Brock Health - Issue 10

EDITOR’SYasmeen NOTE Mann Dear Reader,

At Brock University we have endless opportunities for us to enrich our learning experience. It is my honour to present to you the tenth issue of Brock Health, our own student run academic magazine through which students select, research and write on a topic of health. We are a magazine designed to cover all aspects of health ranging from current breakthroughs to insightful perspectives on issues related to biomedical applications, health systems, public health and more.

Each issue is completely run by students and emphasizes peer-to-peer education through the process to present research within Brock University and worldwide.

The issue that you are currently holding contains a broad spectrum of topics, with our feature article written by fourth year student, Cubby Sadoon. Our feature explores the controversial opt-out versus opt-in organ donation systems and the various international perspectives of both. Additional topics in issue ten include global health initiatives, medical errors, the human microbiome, changing your genetic makeup, and many more. Finally, I am excited to introduce our faculty spotlight on the phenomenal Dr. Paula Gardner!

Beginning last year, our magazine issues and articles have become available digitally, thereby increasing our outreach. Readers can access our magazines from the comfort of their phones, tabloids or laptops. We have also expanded the number of writers for our magazine, reaching a maximum this year! Furthermore, we now invite writers from all departments and subdivisions here at Brock University to write for Brock Health; thus, broadening our perspectives as well as student discussion of health.

Of course, our progress this year would have not been possible without the countless effort of many individuals. Thank-you to our executive team, Saumik Biswas, Shirley Lee, Jessica Wong, Nathaniel Mannella, Dawood Parekh and Joan Lopez. A big thank-you and warm welcome also goes to our community sponsors: Niagara Vision Clinic, Naturopathic Family Practice of Niagara, United Family Martial Arts, Niagara Prosthetics & Orthotics and the Niagara Orthopaedic Institute. Thank-you to BUSU and BUSAC for funding publications for the 2014-2015 year, graduate editors for ensuring accuracy of work and Joanne Boucher for your assistance and support. Our phenomenal layout and graphics is all thanks to Scott Alguire, who has spent numerous hours perfecting the design of our website and magazine. Also, thank-you to all of our writers and readers, without whom this magazine could not exist.

The final thank-you is for Gaibrie Stephen. This is my first edition as the Editor-in-Chief and I appreciate the endless guidance and encouragement you have provided this semester. I encourage those interested to join us next semester by sharing a piece on health that is of your interest.

Readers, I wish you all a happy read and encourage you to explore these various outlooks on health. This magazine is tailored towards you.

BROCK HEALTH TEAM Editor-in-Chief Yasmeen Mann Writers Isabella Churchill Sanyam Jain Hassaan Khalid Joan Lopez Yasmeen Mann Nathaniel Mannella Colin Maslink Gwen McCloskey Caitlin Muhl Jina Nanayakkara Alex Nedeljkovic Melina Passalent Cubby Sadoon Jaya Sam Zanab Shah Managing Editor Saumik Biswas Editors Meagan Barkans Jordan Bunda Devon Day Rachel Gray Stephen Klassen Michaela Morello Stephen Morris Kelly Pilato Michelle Zahradnik Marketing Team Joan Lopez Nathaniel Mannella (Director) Dawood Parekh Communications Director Jessica Wong Creative Director Shirley Lee Graphic/Web Design Scott Alguire Disclaimer: Brock Health is a neutral magazine. It is not strictly hardcore sciences nor public health issues; it is a platform for students to present scholarly, peer reviewed research in any topic related to health.

PRESUMED OR INQUIRED CONSENT The organ donation opt-in, opt-out system| PAGE 11

MEDICAL ERRORS

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BROCKHEALTHMAGAZINE.CA

CONTENTS 3

Male Contraception: What’s Available and What’s to Come

4

Genetically Modified Food

5

Inequality in Global Health Research and Approaches to Reducing It

7 8 9 10

Kids Have the Weight of the World on Their Shoulders

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Feature Article: Presumed or Inquired Consent: The Organ Donation opt-in, out-out system

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Justification for Coffee Addiction

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Shining a Light on Adolescent Depression: Underidentified and Undertreated

15 16 17 18 19 20 21

The Disease Behind the #IceBucketChallenge

My Microbes & Me Medical Errors Change Your Genetic Destiny

Faculty Spotlight: Dr. Paula Gardner Positive Psychology: The Science of Happiness Hot Headlines Thanks to our Sponsers!

Brock Health Team References

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Brock Health We have positions for students interested in: • Writing • Social Media • Photography Email us: BrockHealth@busu.net

MALE CONTRACEPTION: What’s Available and What’s to Come Alex Nedeljkovic It seems that every few years the idea and progress of the male birth control pill appears to make its rounds in the media headlines, but how close are we to reaching this goal, and more importantly, what are the health implications for this contraceptive?

Compared to women, there are few contraceptives on the market for men aside from the traditional condom. Planned Parenthood mentions 4 other non-medicinal methods for men including abstinence, outercourse, vasectomy and withdrawal[1]. However, these options do not offer the same reliability, enjoyment or ease of use for men that the pill offers women. The demand to overcome these challenges has driven several companies to develop novel methods for male birth control.

There is currently a hormone regimen, similar to the pill for women, in the works that prevents sperm production. The exact formulation seems to be a major hurdle as well as up to 20% of men not responding to treatments[2]. A drug called Adjudin is a modified version of an old cancer medication, which seems to disrupt connections between nurse cells and developing spermatids, preventing maturation[3]. The problems with Adjudin are the high production costs and difficulty in delivery. It is important to note, all of these therapies are very early in the research stages and are far from seeing human trials.

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Interestingly, the method closest to hitting shelves is not actually a pill but a system called the Reversible Inhibition of Sperm Under Guidance (RISUG) and is currently in Phase III trials in India. The way this birth control method works is using two chemicals, styrene maleic anhydride and dimethylsulfoxide, to line the vas deferens[4]. These two compounds create a partial blockage that disrupts sperm cell membranes as they pass through, degrading the enzymes required for binding to the ova[5]. Unlike most female contraceptives, one injection provides infertility for up to 10 years! That’s very convenient if you happen to be an easily distracted or forgetful guy. The procedure requires a no-scalpel injection that would take about 15 minutes to complete and only about 72 hours to become fully effective[6]. So far the treatment seems totally safe; aside from some initial swelling, none of the men that started the Phase II trial 15 years ago have left the study due to side effects nor has there appeared to be any abnormal swelling of the prostate[7]. For those that may be concerned that this contraceptive sounds a little too permanent, studies have shown that simple methods such as a baking soda flush[8] or low electrical current[9] can be used to remove the blocking compounds. These primate studies have seen full fertility return in as little as 3-5 months[10].

Even this very promising method of birth control is still several years away from being widely available, plus the method of insertion begs the question: will men take the time to get the procedure? The landscape of male contraception is still fraught with questions and uncertainties that will likely be making headlines in years to come.

GENETICALLY

MODIFIED

FOOD

Caitlin Muhl Have you ever heard of genetically modified organisms? Would you be surprised to know that you’re probably consuming them on a daily basis? GMOs are produced through biotechnology and genetic engineering, which involves modification to the genetic structure of an organism to produce desired traits[1]. They have recently become a highly controversial issue for their increasing presence in food. Introducing GMOs into our diet has instigated ethical dilemmas in terms of potential health risks associated with its consumption, as well as ecological controversy in regards to its manipulation of nature[1].

While some research has shown that GMO food production is unethical and poses a danger in our diet, there has also been research showing that it’s completely safe for human consumption and offers significant benefits to the world[1].

Researchers have found many favourable properties of GMO foods. Our rapidly growing world population has necessitated the development of a technology that is able to manufacture an adequate supply of food, and in turn minimize our carbon footprint through maxiISSUE 10 • NOVEMBER 2014

mization of production[1]. In other words, the introduction of GMOs into food-deprived countries could translate as a step forward in the battle against world hunger. Genetically modified plants have been at the forefront of this issue in producing both new and improved organisms that are resistant to drought, disease, pests, herbicides or even temperature, and produce higher yields[2].

This revolutionary technology has resulted in GMO foods such as soybeans, corn, and potatoes which now have an increased herbicide tolerance and resistance to insects[1]. In addition, the potential for reduced use of chemicals on insect resistant plants would result in significantly healthier food for consumers[2]. The potential for food fortification is also an enticing feature of these organisms by increasing the nutritional properties such as vitamins and minerals, enhancing human health[2]. It has also been pointed out that unfavourable deliberation regarding GMO food health risks have been somewhat based on theoretical considerations, which negates concern[3].

On the other hand, the addition of GMOs into food unveils con-

cerning obstacles in regards to both ethical and ecological turmoil. Many environmental organizations have expressed concern in terms of the effect on ecosystems and human health; in particular the unknown risks that research has yet to uncover[1]. There is also a potential for unpredictable mutations arising in GMOs[2]. Another matter of controversy is the lack of GMO labeling on food products, which inhibits the monitoring of its potential negative health effects[2]. It is important to note that the majority of studies supporting GMO foods have been commercially driven by manufacturers and were of short duration, therefore lacking both independent research and longterm analysis[2].

It’s clear that GMO foods present a great potential for improving health and food security through yield maximization and modification. However, there is still concern in terms of the potential ethical and ecological risks, which is the lack of GMO food labeling and knowledge surrounding potential health ramifications, as well as the effect on our ecosystems. Bon appetite!

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INEQUITY IN GLOBAL HEALTH RESEARCH AND APPROACHES TO REDUCING IT Colin Maslink With the upcoming expiry of the UN’s Millennium Development Goals in 2015, half of which require health research for their achievement, the current lack of equity in global health is becoming a core concern[1]. Less than 10% of research funds are spent on researching the diseases that account for 90% of the global disease burden in a phenomenon known as the 10/90 gap[2]. A critical factor that contributes to this 10/90 gap is the scarcity of research being done in developing countries[3].

There are a number of reasons for this scarcity, such as poor governance, fragmentation, and limited capacity for research. Governance of health research involves the “means and rules by which relevant stakeholders set and achieve their agreed research goals” [2] . Unfortunately, some countries experience difficulty setting their research goals due to the competitiveness of research; funding bodies tend to commission research themselves rather than support research initiated by investigators[2]. Research units have also failed to establish connections with policymakers, NGOs, and the public, resulting in research that is not geared to addressing national health needs[4].

Global health research is also a very fragmented discipline. Gaps exist between local and global interests, between different disciplines of research, between public and private initiatives, and between knowledge and action[5]. Effective research needs to recognize that what happens in one country affects all countries, that we need to build bridges across disciplines, that public-private partnerships optimize capacity, expertise, and funding, and that health improvement requires policy innovations based on research[5].

Finally, developing countries are experiencing poor capacity for research, as efforts to train and retain researchers, as well as to build up research institutions where researchers can work, remain inadequate[2].

Many units also struggle with a “brain drain” in which scientists move to developed countries which offer more

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opportunities and greater security[4].

However, potential solutions do exist that can help alleviate the current inequity in global health. Research capacity can be successfully built through national governments incorporating capacity building in their national plans, along with strong leadership from health professionals, transparent recruitment of supported researchers, and partnership and exchange with developed countries[4]. Through national health research systems, developing countries can benefit from designing their own rational health research policies and contribute to international health research agendas and priorities[6].

In addition, research must be effectively merged with policy, and there is a need to develop core competencies so that policy-makers and practitioners can be effective users of research[5]. Optimally, research should be integrated with a conceptualization of health that emphasizes the social, environmental, and economic contexts in which health interventions are embedded, to avoid the risk of generating more knowledge but little action.

Above all, developing countries should be seen as partners in research, not recipients of handouts.

Developing countries must be empowered to participate in priority setting, regulatory frameworks, and codes of ethics for collaboration[4]. Adopting this solidarity approach to global health research can do wonders in tackling the current state of inequity in research.

Kids Have the Weight of the World on their Shoulders Melina Passalent In today’s society where many people have poor posture and are hunched over a computer at their nine to five job, it’s no surprise that it was reported that 31 million people living in America feel the effects of back pain at any point in time[2].

However, not only adults are feeling pain in their back-a high percentage of school-aged children who carry backpacks to school are reporting back related injuries.

Literature on the negative impact that backpacks have on children has been on the rise recently. In one case, it was found that the weight of school children’s backpacks proportionate to their size more than surpasses the load limit recommended for adults[3].

Backpacks are able to hold heavy books as they spread the weight equally across the back and shoulders. Too much weight put on the body can cause straining in the back or shoulders. Not only that, but it can also alter the back’s natural curvature, which can lead to aggravation of the joints in the spine and rib cage, as well as causing the forward rounding of the shoulders.

Many health professionals have agreed that a backpack weight 10-15% of the child’s body weight is a realistic value[6]. The U.S. Consumer Product Safety Commission stated that in

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made an equivalent estimate of what it would weigh to an adult. The findings were quite surprising: the average backpack load would be equal to 39 pounds for a 176 pound male, and 29 pounds for a 132 pound female[1].

With these results, it is no wonder that 1/3 of students have reported having back pain[4].

In another study, kids aged 11 to 14 were observed to see the characteristics of the people who reported to having a larger amount of pain resulting from backpacks. Eighty two percent of the participants believed that carrying a backpack either caused or negatively affected already persisting back pain. A larger amount of back pain was reported from students at younger ages, female students, and those at risk of scoliosis. Students who had access to lockers had been identified as having less back pain compared to students who were not given lockers in school.

Another interesting finding was that there was no difference found in back pain between one strap and two strap backpacks[5].

With the knowledge gained over rea given year, doctors in the hospital cent years, weight recommendations attend to 7,300 injuries caused by and backpack feature suggestions backpacks. One study conducted in should be taken into consideration Italy measured the average weight of to reduce this increasingly prominent a school aged child’s backpack and health issue in children.

Jina Nanayakkara

My Microbes & Me

If you’re a yogurt lover, you’ve probably noticed the new labels on yogurt containers advertising “prebiotic” or “probiotic” yogurt. What exactly, does this mean? By ingesting these products, you are swallowing tons of tiny microbes and nutrients[1]. Don’t get grossed out! These microbes are your friends, and you wouldn’t be alive without them.

The human microbiome consists of all the bacteria, fungi and protists that make your body their home. In fact, microbial cells outnumber human cells 10:1 in the human body[2].

It makes you wonder if you’re just human, or a “super organism” consisting of many different microorganisms working together.

Great, so microbes are our friends! However, recent research provides evidence that we may be harming our microbial buddies through modern medical practices.

For example, you are probably aware that overuse of antibiotics can be harmful. Overuse of antibiotics can lead to resistant strains of bacteria if not taken properly.

They also kill bacteria that are good for you, not just the bad guys. Antibiotics may even upset microbes in the gut and lead to obesity. Studies of obesity in mice have shown that mice treated with antibiotics early in life, combined with a high-fat diet, are more likely to become obese in comparison with mice that are only on a high-fat diet[3].

To fully understand the impact of modern medical practices on the human microbiome, let’s take a look at a baby’s first encounter with microbes.

When babies are born through a natural birth, microbial colonies in the birth canal coat their skin and stomach. These colonies are the founders of the baby’s microbiome. The mother’s body has optimized the microbes in the birth canal for the baby’s health. For examples, lactobacillus (breaks down lactose in milk) is present in this area[4].

However, if a baby is born through caesarian section, their microbiome contains microbes typically found on skin. The baby does not receive the benefit of specific microbes optimized for their health. It is speculated that births via caesarian section may even lead to long-term health problems. Other factors such as bottle-feeding, ISSUE 10 • NOVEMBER 2014

early use of antibiotics, and even extensive bathing after birth can also harm a baby’s microbiome[5].

Microbes have an impressive impact on our health, from our first breath to our last. It begs the question; what other health problems or trends have roots in our microbiome?

Since World War 2, the number and prevalence of certain diseases (asthma, allergies, obesity) have been on the rise. Many advances in modern medicine have also occurred since this time, advances in hand hygiene, prominent use of antibiotics, advanced surgeries and more. Even though these changes have helped us conquer many diseases, they may be driving certain species in our microbiome into extinction. This is the belief of some scientists, including Dr. Martin Blaser of NYU’s Microbiome program: “we evolved a certain stable situation with our microbiome and with the modern advances of modern life, including modern medical practices, we have been disrupting the microbiome[6].”

In the end, there are many unanswered questions about the role of the microbiome in our health. Luckily, there is growing understanding among the medical and scientific community that we must protect our microbiome, even against standard medical practice. Perhaps with projects like the Human Microbiome project (sequence microbial DNA) we can better understand how our microbiome functions and how we can take care of it.

For now, embrace your microbial friends and eat some yogurt!

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MEDICAL Errors Gwen McCloskey

Universal access to healthcare resources is a human right deeply ingrained in the daily lives of all Canadians. When feeling ill, we depend on doctors and other healthcare professionals to bring us back to health; but did you know that many Canadians experience a deleterious medical error when visiting healthcare facilities? A medical error is defined as the failure of a planned action to be completed as intended, or use of the wrong plan to achieve an aim in a medical setting[1]. This can include communication errors between staff, improper treatment decisions, medication errors, administration errors, or incorrect diagnoses; all of which may lead to prolonged hospital stays, disability, or in some cases, even death[1].

Approximately 187,000 of the 2.5 million patients admitted to hospitals each year are affected by a medical error of some kind², of which the most common is medication error.

Medication error encompasses any error that occurs during the medication use process[3]. Several factors that contribute to medication errors are similar sounding drug names, low therapeutic indexes, poor vision, use of abbreviations, and cognitive biases[3]. Inpatient medication error rates are at approximately 5% within hospitals in North America[3], resulting in major problems for the healthcare system, such as loss of patient trust, prospective legal action or medical board discipline, as well as an enormous economic cost. Using electronic patient records and drug indexes, better drug labeling procedures, and medical reconciliation are a few strategies that will reduce the occurrence of medication errors. The shift to-

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wards electronic records and drug indexes has made the biggest difference in reducing medical errors, as it diminishes the chance of error due to illegible handwriting and medical abbreviations; however, it has not been able to completely eliminate the problem.

Another major concern is the disclosure of medical errors by professionals who have made them. Patients expect physicians to disclose errors and apologize, but medical professionals are not always willing to comply. Physicians may be hesitant to inform patients of a medical error because they believe it is not significant, they do not want to lose patient trust, or they fear both disciplinary action and humiliation[3]. It is vital that patients are aware of mistakes that have occurred during their procedure to prevent future harm, increase faith in the competency of healthcare workers, and allow patients to make informed decisions in regards to their own health.

Although the complete elimination of medical errors is unlikely to be accomplished in the immediate future, many efforts are being made to reduce their severity and incidence. Through the use of technology, medical reconciliation, and better drug labeling procedures, the incidence of errors has been reduced. After medical errors are made, physicians often feel humiliated when disclosing errors to patients, and fear disciplinary action, legal issues, or loss of patient trust. It is important that the healthcare system continues to work towards a more transparent organization, where medical personnel disclose their errors to patients in order to strengthen the quality of services and care.

Change Your Genetic Destiny Hassaan Khalid What if I told you that you could change the impact your genes have on your health and well being? Would you be willing to make a few small lifestyle changes to combat your family history of heart disease? Or cancer? For the first time, research is showing that through lifestyle choices we can actually control the expression of not just protective genes but also the ones directly involved in certain diseases[1]. This information suggests that we may not necessarily be the helpless victims of our inherited genes; but rather have some control over how these genes affect our lives.

This is not to say the influence of genetics is trivial. Scientists in Iceland found that a single nucleotide polymorphism (SNP) for a gene variant on both chromosomes, as compared to just one, doubled the risk of developing early onset cardiovascular disease (CVD)[2]. Similarly, researchers at the University of Ottawa identified a second SNP (on the same chromosome) that also considerably increased the risk of developing CVD in young adults[3]. The study showed that individuals had a 25% greater chance of developing CVD if they had this particular SNP on one chromosome and a 40% chance if they had it on both chromosomes. This suggests that more than one specific genetic variation may contribute to an increased risk for a given disease, and these risks may increase further when multiple variations are combined.

In the past, the benefits of a healthy lifestyle have typically been validated only through correlation. But ISSUE 10 • NOVEMBER 2014

Dr. Ornish and colleagues are starting to uncover the molecular mechanisms underlying the benefits of a healthy lifestyle[4]. These benefits come cheaper than drugs, and may even reverse the progression of cancer and heart disease[4]. For example, researchers at the University of California studied gene expression in thirty patients suffering from low-risk prostate cancer[1]. They investigated the effects of simple nutritional changes such as increasing servings of fruits, vegetables, and whole grains, and supplementing the diet with fish oil and different vitamins. They also examined the effects of moderate exercise (i.e. a daily 30 minute walk), stress management (i.e. yoga or meditation), and weekly support group participation. The results suggested that these simple lifestyle changes could affect the expression of more than 500 genes[1].

The outcomes included the activation of some health-promoting genes

and the deactivation of certain disease-causing genes[1]. Dr. Ornish and colleagues also found that in clinical trials, the single most effective factor in reversing cardiovascular disease was not the severity of disease or genetic predisposition, but the extent to which the patient changed their diet and lifestyle. Thus it appears that the genetic profile is more receptive to environmental influences than was previously assumed.

Even if we are genetically predisposed to develop certain diseases, the recent research suggests that this may not necessarily doom us to any given illness. Perhaps we are all biological machines reacting to similar environments in different ways depending on our genetic composition.

Given that our medical fate is only partially determined by our genetic inheritance and the rest depends on the lifestyle choices we make, the question remains – are we making the right choices?

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Feature Article PRESUMED OR INQUIRED CONSENT: The organ donation opt-in, opt-out system Cubby Sadoon “4,500 people are waiting for organ transplants today”[1]. “Only 2,124 organs were transplanted in 2012”[1]. “256 people on those waitlists died before receiving transplants [in 2012]”[1]. These are just some of the statistics highlighted on the Government of Canada Organ & Tissue Donation website, demonstrating a lack of donors in the country.

Twenty-five. Less than twenty-five percent of eligible Ontarians have registered consent to donate, as of 2013[2]. Canada is extensively reliant on an opt-in service; a system based on allowing patients to consensually agree to becoming donors however, organ donation is diverse around the world, and the recent debate has become whether a change in approach must be taken in order to satisfy the growing number of patients that require organs. Canada in particular has a lower number of donors than most developed countries in the world; taking into consideration our publicly-funded healthcare system, Canada has a lower number than both the United States of America as well as Australia, the latter having a total population fractionally less than our own[2]. The Canadian Transplant Society reports that over 90% of Canadians support organ donation, though less than 20% have taken steps to become a donor[3]. It is therefore critical for us to consider the findings of an analysis done by researchers in the United Kingdom that analyzed and reviewed a variety of organ donation protocols in order

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to judge which system appeared optimal.

With an opt-in system, individuals have to actively register their consent to donate their organs postmortem, whereas an opt-out system conversely relies on implied consent; individuals are automatically registered to be donors unless a specific request is made before death for their organs not to be harvested[4]. Lead author of the UK study “An international comparison of deceased and living organ donation / transplant rates in opt-in and opt-out system”, Dr. Eamonn Ferguson claims that due to the reliance of individuals to actively make a decision regarding their donation status, both system are subject to shortcomings[5].

A theory, perhaps? Are people more inclined to not opt-in due to a belief that the status quo is the “right” decision; alluding to loss aversion and the need to minimalize losses, while sacrificing gains?

The question then begs…in or out?

Dr. Ferguson & co. analyzed the particular organ donation system used in 48 different countries over a course of 13 years, with 23 and 25 countries using an opt-in and opt-out system respectively[5]. Overall donor numbers, number of transplants per organ and total number of kidneys and livers transplanted from living and deceased donors were measured and the results showed opt-out consent led to an increase in deceased donation, but a reduction in living donation rates. Opt-out consent was also correlated with an increase in

the total number of kidney and livers transplanted[5]. This inherently bodes well for Canadians, as 85 of the 256 patients that died in 2012 waiting for a transplant, did so waiting for a kidney. Contrariwise, opt-out systems were found to have a higher rate of kidney donations from living patients versus opt-in systems, however Dr. Ferguson did speak to the fact that “…policy’s role in living donation [was] not taken into consideration before… and is an area that needs to be addressed in the future”[5]. Keep in mind, this study should not be treated like a godsend, as the researchers noted limitations such as not differentiating between the varying degrees of opt-out systems throughout the globe (i.e. “soft” or “hard” opt-out consent); i.e. certain countries require a next-of-kin to co-sign consent for organ donation[5].

So how does Canada move forward taking into account this information?

The suggestion that opt-out systems may increase total liver and kidney transplantation makes a compelling argument for changing Canada’s organ donation system. However, Ferguson et al. (2014) stated that in order for their findings to be externally validated, collaborating with organ donation procedures internationally, involving criteria such as type of consent, hospital bed availability and patient status has to occur[5]. One glaring issue that remains however is that even countries that have implemented an opt-out system, are currently experiencing organ donation shortages. Taking this into consideration, we can conclude that changing to a complete opt-out format may only allow for a decrease in donated organ shortage, without eliminating it entirely.

With this in mind, Canada may be more motivated instead to look to Spain’s outtake on organ donation, the latter having the highest organ donation rate in the world using an updated version of opt-out consent. Dr. Rafael Matesanz, a kidney specialist, created the “Spanish Model” outlined as followed[6]: When a patient is in need of an organ transplant, the hospital mobilizes:

1. A trained coordination team 2. A transplant coordinator who obtains donation consent from the family and who is switched out every three years to avoid burnout 3. A proactive referral method of possible donors to critical care units 4. The referral to and management of potential donors in the ICU (Intensive Care Unit) This method has allowed Spain to become a leader and gold standard in organ donation, which in turn makes it the perfect role model for Canada to solve its crisis. Presently in Canada, if an individual requires an organ, a hospital has to contract Trillium, who then determines whether the surgery will take place or not, based on fair criteria such as suitable blood type match, medical urgency, time spent on waitlist, size of organ, etc.[1]. This has the added disadvantage of potentially becoming a time consuming process and limiting the window of viability certain organs have. Therefore, in order to progress to a point where thousands of patients are not being ushered into a “single-file line”, waiting for an organ, a progressive shift from the current opt-in system towards an opt-out system must take place. The Spanish gave us music, the arts, and architecture…so why not borrow just one more piece of their greatness?

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JUSTIFICATION FOR COFFEE ADDICTION Jaya Sam As we begin to move into the cooler months of the year, coffee consumption will become increasingly more comforting and frequent. Some people may begin to increase their daily coffee consumption but worry that it will begin to take a negative toll on their body. However, reader, don’t fear. Although caffeine may have some nasty side effects, there are several scientifically proven benefits from coffee!

One benefit is that coffee has been linked to preventing eyesight degradation. The retina is one part of the eye that contains a variety of cells that help us to take in and organize visual information. Since it is constantly taking information, its tissue is very metabolically active; meaning it needs to use a lot of oxygen. This leaves the retina susceptible to oxidative damage, which can cause several diseases that lead to blindness[1]. One way these diseases can cause blindness is by hypoxia of the retina (reducing the oxygen supply to the retina). Raw coffee beans contain a chemical called chlorogenic acid that may help.

Chlorogenic acid is an antioxidant and has been linked to being neuroprotective[1]. A study found that retinal cells treated with chlorogenic acid were linked to having significantly reduced cell death by hypoxia, meaning that coffee consumption may help in preventing the

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high coffee consumption is linked to a decreased risk of type‑2 diabetes and the effects on risk are seen in a fairly short time period[2]

degeneration of the retina[1]!

In addition to helping your eyesight from worsening, coffee also helps prevent type-2 diabetes. The Harvard School of Public Health researchers looked at data from three studies. They found that there was an 11% lower risk of developing type-2 diabetes for people who increased the amount of coffee they drank daily over a four-year period by more than one cup compared to those who didn’t change their coffee consumption[2]. Not only that, but people who decreased their coffee consumption by more than one cup per day had a 17% increased risk of developing type-2 diabetes[2]. This shows that high coffee consumption is linked to a decreased risk of type2 diabetes and the effects on risk are seen in a fairly short time period[2].

For those of you who think that the benefits only come from drinking caffeinated coffee, think again.

Decaffeinated and caffeinated coffee were both found to have liver protective effects[3]. People who drink 3 or more cups of coffee daily (caffeinated or decaffeinated) have been shown to have lower levels of liver enzymes compared to non-coffee drinkers[3].

Elevated levels of liver enzymes are associated with several liver diseases, so drinking coffee is helping you to protect your liver!

Now, these are just a few benefits of coffee. It has also been linked to helping prevent heart disease and Parkinson’s disease[4]. Coffee not only helps you get through your day, but also to improve your life! So next time you ever begin to question your coffee addiction, just remember that coffee is so much more than just an energy boost.

Shining a Light on Adolescent Depression: Underidentified and Undertreated Isabella Churchill Until 40 years ago, mood disorders in youth were viewed as controversial, primarily due to the belief that adolescents lacked the mature physiological and cognitive structures necessary to experience mood changes[1].

However, research now shows that major depression in children and adolescents is recognized as a serious mental illness that causes severe morbidity and mortality[2].

The World Health Organization has called for a stronger focus on adolescent health. Mental health is at the forefront for this age group. Globally, it is the number one cause of illness and disability in adolescents, ahead of HIV/AIDS and asthma. In addition, suicide was ranked number 3 among the top causes of death in this population[3].

Although the prevalence of this disorder affects 2% of children and 6% of adolescents[2], and despite this growing problem, only 50% of adolescents with depression will be diagnosed before adulthood[4]. Common barriers to this gap include: limited availability of health professionals, affordability of these services, long wait times, lack of education and the stigma associated with mental illness. These barriers prevent adolescents from receiving specialty mental health services and primary care settings have become commonplace for treating mental health in this population. This means mental health professionals are only treating a small percentage of adolescents[5].

Prescribed antidepressants such as fluoxetine, known by the trade name Prozac, have been found to be the most effective selective serotonin reuptake inhibitor (SSRI) [6] . Finding the right medication for treatment may take months, which can mean months of suffering. Cognitive behavioural therapy (CBT) is also useful for treating dysISSUE 10 • NOVEMBER 2014

functional emotions, maladaptive behaviours and cognitive processes with goal-oriented procedures. However, combination therapy of a SSRI and CBT was found to have a higher rate of clinical response, especially in those with treatment resistant depression and a greater efficacy in the remission of comorbid depression symptomology [7] . Continuing treatment beyond remission of symptoms may also prove to be beneficial in preventing relapse. Exercise has also been found to be effective in the management of depression but is often less promoted[8]. In addition, electroconvulsive therapy (ECT) has proven to be efficacious for adolescent depression, however this form of treatment has been stigmatized from movies such as One Flew Over the Cuckoo’s Nest, depicting the misuse of ECT. Taking these factors into consideration, early recognition, identification and management of depression are important in order to effectively treat adolescents with depression. Since there has been a shift in the care setting of adolescent depression, primary care clinicians should be adequately trained, supported or reimbursed for the management of this disorder. However, adherence to antidepressants can be difficult due to the struggle of finding the right treatment. Studies are now showing that PET scans may be helpful in determining early on what treatment a person needs and may be heading in the direction of personalized treatment[9]. In order to effectively receive proper treatment, the mental health system must also be effectively navigated and we need to become more proactive when it comes to mental health treatments.

WWW.BROCKHEALTHMAGAZINE.CA •

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HOT HEADLINES

THE DISEASE BEHIND THE #ICEBUCKETCHALLENGE Ola Kit Who among us has not heard of the Ice Bucket Challenge? This was the summer of the Ice Bucket Challenge since everyone, from your neighbour to celebrities, were dumping ice water on themselves. The challenge captured everyone’s attention like nothing else had before.

For those who do not know, the #ALSIceBucketChallenge is a campaign to raise money for Amyotrophic Lateral Sclerosis (ALS).

ALS, also known as Lou Gherig’s Disease, is a progressive neuromuscular disease involving nerve cell death resulting in voluntary muscle paralysis[1]. People living with the disease slowly become paralyzed due to degeneration of motor neurons in the brain and spinal cord[1]. ALS is the most common cause of neurological death in Canada, more commonly affecting men[1]. Eighty percent of individuals living with ALS die within 3 to 5 years of diagnosis due to the lack of an effective treatment and cure[1]. Approximately 3000 individuals over the age of 18 live with ALS in Canada[1].

Pete Frates, a communications major at Boston College, was inspired to create the Ice Bucket Challenge following his diagnosis with ALS in March 2012[2]. Frates’ goal was to bring the disease out of the shadows and to the attention of both the public and powerful individuals[2]. And did he ever succeed. Bill Gates, who completed the challenge in August 2014, was one of many philanthropic individuals who were nominated and participated in the Ice Bucket Challenge.

The process is simple. Step one: someone challenges you to the Ice Bucket Challenge. Step two: dump a bucket of ice water on your head and/or donate to a charity funding ALS research. Step three: challenge someone to do the same. The #IceBucketChallenge is a simple selfless act where people put themselves in vulnerable position for an important cause. Who wouldn’t want to be a part of that?!

The #ALSIceBucketChallenge became a trend that successfully captured everyone’s attention and shone a light on an important disease.

The Ice Bucket Challenge was widely successful. To date, ALS Canada has raised $15,021,570 surpassing their goal of $10,000,000[1].

For more information on ALS or to make a donation, please visit www.als.ca.

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Enterovirus D68 Spreading Across North America Joan Lopez New Brunswick has had its first confirmed case of Enterovirus D68, a strain of a severe respiratory illness common in children that has led to numerous hospitalizations across North America. Although scientists have identified more than 120 types of enteroviruses, this current outbreak is rare in terms of both symptoms and scale. Mild cold symptoms are typically associated with enteroviruses like fever, runny nose, sneezing, coughing, and muscle aches, and most children recover on their own. However, there is little information available regarding Enterovirus D68. There is also no treatment or vaccination for D68.

It is suggested to treat this strain like you would for a common cold – stay at home if you’re sick, drink lots of fluids, and get lots of rest. D68 is likely to spread from person to person, with an infected person coughing, sneezing, or touching a surface and other people touching that same surface.

Public health officials are recommending hand washing with soap and water for 20 seconds and to practice proper sneezing/ coughing techniques. D68 is more severe in children due to their smaller airways and lack of a developed immune system. There have been deaths linked to D68 as of late but nothing has been established as conclusive and researchers are looking into the full spectrum of the illness. There have also been reports that D68 may cause paralysis after handful of cases have been reported patients in British Columbia and Alberta but there is still no concrete evidence.

Faculty

SPOTLIGHT Sanyam Jain

Dr. Paula Gardner

Dr. Paula Gardner has often been described as a “dedicated, passionate and encouraging” professor. It has BA, BEd, MA, PhD been two years since Dr. Gardner joined Brock University as an Assistant Professor in the Department of Health Sciences. Dr. Gardner teaches “Public Health and So- in Public Health. The dynamic professor has experience ciety”, “Developing Healthy Communities”, Qualitative teaching a wide range of students in a variety of settings.

Research in Health Sciences” and a new course “Mental Prior to coming to Brock, Dr. Gardner taught at the Dalla Health and Addictions”.

Lana School of Public Health at the University of Toron Dr. Gardner’s research explores community mobil- to and the School of Public Health at the City University ity – “outdoor movement – the ability to independently of New York. Her passion for teaching originates in the get out into our neighbourhood and stay engaged in life classroom - “What gets me really excited is the two-way – is critical to everyone’s health and transfer in learnwellbeing”. As a community-based ing! The students “What gets me really excited is the Gerontologist her work focuses on are learning from identifying and addressing the barme and at the two-way transfer in learning! The riers and supports for ongoing mosame time I learn students are learning from me and at from them.” bility. She takes particular interest in why people customize their mobility

the same time I learn from them.” devices (e.g. canes, wheelchairs) and In addition to how this impacts their health. “I’m learning that when her research, Dr. Gardner also examines ways to intepeople ‘Pimp their Ride’ by adding lights or painting grate mindfulness into post-secondary education and its them cool colours – they increase their social partici- impact on students. In “The Mindfulness Experiment”, pation, they are more active and engaged, and they feel she has learned that encouraging students to participate better about themselves.” Dr. Gardner was inspired by in meditation and focus on the present moment is benefiher grandmother who instilled “a sense of curiosity and cial to learning and coping with stress. adventure about getting old”. “Mobility is a very impor- Dr. Gardner is an advocate for experiential learntant,” she explains “it’s is the difference between being ing. She believes that “experience is the root of underalive and living.” standing.” Dr. Gardner applied this in the course project Dr. Gardner began her education with a BA in Recre- “Through Their Eyes” (www.throughtheireyesproject. ation and Leisure studies from the University of Waterloo. com), where students in her Developing Healthy ComWith a keen interest in teaching, she attended teachers munities course learned from seniors what makes their college at the University of Western Ontario and taught neighbourhood “age-friendly”. elementary school in the London School Board before Dr. Gardner is an integral part of Brock University returning to school herself. She completed her Master’s as both a student-oriented educator and a compelling rein Health Promotion at Dalhousie University and then searcher. Enrollment in her courses will certainly con“loving being a student”; she continued her education at tinue to grow as students appreciate her engaging and the University of Toronto where she received her PhD thought-provoking teaching-style.

ISSUE 10 • NOVEMBER 2014

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POSITIVE PSYCHOLOGY—THE SCIENCE OF HAPPINESS Zanab Shah “The science of psychology has been far more successful on the negative than the positive side. It has revealed to us much about man’s shortcomings, his illness, his sins, but little about his potentialities, his virtues, his achievable aspirations or his full psychological height.”

--Abraham Maslow, creator of Maslow’s hierarchy of needs Psychology, in its essence, is the scientific study of behaviors and human mental processes[1], and as described by Maslow, it has popularized itself in the dissection of negative and weak aspects of the individual.

Positive Psychology is a branch of psychology that challenges this notion. As a science, positive psychology is the study of effective physical and mental interventions that, when applied, assist in the process of leading a happier, healthier life[2]. Psychologists focused in this particular branch utilize the same techniques used to identify weaknesses and negative aspects of the human psyche to highlight strengths, and positive potentiality within their patients[3]. Event analysis, reversing focus, gratitude, and hope-fostering strategies are all methods employed by positive psychologists that can be applied to day-to-day life[4][5][6]. Event analysis focuses on the breakdown of significant events in one’s life to assess the positive values gained from each experience rather than meditating on the negatives[4].

This process alleviates the stress associated with day-to-day events by allowing one to absorb the positive impacts and deflect the negatives.

Similarly, reversing focus is a technique, which focuses on amplifying the constructive facets of a situation[4] while minimizing the negatives involved—for example; instead of dwelling on a bad midterm grade, one can pull attention to a particularly successful test and use similar study tactics to improve their performance on the next midterm. Gratitude visits are comprised of communicating gratitude to a person in one’s life that has helped them through a difficult situation or aided their wellbeing in a cer-

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tain way[5]. Gratitude visits serve as a reminder for the positive influences available to us in our lives and how significantly they impact our journey to wellbeing. Building hope-fostering strategies is one of the most important techniques used by positive psychologists to influence positive behaviors and attitudes towards conflicts. Hopefostering strategies include recognizing the tools and capabilities one possesses while working through difficult situations and gaining reassurance through the reflection of conflicts one has resolved in the past[7]. Hope-fostering revolves around the principle of being able to understand that our actions positively impact the situations we are faced with. Nothing in life is presented to us with quantifiable certainty and, at times, the hurdles we face are neither scheduled nor easily understandable. Remaining optimistic in times of deep concern and uncertainty can be a difficult, and sometimes seemingly impossible thing to do. Positive psychology slowly disassembles the perceived barrier of helplessness and allows us to actualize our capabilities in the form of meaningful, lasting change while paving the way for stability and wellbeing in our daily lives.

Will you get Ebola?

Probably Not Nathaniel Mannella Are you scared of catching the deadly Ebola virus here in Canada?

Ebola, the disease that has killed over 5,000 Africans at the time of writing this article, has been diagnosed in a few major U.S. cities to date. Time to panic, right? Wrong. Welcome to the media circus that is the Ebola “crisis”. Many media outlets have blown the severity of the disease out of proportion, in order to instil fear in the population. Why would they do such a thing? Creating panic leads to more viewers and website hits, and this means that they can continue reporting on the “issue” as long as people think they are at risk. Yes, Ebola is a terrible disease, with a case fatality rate of nearly 50%. There is also no current cure for Ebola. Yet, with the public health infrastructure in place in both Canada and the U.S., there is hardly any chance of outbreak here in North America. Public Health policies have treated each case individually, quickly, and appropriately, to minimize the spread of infection.

These protocols have limited the disease to only a few cases in North America. The more important reason you won’t get Ebola, however, is that it is not spread through airborne contact. Contact with an infected individual’s body fluids, such as vomit, or open wounds, is the only known method of transmission. Even if you were to be in the same room as a person with Ebola, you have almost no chance of contracting the disease. You are far more likely to get the common flu than you are Ebola this year. So now you have the facts.

What’s the next step? Stop panicking.

Oh, and get your flu shot.

A Cancer Detecting Pill? Google Has the Answers Yasmeen Mann

HOT HEAD LINES

Google has a pill in the experimental stage that is anticipated to detect cancer. The pill contains microscopic, magnetic particles that can search for malignant cells by travelling through an individual’s bloodstream. Particles within the pill would contain antibodies or proteins attached to detect biomarker molecules indicating diseases in the body. Disease indications would then be reported to a sensor attached to a wearable device. This project aims to provide a simple, noninvasive way to detect cancer. The particles within the pill are tiny enough to fit inside a single red blood cell, which is predicted to improve on sample blood tests that cannot detect early stages of many cancers.

This pill would move towards proactive medicine, and though the work is in early stages, Google is currently seeking partners to move this technology forward. Careful consideration surrounds the regulation of new diagnostic techniques. Particularly, techniques such as this considering that nanoparticles provide a threat to the health of individuals and the environment when not controlled carefully. The technology will also most likely not be operated by Google, as there is a risk of access to patient doctor. Thus, medical professionals and companies will deal with the technology.

With innovations such as this project, there could potentially be a surge in proactive medicine. Imagine that, an early diagnosis that can potentially save your life with the swallow of a pill.

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This Could Be You!

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REFERENCES Image Sources Cover photo: Trillium Gift of Life Network - http://www.giftoflife.on.ca/img/ photos/xtralarge/_MG_3804.jpg All other graphics: Non-Commercial Creative Commons Share Alike 2.5 license • http://pixabay.com/en/syringe-healthcare-needle-medicine-417786/ • http://en.wikipedia.org/wiki/File:GEM_corn.jpg • http://upload.wikimedia.org/wikipedia/commons/d/d7/John_Maino_ performs_the_ALS_Ice_Bucket_Challenge.jpg • http://commons.wikimedia.org/wiki/File:Resperine_prescription.jpg • http://upload.wikimedia.org/wikipedia/commons/f/fc/Target_ClearRx. jpg • http://upload.wikimedia.org/wikipedia/commons/4/40/Electronic_ stethoscope.jpg • http://upload.wikimedia.org/wikipedia/commons/8/8b/Fancy_a_ cupper.jpg • http://pathmicro.med.sc.edu/fox/strep-pneu.jpg • http://upload.wikimedia.org/wikipedia/commons/8/81/Positive_ psychology_optimism.svg • http://www.giftoflife.on.ca/img/photos/xtralarge/_MG_3733.jpg • http://www.giftoflife.on.ca/img/photos/xtralarge/_MG_3762.jpg • http://pixabay.com/en/sad-woman-sorrow-sadness-young-468923/ Information Sources Male Contraception: What’s Available and What’s to Come [1] Planned Parenthood. Birth Control for Men. 2014. http://www. plannedparenthood.org/health-info/men/birth-control-men (accessed October 10, 2014).

[2] Brady, B M, and R A Anderson. “Advances in male contraception.” Expert Opinion on Investigational Drugs 11, no. 3 (2002): 333-344.

[3] Mruk, D, C H Wong, B Silvestrini, and C Y Cheng. “A male contraceptive targeting germ cell adhesion.” Nature Medicine 12, no. 11 (2006).

[4] Guha, S K. Contraceptive for use by a male. United States Patent 5,488,075. 1996.

[5] Chaudhury, K, A K Bhattacharyya, and S K Guha. “Studies on the membrane integrity of human sperm treated with a new injectable male contraceptive.” Human Reproduction 19, no. 8 (2004): 1826-1830.

[6] Guha, S K. “Biophysical mechanism-mediated time-dependent effect on sperm of human and monkey vas implanted polyelectrolyte contraceptive.”

Asian Journal of Andrology 9, no. 2 (2007): 221-227.

[7] Sharma, U, K Chaudhury, N R Jagannathan, and S K Guha. “A proton NMR study of the effect of a new intravasal injectable male contraceptive RISUG on seminal plasma metabolites.” Reproduction 122, no. 3 (2001): 431-436.

[8] Koul, V, A Srivastava, and S K Guha. “Reversibility with sodium bicarbonate of styrene maleic anhydride, an intravasal injectable contraceptive, in male rats.” Contraception 58, no. 4 (1998): 227-231.

[9] Lohiya, N K, B Manivannan, and P K Mishra. “Ultrastructural changes in the spermatozoa of langur monkeys Presbytis entellus entellus after vas occlusion with styrene maleic anhydride.” Contraception 57, no. 2 (1998): 125-132.

[10] Lohiya, N K, B Manivannan, P K Mishra, S Sriram, S S Bhande, and S Panneerdoss. “Preclinical evaluation for noninvasive reversal following long-term vas occlusion with styrene maleic anhydride in langur monkeys.”

Contraception 71, no. 3 (2005): 214-226.

Genetically Modified Food [1] Watts, C. (2014). Genetically Modified Organisms. Salem Press Encyclopedia Of Science.

[2] Amofah, G. (2014). Recommendations from a meeting on health implications of genetically modified organism (GMO). Ghana Medical Journal, 48(2), 117-119. doi:10.4314/gmj.v48i2.11 [3] Spiroux de Vendômois, J., Cellier, D., Vélot, C., Clair, E., Mesnage, R., & Séralini, G. (2010). Debate on gmos health risks after statistical findings in regulatory tests. International Journal of Biological Sciences, 6(6), 590-598.

Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2952409/ Inequality in Global Health Research and Aproaches to Reducing it [1] Hofmann, K., Blomstedt, Y., Addei, S., Kalage, R., Maredza, M., Sankoh, O., Bangha, M., Kahn, K., Becher, H., Haafkens, J., and Kinsman, J. (2013).

Addressing research capacity for health equity and the social determinants of health in three African countries: the INTREC programme. Global Health Action. 6:19668 [2] Lee, K., and Mills, A. (2000). Strengthening governance for global health

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research. The BMJ. 321: 775-776.

[3] Vidyasagar, D. (2006) Global notes: the 10/90 gap disparities in global health research. Journal of Perinatology. 26: 55-56.

[4] Sitthi-amorn, C., and Somrongthong, R. (2000). Strengthening health research capacity in developing countries: a critical element for achieving health equity. The BMJ. 321: 813-815.

[5] Frenk, J., and Chen, L. (2011). Overcoming gaps to advance global health equity: a symposium on new directions for research. Health Research Policy and Systems. 9:11.

[6] Sadana, R., and Pang, T. (2003). Health research systems: a framework for the future. Bulletin of the World Health Organization. 81:159 [7] Labonte, R., and Spiegel, J. (2003). Setting global health research priorities. The BMJ. 326: 7392-7393.

Kids Have the Weight of the World on Their Shoulders [1] American Chiropractic Association. (2013). Backpack Misuse Leads to Chronic Back Pain, Doctors of Chiropractic Say. Retrieved October 11, 2014 from http://www.acatoday.org/content_css.cfm?CID=65 [2] American Chiropractic Association. (2014). Back Pain Facts & Statistics.

Retrieved October 11, 2014 from http://www.acatoday.org/level2_css. cfm?T1ID=13&T2ID=68 [3] Carabalona, R., & Negrini, S. (January 15, 2002). Backpacks On! Schoolchildren’s Perceptions of Load, Associations with Back Pain and Factors Determining the Load. Spine Journal, 27(2), 187-195.

Retrieved October 11, 2014 from http://journals.lww.com/spinejournal/ Abstract/2002/01150/Backpacks_on__Schoolchildren_s_Perceptions_ of.14.aspx [4] Corcoran, M., et al. (2002). Backpack Use in Children. Pediatric Physical Therapy, 14(3), 122-131. Retrieved October 11, 2014 from http://journals. lww.com/pedpt/Abstract/2002/14030/Backpack_Use_in_Children.2.aspx [5] Early, S., et al. (2006). Back Pain and Backpacks in School Children.

Journal ofPediatric Orthopaedics, 26(3), 358-363. Retrieved October 11, 2014 fromhttp://journals.lww.com/pedorthopaedics/Abstract/2006/05000/ Back_Pain_and_Backpacks_in_School_Children.15.aspxage%2011-14%20 years [6] Triano, J. (2000). Backpacks and Back Pain in Children. Retrieved October 11, 2014 from http://www.spine-health.com/wellness/ergonomics/ backpacks-and-back-pain-children My Microbes & Me [1] Proctor, L. (2013, September 1). The human microbiome: A true story about you and trillions of your closest (microscopic) friends.

Actionbioscience. Retrieved from http://www.actionbioscience.org/ genomics/the_human_microbiome.html.

[2] Morgan, K. (n.d.). Change your microbiome, change yourself. Genome Magazine. Retrieved from http://genomemag.com/change-yourmicrobiome-change-yourself/#.VDwE6EtZ_1o.

[3] Raoult, D. (2008). Obesity pandemics and the modification of digestive bacterial flora. European Journal of Clinical Microbiology & Infectious Diseases 27(8), 631-634. Retrieved from http://link.springer.com/ article/10.1007%2Fs10096-008-0490-x [4] Grens, K. (2014, May 21,). The maternal microbiome. The Scientist.

Retrieved from http://www.thescientist.com/?articles.view/ articleNo/40038/title/The-Maternal-Microbiome/.

[5] Cho, I., & Blaser, J. B. (2012). The human microbiome: At the interface of health and disease. Nature Reviews Genetics 13(4), 260-270. Retrieved from http://www.nature.com/nrg/journal/v13/n4/abs/nrg3182.html.

[6] Blaser, M. (Interviewee). (2014, April 14). Modern medicine may not be doing your microbiome any favors. NPR. Retrieved form http://www.npr. org/2014/04/14/302899093/modern-medicine-may-not-be-doing-yourmicrobiome-any-favors.

Change Your Genetic Destiny [1] Helgadottir, A., Thorleifsson, G., Manolescu, A., Gretarsdottir, S., Blondal, T., Jonasdottir, A., ... Stefansson, K. (2007). A Common Variant on Chromosome 9p21 Affects the Risk of Myocardial Infarction. Science, 316(5830), 1491-1493. doi: 10.1126/science.1142842 [2] Kapranov, P., Cheng, J., Dike, S., Nix, D. A., Duttagupta, R., Willingham, A. T., ... Gingeras, T. R. (2007). RNA Maps Reveal New RNA Classes and a Possible Function for Pervasive Transcription. Science, 316(5830), 1484-1488. doi: 10.1126/science.1138341 [3] Ornish, D., Magbanua, M. J., Weidner, G., Weinberg, V., Kemp, C., Green, C., ... Carroll, P. R. (2008). Changes in prostate gene expression in men undergoing an intensive nutrition and lifestyle intervention. Proceedings of the National Academy of Sciences, 105(24), 8369-8374. doi: 10.1073/ pnas.0803080105

REFERENCES [4] Ornish, D., Weidner, G., Fair, W. R., Marlin, R., Pettengill, E. B., Raisin, C. J., ... Barnard, R. J. (2005). Intensive Lifestyle Changes May Affect The Progression Of Prostate Cancer. The Journal of Urology, 174(3), 1065-1070. doi: 10.1097/01.ju.0000169487.49018.73 Feature Article: Presumed or Inquired Consent [1] Organ & tissue donation. (2013, December 13). Retrieved October 11, 2014, from http://www.healthycanadians.gc.ca/diseases-conditionsmaladies-affections/donation-contribution-eng.php [2] Transplant Newsletter. (2013). International Figures on Donation and Transplantation,18(1), 1-74. Retrieved October 11, 2014, from http://www. ont.es/publicaciones/Documents/newsletter_transplant_vol_18_no_1_ september_2013.pdf [3] Willis, B., & Quigly, M. (2013). Opt-out organ donation: On evidence and public policy.The Royal Society of Medicine, 107(2), 56-60. Retrieved October 4, 2014.

[4] Saunders, B. (2011). Opt-out organ donation without presumptions.

Journal of Medical Ethics, 38(2), 69-72. Retrieved October 12, 2014, from http://jme.bmj.com/content/38/2/69.short [5] Shepherd, L., O’Carroll, R., & Ferguson, E. (2014). An international comparison of deceased and living organ donation/transplant rates in opt-in and opt-out systems: A panel study. British Medical Council BioMed Central, 12(131). Retrieved October 11, 2014, from http://www. biomedcentral.com/1741-7015/12/131 [6] Matesanz, R. (2013). HOW DO WE INCREASE ORGAN DONATION RATES? LESSONS FROM THE SPANISH MODEL. The International Liver Congress, 48(1), 60-68. Retrieved October 6, 2014, from http://www2.kenes.com/ liver-congress/scientific/Documents/PGC_Amsterdam-2013.pdf#page=61 Justification for Coffee Addiction [1] Etchells, Edward et. al (2012). The Economics of Patient Safety in Acute Care: Technical Report. BMJ Quality and Saftey 21(6), 448-456. Retrieved from: http://qualitysafety.bmj.com/content/21/6/448.full.pdf+html [2] Bhupathiraju, S.N., Pan, A., Manson, J.E., Wilett, W.C., van Dam, R.M., and Hu, F.B. (2014). Changes in coffee intake and subsequent risk of type 2 diabetes: three large cohorts of US men and women. Diabetologia, 57(7), 1346-1354.

[3] . Xiao, Q., Sinha R., Graubard, B.I., and Freedman N.D. (2014). Inverse associations of total and decaffeinated coffee with liver enzyme levels in NHANES 1999-2010. Hepatology, doi: 10.1002/hep.27367. [Epub ahead of print].

[4] Nordqvist, Joseph. “What are the health benefits of coffee?” Medical News Today. MediLexicon, Intl., 9 Sep. 2014. Web. 14 Oct. 2014. http://www. medicalnewstoday.com/articles/270202.php Shining a Light on Youth Depression [1] Gentile, S. (2010). Antidepressant Use in Children and Adolescents Diagnosed with Major Depressive Disorder: What Can We Learn from Published Data? Reviews on Recent Clinical Trials, 5(1), 63-75.

[2] Cheung, A.H., Emslie, G.J., Mayes, T.L. (2005). Review of the efficacy and safety of antidepressants in youth depression. Journal of Child Psychology and Psychiatry 46(7), 735-754.

[3] WHO (2014). WHO Calls for a Stronger Focus on Adolescent Health.

Retrieved from: http://www.who.int/mediacentre/news/releases/2014/ focus-adolescent-health/en/ [4] Zuckerbrot, R.A., et al. (2007). Guidelines for Adolescent Depression in Primary Care (GLAD-PC): I. Identification, Assessment, and Initial Management. Pediatrics, 120(5), 1299-1312.

[5] Cheung, A.H., et al. (2007). Guidelines for Adolescent Depression in Primary Care GLAD-PC): Part II—Treatment and Ongoing Management.

Pediatrics, 120(5), 1313-1326.

[6] Emslie G.J., et al (2008). Fluoxetine Versus Placebo in Preventing Relapse of Major Depression in Children and Adolescents. American Journal of Psychiatry, 165(4), 459-467.

[7] Treatment for Adolescents with Depression Study (TADS) Team (2009).

The Treatment for Adolescents With Depression Study (TADS): Outcomes Over 1 Year of Naturalistic Follow-Up. American Journal of Psychiatry, 166, 1141-1149.

[8] Dunn, A.L., Weintraub, P. (2008). Exercise in the Prevention and Treatment of Adolescent Depression: A Promising but Little Researched Intervention. American Journal of Lifestyle Medicine, 2(6), 507-518.

[9] Pedersen, T. (2013). Medication or Talk Therapy? PET Scans May Personalize Depression Treatment. Psych Central. Retrieved on October 14, 2014, from http://psychcentral.com/news/2013/07/05/medication-ortalk-therapy-pet-scans-may-personalize-depression-treatment/56857. html

ISSUE 10 • NOVEMBER 2014

The Disease Behind the #IceBucketChallenge [1] ALS Society of Canada. (2011). ALS Quick Facts. Retrieved on: October 13, 2014. <http://als.ca/sites/default/files/files/Fact%20Sheets/ALS%20 QUICK%20FACTS_Mar52012_revised.pdf>.

[2] Carmine, Galo. (2014). How Pete Frates Found His Calling And Launched The Ice Bucket Challenge. Forbes. Retrieved on: October 13, 2014. <http:// www.forbes.com/ sites/carminegallo/2014/09/05/how-pete-fratesfound-his-calling-and-launched-the-ice-bucket-challenge/>.

Positive Psychology: The Science of Happiness [1] Compton, W. C. (2005). Introduction to positive psychology. Australia: Thomson/Wadsworth.

[2] Seligman, M. E. (2011). Learned optimism: How to change your mind and your life. Random House LLC. [3] McLaffery Jr, C. L., & Kirylo, J. D. (2001). Prior positive psychologists proposed personality and spiritual growth.

[4] Aspinwall, L. G., & Staudinger, U. M. (2003). A psychology of human strengths: Fundamental questions and future directions for a positive psychology. American Psychological Association.

[5] Lopez, S. J., & Snyder, C. R. (2003). Positive psychological assessment.

Washington APA [6] Fairman, N., Knapp, P., & Martin, A. (2005). Flourishing: Positive Psychology and the Life Well-Lived. Journal of the American Academy of Child and Adolescent Psychiatry, 44(8), 834-835.

[7] Duggleby, W., & Wright, K. (2004). Elderly palliative care cancer patients’ descriptions of hope-fostering strategies. International Journal of Palliative Nursing, 10(7), 352-359.

Hot Headlines Enterovirus D68 Spreading Across North America [1] Midgley, C.M., Jackson, M.A., Selvarangan, R., Turabelidze, G., Obringer, E., Johnson, D., Giles, L., Patel, A., Echols, F., Oberste, M.S., Nix, A.W., Watson, J.T., & Gerber, S.I. (2014). Severe respiratory illness associated with Enterovirus D69 – Missouri and Illinois, 2014. Morbidity and Mortality Weekly Report 14(11), 798-799.

[2] Schwartz, D., & Zafar, A. (2014, October 27). Enterovirus D68: FAQ on an emerging respiratory pathogen. CBC News. Retrieved October 30, 2014, from http://www.cbc.ca/news/health/enterovirus-d68-faq-on-anemerging-respiratory-pathogen-1.2786890 Will you get Ebola? Probably Not. [1] CBC News (2014, October 29). Ebola outbreak: Rate of new cases in Liberia slows, WHO says. CBC News. Retrieved October 30, 2014, from http://www.cbc.ca/news/health/ebola-outbreak-rate-of-new-cases-inliberia-slows-who-says-1.2816812 [2] Toronto Star. (2014, October 3). Canada has no reason to panic with Ebola appearing in Texas: Editorial. Toronto Star. Retrieved October 30, 2014, from http://www.thestar.com/opinion/editorials/2014/10/03/ canada_has_no_reason_to_panic_with_ebola_appearing_in_texas_ editorial.htm [3] World Health Organization. (2014, September). Ebola virus disease.

Retrieved October 30, 2014, from http://www.who.int/mediacentre/ factsheets/fs103/en/ A Cancer Detecting Pill? Google Has the Answers [1] The Global and Mail. (2014, October 29). Google wants to detect cancer earlier with a tiny pill in blood. Retrieved October 30, 2014 from http://www.theglobeandmail.com/technology/google-is-developingtiny-particles-that-would-search-for-problems-in-your-bloodstream/ article21361540/ [2] The Guardian. (2014, October 29). Google is developing a cancer and heart attack-detecting pill. Retrieved October 30, 2014 from http://www. theguardian.com/technology/2014/oct/29/google-cancer-heart-attackdetecting-pill

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