World's Smallest Pacemaker Licenced for Canadian Patients
The Medtronic Micra Transcatheter Pacing System is the first leadless pacemaker licenced in Canada and the worlds smallest pacemaker. (CNW Group/Medtronic Canada)
The Medtronic Micra™ Transcatheter Pacing System (TPS) is the First Leadless Pacemaker Licenced in Canada
Medtronic Canada, a subsidiary of Medtronic plc (NYSE:MDT), today announced it has received a Health Canada licence for the world's smallest pacemaker, the Medtronic Micra™ Transcatheter Pacing System (TPS). The Micra TPS is the first Health Canada licenced product with miniaturized pacing technology. It is cosmetically invisible and small enough to be delivered through a catheter and implanted directly into the heart - providing a safe alternative to conventional pacemakers without the need for cardiac wires (leads).
Comparable in size to a large vitamin capsule, the Micra TPS is attached to the heart with small tines and delivers electrical impulses that pace the heart through an electrode at the end of the device. Unlike traditional pacemakers, the Micra TPS does not require leads or a surgical "pocket" under the skin, and there are no visible signs of the device. The Micra TPS responds to patients' activity levels by automatically adjusting therapy.
Micra TPS is the first and only leadless pacing system to be licenced for both 1.5 and 3 Tesla (T) full-body magnetic resonance imaging (MRI) scans, providing patients with continued access to these advanced imaging diagnostic procedures.
The Micra design incorporates a retrieval feature to enable repositioning if needed; however, the device is designed to be left in the body. For patients who need more than one device, the miniaturized Micra TPS was designed with a feature that enables it to be permanently turned off so it can remain in the body and a new device can be implanted without risk of electrical interaction.
In November 2015, data from the Medtronic Micra TPS Global Clinical Trial, which included two Canadian centres, were published in the New England Journal of Medicine and presented during a late-breaking Special Report at the American Heart Association Scientific Sessions. These data showed the Micra TPS was successfully implanted in 99.2 percent of patients, there were no (0) dislodgements, and the system met its safety and effectiveness endpoints with wide margins at six month follow-up.
Data presented in August 2016 at the European Society of Cardiology (ESC) Congress showed that the risk for major complications with the Micra TPS remained consistently low, with 96 percent of patients experiencing no major complications through 12 months follow-up (95 percent confidence interval, 94.2 percent-97.2 percent, P<0.0001). The Micra TPS reduced the risk of major complications by nearly half (48 percent; hazard ratio = 0.52, P=0.001) compared to conventional systems and the risk was lower across all patient sub-groups, whether measured by age, sex or comorbidity (all hazard ratios < 1.0).
The overall reduction in major complications with the Micra TPS was associated with a 47 percent decrease (p=0.017) in the risk of hospitalization and 82 percent (p<0.001) reduction in risk of system revisions (meaning extraction, repositioning or replacement) compared to conventional pacing systems.
"Dating back to the development of the first external battery operated pacemaker more than 60 years ago, Medtronic has a long history of collaborating with clinicians to better understand the needs of patients, and then innovating new products to meet those needs," said Michael Blackwell, director of the CardioVascular Group at Medtronic Canada. "We are thrilled to be the first to introduce a transcatheter pacemaker to patients in Canada, and we're looking forward to working with physicians and educating implanters to extend the positive results of our global clinical trial experience to even more patients."
The Micra TPS was awarded CE Mark in April 2015 and FDA approval in April 2016. It is intended for use in patients who need a single-chamber pacemaker. The device was designed to allow patients to be followed by their physicians and send data remotely via the Medtronic CareLink™ Network; remote monitoring of Micra devices is expected to be available in the near future.
In collaboration with leading clinicians, researchers and scientists worldwide, Medtronic offers one of the broadest ranges of innovative medical technology for the interventional and surgical treatment of cardiovascular disease and cardiac arrhythmias. The company strives to offer products and services that deliver clinical and economic value to healthcare consumers and providers around the world.
New compound shows promise in treating multiple human cancers
A new compound, discovered jointly by international pharmaceutical company Servier, headquartered in France, and Vernalis (R&D), a company based in the UK, has been shown by researchers at the Walter and Eliza Hall Institute and Servier to block a protein that is essential for the sustained growth of up to a quarter of all cancers.
The research presents a new way to efficiently kill these cancerous cells and holds promise for the treatment of blood cancers such as acute myeloid leukaemia, lymphoma and multiple myeloma, as well as solid cancers such as melanoma and cancers of the lung and breast. It is published online today in the journal Nature.
The Servier compound - S63845 - targets a protein of the BCL2 family, called MCL1, which is essential for the sustained survival of these cancer cells.
Institute scientist Associate Professor Guillaume Lessene, who led the Walter and Eliza Hall Institute's research team in Melbourne, Australia, said the work provided the first clear preclinical evidence that inhibiting MCL1 was effective in targeting several cancer types.
"MCL1 is important for many cancers because it is a pro-survival protein that allows the cancerous cells to evade the process of programmed cell death that normally removes cancer cells from the body," Associate Professor Lessene said. "Extensive studies performed in a variety of cancer models have shown that S63845 potently targets cancer cells dependent on MCL1 for their survival."
The institute team of Associate Professor Lessene worked with haematologist Associate Professor Andrew Wei and Dr Donia Moujalled from The Alfred Hospital and Servier scientists, to demonstrate that not only was S63845 effective against several cancer types, but that it could also be delivered at doses that were well tolerated by normal cells.
Dr Olivier Geneste, Director of Oncology Research at Servier, said: "This preclinical research and the identification of drug candidates confirm the potential of MCL1 as a therapeutic target in cancers. S63845 was discovered through collaboration with the fragment and structure based discovery expertise at Vernalis. As part of the ongoing Servier / Novartis collaboration on this target class, clinical development of a MCL1 inhibitor should be launched in the near future."
Associate Professor Lessene said the research provided further evidence of the usefulness of a new class of anti-cancer drugs called BH3 mimetics. "BH3 mimetics inhibit a group of proteins known as the 'pro-survival BCL-2 proteins'," he said. "MCL1 is a member of this protein family, and inhibiting it activates the process of programmed cell death. Walter and Eliza Hall Institute researchers revealed the role of BCL-2 in cancer more than 28 years ago and the essential role of MCL1 for the survival of malignant cells four years ago."
The research was supported through a research collaboration with Servier and through funding from the National Health and Medical Research Council of Australia, the Leukemia and Lymphoma Society (US), Cancer Council Victoria, the Kay Kendall Leukemia Fund, Victorian Cancer Agency, Australian Cancer Research Foundation, the Victorian Government Operational Infrastructure Scheme and the estate of Anthony Redstone.
The Walter and Eliza Hall Institute is the research powerhouse of the Victorian Comprehensive Cancer Centre, an alliance of leading Victorian hospitals and research centres committed to controlling cancer.
About Servier
Servier is an international pharmaceutical company governed by a non-profit Foundation and headquartered in France. With a strong international presence in 148 countries and a turnover of 3.9 billion euro in 2015, Servier employs over 21,200 people worldwide. Corporate growth is driven by Servier's constant search for innovation in five areas of excellence: cardiology, oncology, metabolism, neuropsychiatry and rheumatology, as well as by its activities in high quality generic drugs. Being completely independent, the Group reinvests 25% of Servier's products turnover in Research and Development, and all its profits in its growth.
Becoming a key player in oncology is part of Servier's long-term strategy. Currently, there are nine molecular entities in clinical development in this area, targeting gastric and lung cancers and other solid tumors, as well as various leukemias and lymphomas. This portfolio of innovative cancer treatments is being developed with partners worldwide, and covers different cancer hallmarks and modalities, including cytotoxics, proapoptotics, targeted, immune and cellular therapies.
BELLY BLOATING BUSTERS:
Avoiding Foods That Make You Look & Feel Fat for Every Life Occasion
When planning for a fun get-together with friends everything goes through your mind, from your wardrobe to jewelry and make-up. What many of us don’t plan for, however, is our meals. Eating the wrong foods before an event can sabotage your beauty plan. Certain foods can give your gut an instant bloat that looks and feels awful. However, there is a solution to this dilemma. Instead of skipping dinner to squeeze into your LBD or grabbing bagels for a quick morning bite, there are belly bloat busters. Dr. Christopher Calapai, D.O. is an Osteopathic Physician board certified in family medicine and anti-aging medicine. Here are some of his suggestions:
For a girl’s night out: Don’t be afraid to have a large meal beforehand (large meaning more than just a PB&J). If you are planning for an active night, whether dancing, bowling or party hopping, you will need the fuel. Dr. Calapai has created the perfect meal for this situation:
- 1 grilled chicken breast (approx 4 oz)
- 1/2 cup cooked brown rice and lentils
- 1 cup steamed string beans
This combo will fill you up without weighing you down, and will give you the energy you need to dance the night away!
For a dinner- date: You’re wearing a stunning new BCBG dress that already had to be zipped up by your roommate. When you’re at the restaurant with your guy refrain from ordering a salad to make it look like you’re being healthy. All the veggies in the salad will actually cause your stomach to bloat more. Dr. Calapai advises that a fish dish with one side of grilled veggies is the way to go! “Wild Salmon is jam-packed with heart healthy vitamins and omega 3 fatty acids. If Salmon is not an option, mackerel, sea bass and lemon sole are all good options as well. As for the veggies, try to steer clear of cruciferous veggies (such as cauliflower, broccoli) that can cause bloating. Instead opt for grilled zucchini, asparagus, or carrots - which will keep your tummy tamed!”
For a day at the beach: It’s finally getting warm out and you can take that bathing suit out of hiding. If you’re going to the beach you need a healthy, energizing meal to get you through the morning but you don’t want it to show in your stomach. You’re probably thinking that the easiest thing to eat before you head out is some Special K with skim milk. It’s low in calories after all, right? It doesn’t matter how low-cal it is, the dairy and multi-grains will expand in your intestines, causing your gut to stick out. Instead of cereal, Dr. Calapai has an awesome recipe for oatmeal pancakes. Take 1/2 cup raw oats, 3 egg whites, 1/2 apple, and a dash of cinnamon and throw in a blender to create the pancake mix. This high fiber non-fat breakfast choice offers whole grain fiber plus additional fiber from the apple, and protein from the egg whites. It's a great filling way to start the day, and will not create any abdominal gas or bloating, so you can go bikini-bare with ease!
For an afternoon luncheon: Eating a well-balanced lunch is essential for boosting energy and productivity; giving you power over that mid-day slump and keeping your metabolism active. A lot of times people want to skip lunch in hopes of losing weight and grab an energy drink to keep them going. This is so bad! The carbonation from an energy drink will make you more bloated then a light lunch. Dr. Calapai says, “For a mid-day luncheon, your best bet is a salad chock-full of fresh veggies and greens, and topped with a piece of grilled fish, low-fat tuna salad, or fresh turkey breast slices. Throw a few walnuts or almonds on top and dress with a low fat/low sugar dressing, to finish off your delicious salad creation!”
Before Sex: Luckily, you can eat your dinner or dessert (or both, on good dates) and enjoy sex too. Just lay off the foods that can trigger digestive issues, a real problem if you have a sensitive stomach or suffer from date-related anxieties, which can amplify digestive issues, according to Dr. Calapai. An 8-ounce piece of meat could trigger gas that's particularly foul-smelling. "Gas associated with red meat is more odorous because of chemicals it produces in the colon," Dr. Calapai explains. That's because when you overeat protein, it goes straight to the colon for fermentation where it creates some seriously offensive byproducts. A safer bet is salad greens, cucumbers, tomatoes, bell peppers, mushrooms. Instead of a Margarita drink: Tequila straight up, or wine (a safer bet). This way, you're only up against naturally occurring sugars.
For traveling days: These days airports are getting bigger and so are the food courts. It’s tempting to give in to the convenience of fast travel food, but the combination of a high-sodium smorgasbord and air travel equals a very bloated body from head to toe. You absolutely must resist because there are better options. Eat before you leave for the airport. Dr. Calapai suggests packing your carry-on with fruits, veggies, and granola bars. Believe it or not these are available at kiosks. Also, avoid the beverage service on board. Stick to water, you will have a happier flight and feel revived upon arriving at your destination!
Dr. Christopher Calapai D.O.
Anti-Aging Physician and "The Stem Cell Guru
Dr. Christopher Calapai, D.O. is an Osteopathic Physician board certified in family medicine, anti-aging medicine and chelation therapy. Proclaimed as the "The Stem Cell Guru" by the New York Daily News, Dr. Calapai is a leader in the field of stem cell therapy in the U.S.
His stem cell treatments have achieved remarkable results in clinical trials on patients with conditions as varied as Alzheimer's, arthritis, erectile dysfunction, frailty syndrome, heart, kidney and liver failure, lupus, MS and Parkinson's.
Dr. Calapai started his practice in New York City in 1986 and for over 25 years he has hosted nationally syndicated radio shows, including his two weekly call-in shows on WABC 770-AM, where he offers health and medical advice. He has a show on Saturday morning 8-9am and Sunday evening from 6-7pm. He has consulted with numerous high-profile individuals including Mike Tyson, Mickey Rourke, Steven Seagal, and Fox series Gotham's, Donal Logue and worked as a medical consultant for the New York Rangers hockey team as well as various modeling agencies.
Dr. Calapai received his medical degree from New York College of Osteopathic Medicine and he consults in Manhattan with practices on Long Island, in East Meadow and Plainview. He has appeared on News12 and in the pages of 25A Magazine and Social Life Magazine.
He is the author of E-books Heavy Metals and Chronic Disease, Reverse Diabetes Forever! Seven Steps to Healthy Blood Sugar, Top Ten Supplements You Can't Live Without, and Glorious Glutathione. Learn more about Dr. Calapai on his website, www.drcal.net.
Urging Canadians to get tough on diabetes
Sun Life Financial commitment to diabetes totals more than $17 million
Sun Life Financial Inc. (TSX: SLF) (NYSE: SLF) is proud to be teaming up with the Canadian Football League (CFL) in the fight against diabetes. This unique collaboration, now in its fourth year, encourages Canadians to take a type 2 diabetes online risk test at www.sunlifeagainstdiabetes.ca, reminding Canadians that knowing their risk level is simple yet vital.
"We are excited to join forces with the CFL to encourage football fans and Canadians to take charge of their health and understand their type 2 diabetes risk," said Paul Joliat, Assistant Vice-President, Philanthropy & Sponsorships, Sun Life Financial. "Currently, one in three Canadians is affected by diabetes or prediabetes. The good news is that 90% of those impacted by the disease have type 2 diabetes which can be delayed and/or prevented with healthy eating, exercise, and of course, identifying your risk."
This year, Sun Life and the CFL are launching a multi-media campaign to engage fans through tweets, photos and videos to raise awareness for diabetes and its related complications. Through healthy eating and exercise tips, CFL players from each of the nine teams will be helping to motivate fans to take charge of their health, learn their type 2 diabetes risk and take the necessary action to prevent and/or delay its onset.
"We are thrilled to team up with Sun Life in their efforts to raise awareness for diabetes prevention," said CFL Commissioner, Jeffrey L. Orridge. "We hope to inspire our fans to be leaders in the fight against the disease and go online to take the test."
As part of an overall diabetes awareness campaign, Sun Life is also working alongside the Canadian Diabetes Association (CDA) throughout October and November to encourage Canadians to get screened and potentially prevent new cases of type 2 diabetes. Since announcing support of the cause in late 2012, Sun Life has proudly committed more than $17 million in support of diabetes awareness, prevention, care and research initiatives.
Canadians are urged to get involved. Visit www.sunlifeagainstdiabetes.ca to take the type 2 diabetes online risk test or visit www.cfl.ca/sunlife for more information and to watch the player videos.
About Sun Life Financial
Sun Life Financial is a leading international financial services organization providing a diverse range of protection and wealth products and services to individuals and corporate customers. Sun Life Financial has operations in a number of markets worldwide, including Canada, the United States, the United Kingdom, Ireland, Hong Kong, the Philippines, Japan, Indonesia, India, China, Australia, Singapore, Vietnam, Malaysia and Bermuda. As of June 30, 2016, the Sun Life Financial group of companies had total assets under management of $865 billion. For more information please visit www.sunlife.com.
Sun Life Financial Inc. trades on the Toronto (TSX), New York (NYSE) and Philippine (PSE) stock exchanges under the ticker symbol SLF.
About the Canadian Football League
Today's CFL is more than just our great game of football. It's fans sharing their excitement for what they see on the field, and what they experience off it. Stay up to date on all the non-stop action at CFL.ca. And join all of Canada as we celebrate the 104th Grey Cup, presented by Shaw, next November in Toronto.
HIGH-CALIBRE CUISINE TAKES CENTRE STAGE AT EAT TO THE BEAT
TORONTO’S TOP CULINARY FUNDRAISER IN SUPPORT OF CBCF
Tuesday, November 1, 2016 | 7 pm – 10 pm | Roy Thomson Hall
Toronto, Ontario – October 17, 2016 – A mecca for urban foodies to experience the best Ontario’s culinary scene has to offer, the 21st annual Eat to the Beat presented by KitchenAid®is a fundraiser for the Canadian Breast Cancer Foundation (CBCF) and features 60 female chefs supporting people living with breast cancer on Tuesday, November 1 from 7 pm – 10 pm at Roy Thomson Hall (60 Simcoe Street). General Admission Tickets are $189 (a tax receipt will be issued for the maximum allowable amount). For tickets or to see the line-up of chefs and beverage participants, please visit www.eattothebeat.ca or call 1 (800) 387-9816.
Eat to the Beat guests have the opportunity to enjoy specially prepared savoury and sweet dishes at 60 stations, along with wine, beer and a selection of non alcoholic beverages set up around Roy Thomson Hall’s outer lobby.
“We are so grateful to our participating chefs, sponsors and supporters who have helped to make Eat to the Beat Toronto’s must-attend culinary event and fundraiser over the years,” says Cathy Park, co-chair, Eat to the Beat.
In addition to food and drink, colourful and whimsical one-of-a-kind corsets, inspired by food and created and modelled by breast cancer survivors, have become an integral part of Eat to the Beat.
“A fun, colourful and cheeky tradition at Eat to the Beat, breast cancer survivors will be adding class with a bit of sass, modeling original food-inspired corsets that they have created,” adds Joanne Brophy, co-chair, Eat to the Beat.
Started 21 years ago by sisters Lisa and Abby Slater, Eat to the Beat has raised more than $3.9 million since its inception. Funds raised at Eat to the Beat will support the Canadian Breast Cancer Foundation – dedicated to funding relevant and innovative research, supporting and advocating for the breast cancer community, and providing credible, unbiased information to help empower those affected by breast cancer or at increased genetic risk of developing the disease.
“Just like Lisa and Abby, we’re inspired by the strength of breast cancer survivors and those who are affected by this disease,” says Karen Malone, VP, Research & Programs, Canadian Breast Cancer Foundation, “Thanks to fundraising events like Eat to the Beat, we can continue to offer emotional support and information to anyone affected by breast cancer.”
Eat to the Beat at a Glance:
DATE: Tuesday, November 1, 2016
TIME: 7 pm – 10 pm
VENUE: Roy Thomson Hall, 60 Simcoe Street, Toronto (St. Andrew subway station)
COST: Tickets include savoury and sweet dishes at 60 stations along with wine, beer and a selection of non-alcoholic beverages.
General Admission Ticket: $189 (a tax receipt will be issued for the maximum allowable amount)
Participating chefs and select menu items that will be featured at this year’s Eat to the Beat include:
Sandra Abballe, Succulent Chocolates and Sweets
Vanessa Baudanza and Isabelle Loiacono, The Rolling Pin
Wanda Beaver, Wanda's Pie in the Sky- Grand Marnier Nanaimo bars
Renee Bellefeuille, Art Gallery of Ontario- cured whitefish, rye toast, tarragon crème fraiche and pickled caperberry goat cheese and artichoke puff
Cathy Beneway, CreativeCatering by Cathy
Emma Beqaj, Emma's Eatery Catering- lobster grilled cheese
Arvinda Chauhan and Preena Chauhan, Arvinda’s -spicy curry leaf infused chick pea dip with tomato purée served on cucumber and zucchini rounds and garnished with savoury noodles and curry leaf
Tiiu Christie and Tysa Christie, Marigolds and Onions
Felicia Derose Colette Grand Café
Donna Dooher and Michael Leary, Mildred's Temple Kitchen
Kyla Eaglesham, Madeleines
Rossy Earle, SupiCucu
Michelle Edgar, TheSweet Escape Patisserie
Alison Ferland, Byblos
Mali Fernandez, Xola Mexican Food
Alexandra Feswick, The Drake Hotel- Adobo pulled pork steam buns with daikon pickle
Trish Gill, The Emmet Ray
Bonnie Gordon, Bonnie Gordon College of Confectionary Arts- Macaron in a variety of flavours, homemade chocolates, and langues de chat
Tamara Green, The Living Kitchen
Kimberly Humby, East & Main Bistro
Anna Janes, Cocomira Confections
Vanessa Le Page, Cake Lady - Edible Art - The Shortbread
Tara Lee, Bar Hop- mini pork and ricotta meatballs with a tomato cream sauce
Jacqueline Lo, Ruelo Patisserie
Erin Marcus, Ace Bakery
Lynn Mendelson, Lynn Mendelson Catering- million $ bars
Joan Monfaredi, Park Hyatt Hotel- tuna tartar wonton tacos with pea shoots, chili rice vinegar and scallion
Jennifer Mooers and Chris Brown, Citizen Catering
Lauren Mozer, Elle Cuisine
Catherine O’Donnell, WillowCakes and Pastries
Christine Ostiguy, YorkshirePudding Catering
Angela Panigas, The Sultan's Tent & Café Moroc
Chef Véronique Perez, Crêpes à GoGo Spadinaand Limonana
Jennifer Perusini, BerBer Social
Andrea Poirier, Inn on the Twenty
Karen Rachlin, Bite Catering
Regular Nuit, Pai Northern Thai Kitchen, Sabai Sabai Kitchen and Bar and Sukhothai Restaurant - "Mee kra ti" – stir fried rice vermicelli with coconut milk and tofu
Caroline Reid, Scaramouche- house-cured duck pastrami with celery root salad, hazelnut purée and vincotto
Emily Richards, Professional Home Economist- balsamic roasted pear wedges wrapped in prosciutto with gorgonzola dip
Dufflet Rosenberg, Dufflet Pastries- cookie bar
Barbara Rotberg, Lollicakes
Gauravi Shah, Tilde- chorizo meatballs with lime aioli and grilled pineapple salsa, bean vegballs with roasted tomato salsa and cilantro gremolata
Trista Sheen, Bar Begonia
Alida Solomon, Tutti Matti
Lili Sullivan, Waupoos Winery- cider braised lamb in a filo cup with spiked apple
Meghan Van Horne, Public Schoolhouse @ Jackson’s Falls- polenta crisp with smoked trout, chèvre, wild spinach and walnut pesto
Karen Viva-Haynes, VivaTastings
Elaine Wong, The Omni King Edward Hotel
Winlai Wong, The Badminton and Racquet Club of Toronto
Jeanne Da Silva, George Brown College Chef School- edamame falafels with a cultured vegetable slaw on whole wheat tortilla cups and vegetarian BLT with coconut bacon, roasted tomatoes and a spicy avocado purée on whole grain baguette
Vanessa Yeung, Aphrodite Cooks
Eden Hertzog, New Moon Kitchen
Leyla Kizilirmak, Art Square Gallery and Café- organic and fair trade dark chocolate boobs
Carmen Jeffrey, President’s Choice Cooking School
About the Canadian Breast Cancer Foundation:
The Canadian Breast Cancer Foundation (CBCF) is a national community-driven charity. As the largest charitable funder of breast cancer research in Canada, CBCF’s vision is to create a future without breast cancer. Since its inception in 1986, the Foundation has invested over $360 million in breast cancer research, funding more than 1,400 scientific and community grants. CBCF’s investments in vital research, education, health promotion, support and information programs have led to progress in breast cancer prevention, diagnosis, treatment and care. For more information, visit cbcf.org.
Charitable Registration No. 12799 3608 RR0001
Launching Soon Vlogs - Workouts etc on my Youtube
Im super excited to start my youtube channel and do it the right way! Ive been inspired lately by a lot of bloggers and v-loggers and I've decided to up my youtube game. I hope that I inspire more people and that you will enjoy getting to know me a little bit better!
In its annual review of Ontario's health system, Health Quality Ontario reveals a new perspective on quality care for all
Alicia Bell - Fitness Trainer with exercise band.
Health Quality Ontario is offering those who live in the province the broadest portrayal of quality health care, to date.
In this 10th publication, the yearly report offers those who work within the health system and those who use it the most comprehensive overview of two key matters: Measuring Up 2016 looks at both how the health system is performing, and also looks at the health of those living in Ontario.
"To broaden the lens on health care quality, Health Quality Ontario worked with experts and patients across the system to incorporate new areas to monitor and measure," says President and CEO, Dr. Joshua Tepper. "The significance of this latest report lies in this newfound perspective. Areas in need of attention emerge clearly, allowing the system to better focus its efforts."
A new chapter on palliative care, as an example, reveals one such area in need as the population ages: Nearly two-thirds of those who received palliative care died in hospital despite the fact most would prefer to die at home. This is indicative of a larger issue involving available and appropriate care at home or elsewhere in the community.
Applying a broader health equity lens to many areas throughout the report – another new addition – has, too, allowed for a fuller picture of quality care in the province. Health equity can be understood as all people being able to reach their full health potential – meaning some will need more help than others. It's not the equal dividing of resources so that everyone gets the same; rather, it's an approach whereby factors like income, race, language, geographic location, and disability don't impede health.
This report, however, reveals gaps in equitable care, and therefore, gaps in a key aspect of health care quality: People who live in the north west region of the province do not have the same access to care than those living in the GTA; people who've been hospitalized for a mental illness or addiction continue to struggle disproportionately with transitioning from one part of the system to another; people who live in poor neighbourhoods are much less likely to have prescription medication insurance - the same is true for people with low levels of education and those who've recently immigrated.
"With these areas under the spotlight, there is reason to be hopeful," adds Dr. Tepper. "Health Quality Ontario finds an unmistakable trend as it tracks progress. This annual review finds a relationship between health quality and concerted efforts, often including a combination of policy changes and public health interventions."
A notable example can be found in population health: Smoking rates have decreased significantly in recent years. This is due in part to combined efforts involving changes in policy, changes in regulations, and public health interventions. Other examples include cancer care, cardiac health, and emergency department care.
While certain areas are showing results because of concerted efforts, those in need of similar attention are now starting to be enabled by the Ministry and subsequently implemented by the health system.
Quick facts:
From Measuring Up 2016: Key areas in need of attention:
Smooth out the transitions: Ontario can do better as patients transition from one place of care to another.
a. Less than one-third (30.2%) of patients hospitalized for a mental illness or addiction saw a doctor within seven days after discharge in 2014/15. This rate has not changed in the past five years.
b. Nearly two-thirds (62.7%) of patients who received palliative care had an unplanned emergency department visit in their last month of life. Although some unplanned visits may be unavoidable and appropriate, this can be a sign that people are not receiving enough supports at home or elsewhere in the community.
Improve access to care: People in Ontario still lack timely access to their regular primary care provider.
a. Ontario continues to lag behind, in terms of patients getting timely access to primary care, when compared to other developed countries. In 2015, less than half (43.6%) of people aged 16 or older were able to get appointments with their primary care provider (or another primary care provider in their office) the same day or next day when they were sick or had a health concern. This remains unchanged over two years and is the worst rate compared with people in 10 other Commonwealth countries.1
b. In 2014/15, 85% of the adult complex home care patients (aged 19 and older) who received personal support service received it within the five-day target, however there was substantial variation between regions. The aim is that all these patients receive the service within target.
Reduce inequities: While Ontario's overall numbers look good in many areas, we continue to see unacceptable variation by geography and population groups.
a. Less than one-quarter (23.8%) of adults in the north west region of the province (covering the district of Thunder Bay over to the Manitoba border) were able to see their primary care provider on the same day or next day when they were sick, compared with more than half (53.0%) of adults in the central west region (covering the Greater Toronto Area).
b. Nearly nine out of 10 (85.7%) people aged 12 to 64 living in the richest neighbourhoods had prescription medication insurance, compared with fewer than six out of 10 (56.0%) people living in the poorest neighbourhoods. The ability to afford medication is an important aspect of care, especially among people with multiple chronic conditions.
About Measuring Up:
Measuring Up centres on a set of performance measures called the Common Quality Agenda, as a barometer for two things: The performance of Ontario's health care system, and the health of those who live in Ontario.
Based on these performance measures, work is underway in many parts of the health system to improve care and outcomes, in addition to how to better measure them. For example, the Ministry of Health and Long-Term Care's Patients First action plan is initiating changes to the system to address the key areas of primary care and home care.
Health Quality Ontario (HQO) is the provincial advisor on the quality of health care. HQO reports to the public on the quality of the health care system, evaluates the effectiveness of new health care technologies and services, and supports quality improvement throughout the system. Visit www.hqontario.ca for more information.
1 Health Quality Ontario. Measuring Up 2015: A yearly report on how Ontario's health system is performing. Toronto: Queen's Printer for Ontario; 2015.
Image with caption: "2016 marks the 10-year anniversary of Health Quality Ontario’s yearly report on the performance of Ontario’s health system and offers the broadest portrayal of health care quality to date. (CNW Group/Health Quality Ontario)". Image available at: http://photos.newswire.ca/images/download/20161013_C4697_PHOTO_EN_794561.jpg
SOURCE Health Quality Ontario
Squat Variations
Did you know that squatting is a fundamental human movement pattern that involves nearly every muscle in the body? Squatting improves fitness, performance, and mobility for daily-life tasks. But do you always do the same type of squat? You shouldn’t and here’s why:
Have you ever noticed that when you do an exercise you haven’t performed in a few weeks, you experience a much more intense delayed onset muscle soreness (DOMS) for two or three days afterwards? Well that is because your muscles are moving in a slightly different plane of motion than what they are used to and they’ve become unaccustomed to this newly reintroduced movement. Don’t get stuck doing the same exercises each and every week! Change it up so that you can wake up muscles that may not be getting used if you are continually doing the same exercises week after week.
When you add variations into your workouts you can add strength faster and see more development and changes to your physique. Try new exercise movements, add extra weight or perform more sets and reps each workout. It’s all about the variation. Variations also help keeps you mentally stimulated and non-stagnant in your workout regime. This keeps the workouts fun and exciting as well as challenging. When you add variation exercises to your program you will hit the muscles from different angles, helping to stimulate more muscle fibers and create a nice, fully rounded muscle that really pops. Add variation – you have nothing to lose and everything to gain!
Try these examples of variations for squats that can be built into your current training program. Remember to engage the mind-muscle connection and focus on the contraction, negative and stretch phase of the lift. Don’t rush through the reps, keep tension on the muscle through the entire range of motion to get the full benefit of each exercise.
Front Squat
Place the barbell at the upper chest height in the rack. Step forward and position bar in front of shoulders. Cross your arms and place hands on top of barbell with upper arms parallel to floor. Then move the bar from rack. Squat down by pushing your hips backwards while allowing knees to bend forward, keep your back straight and your knees aligned with your toes. Squat down until thighs are just past parallel. Return to the starting position and repeat.
Bulgarian Split Squat
This can be done with a barbell across your back or dumbbells in both hands. Stand with dumbbells in your hands or bar across your back. Extend leg back and place top of foot on bench. Lower yourself down by flexing both the knee and hip of front leg until knee of rear leg is almost in contact with floor. Return to your starting position and repeat. Then switch legs.
Hack Squat w/ Barbell
Position barbell just behind your legs. With feet flat on floor shoulder width apart, squat down and grasp barbell from behind with overhand grip. Lift bar by extending hips and knees to full extension to stand up tall. Squat down by bending hips back while allowing knees to bend forward, keeping back straight and knees pointed same direction as feet. Squat down as far as you can possible while keeping your head and chest up. Repeat.
Heels Elevated Hack Squat
Place some plates or a step behind you. Position barbell just behind your legs. With toes on the floor and your heels on top of the step making sure that your feet are shoulder width apart, squat down and grasp barbell from behind with overhand grip. Lift bar by extending hips and knees to full extension to stand up tall. Squat down by bending hips back while allowing knees to bend forward, keeping back straight and knees pointed same direction as feet. Squat down as far as you can possible while keeping your head and chest up. Repeat.
Goblet Squat
Stand holding a dumbbell or kettlebell close to your chest. Then squat down between your legs until your hamstrings are on your calves. Keep your chest and head up. At the bottom position, pause and make sure that your elbows are on the inside of your knees and legs. Return to the starting position, and repeat.
Sumo Squat
With bar upper chest height, position bar on the back of your shoulders and grasp bar to sides. Place feet wider than shoulder width apart and make sure to point your toes outward 45° to 30°. Begin by squatting down by bending hips back while allowing knees to bend forward. Keep your back straight and your knees aligned with the direction that your toes are facing.. Descend until thighs are minimally just past parallel to floor. Return to the beginning position and repeat
Curtsey Squat
Stand with your feet hip width apart and hands on hips, weights in your hands or barbell across your back. Move your right foot behind your left leg, as far past your left foot as is comfortable. Using a "curtsy" motion, squat down. Keep your weight in the front leg, head up and chest up. Return to the beginning position of standing and repeat.
Box Squat
From rack with barbell at upper chest height, position bar on back of shoulders. Grasp barbell to sides. Dismount bar from rack and back up until contact is made with box immediately behind. Stand with either a regular squat position with feet shoulder width or a wide stance with feet flared out slightly. Then sit back onto box by bending hips back while bending knees, keeping your knees in light with your toes and your head and chest up. Using a controlled movement then lower your glutes onto box. Once contact is made stand back up returning to the starting position and repeat.
Much of how you use the above squat variations comes down to what you are currently doing in the gym. While I am not suggesting to drop your current routine and start this one, there is value in adding some variation to your training sessions so that you can stimulate the muscle in a different way and keep it responding without hitting plateaus.
At the end of the day, it is important to realize that no matter where you are in your training experience, there is value in the occasional variation adjustment. Whether it is to bring up weak points or to keep your body healthy and in balance, varying stance and bar placement, using dumbbells instead of a barbell can add that missing element and help with your progress.
Happy Training!
Three Ways To Bring Wheat Back Into Your Diet
by Dr. John Douillard
The gluten-free industry is predicted to reach 15.6 billion in sales in 2016, with 28% of people set on avoiding wheat and gluten products. Many are choosing to avoid wheat because they don’t feel good after eating it, want to lose weight or have been convinced it is unhealthy.
Before you give wheat a life sentence as a bad food, here are some whole wheat facts and tips that may allow you to successfully break bread once again.
Eat Wheat Tip #1: Be Choosy
Many gluten-free experts suggest that ancient wheat had much less gluten than our modern wheat and, therefore, conclude that ancient wheat is better than our modern wheat. But wait…are we sure it is the gluten that is the cause of the “gluten sensitivity”?
One study compared the ancient wheat, Kamut, with some modern wheat strains. They found that the ancient Kamut actually had twice the amount of hard-to-digest A-gliadin glutens than the modern wheat. The Kamut, with twice the gluten, was shown to reduce inflammation two-fold, while also lowering blood sugar and cholesterol significantly more than the modern wheat.
In another report by the Journal of Agriculture and Food Chemistry, the average American ate 86 pounds more wheat flour in the year 1900 than they did in 2008, suggesting that the increase in celiac disease and gluten sensitivity may not be from the gluten after all.
The Takeaway: Ancient strains of wheat that include Einkorn, Emmer and Kamut have been found to have more antioxidant activity than modern wheat and are good grains to start with as they are also typically prepared without industrial processing. But, not all modern wheats are created equally. Spelt is a much easier grain to digest because it has 40% less of the hard-to-digest anti-nutrients called phytic acids than common whole wheat. Anti-nutrients protect grains, beans, seeds and nuts from invading bacteria. Sprouting whole wheat is another technique to break down the anti-nutrients, making the bread easier to digest. Rye has been shown to have a significantly lower glycemic index and is better if you are concerned about your blood sugar.
Eat Wheat Tip #2: Eat Fermented Wheat
There is no doubt that the gluten in wheat is a hard-to-digest protein, but history suggests that we are well-adapted to digest it. For starters, new research from the University of Utah have found evidence that early humans have been eating C-3 grasses such as wheat and barley for at least 3.4 million years – not 10,000 years as you may have heard.
As for adapting to wheat, we have. Studies have found microbes that specifically produce enzymes for breaking down gluten in the mouth, esophagus, stomach, small and large intestines. There are also enzymes produced in the small intestine that can break down the hard-to-digest A-gliadin glutens.
The Takeaway: Early bakers discovered that fermenting the wheat flour with beneficial bacteria made the wheat much easier to digest. In a handful of studies, sourdough bread was found to reduce the gluten content of the bread, even rendering it “gluten-free.” In fact, when they served this bread to patients with celiac symptoms, they did not measure any increased intestinal inflammation. This is not suggesting that folks with celiac can safely eat or should try eating sourdough bread, but for those with gluten sensitivity, sourdough bread is a good place to start. You can find healthy versions of these at an artisan bakery or a natural food store.
Eat Wheat Tip #3: If You’ve Never Heard of It, Don’t Eat It.
Did you ever wonder why the bread you buy in the supermarket stays “fresh” and squishy for weeks without getting hard or moldy, while old-fashioned baked or artisan breads get hard in just a couple of days?
Modern breads are loaded with dough conditioners and preservatives that keep the bread squishy and “fresh” or resistant to mold for weeks. In addition to the many chemicals and added sugars put in most breads, the most dangerous of all is the added oils. Most breads have added oils in them, which are key for their so-called freshness, squishiness and shelf life.
The oils used are typically super refined, bleached, boiled and deodorized, which leaves them nothing like the oil when it was originally pressed from the seed or vegetable. Freshly cold pressure oils will go rancid more quickly when exposed to light, and baking even the best oils renders them indigestible for both humans and the bacteria that naturally make bread get hard and moldy.
Remember, the human body is made up of cells that are 90% bacteria and only 10% human – and if the 90% is doing the heavy lifting for most our body’s immunity, mood and functions, don’t you think we should be eating foods that both humans and the bacteria can digest?
The additives and baked oils are what makes foods processed. In one study, when folks ate a diet of processed foods, they had a 141% increased risk of belly fat, high blood pressure, high cholesterol and high blood sugar. When they ate a non-processed diet including whole wheat, they saw a 38% reduction in risk of the same concerns.
The Takeaway: The ingredients in a healthy and digestible loaf of bread should look something like this: organic whole wheat, water, salt, starter – with no cooked oils. As for the rest of the potentially toxic ingredients unnecessarily found in most breads, avoid sugars or sweeteners, even natural ones like cane sugar, honey or molasses. Also, avoid breads with ingredients you do not recognize. If you don’t know what it is, than it’s probably best to not eat it.
Dr. John Douillard, DC, CAP, is a globally recognized leader in the fields of natural health, Ayurveda and sports medicine. Over the past 30 years, he’s helped over 100,000 patients repair their digestive system and eat wheat and dairy again. He is the creator of LifeSpa.com and author of the book, Eat Wheat: A Scientific and Clinically-Proven Approach to Safely Bringing Wheat and Dairy Back into Your Diet, releasing nationwide January 2017. For more information, please visit, www.eatwheatbook.com and connect with Dr. Douillard on Twitter, @johndouillard.
10 SURPRISING REASONS YOU ARE GAINING OR NOT LOSING WEIGHT THAT HAVE NOTHING TO DO WITH OVEREATING
When we see people who are overweight, many commonly assume that the individual is overeating and not exercising. Neither of these instances is cause for prejudice, fat shaming or other negatives. There are men and women who seemingly do everything right when it comes to diet and exercise and they are either gaining weight or simply unable to shed pounds. This can be incredibly disheartening and wreak havoc one one’s self esteem. Here are 10 surprising reasons provided by Dr. Christopher Calapai as to why this might be occurring. Dr. Christopher Calapai D.O. is a New York City anti-aging and stem cell specialist, and long-time nutrition advisor to the New York Rangers hockey team.
Lack of Sleep
There are two issues at work with sleep and weight gain. First, if you're up late, the odds are greater that you're doing some late-night snacking, which means more calories. The other reason involves what's going on in your body when you're sleep-deprived. Changes in hormone levels increase hunger and appetite and also make you feel not as full after eating.
Medication
“Many anti-depressant medications cause weight gain—so if you're depressed and taking pills for it, expect to see a bump in weight between 5 and 15 pounds, with continued gradual accumulation over the years,” says Dr. Calapai. If you're not taking pills, there’s evidence that feelings of depression can correlate to weight gain. If patients are taking anti-depressants that could be the culprit of their weight gain, they should see their prescribing doctor and be weaned off slowly. “There's a long list of medications that can cause weight gain: If you're taking birth control pills, excess hormones for hormone therapy, steroids, beta-blockers for heart disease and blood pressure, anti-seizure meds, breast cancer medications like Tamoxifen, some treatments for rheumatoid arthritis, and even some migraine and heartburn medications, you may notice pounds creeping on,” says Dr. Calapai.
Your gut is slow
Digestive issues, including slow bowel movements, may also account for excess pounds. "Ideally, you eat, and then, an hour or so later, you have a bowel movement," says Dr. Calapai. "But once or twice a day is still in the healthy range." If you're not so regular, dehydration, medications, low fiber, or even a lack of good flora in your gut could be to blame. If constipation is your only symptom, then trying probiotics can help your digestive tract work properly. If you're still having trouble, check with your doctor to rule out a range of disorders, including hypothyroidism or a neurological issue.
You're getting older
It's the one condition that's unavoidable. "Often, I hear patients tell me they think their metabolism is slowing down," says Dr. Calapai. "This is real. We don't burn as many calories at 40 or 50 as we used to burn at 20. So we need more exercise and less foo to keep the metabolism going. "Remember that all calories are not equal when it comes to weight," says Dr. Calapai. "Eating lean protein will cause your body to burn calories more efficiently. On the other hand, carbs are something your body tends to burn more slowly and even store in your body more readily."
You have plantar fasciitis
"Many musculoskeletal conditions, including plantar fasciitis, but also osteoarthritis and knee or hip pain, can result in unintentional weight gain," says Dr. Calapai. "Plantar fasciitis certainly can force you to cut back on your activity enough to cause weight gain."
You have Cushing's Syndrome
Weight gain accompanied by high blood pressure, osteoporosis, and changes in your skin tone and quality, including purple or silvery stretch marks on your abdomen and ruddy cheeks, could be a sign that your body isn't processing nutrients the way it should, due to a cortisol-producing tumor on one of your adrenal glands. The syndrome affects only about 15 in every million adults annually, so proceed with caution before demanding a battery of tests. "Cushing's Syndrome is not terribly common," says Dr. Calapai, "but one of the telltale signs is that your fat distribution is more in the midsection of your body, leaving your arms and legs looking more slender."
LIQUID CALORIES
It is often overlooked that liquids have calories. Calories from juices and soft drinks can quickly add up and at restaurants where free refills are the norm, the calorie build-up can go unrecognized. Wright also explains that liquid calories have no satiety factor. “Satiety relates to how long we stay satisfied after we consume something. If you ate 500 calories of healthy solid food, he/she would be full and unlikely to eat anything for quite some time, but after drinking the same amount of calories in orange juice, cola or root beer, you might be hungry minutes later.”
WEIGHT TRAINING
Many people do not realize that weight gain is not just fat gain. Weight training can increase your muscle mass, therefore increasing your weight. When you gain muscle faster than you lose fat, your body mass is increasing.
Polycystic Ovarian Syndrome (PCOS):
PCOS is one of the most common reproductive problems diagnosed in younger women, striking perhaps up to 10% of women who are of childbearing age (i.e. roughly 12-45 years old). It involves the development of many small cysts on the ovaries, as well as menstrual disturbances. The hormone disruption caused by PCOS has many unpleasant consequences, including unwanted weight gain (usually because of a higher resistance to insulin). If you also suffer from acne, find that you are hairier than most women and do not have regular periods, ask your doctor about being tested for PCOS. This usually involves blood tests and an ultrasound of your ovaries. If you do have PCOS then you can lose the unwanted weight, but the unfortunate fact of the matter is that you will have to adopt an attitude towards healthy eating and exercise that is substantially more diligent than that of your peers.
Quitting Smoking:
Although making the decision to stop smoking is extremely good for your body in a great many respects, most people who do quit smoking end up gaining around 7-10 pounds. Most of this is due to the fact that reaching for cigarettes tends to be replaced with reaching for snacks, but the new absence of nicotine in your body will also lead to a drop in metabolic rate (so you won't be able to eat as much as you used to without gaining weight).
“Carb intake makes it difficult for your body to burn fat as a primary fuel . Low carb diets work well to burn fat and lower cholesterol and lose weight, “says Dr. Calapai. If you suspect you are gaining weight that you can't attribute to your eating habits, medications, or lack of exercise, a few tests—including a blood test and urinalysis, to get an accurate check of your body's cortisol levels, will give your doctor the first clues to this condition. If the levels are deemed excessively high, then your doctor will order further tests, like a CT scan of your pituitary and adrenal glands, to determine if such a tumor exists. If the tumor is confirmed, doctors will likely perform surgery to remove the tumor (and possibly the affected gland), followed by a course of steroids to help regulate the remaining gland.
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