak of syphilis was reported in 1495, when Naples was sacked by the French army.

Interestingly enough, 1492 was when Christopher Columbus sailed to the Americas. Theory has it that soldiers with the Columbus expedition picked up the infection on the voyage, bringing it back to Europe. This competes with another theory that it already existed in the Old World, but was mistaken from another dread disease that left people mutilated -- and where colonies were instituted to shut these outcasts away from society -- suffering from leprosy.

At the turn of the Twentieth Century, people went so far as to deliberately expose themselves to malaria hoping to fight syphilis, thinking that high fevers typical of malaria would extinguish syphilis symptoms, and malaria itself would be cured with the drug quinine. A treatment prior to that saw mercury applied to the skin, or fumigating people with mercury. The world of medicine now responds to treating syphilis with antibiotics. Nothing quite beats prevention and regular testing, however.

This, for a dread disease held to have been eliminated as a health and longevity threat, eliminated as far as the medical community was concerned in the 1990s in Canada. Syphilis when it first presents looks like a sore on the mouth, genitals and anus, a painless nuisance until the symptoms progressively worsen. Without treatment, lying dormant for years, it can be the cause of brain, nerves, eyes, heart, blood vessels, liver, bones and joints damage.

In Canada, the most recent data indicate 6,311 cases of syphilis in 2018, an increase from the 2,399 registered in 2014, according to a report released in November by the Public Health Agency of Canada. The highest rates are seen in 30- to 39-year-olds, with per capita numbers illustrating an enormous swing from 234 cases per 100,000 people in Nunavut, to 2.5 cases in New Brunswick, per 100,000, and with the national average around 11 cases per 100,000.

Treponema pallidum, which causes syphilis, through an electron microscope. AP

The Province of Alberta has seen a large increase in reported cases, with 1,536 in 2018, an increase of 187 percent from the previous year. In 2019, 1,753 new diagnoses were made compared with a mere 151 in 2014. Its rapid spread is of great concern among specialists in the medical community. Moreover, lack of associated data make it difficult to fully understand the contagion, with researchers relying on test reports which lag in time and offer no insights into the non-tested community.

A troubling offshoot of this trend is the emergence of a rise in congenital syphilis, of children born with the infection. Across the country, 17 confirmed cases of congenital syphilis -- the highest rate in 25 years -- were reported across the country, according to the Public Health Agency of Canada. Alberta alone has seen 38 cases of congenital syphilis in 2019.

Dr. Singh of University of Alberta attributes a few factors to this rise; one of which is the use of methamphetamines, the use of which stimulates sex drive and is associated with risky sexual behaviours. Casual sex and multiple sex partners attributable to shifting cultural values and the availability of dating apps are all viewed as possible contributing agents to the rise and spread of this highly communicable disease. Added to which increasing numbers could be linked as well to more frequent testing through blood tests.

Earliest known medical illustration of syphilis, Vienna, 1498

HIV pre-exposure prophylaxis which can prevent HIV infection, led to a reduction in condom use among men who share sex with other men, a practise which pushed sexually transmitted infection (STI) rates higher.

An initiative has been undertaken by the federal government through a five-year action plan to focus on STIs and blood-borne illnesses, including syphilis, HIV/AIDs and hepatitis C in hopes of reducing rates and improving access to treatment and testing.

The rising numbers can be curbed through prevention and regular testing. Annual tests are urged upon people whose sexual behaviour places them at increased risk for contracting syphilis.

I'll Have Two of Those and Five of Those...Woof!

"Our work not only shows that dogs use a similar part of their brain to process numbers of objects as humans do -- it shows that they don't need to be trained to do it."
Gregory Berns, neuroscientist, Emory University, Atlanta

"We went right to the source, observing the dogs' brains, to get a direct understanding of what their neurons were doing when the dogs viewed varying quantities of dots. That allowed us to bypass weaknesses of previous behavioural studies of dogs and some other species."
"Part of the reason that we [humans] are able to do calculus and algebra is because we have this fundamental ability for numerosity that we share with other animals."
"I'm interested in learning how we evolved that higher math ability and how these skills develop over time in individuals, starting with basic numerosity in infancy."
Lauren Aulet, psychologist, Emory University, Atlanta, Georgia

Emory neuroscientist Gregory Berns is researching how dogs think and view the world.   Kay Hinton

In an effort to determine whether the ability of canines' ability to detect amounts, numbers, through training or whether that ability was innate, Emory University scientists set about to solve the riddle. How can dogs know that they've been given a smaller treat than what they've been accustomed to? Why is it that they appear to have the capacity to determine that their bowl isn't as full at meal time as it generally tends to be? It is known that they have the capacity to process numbers, somewhat similar to how humans do, according to a Science Magazine report.

A recent report published in Biology Letters reflecting a later study from Emory University in Atlanta set out to solve the riddle, leading the researchers to believe that dogs certainly take notice when less food is placed in their bowls. They cannot count, but they detect differences in quantity. This has been named "approximate number system", known for some time that animals can differentiate quantity. The article in Science made it clear that earlier studies in research into animal numeracy made us of trained animals as their study subjects.

A canine mathematician waiting to go for a walk. Getty Images

What the Emory University study set out to do was settle the question: animal evolution or trained brain function? Dr. Berns who led the study along with colleagues undertook to recruit representatives of eleven different dog breeds for his examination whether there was an ingrained sensitivity to numbers in a certain part of canine brains. The dogs were placed in a functional magnetic resonance imagine scanner (fMRI) and strapped into place their heads resting on a block, to focus on a group of light grey dots on a black background.

The grey dots changed in number every 300 milliseconds and with those changes the researchers were able to note activity in a region of the canine brain called the parietotemporal cortex, known as the parieta cortex in the brains of humans, which function of the brain aids humans in the processing of changing numbers. Of the 11 dogs, eight passed the scanning test, their brain activity demonstrating a behaviour pattern similar to that of the human brain, while three dogs failed to pass the test, which Dr. Berns felt might be linked to breed.

Getty Images

Understanding how dogs are able to detect changes in quantity might represent a breakthrough of some significance, stated Dr. Aulet, who participated in the study. There is an expectation that the research results will at some future date, offer scientists deeper insights into matters such as how brain abnormalities could be treated.

"It further increases our confidence that [these representations of quantity in the brain] are ancient and widespread among species", concluded Michael Beran, a psychologist at Georgia State University, speaking of the study as compelling and exciting.

Emory University, YouTube

Avian Weather Perceptions

"We don't know how [birds are able to detect when a cold front is approaching]. There are a number of hypotheses but we don't know for sure yet."
"We know that birds and other animals can detect subtle changes in air temperature. Many birds somehow sense that very minute drop in air pressure that typically signals low pressure coming [accompanying a storm]. [Birds have several options] That depends on the bird. They either want to get out of there, or they want to hunker down."
"We've done a lot of work on various sparrow species that forage on the ground. If you're a sparrow in winter and a storm is coming, that probably means there is going to be snow. Sparrows need to eat while they can. When we expose these sparrows to a drop in air pressure they start eating more [to store energy]."
"A large number of animals are probably detecting these subtle changes in barometric pressure. How sharks are sensing that under water is a total mystery. I'm interested in understanding in what situations they can cope, and in what situations they will not be able to cope."
"If these extreme events [in weather] become more common, I think it's useful to understand how animals predict and cope with them. Birds are important, not only for the ecosystem but they are culturally important to us. Really, I'm just motivated in trying to understand how they are coping with the changing environment."
Scott MacDougall-Shackleton, Advanced Facility for Avian Research, University of Western Ontario

Sparrows are      known to eat more when they sense a drop in air pressure signalling he arrival of a winter storm. Photo:  Judith Gustafsson

It remains a speculative mystery to scientists how it is that birds have foreknowledge of a winter storm's arrival. With that knowledge they make decisions that are vital to their survival; whether to fly away to safety or to choose to hide until the storm passes. Whichever decision they make is invariably integrated with their feeding requirements. Sensing changes in air pressure, however slight, they are also able to detect when temperature drops, linked to a cold front incoming.

At the University of Western Ontario where Dr. MacDougall-Shackleton, a behavioral psychologist, has his laboratory, the facility is home to the world's first hypobaric climate wind tunnel for bird flight. Research into the physiology and aerodynamics of bird flight at different altitudes is enabled when researchers turn air pressure up and down to study their effect on birds. When high pressure is simulated in the lab along with cold weather linked to winds out of the north in spring, birds decrease their northbound migratory flight behaviour.

Birds in southeastern states in the U.S. managed to develop through an evolutionary track, a measure to dodge storms approaching from the west. They enact a formula whereby they fly south to avoid the path of the storm, then turn west and finally return flying back up behind the storm. Infrasound --  sound at a frequency too low for human hearing -- may cause birds to react. One current theory is that because low-frequency sound travels a long way, birds can hear the sounds of distant rumbles from thunder "probably many hours in advance" of its actual appearance.

"We have now clearly demonstrated that birds, both when wintering and migrating, have their own internal barometer, which helps them make decisions about everything from flight to feeding,"
"This has been hypothesized for a long time and there is a large body of evidence that animals in the wild behave differently when weather changes but we now have an experimental demonstration where we held everything else constant except for barometric pressure proving definitively this long-held belief."

According to climate theory, a warming world will result in more frequent and more violent storms. Dr. MacDougall-Shackleton would like to find out how this, should it occur, will affect bids and other wildlife. There is the issue to be studied whether too frequent and too violent storms may overwhelm the capacity of birds to persevere.

One of Dr. MacDougall-Shackleton's doctoral students is conducting research on whether a bird may become too physically stressed to survive a frequent succession of such storms. If a laboratory bird is exposed to a simulated storm approaching once weekly, the birds appear capable of handling the situation. Should the lab simulate two storms weekly "they would start losing some weight.So they weren't able to keep up with their energy balance."

"Birds have evolved to cope with bad weather. They have experienced it all through evolution. But it's possible that some species may be in trouble", should increasingly violent weather eventuate in the future over what is being experienced at the present time.

The Living Death

"The problem up until now has been that we develop these techniques, we put them out there, we tell people how to do them and the only patients that benefit are the people who make it into other research institutions. It hasn't been incorporated into guidelines for how one treats these patients. And that has now changed."
"[If we can improve prognosis in that group ... brain injuries in the first  hours after trauma ,,, if we can better understand who might make some recovery] we can perhaps save some of those lives."
"Maybe a different decision is right for some of those patients [rehabilitation rather than pulling life support]."
"What is most tantalizing about this prospect is that it would allow a seriously brain-injured patient to express their current wishes, which may well have changed radically in the interval before they expressed any premorbid opinion."
"Ultimately, the morally challenging question of whether theirs is a life that is 'worth living' is one that could be answered by the patient using fMRI."
Dr.Adrian Owen, neuroscientist, researcher, University of Western Ontario, London, Ontario

Neuroscientist Dr. Adrian Owen at the Robart Institute, University of Western Ontario.

"How reliable is the signal [brain-computer interfaces]? How do we make sure that it's the intent of the person, that it hasn't been hacked and that it is reproducible?"
"It's not good to over-medicate someone but it's much worse to under-medicate."
"[And what good is derived that a loved one seems to have a level of conscious processing, with a scarcity of helping tools?] I think that's where I get stuck."
"The technology has advanced to the point that we must attend to the fact that individuals who we thought were in a persistent vegetative state may not be and, in some cases, certainly are not. And those numbers are bigger than we ever thought."
Dr.Judy Illes, Canada Research Chair, neuroethics, University of British Columbia

Emerging research and statistics now inform the medical community that some twenty percent of people diagnosed as being in a vegetative state, considered to be mentally unconscious, unable to exhibit "willful behaviour", disconnected from cerebral life, in fact really are aware and conscious of what goes on around them, but without the capability to transmit that information, to inform doctors, nurses, medical staff, family members that within that comatose frame remains a brain that is still operational, trapped in a body which it can no longer activate.

British-born researcher Dr. Adrian Owen has been experimenting for years with the use of brain scans with the intention of reaching within the minds of people whom medical science has long considered to be in a mental state of complete nothing, a vacuum in an otherwise-healthy body, de-linked from an inoperative brain. Dr. Owen's objective was to be able to find some way of discovering whether the brain remains quiescently active, and whether some mode of communication could be achieved with someone incapable of speaking or moving.

One of Dr. Owen's patients was a young man who had suffered a catastrophic beating that injured his brain, sending him into the netherworld of disconnected consciousness, 16 years ago, at age 18. The young man from Saskatchewan had a father who refused to believe there was no hope for his son. Which led Paul Tremblay to arrange for Dr. Owen to examine his son Jeffrey whom he flew to London with. The functional magnetic resonance imaging scanner showed Dr. Owen that Jeffrey's brain exhibited electrical activity in the frontal and parietal regions, just as any normal person would.

Paul and Jeffrey Tremblay   Photo courtesy Tremblay family

Dr.Owen and his research team wrote up their study and had it published in the journal PNAS, noting that his patient had indicated no "higher-order" signs  of awareness. Yet he was exhibiting executive processing, engaging in "complex thoughts about real-world events unfolding over time", as the experiment with the fMRI indicated. That was six years ago. Since then the scientist at Western University has used fMRI to re-diagnose people once held to be "vegetative", and to communicate with them through elemental responses to questions such as "are you in pain?", through decoding brain activity.

Now, years later there are bedside EEG machines with small discs placed on the scalp to measure brain activity, moving closer to routine use with catastrophic brain injuries. A recommendation was issued in new guidelines from the American Academy of Neurology that where there is any ambiguity of "inconclusive" findings, brain imaging should be used to hunt for emerging signs of consciousness in the brain-injured, left without recourse to speech or action; a "milestone" development in the history of brain science, wrote Dr.Owen and colleagues in a paper titled "Alive Inside", published in the journal Bioethics.

Dr. Owen feels the optimum time for tests is in the first hours after a traumatic brain injury, with a view to predict which patients might recover from a vegetative state, and which might represent a candidate for rehabilitation, and that these tests be widely adopted. This, in the face of the reality that most decisions whether to remove life support happen to take place within the first 72 hours following injury. Other neurologists are now testing deep brain stimulation in hopes of being able to "Re-awaken" or incite awareness in those in minimally conscious states, including years after their injury.

At the present time what has become standard in checking for "residual" or preserved awareness or cognitive function in brains that a stroke, cardiac arrest or blow to the cranium is the use of bedside scales using response and command-following tasks, such as look this way, squeeze my hand, move a foot, follow the ball with your eyes. What complicates the issue is that people who have been diagnosed in a vegetative state or the larger group falling in the minimally conscious bracket, are unable to marshal physical reactions to blink an eye or move a foot on command; their central nervous system has suffered a disconnect preventing them from any movement whatever even though their mental processes could be intact.

In a later experiment, Dr.Owen and a colleague from the University of Liege, slide a man from Sarnia, Ontario who had been in vegetative state for 12 years, into an fMRI scanner and asked if he was in pain. The patient while in the scanner was told to imagine walking around his house if the answer was "yes" or playing tennis if the answer was "no". "Do any parts of  your body hurt right now?", Owen asked. No, came the answer. Juan Torres, a patient from Toronto, six years after a catastrophic brain injury at age 19, re-enrolled at university. "He's intellectually right back to where he was before", noted Dr. Owen of the exceptional recovery.

"Twenty years ago, people would say to me, 'isn't there some sort of surgery you could do to fix these patients? Well, maybe, but we didn't know where to start. You need the basic imaging and you need to understand what's causing the problem before you can solve the problem of how to fix people."
"And I think we're getting there. We're just at the tipping point right now." Dr.Adrian Owen

"We've got patients who we know are on the edge of being able to establish communication, but we don't really know what to do for them yet."
"Just because we identify consciousness and awareness, it's not enough. It's terrible to know we can make these measurements, identify awareness and not be doing what needs to be done, which is to build a medical infrastructure to support these people."
Dr.Nicholas Schiff, neuroscientist, Weill Cornell Medicine, New York

In 2007, Dr. Schiff was the lead author of a study published in Nature describing a 38-year-old man who had been over five years in a minimally conscious state. Now that man is able to communicate with his family. He was the recipient of electric current pulses to his brain, a therapy called deep-brain stimulation (DBS). Through stimulating the central thalamus whose job it is to relay motor and sensory signals to the cerebral cortex, that part of the brain involved in consciousness, Dr.Schiff's team helped this patient to name objects, to produce hand gestures, and to eat without the use of a feeding tube.  Even years after the occurrence of a catastrophic brain injury DBS "can promote significant late functional recovery from severe traumatic brain injury".

Juan Torres at his home in Oakville, Ont. (Photograph by Cole Garside)

Bitter Green Aversion

"Your genetics affect the way you taste, and taste is an important factor in food choice."
"You have to consider how things taste if you really want your patient to follow nutrition guidelines."
"We're talking a ruin-your-day level of bitter when they tasted the test compound."
"These people [supertasters] are likely to find broccoli, brussels sprouts and cabbage unpleasantly bitter, and they may also react negatively to dark chocolate, coffee and sometimes beer."
"We thought they might take in more sugar and salt as flavour enhancers to offset the bitter taste of other foods, but that wasn't the case."
Jennifer Smith, postdoctoral fellow, cardiovascular science, University of Kentucky School of Medicine Lexington, Kentucky

activebeat

In any population there is a sub-set of people with superlative tasting abilities, thought to number between 25 to 30 percent of the population, according to Scientific American. Being a supertaster doesn't necessarily equate with enjoying food more because your taste is able to identify all manner of flavours, not when some flavours of a definitely bitter variety have their bitterness enhanced to the point of rank under-enjoyment.

No one would want to boast of their capacity to taste all the flavour nuances apparent to them in food choices when that ability teaches them to avoid bitter-tasting, albeit highly nutritional foods whose vitamin and mineral content is undeniably a healthy addition to any diet. A new study presented at the annual meeting of the American Heart Association pointed out that people genetically "hard-wired" to food sensitivity and bitterness will tend to avoid "heart-healthy" vegetables.

There may be plenty of people who would rather not have bitter greens such as arugula, endive and kale on their dinner plate, much less cruciferous vegetables such as dandelion greens, broccoli and brussels sprouts, but these truly are super-stars in nutritional quality. However, researchers have found the likely source of bitter-green vegetable aversion.

Greater number of tasteburds on supertaster tongue

One of some 25 bitter receptors on the tongue, TAS2R38 has two genetic variants: AV1 and PAV, of which researchers at the University of Kentucky School of Medicine, studying 175 people, discovered those who inherit two copies of PAV (supeertasters) are likelier to be susceptible to the flavours of bitter compounds such as sulphur in brussels sprouts, than people who inherit two copies of AVI (nontasters), or those who have one of each (average tasters); 40 to 50 percent of the population.

As a result of their super-sensitivity to bitter taste, supertasters are close to three times likelier to consume fewer vegetables than people without a pair of inherited PAV variants. Despite the researchers' expectations, it made little difference whether participants in their study were supertsters or not; fat, salt or sugar consumption remained the same for all their test subjects.

People genetically 'hardwired' to be more sensitive to bitter tastes eat fewer vegetables, according to a new study.  Getty Images

The Biology of Middle-Age Spread

"As we get older, biology sets us up for weight gain."
"By the age of 50, we could be burning nearly 400 fewer calories a day. If you're still eating the same amount of food as when you were 20, you'll gain weight."
"Bodies like to put on weight, but they don't like to lose it. A diet only works if you stay on it for the rest of your life. That's difficult since most diets are restrictive."
"[Government fails to recognize obesity as a chronic disease.] This would increase access to behavioural therapy and medications for obesity. Most health plans don't cover those things."
Arya Sharma, professor of medicine, University of Alberta, director, Obesity Canada

"Studies show that post-menopausal women store more fat."
"We also see that with a chronic decrease in testosterone, which occurs during andropause or male menopause, men also have an increase in body fat."
"[Monitoring weight can help maintain weight] or at least not gain too much."
"[Exercise alone seldom results in weight loss.] You need the dietary component."
Sylvia Santosa, professor, Department of Health, Kinesiology and Applied Physiology, Concordia University

There are health risks associated with failing to acknowledge what is familiarly referred to as "middle age spread". This, despite the very real scientific medical fact that among the 57 known comorbidities associated with obesity which include cancer, Type 2 diabetes, cardiovascular disease and dementia, ignoring the trigger that hastens the onset of these diseases, doesn't much help in tackling this problem of enormous proportions.

In Canada, the median age is a steady 41 in the population. At the same time obesity rates have been rising, and most particularly among people between the ages of 35 to 49. After age twenty the body begins to burn ten to fifteen fewer calories every single day. This is the impact of age on metabolism in the human body. And then there are hormones. Testosterone, the male sex hormone, manages a decrease in body fat, while the female sex hormone estrogen prevents weight gain as well.

Their positive weight effect, however, decreases with age. A decrease in estrogen leads women to gain weight on their hips and thighs, while a like decrease in testosterone causes weight gain in men, particularly around the stomach area. And while preventing weight gain with the use of hormone replacement therapy is an option in middle age, it is controversial therapy, given possible links to cardiovascular disease.

As a result of hormonal fluctuations that women experience, they are more likely to gain weight throughout their lifetimes. Dr. Sharma is a firm believer in behavioural measures, in medications and for some extreme cases, bariatric surgery for long-term effectiveness in the treatment of obesity. Last year, Canada banned the use of industrial transfats in processed foods. It became illegal for manufacturers to add PHOs -- partially hydrogenated oils -- to foods sold in Canada.

A federal government campaign through Let's Get Moving, a policy document was designed to inform Canadians of a need to move more frequently in view of the fact that only 18 percent of Canadian adults meet the guidelines for physical activity of 150 minutes of moderate-to-vigorous activity weekly. Dr. Sharma feels more is needed to motivate people to take command of their options in avoiding obesity.

Habits ideally, should be changed from those inimical to health to those with clear benefits such as eating nutritionally, sleeping adequately, maintaining a healthy weight, smoke cessation, moderate drinking and reducing sedentary time, to produce a good-habit-routine to live by. These, in combination with regular exercise, relate to healthy lifestyle behaviours.

An article in the BMJ Open Sport and Exercise Medicine open-access journal saw lifestyle reviews of statistics accumulated for 34,061 individuals participating in the Vitality program, an interactive online wellness platform, incentivizing health choices such as exercise, medical checks, sleep, healthy food choices and activities geared to stress-reduction.

"The improvements were greatest in those with the most to gain, those with low baseline physical activity levels."
"Our study extends previous findings that health behaviours such as physical activity, healthy eating and abstaining from alcohol and smoking tend to co-occur in individuals and the presence of one healthy behaviour is followed by other healthy behaviours."
Vitality health research team

Exercise after50  Global News

Alcohol -- a Controlled Risk

"We recommend that healthy men and women reduce the risk of harm by drinking no more than ten standard drinks per week and no more than four standard drinks on any one day."
"[Additionally there is now] greater certainty about links between alcohol and a number of different cancers."
"Drinking above this level increases this risk [of dying from alcohol-related disease or injury], while drinking less frequently and drinking less on each occasion reduces this lifetime risk of alcohol-related harm."
National Health and Medical Research Council, Australia

"We are not saying this is a level that completely eliminates risk."
"The less you choose to drink, the lower your risk of alcohol related harm."
"[The guidelines are] not telling Australians how much to drink. We’re providing advice about the health risks from drinking alcohol so that we can all make informed decisions in our daily lives – for ourselves and for our children." 
"It’s ten years since our last review of the guidelines and we now know more about the effects of alcohol. We know that alcohol continues to have significant direct health consequences for many Australians."
Anne Kelso, report author, Medical Research Council chief executive

A new study suggests you may want to stop after this drink

Yutacar / Unsplash

For the first time in ten years Australia has altered its guidelines for alcohol consumption, releasing a study containing consumer guidelines, updating them from previous such advice of two drinks each day being safe, for a total of 14 weekly. That total is now reduced to no more than ten drinks weekly. A standard drink is epitomized by approximately ten grams of alcohol, the equivalent of one glass of wine. Typically a pint of beer has an alcohol volume of around 5.5 percent, or 15 grams of alcohol.

Under these new guideli8nes, 1-1/2 pint-sized beers is seen as the outer limit for an adult. The type of beer is also to be taken into account such that drinking a stronger beer or increasing the amount poured into a mug should also be taken into account accordingly, since without taking these points into consideration, a drinker could wind up consuming more than a standard serving, requiring some self discipline in limiting themselves.

Further evidence has accumulated in the past decade since the last guidelines. (Syda Productions/Shtterstock)

Australia's move is not that far off guidelines issued by the Center for Disease Control in the United States which defines moderate drinking as one drink daily for women and "up to two" drinks for men. Statistics from the CDC note furthermore that "excessive" alcohol consumption was known to have led to 88,000 alcohol-associated deaths yearly, taking an average 30 years off life expectancy for those affected, according to its latest findings dating back to 2010.

"Young people in the emergency department with alcohol poisoning, having drunk so much they can’t keep themselves safe. Some at risk of their breathing stopping. I also see the smashed up faces, young and old."
"On the other hand, I also see people who used to drink too much but who have now cut back or stopped. Their sleep has improved, their mood has improved, their blood pressure has returned to normal. So working out what amount of drinking is OK for health is so important."
Kate Conigrave, chair, NHMRC alcohol working committee -- professor of addiction medicine, Royal Prince Alfred Hospital, Sydney

The National Health and Medical Research Council’s new guidelines on drinking alcohol say adults should have no more than 10 standard drinks a week – or roughly 1.4 a day – to reduce health risks. Photograph: Caiaimage/Paul Bradbury/Getty Images

The Medical Research Council spent three years in studied research in updating the risks or benefits in relation to consuming alcohol. Pointing out in their report that the risk of alcohol-related diseases like heart and liver disease, high blood pressure and digestive problems drops significantly when alcohol consumption is reduced. The report stops just short of claiming two drinks daily represents a safe level =- rather, that it represents an acceptable risk.

In addition to which the report took pains to recommend that adolescents under 18 years of age should ideally consume no alcohol whatever, since it is well known to harm brain development and increase the risk of injury.

Saving Lives, a Costly Enterprise

"We can now save children we couldn't save before. In 2019, in a first-world country like Canada, about 90 percent of those children will be cured. But ten percent won't, and since ALL [acute lymphoblastic leukemia] is the most common of children's cancers, even ten percent of children who relapse represents a substantial population of patients."
"We want to believe, although I think it's probably too early to say for sure, that those children [treated with CAR-T cell therapy] are cured."
Dr. Jim Whitlock, division head, hematology and oncology, Hospital for Sick Children, Toronto

"[While its] scientific ingenuity is marvellous [at potentially hundreds of thousands of dollars per dose, the therapy is also raising] the age-old question; what is the price of a human life?"
"[While it's a one-time infusion], it's not something you give at home and overnight the person has full remission from cancer."
"How much are we willing to pay to survive disease, and how much are governments willing to pay?"
"The ones [cancer drugs and therapies] that were easy to find, we found them. It's going to be harder to discover new therapies."
"[Though CAR-T therapy should be recognized as a] fantastic achievement [it fails some cancers, and both side effects and cost involved are complicating factors]. But when  your disease is a death sentence, less than perfect solutions are not to be dismissed."
Jonathan Jarry, biological scientist McGill University, Hamilton

Kymriah is a personalised cancer immunotherapy Novartis

"[Novartis] worked collaboratively with Cancer Care Ontario on behalf of all provinces to reach a mutually agreed-upon confidential negotiated price where the clinical value [of the drug] Kymriah and health-system sustainability were taken into consideration."
Novartis Canada

A ground-breaking new therapy has been introduced that seems to be successful in destroying the most common childhood cancer. The new therapy extracts T-cells (white blood cells in the bloodstream) to genetically modify the cells which are forwarded to a specific laboratory for DNA to be added to the cells, programming them to target and kill cancer cells expressing a particular protein. The T cells after having undergone genetic engineering then are infused back into the person from whom the cells have been taken. They multiply rapidly, able to survive for years in the donor/recipient body.

Toronto's Hospital for Sick Children and Sainte-Justine hospital in Montreal took part in a global trial whose outcome was published in the New England Journal of Medicine last year. The trial reported an overall rate of 80 percent remission; on a three-month followup in children and adults given a single infusion of tisagenlecleucel (Kymriah's generic name), representing test subjects who would have no hope for a cure other than for the life-saving effects of the CAR-T cell therapy.

There are, as with the potential of complications in any kind of drug infused into a body in hopes of combating the ravages of deadly diseases, a number of issues. A phenomenon identified as cytokine release syndrome "which is basically your immune system freaking out", explains Dr. Jarry, can be launched with the application of the therapy. High fever, nausea, rapid heartbeat, low blood pressure and problems breathing can occur, requiring an ICU admission. To respond to any such reactions, hospitals must stock an anti-body to reverse the effects.

A ependymoma cell attacked and killed by CAR T cells (red)

While this vital CAR-T cell therapy is in use in Ontario at both Hospital for Sick Children in Toronto and at Hamilton Health Sciences, both Princess Margaret Cancer Centre and the Ottawa Hospital are planning to be able to provide the therapy in 2020. Ontario became the second province following Quebec to cover the cost of Kymriah for eligible patients, for the chimeric antigen receptor-
T-cell (CAR-T), approved by Health Canada in the treatment of acute lymphoblastic leukemia (ALL) in children, and a form of non-Hodgkins' lymphoma in adults.

The discounted price to be paid by the provinces after negotiations with Novartis "improves the cost effectiveness of Kymriah and helps support cancer0system sustainability", the province of Ontario announced. For some children with ALL, conventional chemotherapy works the first time around. It is for the estimated ten percent of children with ALL that standard intensive chemotherapy fails, that the CAR-T therapy is aimed toward. Chemotherapy's effectiveness comes with side-effects; short- and long-term toxicities; low blood counts requiring transfusions, nausea, vomiting, hair loss, mouth sores: "The list goes on", said Dr. Whitlock.

The drug is expensive, reflecting that newer drugs are more complex than were older ones. And the pharmaceutical companies are not in business to rescue humankind from the end effects of dread diseases shortening human life. They are enterprising business relying on profit to motivate their continued industry in research and development. Dr. Jarry explained that industry must recoup research and development costs of failed drugs "which is most drugs" in light of the fact that with drugs to fight cancer the low-hanging fruit has been picked.

Friendly Visits -- With Family Pets

"Our hostess went in to the kitchen to get the vanilla cake, but it was gone. There was frosting on Bodhi's mouth."
"The lesson is that as well as  you think you know y our dog, they can always surprise you."
"Our dog [Bodhi] sleeps with us, but a lot of people don't like a dog in a bed. So we bring our dog bed [for overnight visits], but I confess, our dog doesn't always stay in it."
Sean Sheer, Urban Dog blog

"Do not presume that when you and your family are invited for the holiday or the weekend that this extends to your dog."
"Don't just show up after a six-hour car ride and have your dog pop out of the back seat to a look of horror on the host's face."
"I try to avoid situations that are going to be fraught with peril."
Jodi R.R. Smith, president, Mannersmith, etiquette consulting

"A pet as a weekend guest adds a lot of responsibility for a host, even if they are dog people."
"Sometimes that means getting a pet sitter [if it appears likely the invitation doesn't include the family pet]."
"It's nice to also bring a roller brush so you can keep hair off of the furniture."
Lisa Grotts, etiquette expert, San Francisco

"I would not bring my trio overnight unless someone was literally begging me to do it."
"My dogs are used to a lot of attention. It's better to leave them at home with housesitters and to keep their routine as normal as possible."
"Don't set your dogs up for failure [as a result of constant concerns on your part to have them avoid doing unpleasant things while in someone else's house]."
Becky Pugh, owner, grooming and boarding business

Tricky business, that. You receive an invitation that you were hoping would be forthcoming. But there is no mention of an important part of your family. You speculate that the person doing the inviting knows how important your dog is to your life, and just assume the invitation is all-inclusive. And you may be wrong. It's awkward, when you respond that you'd love to come and thank you for inviting us; do you expand hesitantly to enquire whether that means all of 'us'? This is when assuming too much can be fraught with complications.

It's embarrassing, yes, but that unspoken barrier must be broken and the subject broached. 'Is it all right if Brandy comes too?' 'Did you mean to invite Cocoa along with the rest of us?' 'Would it complicate matters if we were to bring Jangles along for that wonderful weekend with you that we're so excited about?' However it's put, it can be awkward, but there are times when these things cannot be avoided, and that time is not when you've arrived and innocently assume what you haven't bothered to be certain of.

It's important to know the rules at other homes. Photo: tshortell

Could be your dog would never stand up to a kitchen counter to see what's on offer. But can you extract a promise from him that he won't indulge in someone else's kitchen? Blogger Sean Sheer discovered to  his huge embarrassment that  his beloved eight-year-old Weimaraner did just that. He had the kitchen to himself while everyone else was having dinner in the dining room. And there was this irresistible aroma wafting down to him from the kitchen counter...

The people who have invited you to visit their home may have dogs of their own, or cats, or both, but don't assume they'll be delighted to have to cope with situations where their own family pets are disquieted at the presence of other animals and your hosts then have to walk on tiptoes of suspense over how their home, suddenly turned into a bit of a zoo with animals snarling at one another, perhaps threatening physical action, and/or indicating displeasure by leaving unanticipated 'gifts' of protest, end up regretting the invitation....

Make sure the and host pets -- are OK with your visit.

Photo: Elenathewise

So balance your pleasurable anticipation of an enjoyable overnight or weekend stay with people you like with the obligation as a guest to ascertain clearly what is expected of you; minus the family pet, or alternately inclusive, but with the expectation that certain rules must be recognized and followed. There will be strain of some kind, but better that than an aura of irritated annoyance plus strain. Take no offence if the invitation is limited; respond intelligently and with courtesy. It is your host who faces a raft of planning complications.

Should you be informed graciously that your hosts fully expect the arrival of  your pet along with the rest of your family, make yourself knowledgeable about their house rules. Whether dogs are permitted on furniture, or not allowed into certain rooms of the house. Above all, whether they are forbidden to expect food from the table when everyone is dining. Consider bringing along with you everything your dog would normally require, from its bed, to food, feeding bowls, toys and waste bags.

Determine whether your hosts would take offence at your pet sharing  your bed. It is their bed, their home, after all. And what if there's an accident? Clean it up and say nothing? Or alert your host and offer to take care of the resulting mess? Could be they use a certain cleaning formula, so make certain that you follow their orders for the cleaning up of messes in their home. And think twice, and then again, if you've been invited to a house with more than its share of fragile ornaments, antiques or family heirlooms which bespeak a special commitment to good behaviour.

Things will go more smoothly if your pet is friendly to everyone.

Photo: tzooka

Be prepared to apologize profusely should your pet have done something to embarrass you and discommode your hosts. And because your host went to the extremes of accommodation in extending their invitation to include  your pet, go beyond a thank-you note, to include with it after your stay a memorable gift of appreciation. That having been said, enjoy yourself and be a good guest, fully appreciative of everything your hosts have done to make your stay with them pleasant.

The Brave New World of Gene Editing

"It's easy to use [Crispr-Cas9, gene-editing technique]."
"They [scientists] can just type a gene sequence into their phone and program the Crispr molecules to manipulate DNA in ways that previously would have been impossible. It has been truly transformative."
"You can't turn back the clock and put the genie back in the bottle. That's just a reality. You know, you can't undiscover things that you have discovered."
"I ended up having several dreams that were very intense -- where I walked into a room, and a colleague said: 'I want to introduce you to someone, they want to know about Crispr'. And I realized with horror that it was Adolf Hitler. And he leaned over and said: 'So, tell me all about how it works'. I remember waking up from that dream, and I was shaking. And I thought: 'Oh, my gosh. What have I done'?"
"What was so horrifying was to see what a disaster the whole effort has been, both from a scientific and technical point of view, as well as from an ethical perspective. The detailed [gene] changes that were made [by He Jiankui in China on twin girls] have never been seen in humans and never been tested in animals."
"So there's no way to know if those changes are safe or defective. That is a horrifying thing to think about, you know, it reminds you of experiments on humans in the past [Nazi Dr.Mengele's infamous experiments on concentration camp inmates during World War II]."
Dr.Jennifer Doudna, professor, Department of Molecular and Cell Biology, University of California, Berkeley

Technology Co-Inventor CRISPR-CAS9 Jennifer Doudna speaks onstage at WIRED Business Conference Presented By Visa At Spring Studios In New York City on June 7, 2017 in New York City. Brian Ach/Getty Images

Chinese scientist He Jiankui set the scientific world in an uproar of disbelief and concern when he announced a year ago at a Hong Kong conference that he had been responsible for the first gene-edited human babies. He had altered their DNA, intending to confer immunity to HIV, with the permission of their parents. His use of Crispr for these infants was widely condemned as both irresponsible and dangerous, since the alterations he made to the babies' DNA, irrespective of good intentions, could have far-reaching consequences even beyond the impact on the children themselves; their offspring and their offsprings' offsprings would all henceforth reflect those changes.

What he had done is to leap into the great unknown, given the consideration of the complex interactions of genes with each other and with their environment. The world of science is in no doubt that the twins, Lulu and Nana, have altered genes that will reappear in future generations with no knowledge whatever of what those consequences could be. This incident alone would be enough to give haunting nightmares to 55-year-old Jennifer Doudna, responsible for the gene-editing technique called Crispr-Cas9.

It is reminiscent in its own way as a scientific discovery of great moment and unknown consequences, to the impact on the world community of the smashing of the atom to create atomic bombs through nuclear fission. For good or for ill, the world now possesses far, far more explosives of imaginable destructive dimensions than it would take to destroy all life on the globe. The scientists who saw their success in nuclear fission at the Trinity test site outside Alamagordo, New Mexico on July 16, 1945 probably exulted, not envisioning the atomic bombing of Nagasaki and Hiroshima with all the horrors they entailed, less than a month later.

Dr. Doudna, on the other hand, is amazed at the success of the experimental therapy on test patients suffering from sickle cell anemia and beta thalassemia, devastating diseases that prevent red blood cells from carrying as much oxygen as they are meant to do. "Apparently, both patients have been cured. That's an extraordinary thing. Here are diseases of the blood that cause terrible distress and for which there's currently very little that can be done." That, in and of itself, is a tremendous success thanks to the gene-editing technique whose application will go far beyond these two diseases which in this instance have been edited out of the genes of two test subjects.

The HBB gene, responsible for the production of hemoglobin, oxygen-carrying molecules in red blood cells, is one of over a thousand genes on chromosome 11, itself merely one of the 23 pairs of chromosomes comprising DNA. Humans are estimated to have between 20,000 to 25,000 genes, any of which can potentially be edited with use of the Crispr technique. One mutation of the genetic code in DEC2 which influences sleep can permit people to thrive with very little sleep. With Crispr the potential exists for a genetic twist in editing that may allow people to remain healthy with minimal sleep.

Jennifer Doudna in her lab    Credit: Graeme Mitchell/Redux/eyevine

Dr. Doudna has been haunted by uncertainty ever since, in 2012, she published her pioneering paper introducing the concept of Crispr with her co-inventor Emmanuelle Charpentier, ushering in the brave new era of Crispr. A new film explores the extraordinary potential of Crispr, titled Human Nature, where Dr. Doudna speaks of her concerns of the nightmare of eugenics. And Dr. He in China succeeded in making that nightmare a reality with the creation of the first gene-edited human babies. His strange disappearance from public view since then adds another note of mystery. Yet others are determined to follow his example, and Russia may be the next place where something of that nature re-occurs.

"Fifty years from now, people may say: ‘I can’t believe those barbaric people in the early 21st century were just rolling the [genetic] dice with their kids’ lives'."

"The option now exists [to load those dice. Should we use it?]"
"I think the right way to say it is that sex is for recreation, and science is for procreation."
Dr.Stephen Hsu, Vice-President for Research, Professor of Theoretical Physics, Michigan State University