Brock Health - Issue 9

EDITOR’S NOTE Gaibrie Stephen Dear Reader,

I

am thrilled to present you with the ninth issue of Brock Health! Brock Health is a student run academic magazine which hopes to present scholarly and interest based articles for your leisure reading.

Over the past two years, Brock Health has been expanding both in the number of team members but also in the readership of the magazine. Thanks to the hard work of our social media team, Brock Health’s presence on both Twitter and Facebook has been booming! This year has been a pivotal time of growth for the magazine with the launch of our website in December and the creation of our five year business plan. We hope to continue with our success in the upcoming academic year and hope to continue to meet your expectations from the publication.

This issue is not only diverse in its topics but also geared towards you, the reader. Our feature article for this term is written by a talented first year student named Jessica Wong. Enjoy as she presents an exposé on the adverse effects of personal care products. Additionally, Franco Cardone joins us again this term and this time he brings a wealth of knowledge from his years volunteering in the emergency department. Finally, I am also excited to present to you our faculty spotlight and master’s highlight this issue as both Dr. LeBlanc and Soshi Mizutani’s research and stories are explored respectively.

Brock Health magazine could not function unless it had the support of the many individuals involved. I would like to thank Brock Health’s managing editors, Saumik Biswas, Breanne Kramer and Yasmeen Mann for their continued effort. Thank you to Joanne Boucher, Dr. Neil McCartney and Dr. John Wilson for continuing to facilitate the expansion of the publication.

I would also like to thank both BUSU and BUSAC for their support of the magazine both financially and structurally. Importantly, I would like to thank our social media team for tirelessly managing Brock Health’s presence in the digital world. Finally, Brock Health could not be the quality publication that it is today without the expertise and talent of our graphics designer, Scott Alguire. Scott’s dedication to the magazine is infectious and he has been the sole designer of the publication since its beginning in 2009.

Thank you to everyone who has been involved in the making of the Brock Health magazine! I hope you have a wonderful time reading this issue!

Let’s be

riends

facebook.com/BrockUHealth

BROCK HEALTH TEAM Editor-in-Chief Gaibrie Stephen Writers Christilynn Guerin Esther Gizzo Franco Cardone Hailea Squires Isabelle Churchill Jessica Wong Logan Fann Matthew Mueller Nathaniel Mannella Nazir Hoosein Sierra Barrett Smarth Narula Sonja Vukovic Managing Editors Saumik Biswas Breanne Kramer Yasmeen Mann Editors Meagan Barkans Eliza Beckett Carly Cameron Jon Choptiany Kaitlyn Mackenzie Rebecca MacPherson Paula Miotto Madina Naimi Social Media Team Shirley Lee Yasmeen Mann Nathaniel Mannella Liisa Wainman 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.

PERSONAL CARE PRODUCTS Danger to your health?| PAGE 11

GOOGLE GLASS

|PAGE 9

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CONTENTS 3 4 5 6 7 8 9 10 11 13 14 15 16

Got the Winter Blues?

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Life in the ED: Medical Dramas Versus Reality

19 20 21

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To Prevent the Outbreak The Future of Medicine Read Brock Health on the Go! BrockHealthMagazine.ca Master’s Highlight: Soshi Mizutani Cope.Care.Connect: A Student Run Campaign Taking the Campus by Storm Google Glass Hypoplastic Left Heart Syndrome Feature Article: Personal Care Products: A Danger to Your Health?

Prescribing a Dose of Cultural Competance A 30 Second Solution: Save a Life Read Brock Health on the Go! Faculty Spotlight: Dr. Paul LeBlanc

Brock Health Team References

Want to be part of Brock Health?

We have positions for students interested in: • Writing about current health topics • Social Media Marketing • Photography Email us: BrockHealth@busu.net

Nazir Hoosein

T GOT THE WINTER BLUES?

3

he New Year has come and resolutions have been made.

These resolutions could be doing better in school, starting to exercise at the gym or making more time for your friends and family. Some of us lose motivation and fall into some form of negative mood change for a short period of time during the winter months. These symptoms are known as Seasonal Affective Disorder (SAD). Common signs and symptoms of SAD include having a hard time waking up in the morning, feeling nauseated, working with less productivity, oversleeping, and over-or under-eating[1].

There are various ways in which SAD may have developed. One hypothesis is that SAD started through natural selection of our ancestors. This may have occurred due to the hibernation reflex or the low amounts of foods that were available during certain seasons[2].

There are a few known causes of SAD. One change that happens is the alteration of the body’s biological clock. The body’s biological clock is a response system to wake up when the sun is out and to fall asleep when the sun is gone. Because of the limited amount of light and constantly waking up when it is still dark outside causes an imbalance and exhaustion[1]. Also, when sunlight decreases, serotonin (a neurotransmitter) is reduced. This causes the chemicals in our brain to alter and depression takes over. Lastly, as in any change of season, levels of the hormone melatonin alter our sleep patterns.

Sleep patterns can be either longer or shorter depending on the amount of melatonin available. These various changes can lead to suicidal thoughts or behaviours, withdrawal from social activities, and problems at either school or work[3].

Regarding the treatment of SAD, you cannot just walk in and see a specialist instantly. Usually questionnaires, physical exams and medical tests have to be completed first before treatment is warranted. Once diagnosed, there are three forms of treatment: light therapy, medication, and psychotherapy[4]. Light therapy consists of a box that emits light similar to the sun’s rays that helps increase serotonin and melatonin levels in our bodies. Light therapy was one of the first used treatments of SAD but more recent studies have shown that it is more efficient long-term to use medications. However, it takes a longer time to adapt to the medications and see results. The medications used are similar to those used for other types of depression such as Zoloft and Prozac. Lastly, psychotherapy is a constructive way to alter your mood by identifying and then changing the main causes of SAD[5]. An effective way to battle SAD is to change your lifestyle. Try to make time for exercise and eat a healthy, balanced diet. These two lifestyle changes will help to reduce stress and anxiety, both precursors to the development of SAD[6].

Logan Fann

L

ike a Stephen King novel of a zombie outbreak scenario, Canada faces an increasing risk of disease outbreak from insects.

However to date no plans or policies exist to address this threat to the health of Canadians[1]. Recent climate changes resulting in warmer year round Canadian weather has resulted in an increased growth of invasive plant species. The plants provide an abundant new supply of food for a growing pest and animal population that insects can pick up disease from and transmit to humans[2;3]. Insects are commonly known to carry and transmit infectious pathogens, several of which can be harmful to humans.

Common insects such as fleas have demonstrated devastating capability in transmitting numerous diseases first onto animals then humans[3]. It is found that non-identified insects are likely to have contributed to the first case of rabbit haemorrhagic disease appearing recently in Canada[7].

These potential for insect transmitted disease outbreaks in Canada due to the changing environment needs to be addressed by a clear national monitoring and surveillance policy.

Like plants thriving in warm climate, insect metabolism and growth also tend to accelerate with increased temperature[2;Figure 1]. Unlike plants, the physiology of insects is exceedingly receptive to changes in temperature,

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with metabolism doubling for every ten degrees Celsius (10°C) increase in temperature[4;5]. The coldest annual temperature in northeastern North America is projected to increase between three to fifteen degrees (2.6-15.1°C) by year 2100 and expand the habitable environment for many insect pests[2]. This essentially will boost insect metabolisms by up to 250%[2]. This means an increase in individual insect’s physical activity. Figure 1 illustrates this cycle of effects of temperature changing and insect proliferation leading to eventual increased risks of disease outbreak.

The ability for government to respond effectively to crisis and disease outbreaks is largely dependent upon the reliable information available[6]. With the aid of

electronic information systems, businesses such as pest control companies that come into frequent contact with insects should be required to electronically report incidents to ensure current and reliable information that is pertinent to the insect surveillance system Canadians need[6]. Citizens of Canada should advocate for the government to intervene at the local and federal level.

A national system tracking and monitoring this data can provide just the right information and warning to perhaps prevent the next endemic, or pandemic (Figure 1). It may not be a zombie outbreak, but it may just be a very close call to something just as horrifying.

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The Future Of Medicine Smarth Narula

I

magine your laptop gets infected with a computer virus - there is a very simple fix to this. First, you discover what part has been infected and where this infection originated from. From there, you simply have to delete the source of the problem or perhaps delete and download an alternative software. Now, imagine this procedure being used in the human body. Instead of taking medication for an infection or disease, the problem (in this case, the gene responsible) is isolated and deleted or replaced with a correct gene[1]. This is what “gene therapy” offers. Similar to computers, the human body comes with a blueprint containing all the information involved in the development and functioning of the human body. This human “blueprint” is found in the human genome, which represents the entirety of an organism’s hereditary information, and is further encoded on the 23 chromosome pairs[5].

Gene therapy offers a chance to wipe out genetic diseases completely.

Researchers are testing several approaches to this modern therapy including the replacement of the mutated gene with a healthy copy, inactivating the mutated gene completely or introducing a new gene into the body to help fight a disease. This prevents defective genes from being passed down generations, allowing future generations to be infection/disease free[1]. The possibilities of this kind of treatment are endless. With further advancements in the field, it is possible to target diseases such as cancer, Parkinson’s disease or cystic fibrosis. Furthermore, those that are carriers of such diseases would no longer have to worry about passing it down to his/her offspring as the disease will be wiped out completely[2]. Research has shown that if gene therapy is successful, it would have a huge advantage over drug therapy, as drug therapy simply eases the symptoms, rather than erasing them completely.

Although gene therapy is highly regarded as the future of medicine and is being researched thoroughly,

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there are some drawbacks preventing it from being the front line of defense when it comes to diseases. Gene therapy targets the DNA, which as mentioned before is essentially the blueprint of the human body. By targeting genes in the human body, one has the capability to change the function of a the gene, change physical appearances, or target it for physical enhancement purposes[1]. With the amount of power and capabilities that gene therapy has to offer, scientists must ensure it is being used safely and for

the right purposes. A quote by Stan Lee which is often seen in Spiderman movies/comics can be applied to gene therapy: “with great power comes great responsibility” [6] . Although the potential for this therapy is endless, this type of power in the wrong hands could be extremely dangerous[1]. Another thing to consider is the fact that the human genome was completely decoded in April 2003[3]. This means that gene therapy is a relatively new field of study and the safety issues associated with this therapy are still unknown.

All in all, gene therapy is considered by many to be the future of medicine[4], with the ability to eventually perfect the gene sequence in the human body. Soon, gene therapy will replace drug therapy in its ability to offer more effective treatment. With gene therapy becoming the front line of defense, diseases and infection will be a thing of the past.

Master’s Highlight: Soshi Mizutani

Matthew Mueller

M

inimizing error is crucial in any field – especially when it comes to healthcare. Data analysis and statistics in the medical field is essential for ensuring patient safety and for making healthcare resources more efficient and effective. Soshi Mizutani, a student of the Physics Master’s program at Brock University, understands this importance.

Originally from Japan, Soshi started his academic career after moving to Beloit College, Wisconsin. Shortly after starting as an undergraduate student, Soshi began researching computational quantum mechanics. He arrived at Brock University as an exchange student majoring in condensed matter physics in the summer of 2013.

Alongside his studies in physics and mathematics, Soshi developed a growing interest in the medical application of his studies. Working alongside Dr. Xu of the Mathematics Department, Soshi has since developed his knowledge of math in order to contribute to better healthcare. “I hope my research will improve the efficiency and reliability of our healthcare system”, says Soshi. “Brock allows me flexibility to study various fields of interest with close interaction to expert faculty”.

Using cutting edge mathematics, Soshi has recently completed his thesis which works to optimize the data sampling techniques during the clinical trial of various drugs. “My work counters classical data analysis”, explains Soshi, “instead of analyzing given data, my method works to improve the way data is collected”. In most experiments, researchers evenly distribute the total sample of patients. However, Soshi discovered that certain points on the dosage-response curve are more important

than others. “By increasing the sample size at these special points, you can minimize the standard deviation of the entire dose-response graph”. By consulting biomedical professionals, Soshi is able to predict the likely behaviour of the graph. With this information, he is able to distribute the sample accordingly. This method would reduce the number of years required to test new drugs, making them available sooner. In addition, the method also has the potential to increase the efficiency and accuracy of drug dosage in Canada.

In his spare time, Soshi enjoys playing sports on a regular basis. He has played on several Brock University intramural teams, including the championship coed outdoor soccer team of the 2013 fall season.

Whether you find him on the court or the field, Soshi loves sports because they refresh his mind and body, while allowing him to be socially engaged. In addition to sports, Soshi also enjoys playing piano. He serenades his friends by playing piano covers of pop, rock, jazz, and classical music. “Participating in many different activities has a positive effect overall”, says Soshi.

In the future, Soshi has much to look forward to. He has been asked to present his thesis at the 2014 Annual Meeting of the Statistical Society of Canada, which is held at the University of Toronto this coming spring. After completing his Master’s degree, Soshi plans to go on and attain his PhD in theoretical physics, while continuing his research in the medical field. He hopes to make significant contributions in the science community. In all areas of life, especially academics, Soshi lives by the motto “do what you like, and like what you do”.

“do what you like, and like what you do”

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Guide Cope.Care.Connect:

A Student Run Campaign Taking the Campus by Storm Hailea Squires

Y

ou know that subjective grey area, where getting back up when you feel so far down seems nearly impossible? When we are empowered with the knowledge to access resources within a stones throw from us, when we have a strong social circle that never quite lets us slip away, and when we have been down this road so many times before that we just know it will get better in due time—that’s resiliency.

Brock University’s student run Cope.Care.Connect campaign is intended to increase resiliency and positive coping skills among first year Brock university students. Through Facebook, students are spreading the message that feeling overwhelmed is normal, and Brock has resources to support them here on campus.

The reception for the campaign, which is facilitated by Student Health Services, has been fantastic. This is because the campaign has the potential to reach nearly everyone on campus, no matter if they are a first year student or a seasoned pro on the verge of graduation. It’s a safe assumption that we can all relate to feeling overwhelmed— mental health and stress amongst university–aged students is well established. For example, the 2012 National College Health As-

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sessment Survey concluded that more than 50% of Brock students reported feeling overwhelmed in the past 12 months.

In addition to this statistic, our representatives on the front lines of this campaign have reported complimentary anecdotal evidence. One campaign member who staffs the Cope.Care.Connect display tables reported that people have been extremely open in sharing their stress–related experiences with students candidly; disclosing moments where they broke down in tears due to stress, or instances when student support resources provided by the student health services has helped students bounce back.

The campaign will have run for a total duration of 4 weeks at Brock university. The students and staff behind Cope.Care.Connect hope to see a rippling effect of more and more students empowering themselves to engage with the resources available to them on campus long after the campaign has passed. If more students can harnesses their potential to manage and overcome daily anxiety and stressors, you can bet that we’d see a stronger, closer, resilient student population at Brock!

COPE. CARE. Check out the resources available to you: Facebook.com/CopeCareConnect www.CopeCareConnect.ca youtube.com/CopeCareConnect

CONNECT. 8

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GOOGLE Glass Sierra Barrett

T

echnology has become a large part of daily life and is continuously advancing. The healthcare field is no exception to the technology trend and one of the most interesting recent developments is the use of Google Glass in medicine. For those who unaware Google Glass is a nifty, somehow Star Trek reminiscent, pair of ‘glasses’ that allows the user to Google search, take pictures, videos and much more, completely handsfree. The device works on spoken command so all that the user needs to say is “Okay glass, Google images of the heart” and the search will come up right before your eyes in hologram form. Although it may seem like science fiction, this technology has already been used during surgery. A surgeon in California was able to assist on a knee surgery that was streamed live from the Google Glass of the lead surgeon performing the operation in Spain.

[1] This is only skimming the surface of health care possibilities. Potentially life-saving information is at hand as fast as you can say “Okay glass…”, not to mention instant access to patient charts and history, lab results, and vitals. There are also unique teaching opportunities that include allowing medical students to watch surgeries directly from the surgeon’s perspective and improving students’ bedside manner by reviewing through the eyes of a patient wearing Google Glass.[2] While many promising possibilities have been recognized, there are a few outstanding problems with the use of this new technology. Google Glass appears to be a great way to enable multitasking. However, studies have shown that multitasking by health care professionals

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leads to significant increases in error.[3,4] Additionally, there is a good possibility that the communication between the health care worker and their “Glass” may influence bedside manner, particularly for patients who are older or confused.

The frontrunner of ethical concerns in this case, as with many others in medicine, is that of privacy and patient confidentiality. Google Glass can take a picture with a simple wink from the wearer making it easy to see how pictures and videos could be taken without a patient’s knowledge or consent.[5] Even when used responsibly there is still a risk of this information being hacked by others which could result in serious breaches in patient confidentiality.1 Anyone who has been involved in the health care system knows that confidentiality is paramount and with new technology there are unique legal considerations to be examined. For example, if patient information were to be accessed through Google Glass it would first be streamed through the Google server; this would violate the Federal Accountability Act, which prevents any third party from accessing patient information.

[6]

This is just a brief view of the strengths and weaknesses of the implementation of this new technology in healthcare. There are certainly valid concerns, however, the endless possibilities of Google Glass in health care cannot be denied. When it comes to technology, progress will march on and as a society we have a responsibility to be informed and to avoid blindly moving forward without considering the repercussions.

Hypoplastic Left Heart Syndrome Christilynn Guerin

O

n July 10th, 1998, my cousin was brought into this world.

Prior to birth, ultrasounds showed she suffered a small heart murmur, and her parents were told not to worry. On September 24th, 1998, her skin appeared blue, and taking the necessary precautions; her parents brought her to the doctor.

During evaluation, the doctor determined that her blood-oxygen levels were at 47%, opposed to healthy levels of 95-100% 1She was rushed to Sick Kids Hospital where a cardiologist stated that her heart was a “literal mess”, and was in severe heart failure. That day, she was diagnosed with hypoplastic left heart syndrome (HLHS) and underwent her first of three heart operations, the Norwood Operation with Blalock Taussig shunt which creates a new aorta, connecting it to the right ventricle, allowing the heart to pump blood through the pulmonary and systemic circuit. At nine months, she underwent the Bidirectional Glenn Shunt/ hemi-Fontan operation, creating an uninterrupted connection between the pulmonary artery and vesicle, allowing deoxygenated blood to return to the upper body to the lungs.

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Finally, at two and a half years she underwent a Fenestrated Fontan, attaching the pulmonary artery to the inferior vena cava, promoting return of deoxygenated blood from the lower body, to the heart, and blood from rest of the body to the lungs. This procedure ensured oxygen poor and rich blood no longer mixes in her blood vessels[2].

HLHS is categorized as a congenital heart disease. It is one of the most complex cardiac defects, where all structures of the left side of the heart are critically underdeveloped[3] and surgical mediation is recommended for improved survival[4]. It is absolutely fatal without surgical mediation. Congenital heart diseases, such as HLHS, are deemed challenging because there is an incredibly high risk of death in infants[5]. With surgical procedures, treatment, and gradual development of the human body, more health problems may result. If the final procedure fails over the course of time, a heart transplant is needed to assist in mortality prevention[6].

In addition, HLHS affects 56 to 126 Canadian newborns each year, and is one of the least common of

congenital heart defects. Due to the severity of underdevelopment and late detection, HLHS constitutes for approximately 2% to 9% morbidity rates and for 23% of neonatal mortality in the population of congenital heart diseases[7] .

My cousin, Natalie Ferry, now sixteen years old, suffers from respiratory difficulties, a growth defect, osteopenia, transient ischemic attacks and an albumin deficiency. Her physical activity is limited and she will be required to take heart medication for life, therefore, medical surveillance is necessary for her condition. This includes office visits and electrocardiograms every six months, angiograms, pulmonary function tests and other laboratory values are taken into consideration, such as tests that monitor liver, thyroid and brain function due to low blood and oxygen levels.

It is absolutely outstanding how advanced medicine is becoming, and our family has been truly blessed to be standing in the midst of advancing equipment and medical procedures that have given Natalie life to experience. She is currently on the transplant list awaiting a new and healthy heart.

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FEATURE PERSONAL CARE PRODUCTS: Danger to your health?

Jessica Wong

H

ow many personal care products have you used today? Three? Six? Ten? Personal care products include anything from shampoo to soap to sunscreen to make-up. Chances are, many people use these products every day. But have you ever stopped to think about what is really in these products and how they affect our health? How safe are the ingredients?

Often, the skin is neglected and disregarded as being important. However, it is considered the largest organ of the human body[1]. It has the ability to absorb substances that are applied on it, such as sunscreen[1]. Its ability to absorb is important, but also dangerous if toxic substances are transported into the body’s bloodstream. Due to the fact that the skin is able to absorb various substances, a closer look at what is in these substances is crucial to our health.

Have you ever reviewed the ingredients list on the back of your face cleanser and wondered what they all mean? There is a good chance that “paraben” is included.

People are exposed to parabens everyday[2]. Parabens are found in food in low concentrations; however, higher concentrations are used in personal care products[2]. A survey found that parabens were used in 99% of cosmetic products[2]. Parabens are used often in personal care products because of its ability to act as a preservative and its low cost[3]. Furthermore, they are absorbed quickly through the skin[2]. Although no definitive evidence has shown that parabens are harmful for humans, there are studies that indicate they could cause chromosome ab-

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normalities, mitochondrial dysfunctions, and a higher risk of breast cancer[2]. This risk is increased if products containing parabens are used on the underarms or near the breast area, such as deodorant[2]. Parabens have the ability to bind to oestrogen receptors – they can increase the growth of cancer cells in the breast[2]. Concentrations of parabens have been found in breast tumours, sparking questions and concerns on whether or not they have a potential role in the development of breast cancer[3]. This is a need for concern, especially since there is some evidence that high concentrations of parabens in the body may be associated with higher risks of breast cancer[3].

This may also help explain why the prevalence and rates of breast cancer has been escalating so quickly – women are more often the consumers and users of personal care products[4], which is a possible source of how parabens entered into their bodies.

A relatively new controversial technique used in personal care products is the use of nanoparticles. Nanotechnology uses extremely small materials that are measured in nanometers, which is one billionth of a meter[5]. Due to a nanoparticle’s extremely small size, it has the ability to penetrate through the skin with incredible ease[5].

This could prove either incredibly useful or incredibly dangerous[5]. Products with nanoparticles generally have a smoother texture, which is desired by many consumers[5]. However, along with some benefits, there are also disadvantages that can be potentially fatal. Its small size guarantees that harmful substances will easily penetrate

ARTICLE through the skin and into the body’s system[5]. There is a possibility that nanoparticles produce harmful intermediates, which can damage DNA, proteins and membranes in cells[5]. This could ultimately lead to cellular death[5]. The use of nanotechnology has been particularly common in sunscreens[5]. Even though there are perceived dangers of the use of nanoparticles, research has shown that DNA damage or skin cancer from sunscreens with nanoparticles is rare and only occurs in situations in which high concentrations of nanoparticles are present[5].

Although this is good news, the threats and possible dangers of nanoparticles should not be disregarded.

Painting nails is often enjoyed by many, ranging from children in pageants to women in their forties and beyond.

Although it is a fun and cathartic activity, there are some dangers involved that may possibly endanger your future children[6,7]. Many nail polishes contain harmful toxins, one of them being phthalates[6]. Phthalates, in addition to being found in many nail polishes, are found in some hair sprays and household products as well[6]. Phthalates enter the body through skin exposure and inhalation[6]. Different forms of phthalates, DBP and DEHP, which are toxic as well, disrupt the endocrine system, which can result in negative effects on ovulation and fertility difficulties in women[6]. In an experiment involving male animals, it was shown that DBP, DEHP, and BBzP had negative effects on an unborn fetus, which resulted in abnormalities such as the formation of external genitalia[6]. A study involving pregnant women in New York and Poland showed that they were exposed to phthalates in their environments and that all of the women in the sample had four different types of phthalates in their systems[6]. Although this study did not test the effects of phthalates on fertility or pregnancy, this fact is a concerning one, since many other studies provide evidence that phthalates can increase the ISSUE 9 • MARCH 2014

risk of various birth defects and miscarriage[7].

Parabens, nanotechnology, and phthalates are only three of thousands of chemicals and technologies that are used in the production of personal care products. Despite strong, consistent evidence that many of these chemicals can be toxic and dangerous, many are quick to disregard these dangers. Next time when you are about to apply sunscreen on your skin or use shampoo in the shower, take a closer look at the ingredients list. Although unlikely to cause any negative effects in the short-term, there is a possibility that the ingredients you are looking at have the ability to increase the risk of breast cancer, cellular death, birth defects, and miscarriage in the longterm[2,5,7]. Safer alternatives include products containing organic ingredients – these products utilize nature’s best and reduce the risk of adverse health effects with safe ingredients such as peppermint oil and fruit extracts[8].

What you apply on your skin makes a difference – the safety of personal care products has been disregarded and mostly unregulated, and it is time that people realize this.

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many cultures, it is important that our future health care professionals have an understanding and appreciation for other cultures. These efforts are required to ensure that all citizens receive the health care they deserve.

Canada is home to approximately 1,162,900 immigrants, with the largest immigrant populations residing in Ontario, British Columbia, Quebec and Alberta. In 2011, the proportion of foreign-born populations in Canada was at 20.6% -- the highest among the G8 countries.

With these statistics in mind, it is important that cultural competence is understood and built within the field of Canadian healthcare.

Cultural competence refers to the understanding of cultural and social dynamics that influence people’s health beliefs.[3,4] The understanding is used to have a set of policies, attitudes and behaviours among healthcare professionals which ultimately leads to an efficient provision of services to diverse cultures within the Canadian society. It is important to note that the knowledge should not only be used in a clinical setting but also in other aspects of health care such as policy making.

Over time, cultural competence has expanded from being one dimensional and providing care solely for the immigrant population to what it is today: a dynamic ever-changing process that encompasses many variables[5].

Thus it is imperative to be aware of the changes in order to be proactive in decreasing the health and health care disparities in our communities. To our future health care professionals: remember that different cultural beliefs influence people’s view on health and it is important to be understanding, and if you come across a language barrier…well, there’s always Google Translate.

PRESCRIBING A DOSE OF CULTURAL COMPETENCE Sonja Vukovic

I

magine this, you suddenly fall ill in a foreign country and you need professional help. You worry that your condition may be something more serious than the common cold. However, you cannot string one sentence together in this country’s native language. You do not know what to do. How would you seek help? Would you feel discouraged? Scared? Are you able to seek professional help in the face of a language barrier?

This is precisely what my parents and I went through in the first years upon immigrating to Canada. During this time, the Internet and Google were not accessible and we had no means of effectively communicating our healthcare issues to our physician. Recently, I asked my mother to reflect on her first experience in a physician’s office in Canada. She recalls feeling terrified, lost, and unable to describe her symptoms in English. Luckily enough, my parents had a friend who attended the appointment as a translator.

Language barriers along with different cultural beliefs can create health disparities in communities. With Canada being such a diverse country that consists of

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BROCK HEALTH? Email us: BrockHealth@busu.net

A 30 second solution: Save a life Isabella Churchill

E

very day hospitals across the country will admit patients who require a trip to the emergency department, scheduled surgery or some form of treatment. When entering a hospital to receive medical care, the notion of patient safety does not often cross one’s mind, as the health care system exists to improve the health condition of patients. However in some cases, patients suffer harm as a result of their hospitalization, whether it be from an infection or injury due to human error. Further complications are often the result of the healthcare environment, rather than the patient’s underlying condition. This can lead to disability, prolonged length of acute care stay, morbidity at the time of discharge or even death[1]. There is an economic burden attached to this issue as well as a human cost. Over the past decade, improving patient safety has received considerable focus from both public and professional interest[2].

A major threat to patients in the healthcare system includes hospital-acquired or nosocomical infections, in which 1.4 million people around the world are affected at any given time[3]. This is costly, given that a large amount of hospital funds must be allocated to treating preventable conditions leading to infections rather than solely treating the primary illness. It is estimated that 400 million dollars a year in Canada is spent on treating these infections, which places patient safety as the third most expensive hospital-related condition[4].

One simple and effective method to combat infectious bacteria is hand hygiene. Hand hygiene compliance rates among health care workers have been considered unacceptably poor by public health authorities[3]. Physi-

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cians have claimed that hand washing rates in the ICU were 73%, when in fact, it was found to be less than 10%. Shockingly, health care workers demonstrated hand washing guidelines 25% of the time when overcrowded and understaffed[5]. As hospitals continue to experience overcrowding, leading to an increased prevalence of nosocomical infections, it is important that measures be implemented to prevent the spread of these anti-microbial pathogens. To combat the problem, many hand hygiene campaigns have been implemented but the lasting effects of the compliance rates have rarely been observed[3].

A goal of the World Health Organization’s World Alliance for Patient Safety is the substantial reduction of hospital-acquired infections[3]. In order to decrease the economic burden suffered by health care systems and reach this goal, there must be an improvement to the compliance of hand hygiene guidelines. Due to the fact that noncompliance with these guidelines is a universal problem, standardized measures for both the research and monitoring of this issue must be implemented. Research suggests that it is important to follow a planned and stepwise approach to the development and implementations of interventions[3].

Dr. Edwards Etchells, associate director of the University of Toronto Centre for Patient Safety tells us “we must think of safety in degrees and understand how much each additional layer of safety costs”[6]. If implemented consistently, a simple and cost effective 30 second solution such as hand hygiene for health care workers, visitors and patients could help to decrease the prevalence of acquired infections.

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Faculty

SPOTLIGHT Esther Gizzo and Nathaniel Mannella

A

Dr. Paul LeBlanc

ssociate professor Dr. Paul LeBlanc, who specializes in nutrition and health, has a bit of a difBSc, MSc, PhD ferent background than you may have expected.

Born and raised in the Northern Ontario city of Kapuskasing, Dr. LeBlanc completed his undergraduate and diabetes, and muscular dystrophy. master’s degrees at the University of Guelph, in Marine Through all this, Dr. LeBlanc still finds time to act Biology and Animal Biology respectively. Upon realizing as Interim Director for the Centre For Bone and Muscle his interest and enthusiasm for human health, he redirect- Health on campus. This program, located in the Cairns ed his studies to focus on human physiology, by attending Complex, houses 16 investigators from the Faculty of ApMcMaster University plied Health Sciences, Facand completing his ulty of Mathematics and Scidoctorate in medi- “...really be critical of everything you see ences, the local community, cine. He acknowl- and read, everything you come across. It is and additional universities, edges that his extenthem to collaborate important to be an independent thinker.” enabling sive background in and study together rather in metabolism allowed isolation. The centre focuses him to make an easy switch. From there, he applied for on the prevention of musculoskeletal diseases, something a position to work along Dr. Sandy Peters in the Depart- Dr. LeBlanc is very familiar with. It also aims to bridge ment of Kinesiology at Brock University. A year later, in the gap between research and the community, provid2005, a teaching position opened up; Brock University ing opportunities for education and community involvewas looking for a new nutrition professor. With his ex- ment. emplary background, Dr. LeBlanc successfully acquired When Dr. LeBlanc does find spare time in his crowdthe position and has been educating students in nutrition ed schedule, he enjoys spending it either with his two sciences ever since. He jokes: “I was brought in to be a kids, or out on the links playing some golf. He is also a nutrition professor, and that’s exactly where I’ve stayed self-professed avid reader of Brock Health Magazine. His all these years.” advice to students is to: “really be critical of everything In addition to teaching two nutrition courses at you see and read, everything you come across. It is imBrock, Dr. LeBlanc is one of the only researchers from portant to be an independent thinker.” He suggests you the Department of Community Health Sciences to study critically evaluate everything around you, as too often in a wet lab, performing his own research experiments. he sees students accepting information and research at His focus is on examining the effects of cell membranes, face value, when in fact it may not be valid, accurate, or and their lipid composition in relation to cell function. truthful. He dares students to challenge him in lecture, He also looks at the long lasting benefits of nutritional making sure the information is relevant and precise. Dr. health and exercise on skeletal muscle, as well as their LeBlanc is a very passionate instructor, and is an integral effects during aging, specifically soy isoflavones (which and important member of the Faculty of Applied Health are present in infant formulas), and folic acid, nutrients Sciences, providing excellent research and courses that that play an important role in morbidity; obesity, type II benefit the entire Brock community.

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LIFE IN THE EMERGENCY DEPARTMENT: MEDICAL DRAMAS VERSUS REALITY Franco Cardone

D

o the medical dramas on TV provide a realistic look at life in the Emergency Department? The answer is no and this article will dispel some myths and provide real facts about Emergency Department care.

Given the millions of viewers watching medical dramas, there are often misconceptions about what really happens in the Emergency Department (ED). This can pose problems for health professionals when interacting with patients whose expectations have been influenced

by TV medicine. To the disbelief of many, the ED is usually not a war zone with gunshot wounds and patients impaled by metal objects. In reality, the ED treats many

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patients that are unable to obtain care from a family physician because they cannot get an appointment or they do not have one[1]. Often, those with a family physician may not be able to attend walk-in clinics because their doctor may de-roster them as a patient. Many people think that an ED has a dozen doctors working to treat patients, in reality there is usually far less. Another misconception is that the time from diagnosis to treatment is minutes, as is often depicted on TV. However, the process of ordering a test, receiving results, providing treatment and following up with more testing can actually take much longer than patients expect. In fact, wait times in Ontario as reported by the Ministry of Health were only 2.2 hours on average for minor conditions in January 2014[2]. Wait time measurements occur from the moment a patient registers, until they either discharged or admitted. Another problem is that TV medicine shows the indiscriminate use of antibiotics to treat a variety of illnesses. In the ED, this is an issue as patients actively seek antibiotics for their viral illnesses like the common cold[3]. Patients often complain about their treatment if they do not receive some sort of antibiotic and these actions further burden the already busy ED. TV also has us believe that six doctors swoop down to treat a cardiac arrest patient and resuscitation occurs after five minutes of CPR and using a defibrillator. Resuscitation can actually take up to 30 minutes depending on each unique situation. While defibrillators are excellent tools, television shows them having close to 100% effectiveness. This is not the case in reality as many patients suffer non-shockable rhythms, which medical dramas do not tend to show[4]. The truth is that only 4.3% to 9% of patients survive cardiac arrest in Canada when it originates inside a hospital, where they have the best chance of survival[5]. Research has shown what patient’s expect out of emergency care, but not how television has contributed to these beliefs. Patients often expect short wait times currently not attainable in Canada and sometimes-patient expectations can be unrealistic[6][7]. Patients need to focus on sorting the medical facts from fiction, as they are more likely to be satisfied with their care when they have expectations not skewed by television.

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REFERENCES Image Sources Cover photo: Syda Productions/Shutterstock.com

pubweb/~mcclean/pls [3] Pros and Cons. (n.d.). Gene Therapy. Retrieved December 27, 2013, from http://www.gtherapy.co.uk/pros-and-cons

All other photographs: Non-Commercial Creative Commons Share Alike 2.5 license

[4] Winslow, R. (2012, December 31). The Future of Medicine Is Now. Wall Street Journal. Retrieved December 27, 2013, from http://online.wsj.com/ news/articles/SB100

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Got the Winter Blues?

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[5] Rohan, K. J., Lindsey, K., Roecklein, K. A., & Lacy, T. J. (2004). Cognitivebehavioral therapy, light therapy, and their combination in treating seasonal affective disorder. Journal Of Affective Disorders, 80(2/3), 273-283. doi:10.1016/S0165-0327(03)00098-3

[6] How many chromosomes do people have?. (2014, February 25). Genetics Home Reference. Retrieved March 3, 2014, from http://ghr.nlm. nih.gov/handbook/basics/howmanychromosomes Google Glass [1] CBC White Coat Black Art: “Google Glass and medicine: promise and peril” Dr. Brian Goldman, September 2013.

[2] CNNTech Our Mobile Society: “Why life through Google Glass should be for our eyes only” Andrew Keen, February 2013.

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[4] Coiera, E. W., Jayasuriya, R. A., Hardy, J., Bannan, A., & Thorpe, M. E. (2002). Communication loads on clinical staff in the emergency department.

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To Prevent the Outrbreak

[1] ”Hypoxemia (low blood oxygen)”. Mayo Clinic. mayoclinic.com. Retrieved 29 January 2014.

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[5] Clarke, A. A., & Fraser, K. P. (2004). Why Does Metabolism Scale with Temperature?. Functional Ecology, (2), 243. doi:10.2307/3599364 [6] Lawrance, K. (2013, November 27). Canadian Health Policy. Pandemic Flu Planning. Lecture conducted from Brock University, St Catharines, ON. [7] Gould, E. A. (2012). First case of rabbit haemorrhagic disease in Canada: contaminated flying insect, vs. long-term infection hypothesis. Molecular Ecology, 21(5), 1042-1047. doi:10.1111/j.1365-294X.2012.05462.x The Future of Medicine [1] An Overview of the Human Genome Project. (2012, November 8). An Overview of the Human Genome Project. Retrieved December 26, 2013, from http://www.genome.gov/12011238 [2] Fleck, A. (n.d.). A New Future: Gene Therapy. A New Future: Gene Therapy. Retrieved December 28, 2013, from http://www.ndsu.edu/

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Hyposplastic Left Heart Syndrome

[2] Bove, E. L. (1999). Surgical treatment for hypoplastic left heart syndrome. The Japanese Journal of Thoracic and Cardiovascular Surgery, 47(2), 47-56.

Retrieved from http://link.springer.com/article/10.1007/BF03217941 [3] Feinstein, J. A., Benson, D. W., Dubin, A. M., Cohen, M. S., Maxey, D. M., Mahle, W. T., . . . Martin, G. R. (2012). Hypoplastic left heart syndrome.

Journal of the American College of Cardiology, 59(1), S1-S42. doi:10.1016/j. jacc.2011.09.022 [4] Bacha, E. A. (2013). Individualized approach in the management of patients with hypoplastic left heart syndrome (hlhs). Seminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery , 16(1), 3-6. Retrieved from http://www.sciencedirect.com.proxy.library.brocku.ca/science/ article/pii/S1092912613000021 [5] Thompson, M. D. Public Works and Government Services Canada, The House of Commons, Parliamentary publications. (2001). An act establishing a day for hearts: Congenital heart defect awareness day (BILL C-265).

Ottawa: Speaker of the House of Commons.

[6] Razzouk, A. J., Chinnock, R. E., Gundry, S. R., Johnston, J. K., Larsen, R. L., Baum, M. F., Mulla, N. F., & Bailey, L. L. (1996). Transplantation as a primary treatment for hypoplastic left heart syndrome: Intermediate-term results.

The Annals of Thoracic Surgery, 62(1), 1-8. Retrieved from http://www. sciencedirect.com/science/article/pii/0003497596002950 [7] Fruitman, D. S. (2000). Hypoplastic left heart syndrome:prognosis and management options .Paediatric and Child Health, 5(4), 219-225. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2817797/ Feature Article: Personal Care Products: A Danger to Your Health?

[1]Walters, K.A. (Ed.). (2002). Dermatological and Transdermal Formulations.

Boca Raton, FL: CRC Press.

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REFERENCES G.S. (2004). Concentrations of parabens in human breast tumours. Journal of Applied Toxicology, 24, 5-13. doi:10.1002/jat.958 [3] Sandanger, T.M., Huber, S., Moe, M.K., Braathen, T., Leknes, H., & Lund, E. (2011). Plasma concentrations of parabens in postmenopausal women and self-reported use of personal care products: the NOWAC postgenome study. Journal of Exposure Science and Environmental Epidemiology, 21(6), 595-600.

[4] Adams, Rebecca. (2013, September 23). This is why it’s more expensive to be a woman. Retrieved from http://www.huffingtonpost. com/2013/09/23/beauty-products_n_3975209.html [5] Zippin, J.H., & Friedman, A. (2009). Nanotechnology in cosmetics and sunscreens: An update. Journal of Drugs in Dermatology, 8(10), 955-958.

[6] Adibi, J.J., Perera, F.P., Jedrychowski, W., Camann, D.E., Barr, D., Jacek, R., & Whyatt, R.M. (2003). Prenatal exposure to phthalates among women in New York City and Krakow, Poland. Environmental Health Perspectives, 111(14), 1719-1722.

[7] Brent, R.L. (2011). The role of the pediatrician in preventing congenital malformations. Pediatrics in Review, 32(10), 411-422.

[8] Gabriel, J. (2013). The acne diet: Holistic plan to achieve clear, youthful, acne-free skin with natural nutrition, stress relief and organic skincare.

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Prescribing a Dose of Cultural Competance

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[2] MOHLTC. (2013, November). Emergency Room Wait Times. Retrieved January 13, 2014, from Ontario Wait Times: http://edrs.waittimes.net/En/ Datax?LHIN=4&city=&pc=&dist=0&hosptID=0&str=&view=0&period=0&e xpand= [3] Cliodna A. M. McNulty, P. B. (2007). The public’s attitudes to and compliance with antibiotics. Journal of Antimicrobial Chemotherapy (, 63–68.

[4] Charles Deakin, L. M. (2010). 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. Resuscitation, 93-174 [5] Vaillancourt, C. (2004). Cardiac arrest care and emergency medical services in Canada. Canadian Journal of Cardiology, 1081-1090.

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[1] Statistics Canada. (2011). [PDF File]. Immigration and Ethnocultural Diversity in Canada. Retrieved from: http://www12.statcan.gc.ca/nhsenm/2011/as-sa/99-010-x/99-010-x2011001-eng.pdf [2] Statistics Canada. (2011). [PDF File]. Immigration and Ethnocultural Diversity in Canada. Retrieved from: http://www12.statcan.gc.ca/nhsenm/2011/as-sa/99-010-x/99-010-x2011001-eng.pdf [3] Betancourt, J. R., Green, A. R., Carrillo, J. E., & Ananeh-Firempong, O. (2003). Defining cultural competence: a practical framework for addressing racial/ethnic disparities in health and health care. Public health reports, 118(4), 293.

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Thanks for reading!

A 30 Second Solution: Save a Life [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] Shekell, Paul G. et. al (2013). The Top Patient Safety Strategies that Can be Encouraged for Adoption Now. Annals of Internal Medicine 158(5), 365369. Retrieved from: http://annals.org/article.aspx?articleid=1657884 [3] Erasmus, Vicki et. al (2010). Systematic Review of Studies on Compliance with Hand Hygiene Guidelines for Hospital Care. Chicago Journals 31(3), 283-294. Retrieved from: http://www.jstor.org/stable/10.1086/650451 [4] Kim, Alisa. Counting the Cost (July 30, 2012). Research News: Sunnybrook Health Sciences Centre. Retrieved from: http://sunnybrook.ca/research/ media/item.asp?c=2&i =822&page=524 [5] 11 Hand Washing Facts. National Collaborating Centre for Infectious Disease. Retrieved from: http://www.nccid.ca [6] Study to Examine Economics of Patient Safety (June 7, 2010). Research News: Sunnybrook Health Sciences Centre. Retrieved from:http:// sunnybrook.ca/research/media /item.asp?c=2&i=445

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