Makanont: October 2022

Monday, October 31, 2022

Study shows link between genetics and response to electroconvulsive therapy - Medical Xpress

Electroconvulsive therapy (ECT) is a treatment reserved for the most severe cases of depression, bipolar disorder and schizophrenia. Positive results are not guaranteed.

Could genetic insight in the form of a patient's "polygenic risk score" help to predict whether electroconvulsive therapy will be effective for that patient?

That's the focus of a recent study published in the American Journal of Psychiatry, co-led by Dr. Kaarina Kowalec, assistant professor of pharmacy in the Rady Faculty of Health Sciences at UM.

A polygenic risk score is derived from testing a patient's DNA. It reflects the patient's "polygenic liability" for certain disorders, based on the presence of genetic biomarkers.

"There are differences in our genetics that can increase the risk of disorders like depression and bipolar disorder," Kowalec says. "Scientists are starting to demonstrate that genetic biomarkers can also tell us if someone is more likely to respond to a particular treatment. We can potentially use this information to make patients' outcomes better."

The goal of improving patient outcomes has been central to Kowalec's research. When her mother was diagnosed with multiple sclerosis (MS), she wanted to understand why some people with neurological or psychiatric disorders are more likely to experience poor outcomes.

"I started to realize just how much was unknown about these disorders," she says. "Over the past five years, I've researched severe conditions like schizophrenia and MS that haven't responded to treatment."

In movies like One Flew Over the Cuckoo's Nest, electroconvulsive therapy has been negatively depicted as a treatment for psychiatric disorders. But it can be extremely helpful for people who have been unresponsive to other forms of treatment, Kowalec says.

The electrical current, given to the patient after anesthetic, causes a brief seizure, and that can cause changes to the chemicals in the brain. Patients usually receive the treatment 8 to 10 times before they begin to see improvement.

The remission rate after treatment is fairly low, between 30% and 50%. While it is a safe procedure, it can have negative side effects, such as memory loss.

"Patients may not want to risk the side effects if their genetics suggest they won't respond," Kowalec says. "With the polygenic risk score, patients could make better-informed decisions with fewer risks."

Kowalec, who holds a Ph.D. in genomics and epidemiology, completed a postdoctoral fellowship in Sweden before joining UM in 2019. She co-led the recently published study with Dr. Robert Sigström and Dr. Mikael Landén from Sweden's University of Gothenburg.

The researchers analyzed more than 2,300 patients in Sweden who underwent electroconvulsive therapy for a major depressive episode and agreed to have their DNA tested via a blood sample.

The results revealed that a higher polygenic risk score for major depressive disorder was significantly associated with a lower chance of improvement after the therapy. "This means that a person who is more genetically prone to severe depression is less likely to respond well to ECT," Kowalec says.

On the other hand, being genetically prone to bipolar disorder was associated with greater improvement after ECT. The study found no relationship between polygenic liability for schizophrenia and the effectiveness of the treatment for a major depressive episode.

The researchers hope to expand the project to study patients' responses to ECT worldwide. They would also like to examine the relationship between polygenic risk scores and other forms of psychiatric treatment.

"Based on certain genetic markers, health-care professionals could stratify patients into those more likely and less likely to respond to a certain treatment," Kowalec says. "This could help patients get the treatment that works best for them much sooner, without trying a number of ineffective therapies."

Explore further

Genetic risk for psychiatric disorders linked to brain changes

More information: Robert Sigström et al, Association Between Polygenic Risk Scores and Outcome of ECT, American Journal of Psychiatry (2022). DOI: 10.1176/appi.ajp.22010045

Provided by University of Manitoba

Citation: Study shows link between genetics and response to electroconvulsive therapy (2022, October 31) retrieved 31 October 2022 from https://ift.tt/XWHnNUF

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Niagara's Danny Lamb continues to dream big with new single - St. Catharines Standard

Danny Lamb and The Association have released a new single, "Bigger than Me."

Danny Lamb has always been a dreamer.

The Niagara-on-the-Lake native has been a fixture on the Niagara music scene since his days fronting Mrs. Johnson a decade ago to his philanthropic efforts to raise awareness for spina bifida and hydrocephalus, something he lives with, through his Song a City initiative. The latter has shown him there is much more he can be than an entertainer.

“So much of what I am doing today as an artist is bigger than that,” Lamb said. “Stuff like Song a City, and how it plays a role in those things that are bigger than me.”

Lamb was just three years old when he was diagnosed with spina bifida, a defect in the neural tubes. The spinal column fails to develop properly, resulting in varying degrees of permanent damage to the spinal cord and nervous system. Hydrocephalus, which often occurs alongside spina bifida, is a neurological condition that exists when excess cerebrospinal fluid builds up in cavities, called ventricles, inside the brain. Hydrocephalus is usually treated by surgically implanting a shunt that takes excess CSF from the brain to another part of the body.

Lamb’s continuing advocacy work has resulted in him moving beyond producing music for the sake of making music. To him, it means much more.

That is the inspiration behind his new single, “Bigger than Me,” released with the help of longtime friends Kayd and Jason Golden under the banner Danny Lamb and the Association.

“The three of us are the foundation,” Lamb said. “And we’ve always been lucky to have very talented people come in to play bass and drums.”

“Bigger than Me” is Lamb’s way of acknowledging what he sees as his purpose as a musician.

“It’s kind of where the song comes from — my own personal growth as a big dreamer.”

What inspires him today is the music being written by younger musicians he has worked with over the years through his music school in Niagara Falls.

“I work with a lot of young people who are doing a lot of cool things through their music. They’re very aware of what’s going on, what is right and wrong about things in the world. We work hard to create spaces to have their voices heard. It’s inspiring for to hold myself to that standard.”

His career as a teacher also helped him navigate the two years of the COVID-19 pandemic. While venues were shut down and many musicians were left scrambling for an income, he counts himself blessed that he didn’t face that problem.

“I’m grateful that as a music person, I don’t rely on gigging and performing,” he said. “I’ve been very lucky for that.”

Lamb is still deciding where his musical journey will take him next. One thing's for sure, he has no plans to stop any time soon.

“I haven’t put out an EP or record for a while, but I’m definitely thinking about it,” he said.

The song is also going to be a part of a livestream on Oct. 25 that will be aired by the PUSH (People and organizations United for Spina Bifida and Hydrocephalus) Global Alliance.

“Bigger than Me” is available on all streaming platforms and at www.dannylamb.com.

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Niagara's Danny Lamb continues to dream big with new single - St. Catharines Standard
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The Shangazi Kati Yetu Story - IN Magazine

Providing health literacy and equitable treatment for ACB women living with HIV…

Since 1985, the AIDS Committee of Ottawa (ACO) has been providing support, prevention, education and outreach services from an integrated anti-racism, anti-oppression social justice framework that promotes the holistic well-being of people in Ottawa who are living with, affected by, impacted by, or at risk of HIV/AIDS.

As part of its innovative programming, last year ACO launched Shangazi Kati Yetu (Swahili for “Aunties Amongst Us”). The 12-month project brought together African, Caribbean and Black (ACB) women living with HIV to create a dialogue and identify pathways for these women to advocate for equitable HIV treatment.

As the project comes to a close, we spoke with Haoua Inoua, manager of education and prevention at ACO, about the unmet needs for ACB women living with HIV, and how they can best be supported when it comes to optimizing treatment and treatment adherence.

Can you tell us a bit about your background and your connection to ACO?

ACO is my second home. They say that what doesn’t kill you makes you stronger. I had moved to Canada in 1999 with my one-month-old child as a person impacted with HIV. I first landed in Quebec because my native language is French, but after facing discrimination, I moved across the river to Ontario and discovered ACO in 1999. I volunteered for 10 years before getting my first job as an ACB support worker, and that’s really where I found my calling. I get to work closely with people to make sure they don’t have to go through what I went through.

How was the Shangazi Kati Yetu/Aunties Amongst Us project created?

Like all ACO programs, it began with asking participants what kind of programs or services they need. With Shangazi Kati Yetu/Aunties Amongst Us, it began when a group of us women were discussing how, when it comes to matters of sexuality, we usually don’t discuss it with our moms. Instead, we go to our aunt. Even on our wedding nights, it’s often the auntie who comes to advise you on what to do or not to do. So, when we put together the proposal for a program about discussing health and sexuality for Black women living with HIV, it made sense to bring that context to it.

Can you tell us about the details of the program, the participants and the desired outcomes?

The program facilitated kitchen table conversations to provide a space for women to share their experiences on HIV treatment and adherence. These conversations included 30 women living with HIV who were representative of a diverse range of ages and sexualities. Themes identified from these conversations helped inform health literacy workshops that unpacked the barriers faced by ACB women living with HIV. The project will conclude with a report summarizing best practices to support women living with HIV to receive effective treatment and treatment adherence. 

With the program coming to a close, what key learnings have you gathered that will help further support ACB women living with HIV?

The key learnings we found were around unmet needs in relation to medication access and treatment information. In order to make informed decisions on individualized HIV treatment, it is critical for women to understand the available options to make the best decision for their health. Most of the women we spoke with relied on their service providers to make the decision for them, which led to poor outcomes. To me, that’s a form of violence against women. Not providing women with the information that they need to make informed decisions puts the providers in control over women’s health. Historically, this has been true in Canada for Black and Indigenous women, and we need to shift that narrative. Coming out of this program, it is clear there must be better access to treatment knowledge for women to properly advocate for themselves.

Is there any programming coming down the pipeline to further enhance the learnings from this project?

We’re aiming to launch our report at the end of November. Once the report becomes public, we’ll have the proof point to advocate for training. We need to train these women to advocate for themselves. That will be Shangazi Kati Yetu 2.0.

ViiV helped ACO bring this program to life through their Community Education and Services Grant. Why are partnerships like the one with ViiV important?

The partnership with ViiV is important because our objectives are the same: making a better life for those living with HIV. Working together, we can be more effective in making that happen. For us, funding is key to making our work realistic and viable – and to put into action the learnings in the Shangazi report, we’ll need funding. We are grateful for ViiV and thrilled that this partnership allowed us to bring Shangazi Kati Yetu/Aunties Amongst Us to life.

To learn more about how ACO is supporting ACB women living with HIV in Ottawa, please visit aco-cso.ca. 

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The Shangazi Kati Yetu Story - IN Magazine
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Sunday, October 30, 2022

‘We’re getting frustrated’: Calls grow for N.S. to cover high-dose flu shot for seniors - Global News

The flu shot campaign is well underway across Canada, and in Nova Scotia, calls are growing for the province to cover the cost of the high-dose influenza vaccine for all seniors.

“I’m hearing about this regularly,” said Bill VanGorder, a senior spokesperson with the provincial chapter of the Canadian Association of Retired Persons.

“We did a webinar on fitness last night of all things. We had over 200 people on the webinar and even in the fitness context, they brought up the concern about not being able to get the high-dose.”

“We’ve been asking for it for three years,” VanGorder told Global News in an interview at Province House on Thursday. “We’re getting frustrated, frankly, that it hasn’t happened yet.”

He was there watching Liberal MLA Angela Simmonds table a bill in the N.S. Legislature that called for the provincial health plan to cover the cost of the high-dose shot for all seniors over the age of 65.

Currently, Nova Scotia only covers the cost of the high-dose flu shot for seniors in long-term care homes or those in hospital waiting for a long-term care placement.

N.S. begins booking seasonal flu shots, ordered 474,000 doses this year

The province’s lung and pharmacy associations set up a clinic at Province House so MLAs and staff could be more aware of the issue.

“Prior to the pandemic, 70 to 80 Nova Scotians a year passed away,” said Robert MacDonald, the CEO of the Lung Association of Nova Scotia and Prince Edward Island.

He said those people are some of the 4,500 that, on average, pass away annually across the county due to influenza.

“Now that people are moving around more and more often, there’s more susceptibility to getting the flu, and the vaccine is the best way to protect yourself from getting that,” he said.

Nova Scotia is one of four provinces — and the only Maritime province — that doesn’t cover the cost.

VanGorder said covering the high-dose shot for all seniors would save the province money in the long run, because it would help keep people out of the hospital.

After tabling her bill Friday, Angela Simmonds, the Liberal party’s seniors and long-term care critic, told Global News that expanded coverage should start now.

“It represents equity throughout,” she said. “There [is] definitely a gap for seniors 65 and over.”

Susan Leblanc, the NDP’s health critic, also introduced similar legislation recently.

“We know that NACI (National Advisory Council on Immunization) recommends that all seniors over 65 get the high-dose flu vaccine,” she said in an interview.

“It will keep people healthier and, of course, seniors are at higher risk for bad consequences when it comes to getting influenza,” she added.

“I’m a little befuddled as to why the minister is not listening to NACI.”

But Michelle Thompson, the province’s health and wellness minister, says that coverage is under review.

“We know that the regular flu vaccine is safe and effective and we just encourage folks to go out and get that coverage,” Thompson said. “We continue to review whether or not the high-dose flu is something we’ll offer in the future, but not this year.”

That’s despite challenges amplified by the cost of living crisis.

“My wife and I had it last week and, together, we paid a bill of $213.60,” VanGorder said. “We’ve been asking for [this coverage] for three years… We’re getting frustrated.”

You can book your influenza or COVID-19 vaccine here or call by calling 1-833-797-7772.

&copy 2022 Global News, a division of Corus Entertainment Inc.

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‘We’re getting frustrated’: Calls grow for N.S. to cover high-dose flu shot for seniors - Global News
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Climate Changed: Canada's health system isn't ready for new reality, say doctors - Winnipeg Free Press

Montreal family doctor Claudel Pétrin-Desrosiers sees climate change as an all-encompassing “risk amplifier.”

She says it raises the potential for hazard across the board, from threatening the most basic health determinants, such as air quality and access to food and water, to exacerbating seasonal allergies and tick-borne Lyme disease.

Pétrin-Desrosiers, president of the Quebec chapter of the Canadian Association of Physicians for the Environment, is among a group of doctors who say Canada’s health-care system isn’t prepared for the worsening effects of climate change.

A man jumps on a skimboard while riding on tidal pools at Spanish Banks as smoke from wildfires hangs over the downtown core, in Vancouver, B.C., Thursday, Oct. 6, 2022. A group of doctors says Canada's health-care system is not prepared for the worsening effects of climate change and failing to adapt would mean more lives lost. THE CANADIAN PRESS/Darryl Dyck

Finola Hackett, a locum physician working in rural communities throughout southern Alberta, said ignoring the “climate crisis when it comes to health, long-term, it’s going to be very costly, not just in terms of dollars, but in lives.”

Both say acting now has the potential to save lives.

“That’s motivating enough for us to do the work,” said Pétrin-Desrosiers.

Hackett and Pétrin-Desrosiers are the lead co-authors of a policy brief on Canada released last week alongside a global report produced by the Lancet Countdown on health and climate change, which is published by the Lancet medical journal.

The Lancet report underscores the health risks of global heating, pointing to the heat dome that settled over British Columbia in summer 2021 as an example.

The heat dome, which caused more than 600 deaths in B.C., would have been “virtually impossible” without the influence of climate change, the peer-reviewed report says.

The Canadian policy brief says the health-care system has the potential to increase resilience to such extreme heat and other climate-related health risks, but it’s far from ready, especially given the COVID-19 pandemic.

It says heat waves may increase the number of emergency room visits by 10 to 15 per cent, further straining health-care capacity and reducing quality of care.

In Alberta, Hackett said she sees patients with asthma and chronic obstructive pulmonary disease, or COPD, during periods of air pollution from wildfire smoke.

Both Hackett and Pétrin-Desrosiers said they’re also concerned about the effects of climate change on mental health, having seen evidence of increasing instances of post-traumatic stress disorder following extreme weather events, such as flooding.

That’s worrying, Pétrin-Desrosiers said, because access to mental health care in the public system is already lacking, with long waiting lists across the country.

Health Canada’s own assessment of climate change and health published earlier this year says global heating is “already affecting the health of Canadians, and, without taking concerted action, will continue to result in injury, illness and death.”

Greater warming will bring greater risks, but many impacts could be avoided “if Canada rapidly and substantially scales up efforts now to adapt,” the report says.

The linkages between climate change and health are also the focus of the annual report from Canada’s chief public health officer, Theresa Tam, released last week.

The report says “urgent public health action is required to prepare for, protect against, and respond to current and future health impacts of climate change.”

Both the Health Canada and public health officer’s reports emphasize the importance of involving people who are most affected by climate change in adaptation planning, noting vulnerability is often linked with additional social inequities, such as low income, inadequate housing and food insecurity.

Such reports, along with some actions at the provincial level, show there is increasing recognition of the health risks posed by climate change, Hackett says.

“But in terms of, actually, do we have measures in place in our clinics, in our hospitals, in our health organizations, we’re just in the early stages,” she says.

The Canadian policy brief notes the governments of B.C., Ontario and Quebec have taken steps to assess links between climate change and health, but Hackett said such initiatives are “fragmented” without some kind of national co-ordination.

Similarly, Pétrin-Desrosiers said Health Canada committed on paper to improving resiliency in the health-care system, but that hasn’t yet translated into action at the pace needed to address the growing risks.

The doctors’ policy brief recommends that provincial and territorial health authorities undertake climate-resilience analyses to identify priority actions, and calls on Ottawa to create a national secretariat “to co-ordinate the transformation of Canada’s health system” into one that’s resilient to the effects of climate change.

Itsuggests adaptation measures could include climate risk training for health workers and creating health-care contingency plans for extreme weather events.

The federal government is set to finalize a national climate change adaptation strategy by the end of this year, with health and well-being as one of five key areas.

This report by The Canadian Press was first published Oct. 30, 2021.

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Climate Changed: Canada's health system isn't ready for new reality, say doctors - Winnipeg Free Press
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Saturday, October 29, 2022

B.C. sees record uptake for free flu vaccines - Times Colonist

Despite a bumpy rollout of B.C.’s influenza immunization campaign, a record number of British Columbians have rolled up their sleeves to get a shot, said the Health Ministry.

More than 630,000 British Columbians have received a flu vaccine since the campaign’s Oct. 11 launch.

About 43 per cent who received their flu shot got their COVID-19 fall booster at the same time.

Health experts have been predicting a surge in flu cases this year compared with the last two years when pandemic precautions such as masking and social distancing helped cut down on cases.

But with society largely back to normal, B.C. health officials are urging people to get a flu shot as well as a bivalent COVID booster to better protect themselves during the upcoming respiratory season.

For the first time, the province is offering everyone six months of age or older free flu shots, which can be administered in health-authority clinics, doctor’s offices or pharmacies. Seniors 65 and older are eligible for an enhanced influenza vaccine, which is also free.

Health officials say it’s safe to get the COVID booster and flu vaccines at the same time. The province’s Get Vaccinated system allows you to book one appointment for both shots.

If you prefer getting the COVID booster and flu shot on different days, however, choose which one you want to get first. When that appointment is complete, the system will allow you to book a second appointment.

How to get your flu shot:

• Book an appointment at a health-authority clinic or pharmacy through Get Vaccinated (you have to be registered with the system).

• Book an appointment by phoning the toll-free provincial call centre at 1-833-838-2323.

• Book an appointment at your doctor’s or primary health-care provider’s office if they provide flu shots.

• Visit a pharmacy or health-authority clinic offering walk-in appointments.

B.C. will distribute more than 1.9 million doses of influenza vaccine this season, including more than 660,000 doses of the enhanced flu vaccine for seniors.

In the 2018-19 season, about 42 per cent of Canadian adults received a flu vaccine.

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B.C. sees record uptake for free flu vaccines - Times Colonist
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Friday, October 28, 2022

B.C. sees record uptake for free flu vaccines - Vancouver Sun

Despite a bumpy rollout of B.C.’s influenza immunization campaign, a record number of British Columbians have rolled up their sleeves to get a shot, said the Health Ministry.

More than 630,000 British Columbians have received a flu vaccine since the campaign’s Oct. 11 launch.

About 43 per cent who received their flu shot got their COVID-19 fall booster at the same time.

Health experts have been predicting a surge in flu cases this year compared with the last two years when pandemic precautions such as masking and social distancing helped cut down on cases.

For the first time, the province is offering everyone six months of age or older free flu shots, which can be administered in health-authority clinics, doctor’s offices or pharmacies. Seniors age 65-and-older are eligible for an enhanced influenza vaccine, which is also free.

Health officials say it’s safe to get the COVID booster and flu vaccines at the same time. The province’s Get Vaccinated system allows you to book one appointment for both shots.

How to get your flu shot:

• Book an appointment at a health-authority clinic or pharmacy through Get Vaccinated (you have to be registered with the system).

• Book an appointment by phoning the toll-free provincial call centre at 1-833-838-2323.

• Book an appointment at your doctor’s or primary health-care provider’s office if they provide flu shots.

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B.C. sees record uptake for free flu vaccines - Vancouver Sun
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B.C. sees record uptake for free flu vaccines - Vancouver Sun

Despite a bumpy rollout of B.C.’s influenza immunization campaign, a record number of British Columbians have rolled up their sleeves to get a shot, said the health ministry.

More than 630,000 British Columbians have received a flu vaccine since the campaign’s Oct. 11 launch.

About 43 per cent who received their flu shot got their COVID-19 fall booster at the same time.

Health experts have been predicting a surge in flu cases this year compared to the last two years when pandemic precautions such as masking and social distancing helped cut down on cases.

But with society largely back to normal, B.C. health officials are urging people to get a flu shot as well as a bivalent COVID-19 booster to better protect themselves during the upcoming respiratory season.

For the first time, the province is offering everyone six months of age or older free flu shots, which can be administered in health-authority clinics, doctor’s offices or pharmacies. Seniors age 65 and older are eligible for an enhanced influenza vaccine, which is also free.

Health officials say it is safe to get the COVID-19 booster and flu vaccines at the same time. The province’s Get Vaccinated system allows you to book one appointment for both shots.

If you prefer getting the COVID-19 booster and flu shot on different days, however, choose which one you want to get first. When that appointment is complete, the system will allow you to book a second appointment.

How to get your flu shot:

• Book an appointment at a health-authority clinic or pharmacy through Get Vaccinated (you have to be registered with the system).

• Book an appointment by phoning the toll-free provincial call centre at 1 833 838-2323.

• Book an appointment at your doctor’s or primary health-care provider’s office if they provide flu shots.

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B.C. sees record uptake for free flu vaccines - Vancouver Sun
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Thursday, October 27, 2022

UNBC Fall Influenza Vaccine Clinic Information - University of Northern British Columbia

We are happy to announce the 2022 UNBC Flu Clinics dates!!

UNBC Fall Influenza Vaccine Clinic Information

Flu Vaccine clinics are hosted by the UNBC Medical Clinic in collaboration with UNBC Nursing Students. Please remember that these clinics are intended to be a learning opportunity for our Nursing Students, so if you have any particular health concerns or special considerations, please speak to your Primary Care Provider about vaccination or refer to the information below before booking your appointment.

Please note that we will not have COVID-19 vaccines available at these clinics.

UNBC Clinics Dates and Location

Bentley Center Alcove/Alumni Lounge on the Prince George Campus

Thursday Oct 27, 2022 10:00am – 2:00pm
Wednesday Nov 2, 2022 10:00am – 2:00pm
Friday Nov 4, 2022 10:00am – 2:00pm
Tuesday Nov 8, 2022 10:00am – 2:00pm
Thursday Nov 10, 2022 10:00am – 2:00pm

Who is eligible: Any UNBC student, staff or faculty member

How to book an appointment

This year we are happy to offer both booked and drop-in appointments. You can either book an appointment at the link below or drop-in the flu clinics at the times listed. Please note that there may be a wait time if you choose to drop-in. To provide you with a convenient means of scheduling your appointment, please consider using Signup Genius to do so.

To access the Signup Genius created for the flu clinics please copy and paste the following link into a separate browser window.
https://www.signupgenius.com/go/10c0d49a5a62ca6fcc25-unbc1

You DO NOT need to create an account to use this sign up. If you use your actual email address, Signup Genius will send a confirmation of your appointment booking only. It may also help UNBC Medical Clinic Staff to alert you if a change to your appointment is required.

Signup Genius operates and stores any information you provide in the USA. When using this system, the information you provide will only be visible to UNBC Medical Clinic staff, however you may also choose to use an alias, or pseudonym and/or fake email address to further protect your privacy. While creating pseudonyms can be fun, we will not accept your appointment if your pseudonym is offensive or derogatory. UNBC Medical Clinic staff will ask you to provide your name or pseudonym when you arrive for your appointment time.

This service intends to provide a convenient tool to allow you to schedule your appointment. However, if you are concerned about using this service while incorporating the advice we provided above, you can contact the UNBC Medical Clinic at 250-960-6370 or nurse@unbc.ca. Please be patient, as there may be delays in responding to your request through these means.

Prior to your appointment

We request that you please wear a mask to your appointment.

Influenza vaccines can be administered any time before or after the administration of any COVID 19 vaccine.

Do not attend your appointment if you are experiencing any symptoms related to COVID 19 or if you have been asked to self-isolate. Current COVID 19 symptom and information found here: www.bccdc.ca/health-info/diseases-conditions/covid-19/about-covid-19/sym...

Expect to remain in clinic area for 15 minutes after your vaccination.

Other options

You may also be able to obtain your flu vaccine from:

Primary Care provider or Family Doctor’s Office
Local Pharmacy
Northern Health Flu Clinics

For information on flu clinics offered in your area, go to www.getvaccinated.gov.bc.ca or www.northernhealth.ca

Please note, we try our best to have enough vaccine product available for the UNBC Clinics, but we are not guaranteed to receive all the doses we request.

More Information about Influenza

https://www.northernhealth.ca/health-topics/flu
https://www.healthlinkbc.ca/health-feature/flu-season
http://www.bccdc.ca/health-info/diseases-conditions/influenza

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What's ECMO therapy? It saves the lives of COVID-19 patients, but the treatment can lead to higher mental health diagnoses - Vancouver Sun

A new study by Ottawa researchers found that survivors of ECMO had a 24 per cent higher rate of mental health diagnoses after discharge compared to other ICU survivors.

Photo by Dr. Yoanna Skrobik/Supplied /PST

It has been called life support of the last resort, and during the pandemic ECMO, or extracorporeal membrane oxygenation, has helped pull some critically ill patients back from the brink of death.

But treatment with the advanced form of life support appears to come at a cost for some patients, according to a new study by Ottawa researchers.

The study, published in JAMA this week, found that survivors of ECMO had a 24 per cent higher rate of mental health diagnoses after discharge compared to other ICU survivors.

“We already knew that ICU survivors can suffer mental health impacts from the trauma of invasive treatments, living with new physical limitations and dealing with long recovery times,” said lead author Dr. Shannon Fernando, a critical care physician at Lakeridge Health and postdoctoral fellow at The Ottawa Hospital and the University of Ottawa.

“We suspected ECMO survivors would be at greater risk of mental health impacts because they are sedated and ventilated for longer and often face a more challenging recovery. But we didn’t have clear data until now.”

ECMO, which temporarily replaces the heart and lungs of patients suffering from heart or respiratory failure, is used at five centres in Ontario, including the University of Ottawa Heart Institute.

The timing of the research is particularly relevant, say researchers, because use of ECMO grew worldwide during the COVID-19 pandemic to address record numbers of patients with severe respiratory failure. At one point, Ontario had twice as many patients on ECMO as it did pre-pandemic. It has typically been used infrequently because of limits on who qualifies and would benefit from use.

“We suddenly have a lot more ECMO survivors because of COVID-19,” said Dr. Kwadwo Kyeremanteng, co-senior author and scientist and critical care doctor at The Ottawa Hospital. “We need to make sure they have the mental health support they need to recover and survive.”

OTTAWA – Dr. Kwadwo Kyeremanteng, co-senior author of the paper, said patients who received ECMO in larger numbers curing the pandemic need mental health support. Credit Michelle Valberg Photo by MICHELLE VALBERG /jpg

Because it is so invasive, ECMO is generally used on younger patients. About 50 to 65 per cent of those who receive the treatment survive and most are alive five years later, said Fernando.

The researchers from The Ottawa Hospital, the Institut du Savoir Montfort, ICES and the University of Ottawa studied health records from all ICU survivors in Ontario between April 2010 and March 2020. They matched 642 ECMO survivors with 3,820 ICU survivors who had similar characteristics, including age, sex, mental health history severity of illness and length of stay.

Thirty seven per cent of the ECMO survivors were diagnosed with a new mental health condition, such as depression, anxiety and traumatic disorders, a 24 per cent higher rate of new mental health diagnoses than the other ICU survivors.

Fernando led earlier research that found survivors of ICU are at higher risk of suicide and self harm after discharge. He said further heightened suicide and self-harm risk was not seen in the study on ECMO patients, but the research calls for a greater focus on the mental health of patients discharged from ICU and especially those who received ECMO treatment.

“Patients will need help long after they leave the ICU.”

Fernando said he has cared for patients recovering after receiving ECMO treatment. Patients would frequently describe nightmares and recurrent thoughts that were in keeping with post-traumatic stress disorders.

Dr. Shannon Fernando says ECMO and ICU patients need support “long after they leave.” Credit The Ottawa Hospital Photo by Supplied /The Ottawa Hospital

“It became clear it was exceedingly common.”

Knowing that can help to reassure patients, said co-senior author Dr. Peter Tanuseputro, physician-scientist at The Ottawa Hospital and ECES and investigator at the Bruyère Research Institute.

“As care providers, we can tell our patients that its common to struggle with your mental health after an ICU admission. ICU survivors need to realize that they often face months or years of recovery and families and healthcare providers need to support them.”

The full study can be found here.

For more health news and content around diseases, conditions, wellness, healthy living, drugs, treatments and more, head to Healthing.ca – a member of the Postmedia Network.

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"Dark Matter" That Shapes Cancer Behavior Unveiled in Landmark Studies - Technology Networks

Cancers can evolve to become more aggressive without relying only on DNA mutations, two major studies published simultaneously in Nature reveal.

The research characterizes a whole extra level of control of cancer gene activity within tumours, which the researchers describe as cancer’s "dark matter".

The two landmark studies showed how a level of gene control called ‘epigenetics’ plays a central role in the development and progression of bowel cancer. Testing cancers for DNA mutations alone misses this level of control – and so can fail to predict how cancers may behave and respond to treatment.

The research, published today in Nature, was led by scientists at The Institute of Cancer Research, London, Human Technopole in Milan and Queen Mary University of London. It was funded by Wellcome, the Medical Research Council (MRC) and Cancer Research UK.

More accurately predict cancer's behaviour

The research could change the way we think about cancer and its treatment – and lead to new forms of tests that predict cancer’s behaviour more accurately.

Epigenetics involves chemical changes to the three-dimensional structure of DNA which don’t alter the DNA code itself but can control access to genes. It has increasingly been recognised as playing an important role in the development of cancer.

Now for the first time, scientists have been able to track the influence of epigenetic control on how bowel cancers grow, develop and evolve over time, separately from the influence of mutations to the DNA code, which they mapped simultaneously.

The researchers observed important epigenetic changes in every cancer they examined and found signs that epigenetic changes are involved in cancer’s ability to evolve and become more aggressive.

In the first paper, the researchers collected 1,373 samples from 30 bowel cancers and looked at epigenetic changes as cancers evolved. They showed that epigenetic changes:

are highly common in cells which have become cancerous and occur around genes already known to drive cancer
are heritable, meaning they can be inherited by cells with each cell division, and that they contribute to cancer evolution
influence how cancer cells accumulate DNA mutations
were present in cancer cells that had survival advantages which helped them to grow more than other cells.

Survival advantages

The second Nature paper aimed to understand why cancer cells within the same tumour can be so different to one another – a characteristic that helps some cells develop survival advantages and become resistant to cancer treatments.

The researchers wanted to understand whether the diversity of cell types within a tumour is governed by variation in the DNA code, or something else. They looked at the DNA sequence in diverse samples taken from different parts of the same tumour.

They found:

less than 2 per cent of changes in the DNA code in independent areas of a tumour were associated with changes in gene activity
variation in cancer cell characteristics throughout tumours is often governed by factors other than DNA mutations.

The researchers point out that their findings are observational in nature and more work needs to be done to determine cause and effect between specific epigenetic changes and modifications to cancer behaviour.

Fundamental advance in our understanding of cancer

Collectively, the papers represent a fundamental advance in our understanding of cancer. The researchers stress that DNA mutations are fundamental in "setting the scene" for a cancer’s development and evolution – but that much of the subsequent behaviour of cancer cells is determined by other factors, such as epigenetics.

That could help explain why DNA tests don’t always predict how cancers will respond to treatment and help doctors to tailor treatments for patients more effectively. It could also explain why some environmental exposures can cause cancer without leading to mutations in the DNA code.

Professor Trevor Graham, Director of the Centre for Evolution and Cancer at the ICR, said:

“We’ve unveiled an extra level of control for how cancers behave – something we liken to cancer’s ‘dark matter’. For years our understanding of cancer has focused on genetic mutations which permanently change the DNA code. But our research has shown that the way the DNA folds up can change which genes are read without altering the DNA code and this can be very important in determining how cancers behave.

“I hope our work will change the way we think about cancer and its treatment – and should ultimately affect the way patients are treated. Genetic testing for cancer mutations only gives us part of the picture about a person’s cancer – and is blind to ‘epigenetic’ changes to how genes are read. By testing for both genetic and epigenetic changes, we could, potentially, much more accurately predict which treatments will work best for a particular person’s cancer.”

Professor Andrea Sottoriva, Head of the Computational Biology Research Centre at Human Technopole in Milan, who co-led the research, said:

“When we study how cancers evolve over time, we tend to look at DNA mutations, but it’s clear that epigenetic changes also enable cancer to adapt and develop a survival advantage over other cells.

“We have for the first time been able to map epigenetic changes alongside the accumulation of DNA mutations as a colorectal tumour evolves. This provides exciting opportunities to create new treatments for cancer that don’t target the effects of DNA mutations, but instead the epigenetic changes which determine how genes are read.”

"Open's up exciting future opportunities"

Professor Kristian Helin, Chief Executive of the ICR, London, and a world leader in the study of epigenetics, said:

“This discovery represents an exciting advance in our understanding of cancer biology. Cancer’s ability to rapidly change and evolve is a key reason why it is so hard to treat. Exactly how cancer cells do this, and the factors that control how it can adapt to evade treatment, is not well understood.

“This important work demonstrates the potential role of epigenetic regulation in the development of cancer and the complexity of its behaviour. It opens exciting future opportunities to assess cancer using both genetic and epigenetic tests, and eventually to treat cancer with epigenetic-directed drugs."

References:

Heide T, Househam J, Cresswell GD, et al. The co-evolution of the genome and epigenome in colorectal cancer. Nature. 2022:1-11. doi: 10.1038/s41586-022-05202-1
Househam J, Heide T, Cresswell GD, et al. Phenotypic plasticity and genetic control in colorectal cancer evolution. Nature. 2022:1-10. doi: 10.1038/s41586-022-05311-x

This article has been republished from the following materials. Note: material may have been edited for length and content. For further information, please contact the cited source.

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ECMO survivors have higher rate of new mental health diagnoses than other ICU survivors - - The Ottawa Hospital

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ECMO survivors have higher rate of new mental health diagnoses than other ICU survivors - The Ottawa Hospital
What's ECMO therapy? It saves the lives of COVID-19 patients, but the treatment can lead to higher mental health diagnoses Ottawa Citizen
ECMO May Come With Mental Health Costs Medpage Today
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Soaring RSV rates in parts of Quebec lead national cases, strain hospital staff - Delta Optimist

MONTREAL — Soaring cases of respiratory syncytial virus in Quebec have pushed the positivity rate to 15 per cent in Montreal and Quebec City.

Weekly provincial surveillance data ending Oct. 22 show positivity rates of the childhood illness hover just over 13 per cent provincewide, with slightly higher rates in the two cities and wide variation among smaller communities.

It’s several times the most recent federal positivity rate of 3.5 per cent, although that data is a week behind and covers the week ending Oct. 15.

The head of the pediatric emergency department at Montreal's CHU Sainte-Justine said Tuesday his emergency rooms “are completely jammed with patients” with respiratory viruses, largely driven by RSV.

"There's just so much more — a larger wave with sicker patients therefore more hospitalizations, and our hospitals are just full to the brim," Dr. Antonio D’Angelo said Tuesday.

"In the emergency rooms, well, they're just all over the place — they're in our respiratory unit in the emergency room but they're also in sort of a makeshift corridor for a temporary unit there. And then we had to open up another corridor with patients with respiratory cases that needed treatments.

"And that's very, very unusual. In fact, we've never had it this bad."

A pediatric infectious disease specialist at the Montreal Children's Hospital reported similar spikes there, noting that admissions suggest Quebec is already in the middle of a very bad RSV season when normally it shouldn't have even started yet.

Dr. Jesse Papenburg explained the early onset as the legacy of a similarly early and intense RSV season last year. He said it began in September 2021 and "was over" by January, when other provinces hadn't even yet reached their peak.

As for why Montreal saw the early spike, he said France and New York City each saw springtime RSV outbreaks in 2021. Since both regions attract a lot of travel from Montreal, it's possible that importation combined with a susceptible population and easing pandemic measures created the right circumstances for a summer surge.

Further adding to the burden this year is the fact RSV seems to be hitting more than just babies and toddlers to include three- and four-year-olds, who are getting the virus for the first time because they had been shielded by now-lifted pandemic precautions, said D’Angelo.

D'Angelo said he expected similar rates to emerge in other Canadian centres, acknowledging that other hospitals are already seeing increasing numbers of respiratory patients, as well as strained resources and staff.

The national figures show a positivity rate of two per cent in Ontario and 3.4 in Atlantic Canada. The lowest rates were 1.4 per cent in British Columbia, one per cent on the Prairies and two per cent in the Territories.

Ottawa pediatric hospital CHEO said for the week ending Oct. 15, out of 298 RSV tests 30 were positive — about 10 per cent.

A CHEO spokesperson said 12 patients were hospitalized for RSV last month — the same record-high number as last year, and much higher than the pre-pandemic average of about one to two hospitalizations for September.

D'Angelo said RSV typically spreads by community, and does not generally emerge at the same time across the country.

"It often happens where there'll be one sort of epicentre where everything sort of starts to occur, and then it sort of spreads out," he said.

D'Angelo said strain at his hospital was compounded by the fact that about 30 per cent of patients there don't have a family physician and end up going to emergency with minor ailments that otherwise could be treated elsewhere.

"Now everything's sort of by appointment instead of just walk-in," he said, believing more walk-in clinics could address hospital demand.

"With the amount of viruses that we're seeing, a lot of these docs don't have any more time available for their own patients, which is kind of sad."

While only a small percentage of RSV cases result in hospitalization, the illness is common among children. By age two, 90 per cent of kids will have had an RSV infection, said Papenburg.

However, some infants are at greater risk of severe illness and that's when it's important to be have a predictable viral season, he said.

The RSV season typically runs from November to March but Quebec experts noticed a five per cent positivity rate in August, said Papenburg.

He said that prompted the province to move a preventive campaign for high-risk babies to mid-September, instead of the usual November.

A monoclonal antibody injected monthly to very high risk infants can cut their risk of hospitalizations by half, he said. These may include children younger than one year of age who were born very prematurely, or who have congenital cardiac disease or chronic lung conditions.

— With files from Cassandra Szklarski in Toronto.

This report by The Canadian Press was first published Oct. 25, 2022.

The Canadian Press

Note to readers: This is a corrected story. A previous version stated Quebec's provincial RSV rates were nearly 14 per cent. In fact, they were slightly over 13 per cent.

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Wednesday, October 26, 2022

Community Condom Access Pilot Program - Government of Northwest Territories

The Government of the Northwest Territories (GNWT) is launching a pilot program to install up to 200 free condom dispensers in public locations in all NWT communities to combat the ongoing syphilis outbreak.

To launch this program, the Department of Health and Social Services is working with the business, education, and local government sectors to identify locations where condom dispensers can be placed. Free condoms will be available in public places people frequently visit, as well as places that are open outside of regular business hours. Efforts will prioritize smaller communities with limited access to condoms for purchase.

The Northwest Territories has one of the highest rates of syphilis in Canada. In response, the health system is ramping up awareness and testing efforts to trace and treat infections, including promotion on how to prevent infections. Free condoms have been identified as a priority and a gap in current sexual health promotion in the NWT. While condom use does not guarantee full protection from sexually transmitted infections (STIs), men who regularly use condoms during their sexual encounters can significantly reduce the risk of STIs. This project is meant to ensure a consistent supply of condoms are available throughout the NWT during the syphilis outbreak to limit the spread and improve access to safer sex options.

Dispensers will begin to be placed in communities over the coming weeks.

For more information on the syphilis outbreak, visit: https://www.hss.gov.nt.ca/en/services/syphilis

For media requests, please contact:

Jeremy Bird

Manager, Communications

Department of Health and Social Services

Government of the Northwest Territories

Jeremy_Bird@gov.nt.ca

(867) 767-9052 ext. 49034

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