Negotiating the Emotional Minefield of Stress

"Stress can have a lasting, negative effect [on] the brain. Exposure to even a few days of stress compromises the effectiveness of neurons in the hippocampus -- an important brain area responsible for reasoning and memory."

"Think of it this way: If the complainer were smoking, would you sit there all afternoon inhaling the second-hand smoke? You'd distance yourself, and you should do the same with someone who causes you stress."

Travis Bradberry, author: Emotional Intelligence 2.0

"Our heart rate and blood pressure increase, and we feel angry, anxious, out of control or overwhelmed or numb."

"When we're around people who cause us strongly negative emotions, we have a 'fight, flight or appease response."

Dr. Marianne Trent, clinical psychologist

"Remember that if someone is being difficult, it can be helpful to reframe it to understand that it's usually because their life is difficult right now."

"They might have pressure at work from someone higher up, or there could be something going on in their life that has made them particularly snappy that day."

"It can be a supportive thing in a stressful moment to consider that and give yourself a chance to pause. Remember that two things can be true at once; someone can be difficult or angry with you, you can understand them, and it's OK for you to feel how you feel."

Katerina Georgiou, psychotherapist

Encountering and having to cope with your own emotions set off when you're in close proximity to someone whose attitude and manner toward you seems combative or hostile is not the most pleasant of feelings at the best of times. It can colour your entire day, if you're left fuming at the discomfort of feeling put-upon, let down, or blamed for something you weren't guilty of, or even feeling frustrated for an encounter that clearly placed you on the defensive. Close encounters with some people who are irritated and morose can ruin your day.

The sensible thing to do would be to separate yourself from proximity to anyone whose manner is so abrasive with an attitude  compellingly insensitive, but there are times when you cannot, and there you are, uncomfortable and resentful while someone you would prefer to avoid unloads on you or demands from you something you're not prepared to give emotionally. These encounters raise stress levels and leave one with an impression of being under pressure.

That pressure could emanate from an exchange with someone you're answerable to in your employment, or from someone within your close or extended family toward whom you feel a familial obligation to patience, or a neighbour whose interaction with you tends to be off-putting. Any of these fraught relationships can result in long-term serious effects on physical and mental health. Repeatedly feeling under pressure raises stress hormone production (adrenalin and cortisol), and we can spiral into a state of 'hyper-arousal'.

That's in the short-time; long term the risk of chronic insomnia may arise, and even heart disease and stroke. Relationship counsellors recommend removing oneself from the person's abrasive presence, if at all possible. Perhaps temporarily for 20 minutes to allow stress hormones to re-adjust. The journal Frontiers in Psychology published a study in 2019 that established a dose time of 20 minutes for effectively lowering stress levels. Should that 20 minutes be spent in a green environment, say walking through a local park, all the better.

Psychotherapist Georgiou, author of How to Understand and Deal with Stress advises "sandwiching" a questionable encounter such as a meeting or lunch with a difficult family member with "supportive" activities. "This could be going to a coffee shop or for a swim or speaking to a friend. Any activity that you enjoy and will give you a boost."

"This can be done politely, but firmly", advises clinical psychologist Dr. Trent. "People who are 'unboundaried' don't like having boundaries put in place around them, but that doesn't mean you can't add to them." Cognitive behavioural therapy teaches techniques that help reframe perspective and replace unhelpful beliefs and thoughts with those seen to be more realistic. Moving your thought process to an empathetic view of an irritating person; everyone has their background problems.

SutterHealth.org

 

The Journal of Personality and Social Psychology published a study in 2014 that found how we 'talk' to ourselves affects how we process emotions and manage stress. Self-esteem can be impacted by stressful relationships; particularly true in relationships with family members resulting in constant challenges. "You see it with children whose parents have been strict with them --- we start to speak to ourselves in the way we've been spoken to". Dr. Trent suggests making a conscious effort to speak to yourself the way you would to a best friend, with empathy and understanding.

"Positive self-talk helps you to reframe the way you look at stressful situations, understanding that you will approach challenges with the best of your ability and that whatever the outcome -- you did the best you could. Tackling these situations with an 'I can do this' mindset rather than a negative 'This is too hard' one, opens new ways of thinking and problem-solving", offers psychotherapist Elaine Meade who specializes in positive psychology.

For Optimum Health in the Elderly; Maintain Muscle Mass

"The trajectory is that most people will get heavier with age until they reach their 60s, and then they begin to lose weight. [But the] ideal weight depends on the individual.There are going to be larger people who are metabolically fit and skinny people with diabetes."

"[When you lose or gain weight the number of fat cells in your body remain stable; think of them] like balloons -- the fat cells expand or shrink and everyone's fat cells expand to differing degrees, meaning people store different amounts of fat safely."

"Tracking BMI [Body Mass Index] across a population is useful on average, the higher your BMI, the more fat you carry, and the more unhealthy you're likely to be. But on an individual basis, it's not the best measure; if you're a doctor looking at the human being in front of you, you need to look at how healthy the individual is. Are they young, muscular, older, have they just had a baby?"

"People in middle age tend to be less active because we're sitting on our backsides doing our jobs, plus the fact that we have more money on average, and so eat richer foods."

"Your metabolism stays stable for a surprisingly long time -- until 60 or so -- before it begins to fall. When people get older, we're not as physically active and you begin to lose muscle. Muscle has the highest metabolic rate in your body, so you could be the same weight, but carrying more fat than muscle, and then the metabolic rate will be lower."

Giles Yeo, professor of molecular neuroendocrinology, University of Cambridge

Scientists from Australia's Monash University conducted a study of over 16,000 healthy pensioners, and discovered that elderly men who lost over ten percent of their body weight were almost three times more at risk of dying in the following few years than those who maintained their weight. That same mid-April study led to the discovery that a ten percent body mass loss more than doubled the risk of death for women. The subjects in the study had no existing chronic illnesses at the study start after which they were assessed over four and a half years.

 

Body Mass Index representing weight in kilograms divided by the square of height in metres -- was thought to represent the most accurate health measurement. "The major problem with BMI is that it doesn't take into account the amount of fat or muscle you have", explained Professor Yeo. Experts more recently emphasized a healthy waist-to-height ratio determined by dividing waist size by height; men and women should maintain waist circumference at no more than half their height.

 

An increase in overall weight is not as dangerous as extra inches around the middle since visceral fat accumulates around internal organs and is linked to an increase in risk of cardiovascular disease and cancer. The risk of health conditions such as stroke, heart disease, Type 2 diabetes and some types of cancer rises with obesity (BMI of 30 or over). In later life, however, underweight (BMI of under 18.5) is also linked to health outcomes such as nutritional deficiencies, bone fractures and osteoporosis and weakened immune systems. 

Physical activity in middle age helps to counteract that infamous 'middle-age-spread'. Moderate daily exercise of 30 minutes daily helps -- inclusive of brisk walking, hiking or riding a bicycle. Maintaining muscle mass and keeping weight-to-height ratio makes for one's BMI remaining within the healthy range; preferable to focusing on weight itself. A slowing metabolism is also aided by keeping weight within a healthy range. A diet rich in protein, low in processed foods and refined carbohydrates such as white bread, pasta, pastries and pies helps immeasurably.

Published in the Journal of Epidemiology and Community Health, a study found all-cause mortality was lowest among people aged 65 and over, among those who had a BMI of 25-29.9 for men and 25-32.4 for women. "In your 60s, it's probably not too late to lose weight, as it enhances your ability to live healthier for longer", comments Professor Yeo. Moderate aerobic exercise like brisk walking works when built to the point the recommended 150 minutes per week is reached.

Older patients with a higher BMI had a significantly reduced mortality risk following surgery, according to another recent study from the Archives of Orthopaedic and Trauma Surgery. "As you go into your 70s and 80s, in particular, obesity is no longer a major problem because you lose weight quite rapidly", through loss of muscle mass or appetite, notes Dr. Yeo. "I think people underestimate how much that matters [muscle helps to maintain cardiovascular health and bone density with moderate strength training] and it really, really matters when you get older."

Canada's 'Safer Supply' Drug Addiction Mitigation Program

"We quickly assembled health-care teams to dish out and prescribe mass quantities of opioids and it wasn't very long until gangs infiltrated the hotels."

"These are disabled people. Old people. Little women. So very early on, we knew it was happening."

"My colleagues have had some high-profile overdoses -- a 12-year-old and a 14-year-old, fatally over-dosed. We've never seen kids that young overdosing before."

Dr. Caroline Ferris, front-line addiction physician, Victoria, British Columbia

Greg Sword with a picture of his 14-year-old daughter Kamilah, who died of a drug overdose last August. Photo by Jason Payne /PNG

"As in many Canadian cities, the pandemic created a homelessness crisis in Victoria, which lead to the rise of several dangerous encampments, whose residents were eventually relocated to hotels that had been converted into supportive housing."

"At first, Dr. Ferris thought it was  beneficial that dirt-cheap, diverted hydromorphone was flooding into Canadian communities, as she assumed that it would mitigate fentanyl consumption. However, Dr. Ferris said that 'it hasn't really gone that way' and that diverted hydromorphone is going to youth and to 'regular Joes who would never use opioids unless their colleague was offering them one for a buck a pill'."

"She now believes that it's 'a bit facile' to argue that hydromorphone diversion mitigates fentanyl consumption, especially given the increasing number of fentanyl overdoses in British Columbia."

"Though safer-supply advocates claim that the strategy's critics are merely fringe voices, Dr.Ferris said that half of the health-care professionals she knows have been 'passionately lamenting this since the start of the pandemic'.

Adam Zivo, Investigative Journalist, National Post

Canada's 'safer supply' drug strategy has come under some intense scrutiny of late, and deservedly so. Front-line addiction physician Dr. Caroline Ferris prescribes safer supply hydromorphone, an opioid more potent than heroin, where she works in community settings in British Columbia's capital city, Victoria. The idea behind safer supply was to reduce the incidences of overdoses and deaths. British Columbia has been experiencing an alarming increase in both.

Making free pharmaceutical opioids available to drug users was seen as an attractive and life-saving alternative to street drugs which could be tainted with, for example fentanyl and carfentanil, two potentially deadly drugs mostly manufactured in China, entering the illicit market to capture ever increasing numbers of users as merchants of death, drug dealers, bring it to the streets and adulterating less potent drugs with the potentially lethal products.

Dr. Ferris initially was taken with the thought that progressive drug policies inclusive of drug legalization would be of benefit. It was during the coronavirus pandemic when the initiative was taken to increase safer supply across the country that she began to have second thoughts. She would be informed by vulnerable patients their experiences of gang members confiscating their drugs. And so it became understood within the profession that criminals were acquiring hydromorphone and shipping it across Canada.

 

Artwork about harm reduction adorns an appointment room at Parkdale Queen West Community Health Centre in Toronto. Laura Proctor for STAT

Now, she and some of her colleagues meet to discuss the issue, all of whom are "concerned by the number of youth using hydromorphone, or who started with it and then moved on to fentanyl." Youth whose ages between 12 and 14, are "unprecedentedly young". The number of patients of all ages also alarms Dr. Ferris for those who have relapsed or have developed new addiction issues resulting from hydromorphone use. She conducted a survey of her patients to discover that of 41 current patients requiring assistance for opioid use disorder five used hydromorphone alone, but another ten were using hydromorphone along with another drug.

She has seen and recognized some benefit to the safer supply program among patients in the early stages of recovery-oriented treatments, like methadone. Because many patients expect they will receive hydromorphone in perpetuity, however, they occasionally become abusive when informed they must discontinue the drug once it has performed its required function to bring them to the next stage of recovery.

As well, patients suffering from chronic pain and who as a result of prescribing restrictions cannot access the opioids they need for pain-free living, can benefit from safer supply. "True" safer supply for fentanyl users requires pharmaceutical fentanyl options, she feels, which should be provided with caution. A very limited model of safer supply differing dramatically from the grossly irresponsible 'one-size-fits-all' in use in Canada today, has its attractions. The current safer supply, she feels, represents an inadequate solution for chronic pain management, and the diversion crisis must be addressed since it serves to add fuel to the opioid epidemic.

“We know that there has been an issue with diversion, but we really do believe that safe supply is an evidence-based approach in saving lives,” insists Minister of Mental Health and Addictions Carolyn Bennett. Photo by Darryl Dyck  /The Canadian Press

"The anecdotal evidence precedes the data collection. Somebody sounds an alarm and then we collect data. With the OxyContin crisis and fentanyl, we in the field knew what was happening before there was data to support it."

"It's disrespectful to discount our observations."

"It's disrespectful to ignore the concerns of prescribers and communities who see this happening."

"A lot of these folks are, in fact, older people who have chronic pain conditions and have been de-prescribed due to fear from our professional college [as a result of onerous prescribing restrictions implemented after the OxyContin crisis], or they've lost their family physician and can't find anybody to prescribe, because, of course, the optics of going around to clinics and asking for Dilaudid [hydromorphone] are very poor."

Dr. Caroline Ferris, front-line addiction physician, Victoria, British Columbia

 

Booths for supervised consumption services. Laura Proctor for STAT

Labelled 'Health' Products, Are they Safe and Healthy?

Vanessa died in 2000 after complications from Prepulsid

"[The provisions had been discussed before, but] there was nothing that would have indicated to industry that it was imminent."

"The industry and the association were both caught off guard when we saw that included in the budget."

"We have seen no consultation efforts to persuade us that the regulatory powers conferred in Vanessa's law would be appropriate for the lowest-risk products, such as natural health products."

Aaron Skelton, president, Canadian Health Food Association

"I think post-market surveillance the monitoring for safety around natural health products is urgent."

Senator Judith Seidman, epidemiologist, health researcher

"We have no recourse."

"There's no reporting on side-effects, there's no follow up, there's no nothing for natural health products to this point -- not the same way that there is with the other prescriptive drugs or other therapeutic products that are much more regulated."

Katharine Kovacs Burns, co-chair, Patients for Patient Safety Canada

A new plan to force hospitals to report adverse effects of "natural health products" such as herbal remedies and supplements has come as a surprise to manufacturers, who say they were blindsided by the proposed change. THE CANADIAN PRESS/Darryl Dyck

 

Vanessa's Law, passed in 2014 -- was meant to improve adverse health reactions reportage -- named after Vanessa Young, the 15-year-old daughter of a Conservative Member of Canadian Parliament. She died in 2000 after her heart rate was morbidly affected by prescription medication her physician gave her a script for. 

Hospitals would be required to report any unintended consequences that might be associated with natural health products if they were to be placed under that framework. Such reports would enable Health Canada to recall products or to order that they be re-formulated should that be deemed to be necessary to ensure their safety to the consuming public.

The new plan would impose reporting of adverse effects of "natural health products" on hospitals with respect to herbal remedies and supplements. The plan was included by the federal government in the 2023 budget bill, now making its final passage through the House of Commons before it becomes law.  Once it does, natural health products would fall under the same category as pharmaceuticals respecting monitoring them once they are on the market.

The debate over whether natural health products should be included in Vanessa's Law generated "quite the discussion" when it was initially introduced  noted Senator Seidman.. Several high-profile tragedies since then where parents and patients chose to substitute conventional medicine in favour of natural remedies ensued, prompting a renewal of the conversation on regulation of natural health products in Canada. The Canadian Pharmacists Association has stated that natural health products should have been included when Vanessa's Law was originally passed back in 2014.

The federal auditor general in 2021 found Health Canada fell short of making certain that products were safe and effective on the market. Gaps in monitoring of such products left consumers exposed to potential health and safety risks. In that same report it was pointed out that 88 percent of natural health products reviewed were advertised with misleading product information. Some products had unproven and unauthorized health claims, incorrect dosages, incomplete lists of ingredients, or unreadable information on the product label.

The issue has heated debate to the extent that Aaron Skelton, in his position as president of the Canadian Health Food Association was left to argue that manufacturers are responsible themselves for reporting any ill effects associated with their products. Health Canada, he pointed out. has the power to stop sales and seize products at the present time.

Arguments in defence of his industry and his contentions that there is no need for government to impose additional restrictions on the health food production industry, nor to impose on hospitals the responsibility to keep records to report on all side effects or other incidents relatable to health food products, fails to impress the volunteer patient-advocacy organization Patients for Patient Safety Canada.

In the United States, the National Center for Complementary and Integrative Health, an American government agency regulating such products, notes that simply because an ingredient has 'natural' origins not synthetically manufactured, should not be construed as the product being completely safe. It cites as an example, that kava, a plant native to the South Pacific used as a dietary supplement may be implicated in severe liver damage.

Fixated Focus on Longevity

"[Project Blueprint focus aimed at] maximally slowing your pace of aging and reversing the aging that occurs."

"[Achieved by] routinely taking hundreds of measurements of my body's 70+ organs, enabling my heart, liver, lung and kidneys to speak for themselves what they need to be in their ideal state."

"The proposal is not that my father and I get sewn together. [But by donating plasma] it's possible that this will help him in a variety of ways."

"It [his focused experiment on longevity extension] does something special to just get under people's skins. They seem to just boil [when they read the blog] and they just want to unleash on me."

"I do have to confess; I do love it."

Bryan Johnson, tech entrepreneur, Project Blueprint

In what Bryan Johnson described in a video posted to YouTube as one of the sweetest and most emotional experiences of his life, the entrepreneur was infused with plasma extracted from a litre of blood taken from his son’s body. Photo by Bryan Johnson / Instagram

There's just something about high-tech entrepreneurs out of Silicon Valley. They seem to thrive and vibe over the concept of extending their lives, determined they will find a method, and prepared to spend what it takes out of their tech-gained riches and sacrifice themselves to the prospect of living well beyond nature's cut-off date of human longevity. Not merely to live a generously extended lifespan, but to do it in a manner that reverses the aging process itself.

And tech mogul Bryan Johnson is one of those eccentric multimillionaires. He promotes multi-generational plasma swaps as a brilliant method by which an infusion of youth can counteract the wear and tear of years of life on those among us whom age takes its natural course. A course not for him, he has something to prove, that he has devised a formula to extend his life well beyond anything considered normal.

Along with the 45-year-old Johnson's 17-year-old son Talmage, and Johnson's own 70-year-old father Richard, on arrival at a medical spa and wellness centre in Texas, all three swapped their blood. The clinic uses platelet-rich plasma more commonly for the regeneration of hair in men who suffer from male pattern baldness by injecting it into the scalp. What Bryan Johnson had in mind was somewhat different.

Posting a video to YouTube the entrepreneur underwent infusion of plasma extracted from a litre of blood from his son's body, and himself donated blood with the resulting plasma infused into his father Richard. Since selling his payment-processing company, Bryan Johnson has focused on his Project Blueprint website, where he documents his painstakingly detailed measurements of his body organs; data accessible to anyone interested in his very personal experiment.

 

It occurred to Johnson that "it would be pretty epic" if he, his son and father participated in a novel exchange of bio-fluids, an experiment leaning heavily on old research in mice that suggests young blood is capable of rejuvenating shrinking tissues of elderly rodents. Plasma, the yellowish liquid element in blood normally holding red and white blood cells and platelets in the blood in suspension is the key, he feels to restoring youth and longevity of life. 

Researchers, in 2005, surgically stitched an old mouse to a young mouse. Five weeks later the older rodent demonstrated restored muscle and liver cells, the experiment reported in the journal Nature. Blood evidently is not the only thing they share when two mice are sutured together; the old rodent had access to younger lungs, hearts, livers and kidneys.

 

The latest transfusion session including Johnson's son and father is not his first foray into plasma transfusion. He had been undergoing transfusions from an anonymous healthy donor

 

The same research team developed a more direct blood exchange system with the use of a special device carrying blood between young mice and old mice in a later experiment, until each mouse had half of the other's blood. While the older mouse showed improvements in muscle and liver, the young mouse became swiftly older. Old blood dominated; young blood cannot be added in sufficient volume to an older body to counteract the ageing process.

There are few human studies. Young-blood transfusions are considered invasive, as an experimental therapy. "There's some level of risk here", agreed Mr. Johnson. "We have not learned enough to suggest this is a viable human treatment for anything. To me, it's gross, evidence-free and relatively dangerous" commented Charles Brenner, a biochemist at city of Hope National Medical Center in Los Angeles.

Interestingly, there is no proven clinical benefit of the infusion of plasma from young human donors to "cure, mitigate, treat or prevent" conditions such as normal aging or memory loss, according to the U.S. Food and Drug Administration. When clinics began appearing in several states offering young blood from paid donors ages 16 to 25, at a cost of up to thousands per infusion, the FDA issued the warning.

Outside clinical trials, plasma from young donors typically does not undergo testing required by the FDA to make certain it's reasonably safe. For medical purposes for people requiring a transfusion of plasma, the benefits outweigh the risks, states the FDA.

A laboratory technician prepares to process a bag of blood plasma from a donor. Anti-ageing start-ups have experimented with infusing young blood plasma in older people. Representational image/AFP

Back by Unpopular Demand : XBB Omicron Subvariant

"The number of infections will be less. The severe cases will be certainly less, and deaths will be less, but that could still be a large number."

"Even when we think this is a milder wave, it could still be quite a substantial health impact on the community."

Ben Cowling, epidemiologist, School of Public Health, University of Hong Kong

People walk at the tourism site of Qianmen street in Beijing.  Photograph:(Reuters)

There is no complacency over the vastly lower presence in our consciousness of COVID. Globally, one country after another has declared SARS-CoV-2 to have been established as a constant presence which in its various presentations following mutations veered toward greater infectiousness, but lower infections of serious qualities. It still has been capable of great health injury, and the lingering effects of Long COVID, bedevil the unfortunate, but there are far fewer hospitalizations and deaths. 

 

The everyday cautions in the first few years of the coronavirus pandemic such as mask-wearing and enhanced hygiene along with distancing have been officially relaxed at the very same time that regional health authorities warn that the threat of viral infection remains and with it health risks, counselling those at greatest risk to continue practicing those everyday cautions. 

 

In China, the state's 'zero-COVID' policies, strictly policed, made for abject misery for the population. A population so vexed at the severe restrictions that rebellion was in the air, influencing Beijing's decision to release itself from that draconian policy. And people adjusted to life's ordinary freedoms again following a huge outbreak of large-scale infections, which in the final analysis came close to herd protection against the virus.

 

Yet despite the fact that an immense swath of the population was exposed to the virus at some level said to represent fully 85 percent of the population, a new wave of the coronavirus is spreading throughout China with expectations that it will affect up to 65 million people weekly. The new XBB variant of the virus has evolved to overwhelm the built \-up immunity that resulted from the abrupt lifting of the 'zero COVID' mandate of the Chinese Communist Party.

 

As a result Chinese medical authorities are expediting vaccines, two of which, a Chinese epidemiologist, Zhong Nanshan explained, were designed to overcome the XBB omicron subvariant, have been given initial approval. Speaking at a biotech forum in Guangzhou, Dr. Zhong stated that three to four other vaccines would be approved shortly to address the new outbreak which could become the largest infection wave since the zero-COVID regime was dismantled.

Experts in the United States have not ruled out new variants creating another wave of infections in years to come. An increase in infections has been noted in the U.S. caused by the new variants -- which had no impact on the declaration of the end of the public health emergency on May 11. 

Public health experts feel an aggressive vaccine booster program and a ready supply of antivirals at hospitals are required in prevention of another death spike among China's large elderly population despite the acknowledgement that the new wave is expected to be less severe.  Most residents in China are continuing life as usual, and the government has made no effort to prevent infections, resembling the severe restrictions of previous years.

 

NBC News

Educating (Indoctrinating) the Younger Generation in Canada

"Have condoms and lube with you. You may want to have sex while high."

"Adding a personal touch to  your snorting equipment will help you better recognize your own when using with others."

"You may be new to snorting drugs or have snorted drugs for many years. Either way, this resource has something for you."

Staying Safe When You're Snorting information booklet

 

"We were recently made aware of materials that were left at one of our school sites from a third-party harm reduction and drug addiction presentation that we do not consider school or age appropriate."

"[We are undertaking a] full investigation [of our policies with respect to third-party presentations]."

"While the District does support harm reduction as a well-researched and effective method of addressing the ongoing opioid crisis and conversations around drugs and drug addiction, we aim to ensure that the teachings related to it are appropriate for our students."

Cowichan Valley (British Columbia) School District

Safer snorting kits were handed out by a third-party after a presentation at a B.C. high school. Photo by Aaron Gunn / Twitter

A British Columbia conservative commentator issued a tweet on Saturday -- popular enough that 600,000 views resulted -- about 'safe snorting kits' being distributed to students at a Cowichan area high school. "Today in British Columbia ... they are handing out 'safer snorting kits to children as young as 15", wrote Aaron Gunn. Including images of the kit, Mr. Gunn remarked the kit had been handed to students in a region just north of the provincial capital, Victoria.

The revelation prompted the school district to launch an investigation of the 'safer snorting kits' being handed out to assembled teens. Straws, wallet-sized cards for cutting powdered drugs into snortable lines, along with a booklet on "staying safe when you're snorting" formed part of the kit. The booklet addresses the wide variety of drugs that can be snorted ranging from cocaine to crystal meth, fentanyl and ketamine.

The kit -- advised an obviously embarrassed social media statement by the Cowichan Valley School District -- had been distributed by a "third party", the situation not in keeping with district policy. The Canadian AIDS Treatment Information Exchange (CATIE), largely funded by government grants including the Public Health Agency of Canada and the Ontario Ministry of Health, is the publisher of the Safer Snorting booklet as well as its distributor.

To clarify, the B.C. Centre for Disease Control offers bulk shipments of "harm reduction supplies", inclusive of syringes, tourniquets, flavoured condoms, pipes and snorting straws. Perhaps in a nod to the reality that their target audience in this instance is young people, its supply requisition form offers snorting straws in bags of 250, in four colours. In 2021, the centre announced it was "pleased" to say that drug snorting straws would be offered henceforth in biodegradable paper instead of single-use plastic, deemed less environmentally harmful.

Elsewhere in Canada, a York University student last year scored 1.2 million views for a TikTok post that featured a "safer snorting kit" that had been distributed to students. His little joke noted that the Toronto school was handing out "coke kits". "We won't ask you for ID when you order or pick up your supplies. Plus, supplies come in non-identifiable packing", the centre notes, encouraging orders to be made through an alias.

And at the University of Victoria an on-campus Harm Reduction Centre offers free, no limit, no-questions-asked packages of "safer snorting supplies", "safer injection supplies", and "safer smoking supplies". While the service is meant to be reserved for registered University of Victoria students, the Harm Reduction Centre's only check of student status appears to be a single, anonymous online check box. 

 

A public health nurse in March invited to speak to Grade 8 students at a Fort Nelson, B.C. school, handed out cards containing descriptions of extreme sex acts. These compassionate, youth-friendly talks and assurances and usefully available tools to a lifetime of recreational drug dependency appear to have taken the place of teaching complicated subjects like personal responsibility and the functionality of a drug-unaltered mind.

The bright minds who see great social merit in 'educating' the young on the finer points of recreational drug use and accompanying sexual exploits appear fixated on the assurance that they are involved in a public social service to the young and impressionable in Canada. What they are doing in fact, is impressing on malleable young minds that these perverse life-altering addictions are perfectly fine, else the school authorities would not be recommending them. 

"The best way to prevent harms when snorting is to use your own equipment and not share with others."

"There are many ways drugs are snorted. You might use straws, rolled paper, glass or metal tubes, or you may snort your drugs straight from your hand or a hard surface."

"[The booklet explains] the basics of safer drug snorting, nose care and prevention of hepatitis C infections."

Canadian Aids Treatment Information Exchange (CATIE)

  

 

Marine Traffic Introduction to Gladis

"That traumatized orca is the one that started this behaviour of physical contact with the boat."

"[Her] critical moment of agony [made Gladis aggressive toward boats, that aggressive behaviour copied by other orcas]."

Alfredo Lopez Fernandez, biologist, University of Aveiro, Portugal

 

"At that point, we were like 'there's definitely something down there'."

"After that was when we got the first sighting of them."

"Once the main pod turned up it looked like there was a matriarch with a calf. I thought 'oh dear' when I saw them. There's not a lot you can do at that point."

"After reading reports and knowing what has been going on, I just thought we were in for a ride now."

Skipper Greg Blackburn, from Leeds

 

"The little ones shook the rudder at the back while the big one repeatedly backed up and rammed the ship with full force from the side."

"The two little orcas observed the bigger one's technique and, with a slight run-up, they too slammed into the boat."

Captain Werner Schaufelberger, Strait of Gibraltar 

Killer whales attack a sailing boat off the coast of Morocco Credit: Stephen Bidwell / SWNS

 

Ship captains have been placed on alert. There's a female orca, leader of her pack, who has a grudge. The theory is that Gladis the killer whale, has taken to leading orca gangs into conflict with yachts around Gibraltar. She now has three boats sunk in European waters to her credit. White Gladis, believes researchers, has taken a course of vengeance following a traumatic experience when she was in collision with a boat, or possibly found herself trapped in illegal fishing nets.

It has become obvious that other orcas, known to be sensitive, socially cohesive animals, are emulating Gladis's behaviour. The balance of the killer whale population has taken to copying Gladis's attack mode; they have learned how to ram vessels from their ringleader. Six of the predators slammed into the hull of the Bavaria 46 on May 2, sailing in the Strait of Gibraltar, near Tangier in Morocco.

"Heavy weather" of 25-30 knot winds and a rolling swell of two to three metres were already distracting Skipper Greg Blackburn before he realized that he had other adversaries to maritime safety to be concerned about. There were two thunderingly-loud knocks when the whales impacted his rudder. The first ram raids had been carried out by two large orcas, when another four turned up, and that's when Captain Blackburn knew of a certainty he was in trouble.

He dropped the main sail attempting to present his ship to the whales "as boring as possible", presumably to divert them and confound their attention. Eventually the whales seemed to lose interest, but before that happened they managed to cause extensive damage of thousands of dollars' worth, leaving the boat to limp back to port, another injury statistic.

 

A couple was enjoying a sailing course off the coast of Morocco when they spotted a pod approaching Credit: Greg Blackburn / SWNS

 

A pod of three orcas two days later attacked and sank a third sailboat after piercing its rudder on May 4 in the Strait of Gibraltar off the Spanish coast. A similar attack took place off the coast of Portugal last November. Spanish coast guards rescued the crew of Captain Werner Schaufelberger's vessel, but as it was being towed to shore, it sank at the port entrance of Barbate.

May 2020 marked the first reports of aggressive orcas' action off the Iberian coast. Spanish authorities banned sailing boats of over 50 feet in September of 2020 from setting sail from the country's northwestern tip aiming to protect shipping following the registration of 29 orca ram raids. Since then the assaults became increasingly frequent, according to a study published in the journal Marine Mammal Science in June of 2022.

Mostly, these attacks aim for sailing boats and follow a similar pattern where the orcas approach from the stern then hit the rudder before losing interest once the boat has been engaged and placed out of commission.

Researchers believe White Gladis, pictured, is now teaching other whales to attack yachts Credit: Grupo de trabajo Orca Atlántica

"Liquid Biopsy" Cancer Blood Tests

"Unfortunately, people with metastatic breast cancer don't have a good prognosis -- so there is no time to waste wen it comes to determining their most effective course of treatment."

"We are giving [oncologists] a tool that allows them to make an informed decision that ultimately leads to a better outcome and a higher quality of life for patients."

Irsa Wiginton, researcher, co-founder, mDetect 

"[Oncologists] are really very blind to what they are doing. It takes a long time to get results from CT scans."

"You don't want to wait three months on a drug that is doing you no good and has toxic side-effects."

"I think one of the big things is that we are really going to reduce the side-effects that women are experiencing."

"If we can do that, they are going to have a better quality of life."

Chris Mueller, senior scientist, professor, Cancer Research Institute, Queen's University. President, founder mDetect

Irsa Wiginton won an award from Mitacs, a non-profit research organization that aims to build partnerships among academics, industry and governments, for the work on the liquid biopsy. Photo by Mitacs /Handout

Researchers at a laboratory in Kingston, Ontario have developed a blood test they believe can save breast cancer patients from unnecessary tests and treatment, which would allow their doctors to more quickly select a therapy that would  be most effective in their treatment. A clinical trial is in the process of being set up that will begin once patients with metastatic breast cancer have been recruited for the trial to proceed meant to measure the efficacy of the "liquid biopsy" blood test.

 

Should the test be approved it has the potential to extend the lives of metastatic breast cancer patients while improving their quality of life. At the present time oncologists make use of CT scans to determine whether treatment of a specific kind for metastatic breast cancer is effective. CT scans deliver greater doses of radiation than do X-rays and are used sparingly, leaving patients and oncologists no option but to wait some three months following treatment initiation to determine whether it is successful. 

This caution results in an 18- to 24-month gap in cycling between potentially successful treatments before the most effective one is determined for individual patients. The "liquid biopsy" blood test, on the other hand is minimally invasive and could be in use only weeks following treatment initiation, allowing oncologists to more efficiently shift to another treatment in their quest to discover the most effective one for their patients. A process that would prevent months of patients on harsh therapies that fail to work for them.

 

Researchers at Queen’s University have developed a more sensitive means of detecting and monitoring the presence of cancer. This innovative and cost effective test, researchers say, may lead to earlier cancer detection, including relapse.

 

Researchers are anticipating that 150 patients from Kingston and The Ottawa Hospital will agree to participate in the clinical trial which could span a three-year period. Oncologists will be engaged to assist in the enrolment of patients whose illness falls within the category of the clinical trial's parameters for the research to commence and follow their treatment over time. In return, researchers should expect to identify indications of how well the test works, in comparison to CT scans.

DNA in blood indicating whether metastatic breast cancer is growing or shrinking is measured by the test. Liquid biopsies in development represent an expanding field which would encompass other cancers, including the monitoring of lung cancer. Should clinical trial findings be seen as positive, the next move would be obtaining approval for use in hospitals. 

Lauren Michelberger, fourth-year thesis student in biochemistry, processing a blood sample from the lung cancer mDETECT project, PIPEN. (Supplied photo.)

MAID-Accessing Depression - and Potential Alternatives

"To our knowledge, this is the first report of ketamine or any other intervention yielding remission in a patient who would have otherwise likely been eligible for MAID [Medical Assistance in Dying/Euthanasia] for depression."

"Accordingly, it is essential for clinics to have up-to-date and reliable evidence about all potential treatments."

"A lot has improved. There's ups and downs. She [patient] had a lot of challenging life events. [She is not cured, not necessarily] thriving [but her MAID request remains withdrawn]."

"In our hands, we're never really sure how much is biological and how much is psychological about the experience. We think there's a lot of both."

"At the least, before taking an irreversible step like MAID, a trial of ketamine warrants consideration."

Dr. Kyle Greenway, psychiatrist, McGill University / Jewish General Hospital, Montreal

"We don't know how psychedelics, and especially very transformative, deep spiritual experiences even, can shift people's attitudes toward death and toward MAID itself."

"How might we respond to someone who says, 'I do feel a deeper interconnection with the world, a deeper sense of well-being."

"I'm at peace where I'm at, and I would actually like to pursue MAID now."

"That's entirely possible as well."

"[It's] wonderful and important [that people are able to have their suffering alleviated]."

"[Caution is required] so that we're not fuelling additional hype around some of these psychedelic medicines as an easy way, or a magic bullet to reverse MAID decisions."

Daniel Buchman, bioethicist, independent scientist, Centre for Addiction and Mental Health, Toronto

 

In a single case of a suicidal woman who had tried psychiatric drugs, electrical pulses to the brain, shock therapy, none of which provided her any relief from her severe depression, which led her to apply for medically assisted death, her life suddenly turned around when her doctors gave her ketamine. Her depression in the space of under two weeks "rapidly and robustly remitted".

 

This single success has led researchers to be concerned that ketamine may be "easily overlooked" by people considering MAID for major depression, along with their doctors, when medical assistance in dying becomes an available option for people suffering acutely from depression. This case study illustrates the potential for "grave and irreversible consequences" of prematurely declaring an individual's depression to be irremediable; incurable.

There are responses of the study on the careful side cautioning that psychedelic-assisted psychotherapy may not be an automatic lifeline for those seeking assisted death, since requests could conceivably be in either direction, with some people becoming more at peace with such a decision. At the present time, Canadians whose underlying illness is a mental disorder are not eligible for assisted death. 

However, the federal government introduced a bill delaying MAID eligibility for people with mental illness until March 17, 2024, an extension from the original timeline to allow psychiatrists additional time to prepare for the change, in response to outcries of consternation that assisted death be available to people suffering ill mental health. Even as it would be critical in granting euthanasia that "incurability" be established.

Ketamine, available since the 1960s, is one of the most commonly used anesthetics in medical use worldwide, for surgery and for rapid pain relief in emergency procedures such as replacing a dislocated shoulder. It is also a risky and illegal club drug "for those looking to feel a little lighter and a little loopier on the dance floor". Across the United States, ketamine clinics are opening -- with more than a dozen operating privately in Canada.

The charge is about $1,000 per treatment. Dr. Greenway's team is able to treat only a few patients weekly. In 2000, scientists for the first time began testing ketamine as an antidepressant. One very small trial with seven subjects suffering major depression found a significant improvement in symptoms reported by people, within 72 hours of a ketamine infusion. Following that, a review of evidence from 83 publications found depression symptoms can be reduced within one to four hours after a single treatment, lasting up to two weeks.

A Canadian and American research team raised serious safety concerns recently on the effects of repeatedly inducing an altered mental state.  Dr. Greenway, operating out of a ketamine clinic at the Jewish General Hospital, is cautious. The findings are that altered consciousness has a range from a fleeting, pleasant euphoria to "significant psychosis". When used as an anesthetic "people feel a little bit strange, and they might see the room a little bit distorted". 

People experience vivid and "pretty pronounced" hallucinations within ten to 20 minutes when injected in lower doses, part of ketamine-assisted psychotherapy, noted Dr. Greenway. People report variously feeling like they're dissolving, or melting into the universe, as a mystical experience. "Sometimes very emotional stuff comes up. It's very psychedelic that way", explained Dr. Greenway. After about 90 minutes there is a return to normal.

It is unknown how ketamine eases depression and suicidal thinking. There are studies that suggest ketamine promotes the growth of neurons and connections between neurons. People are encouraged by Dr. Greenway to use the "momentum" from immediate effects of ketamine to make life changes and take to psychotherapy -- "stuff that will help keep people well without necessarily needing repeated or weekly doses for the rest of their lives."

Ketamine is inexpensive, about three dollars each dose, requiring an infusion pump, a quiet room, a nurse and a therapist. And not everyone responds; about ten percent of those receiving ketamine for depression remit robustly, though some evidence exists suggesting the greater the treatment-resistance, the greater the odds of ketamine helping to avoid MAID  requests.

All drugs have side effects. When someone is suicidal or severely depressed, possible benefits may outweigh possible risks.

Ketamine given by infusion may cause:

• high blood pressure
• nausea and vomiting
• perceptual disturbances (time appearing to speed up or slow down; colors, textures, and noises that seem especially stimulating; blurry vision)
• dissociation (sometimes called out-of-body experiences); rarely, a person may feel as if they are looking down on their body, for example.

Generally, any changes in perception or dissociation are most noticeable during the first infusion and end very quickly afterward.

Harvard Health

Killer Pandemics : The Eye of the Storm

"Today, more infectious outbreaks seem inevitable. It is not an exaggeration to say that there is potential of a Disease X event just around the corner."

"The recent spate of H5N1 bird flu cases in Cambodia is just a case in point."

"[Surveillance may be] a key approach in our ability to detect a spillover event before it becomes too widespread." 

"[One Health is key to] effectively identifying and responding to these threats as it provides a trans-sectoral and multidisciplinary approach to identifying and responding to public health threats."

Pranab Chatterjee, researcher, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore

"Nature is producing new viruses all the time .. What we're trying to say [with Disease X] is, let's think creatively about designing vaccines and therapeutics and drugs that not only affect known agents but also can affect future and emerging pandemic pathogens."

"And you can predict pretty clearly that the places where new emerging diseases are most likely to start are countries where there's a lot of wildlife diversity ... means tropical and subtropical countries."

Peter Daszac, president of EcoHealth Alliance, global environmental non-profit

"With the resources and technologies we have now, I don't think it's too much to ask to be ready for 120 different viruses ... so, I just think it's a call to action to have much more investment in basic research, and preparedness and understanding of biology and understanding of the threats."

"All global threats began as regional problems. Even HIV was a regional problem until we missed it for two or three decades, and then it became a global problem."

"And it's in the high-income countries' best interest to help low-income countries have the facility and capacities to solve their own problems regionally before they become global problems."

"You know, we act like we're only going to be on the planet for another five years. And we need to be thinking longer term, we need to be thinking outside of an election cycle. Our thinking needs to be about 100 years, for me, not two years."

Barney Graham, senior adviser, global health equity, Morehouse School of Medicine, Atlanta 

Eco Health Alliance

 

Speculation is rife and it has been for years, over where the next world threat through an infectious virus will come from, how virulent it will be, and the level of its human-destructive force. Major infectious events are on the horizon and have been, for some time. Preparedness for reaction to such events is still in the gestation stage. Scientists estimate that 1.67 million viruses, yet to be discovered, prey on mammals and birds, some half of which have the potential to spread to humans. 

 

The World Health Organization back in 2018 spoke of the unknown future outbreak as Disease X, representing the "knowledge that a serious international epidemic could be caused by a pathogen currently unknown to cause human disease". It took but a year before SARS-CoV-2 appeared on the world scene, the first in the category of mystery viruses scientists were concerned about, alerting the world medical community.

The appearance of the next, anticipated outbreak will take creativity and vigilance to track it since the perspective is, following COVID-19's global disruption, this is only the beginning. There is general consensus that the next Disease X will be zoonotic, like SARS-CoV-2, a virus specific to animals that made its way, leaping the species barrier, to infecting humans. Almost 75 percent of emerging infectious diseases -- Ebola, HIV-AIDS, rabies and COVID-19 are several among a staggering number of potential zoonotic threats.

Nearly all recent infectious diseases of global concern, including COVID-19 are caused by animal viruses attaining human transmission, according to data. Zoonotic viruses continue to represent the pathogens of interest as future diseases with the potential to become pandemics. And that would include diseases known from a specific source that could evolve into a mutated form to threaten its virulence widely.

Rift Valley Fever, a virus listed as one of eight known disease by WHO, that poses the greatest public risk of a health emergency is one such example which in severe form is capable of resulting in blindness, excessive bleeding and brain swelling. Generally, it spreads to humans through mosquito bites, with no human-to-human spread yet documented. However, if its causative virus changes its transmission mode to respiratory spread similar to flu viruses it could be the next Disease X.

 

EcoHealth Alliance scientists are sampling humans and wildlife around the globe to track and discover new viruses

 

Of the 1.67 million unknown viruses, all belong to roughly 25 viral families through which scientists have identified 120 viruses from these families posing potential risk to humans. Scientists in view of the fact that it is not possible to prepare for each viral pandemic threat, devised a strategy to identify prototype virus models that have the potential to cause the greatest risk to humans for which no known medical countermeasures exist.

Another considerable factor is rising global temperatures with the potential to unleash zombie viruses frozen for thousands of years in permafrost. The main drivers of the next Disease X pandemic appears to be land usage change, deforestation, population growth and activities such as wildlife trade where "humans come in contact with 'new to us' pathogens".

ProMED, an internet-based reporting network supported by the non-profit International Society for Infectious Diseases is open to all, accessed free of charge. Unlike government organizations this system can inform the public of the initial case first captured by informal and/or local reporting, whether through social media, local media or when that case initially presents to a healthcare worker. Which makes ProMED critical to the global public health community.

"There is no one perfect surveillance system, nor will there ever be. We have to remain vigilant for both known and unknown threats, using event, artificial intelligence, routine, and lab-based surveillance. ProMED is one piece of the disease-surveillance space occupying a very specific niche where we try to identify outbreaks before definitive results are available."

"...It wasn't until a local media source captured it [the significance of informal information] and Pro MED disseminated it that it was identified as a real threat."

"In outbreaks with pandemic potential any extra days we can move the response to the left on the timeline means lives and dollars saved."

Jarod Hanson, chief content officer, Program for Monitoring Emerging Diseases (Pro MED), Maryland

A nurse works in the intensive care unit at the Humber River Hospital in Toronto during the COVID-19 pandemic. Nathan Denette / The Canadian Press