Third Issue - Brock Health

Editor’s Note

Brock Health Team

Shahla A. Grewal Editor-in-Chief Shahla A. Grewal Dear Reader,

I am pleased to present to you the third publication of Brock Health! The purpose of this academic publication is to enhance the peer-to-peer educational experience and to inform the student body of current health research. This magazine covers a wide range of health topics as health care these days is taking more of a multidisciplinary approach.

We have several great articles in this publication including the feature article by Brittany Ferren; who writes about measuring conscious awareness and explores the vegetative state. First time writer, Daniel Korpal, tackles the issue of spiritual health, a topic that is often brushed under the rug. We also have new additions to the magazine called ‘Master’s Highlight” and “Professor Research, where PhD candidate Dan Chirico talks about his research and Dr. Tamemmagi explains his research. We also have other interesting articles such as electronic cigarettes and phototherapy.

This publication could not have materialized without the numerous people who have worked so hard to bring it to you. Brock Health has many new faces this year with more and more people wanting to get involved. First and foremost I would like to thank Brock Health’s managing editors Phuc Dang, Kristie Newton, Shirin Pilakka, and Yumna Ahmed, without them this issue would have been published by the next academic year. I would also like to thank 1

Managing Editors Phuc Dang Yumna Ahmed Brock Health’s layout and graphic Kristie Newtom designer Scott Alguire for his amaz- Shirin Pilakka ing work on the cover, layout design and website.

Layout Design Scott Alguire

I would also like to express Yumna Ahmed my sincere gratitude to Brock’s Shahla A. Grewal University Student Union (BUSU), especially VPSS Kenneth Truong, Editorial Board for funding this publication for the Nida Ahmed 2010/2011 academic year and Mad- Stephanie Bryenton elyn Law for her very generous do- Brittany Ferren nation to Brock Health. This will Eliza Beckett be the last time I will write an Edi- Singha Chanthantham tor’s Note and will be leaving Brock Steve Demetriades Health in the very capable hands of Vicky Horner Yumna Ahmed. Before I sign off, I Jessica Rozman would like to sincerely thank each Ryan Schapoks-Siebert and every one of our professors, for Daniel Korpal educating us and giving us the base Kelsey Fallis for our futures in the health field. Carolyn Czyrko For giving us the invaluable tools Jacqueline Stevenson and skills to take health care to the Mina Francis next level.

Michele Leech Whitney Brown

“The dream begins with a teacher who believes in you, who Graduate Editors tugs and pushes and leads you to the Gregory McGarr next plateau, sometimes poking you Lauren McMeekin with a sharp stick called “truth.” Rebecca MacPherson ~Dan Rather Health Seminar Series

“I can no other answer Stephen Demetriades make, but, thanks, and thanks.” Shirin Pilakka ~William Shakespeare Photographer Emily Loveday Webmaster 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.

Faculty Consultant Kelli-an Lawrance (PhD)

Contents • How Much Faith Can We Place in Spiritual health

Page 3

• Human Papilloma Virus

Page 5

• Faculty Spotlight - Dr. Ana Sanchez

Page 6

• How Can We Keep Patients Safer

Page 7

• Faculty Spotlight - Dr. Deborah O’Leary

Page 8

• Fungus: Medicinal Properties

Page 9

• Plastic Makes Perfect: Medicalization of Women’s Bodies

Page 10

• Dial D for Deficiency

Page 11

• A New Fad Goes Up In “Smokes”

Page 12

• Feature Article: Measuring Concious Awareness

Page 13

• Sleep Deprivation & Melatonin Therapy

Page 15

• Date Rape: What You Need To Know

Page 16

• Phototherapy: From Healing Acne to Healing Wounds

Page 17

• Professor Research - Dr. Martin Tammemagi

Page 18

• Are They Clumsy or Cursed?

Page 19

• Breakfast: What Is There Really To Gain?

Page 20

• Electronic Health Records: Better Data Better Health

Page 21

• New CHSC Academic Advisor: Maryann Polce-Gordon References

Page 22

• Master’s Highlight - Dan Chirico

Page 22

• Say What?

Page 23

• Refrences

Page 24

• Brock Health Team

Page 25

March 2011 - Issue 3

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How Much Faith Can We Place in Spiritual Health?

Daniel Korpal

For epochs untold, humanity has turned to that which cannot be seen - the mystical, the ethereal, and ultimately the spiritual to cure poor health. More recently these age-old traditions of appealing to spiritual realms for aid in times of ill health have been met with skepticism by the scientific community.

Even among professors here at Brock there are conflicting opinions on the value of spiritual health and spiritual interventions to improve health. As I continued to research and delve into the topic at hand, it occurred to me that it was entirely necessary to define the parameters of the conversation? What is spiritual health, can we quantify it?

With this ideological framework in place we can examine the relevant information, and hopefully answer the question: how much faith can we truly place in spiritual health? Before I begin any sort of discourse on the topic at hand it seems prudent and appropriate to make a disclaimer of sorts.

This article is based entirely on information from high validity, peer reviewed articles and other sources. Furthermore, this article represents no particular theology or faith. Examples will, however, draw specifically on a western research paradigm and analogous western examples including western definitions of spirituality and health.

Spiritual health -- as defined by Faught and Law in Health, the basics -- is an inner quest for well-being1. Faught explains that “spiritual health reflects our values, beliefs, and perceptions of the world and all 3

living things.” The idea of spiritual health also carries connotations of a healthy hope for the future and a peace with the present.

in a therapeutic setting was a study

by Randolph Byrd in 1988 8. Dr. Byrd performed a double blind randomized control trial, which again had a group receiving prayer, and

The term spiritual inter- another receiving no prayer as a vention refers to any sort of action control. At entry, both populations (prayer, meditation, or a physical were shown to be normally distribaction) that attempts to commune uted, and prayer was performed by with a world entirely apart from the a group of Christians outside of the dimensions we experience so as to hospital. The study found that the alter the reality of a given set of cir- control group had a significantly cumstances. In truth, these defini- higher need for antibiotics, ventilations are neither exhaustive nor uni- tory assistance and diuretics than versal, howeverthey are sufficient those who received prayer. parameters to frame a discussion on spiritual health.

Byrd concluded that prayer “has a beneficial therapeutic effect.”

As difficult as it may be to These results have been replicated find a universally acceptable defi- in many other smaller, more recent nition of spiritual health, it is even studies, and positive therapeutic more difficult to empirically mea- effects have been found to be assure the efficacy of spiritual inter- sociated with many other spiritual ventions in health situations. Given interventions, such as the use of these difficulties, it is impossible to yoga to aid in recovery from eating directly quantify spiritual health, disorders (Carei, 2010) or the use however, there are many examples of faith based physical activity to of studies utilizing double blinded lower diabetes risk factors (Duru, randomized control trials to attempt 2010) 10,3,4. to measure the effect of spiritual interventions on health. For ease While there is a large body of of comparison let us consider the evidence supporting potential posiuse of prayer to the Judeo-Christian tive therapeutic effects, there is an God3,5,8,9,10. equally large and valid body of information suggesting that spiritual

In 1999, Harris et al., con- intervention has no effect or even ducted a study consisting of 990 negative effects on health. patients admitted consecutively to a coronary care unit5. These patients In 2006, Benson et al. conwere then divided into two groups, ducted a study with a sample size the first receiving prayer daily for 4 of 1802 cardiac bypass patients alconsecutive weeks, while the other most identical in methodology to received no prayer. The authors the study by Byrd and Harris, with found prayer to have a protective the exception that Benson separated effect, concluding that, “prayer may the group receiving prayer into one be an affective adjunct to standard group who medical care.” Perhaps the bestknown and most cited study to find a positive protective effect of prayer

were informed that they were re- point we do not have the theory and ceiving prayer and another group the methods to adequately join scithat was unaware of receiving ence and theology” (2002) 7. prayer 2.

It would seem that Roberts

Benson found that those et al. agree, concluding that, “we are who were not aware they were re- not convinced that further trials of ceiving prayer had no statistically this intervention should be undersignificant difference in health from taken and would prefer to see any the controls, while those informed resources available for such a trial that they were receiving prayer had used to investigate other questions a higher incidence of complications. in health care” (2009) 9.

Benson’s study is merely one good example of the high validity studies By definition, spirituality is which seem to contradict studies of outside of the confines of this world, similar validity and methodology. and therefore outside of the measurements of science and I would

Roberts et al. comes to a agree that attempts to measure spirsimilar conclusion in their system- itual health may not be worth the atic review, stating that “although time and resources. some of the results of individual studies suggest a positive effect of However, this lack of eviintercessory prayer, the majority do dence is not necessarily evidence not and the evidence does not sup- that spiritual health is groundless. port a recommendation either in In fact, one could argue that it is favor or against the use of interces- logical that spiritual health be so ilsory prayer”(2009) 9.

lusive to our perceptions, Roberts also speaks of spiritual health as a “paradox,” as “ambiguity” and as “a mystery” (2009) 9.

In the past, science has discovered the source of many mysteries but this may be one mystery that will never be concluded. I would encourage you to see this mystery as an adventure that we all have the opportunity to explore.

Special thanks to Dr. Jeynes

Interested in joining the Brock Health team?

Contact us at: brockuhealth@gmail.com

Perhaps this dichotomy of research is to be expected; it could be argued that even though a blinded, randomized control trial may be considered the highest possible validity study, it may still be inadequate to appropriately quantify spirituality. The fact of the matter is that despite the robust study designs, the seemingly infinite possible confounders cannot be controlled (consider social, mental, and psychological confounders for instance).

Furthermore, all of the given studies fail to take in to consideration the specific criteria of the specific religion or faith that the prayer is a part of.

For instance, those receiving intercessory prayer in the aforementioned study, according to the JudeoChristian interpretation, would have gotten better or worse in accordance with the will of God rather than the magnitude of intervention. We then being to stray into the realm of philosophy and theology, which is perhaps where this topic best abides.

As O’Connor et al. state: “At this March 2011 - Issue 3

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HPV:

Human Papilloma Virus

Jacqueline Stevenson is that, often, condoms aren’t used for the entire duration of sexual intercourse; particularly, sexual partners often have genital contact with or without penetration prior to condom use.9,10 While male circumcision is an effective intervention for reducing heterosexual transmission of HPV, it is only partially protective.11

Many of you may have heard of human papillomavirus (HPV), but why should you care about it? An estimated 75% of Canadians will have at least one HPV infection in their lifetime.1 There are more than 130 types of HPV,2 with some types infecting the genital area and being able to cause cervical cancer.

Others either infect the skin or the genital area and can produce either warts or genital warts. Additionally, some infect the genital area and can lead to cancer of the vagina, vulva, penis, anus, mouth, or throat.3 An estimated 1500 Canadian women are diagnosed with cervical cancer each year.4

Women of low socio-economic status (SES), immigrant women, and Aboriginal women tend to be under-screened; therefore, the prevalence reported is inaccurate. Because HPV is generally transmitted through skin contact or contact with mucosal surfaces, there are less prevention measures as opposed to the wellknown prevention measures for other sexually transmitted infections.5,6

Even with condom use, it’s possible for sexual partners to transmit HPV.7,8 The downside of condom use as a method of HPV prevention 5

was associated with younger age.23

Smoking is a risk factor for development of cervical neoplasia among women with high risk HPV infection, but the mechanism of this effect is not known.24 Canadian guidelines strongly recommend tobacco smoking cessation for women with a diagnosis of HPV infection or any

The most effective way to stage of associated disease.25 prevent genital HPV infection is abstinence, not only from vaginal or anal Generally, the Pap test may be penetration, but also from all skin- the best method of secondary prevento-skin anogenital contact and from tion.26 It’s not a test for HPV infection, sharing sextoys.12 Having multiple but it detects abnormal changes to the lifetime sexual partners was one of cervix caused by HPV,27diminishing the highest risk factors for HPV infec- the risk of progression to cervical cantion for women.13 If you are sexually cer. During a pelvic exam, a clinician active, you and your sexual partner uses a small brush to take cells from maybe more likely to clear any previ- the cervix, which will be examined ous HPV infections if you wait before under a microscope.28 There are sevinitiating sexual intercourse with a eral other reasons for abnormal Pap new partner or increase the time be- results besides HPV infection, and tween sexual partners.14 so a clinician may follow-up with an HPV DNA test or a colposcopy.29

It’s known that persistent HPV infections can cause the development There are several ways to treat of cervical cancer and its precursors.15 abnormal cervical tissue or, with miHPV types 16 and 18 probably cause nor abnormalities, the clinician may upwards of 70% of cervical cancer, wait to see if the cervical cells heal with 13 other types of HPV also being on their own.30 In Ontario, the recomable to cause cervical cancer.16,17 The mendations that apply to most women association of HPV and cervical can- aged 20-69 years are to get Pap tests cer has been called the first necessary beginning within 3 years of becomcause of a human cancer.18 ing sexually active and, after getting normal results 3years in a row, to get

Some of the factors associat- regular Pap tests every 2-3 years.31 ed with prevalence of high-risk HPVs (types that can cause cancer) differ Regarding diverse sexual from the factors associated with low- identities and sexual orientations, Dr. risk HPVs (types that don’t cause can- Darrell Grant, Medical Director of cer).19 Also, the high-risk HPVs are Student Health Services, said “Cervix often a “silent infection”; most people plus sex equals need for screening. It will not know that they are infected.20 doesn’t matter who one is having sex with.”

High-risk HPVs are persistent and tend to be associated with lifetime sexual activity (e.g., lifetime number of sexual partners).21,22Prevalence of high-risk but not of low-risk HPVs

Generally, vaccination may represent the best method of primary prevention of HPV because condoms have limited efficacy, and abstinence is unacceptable to manypeople.32 There are currently 2 vaccines.

main high-risk types of HPV, 16 and 18. Because the vaccines target types 16 and 18 but not all high-risk types,34 vaccinated women should still follow the recommended guidelines for Pap testing.

Gardasil is called a quadrivalent vaccine because it targets 4 HPV types: 6, 11, 16 and 18 (Types 6 and 11 are low-risk types that are responsible for most genital warts).33 Cervarix, a bivalent vaccine, targets the 2

Ontario’s publicly funded HPV vaccination program is offered only to grade 8 girls, and other women who want to be vaccinated have to pay $400-$500 for the 3 dosages or rely on coverage from private health

insurance.35

In consultation with physicians, Cervarix and Gardasil are both offered as options at Brock’s Student HealthServices.36 In Canada, the Society of Obstetricians and Gynaecologists launched a public awareness campaign on HPV in 2006 called “Spread the Word, Not the Disease”.

If you have more questions, visit the campaign’s website: http://www. hpvinfo.ca

INTERNATIONAL EXPERIENCE Dr. Ana Sanchez BSc, MSc, PhD

By: Jessica Rozman

I recently had the privilege of speaking with Dr. Sanchez regarding her trip to rural Honduras. It was interesting to hear how the culture in this community was somewhat similar to Canadian communities. Many people had cell phones, the children wore uniforms to school, and I was surprised to hear that some children even owned game consoles such as Playstations.

However, the children spent a lot more time outdoors and were much more active. While they were there, Dr. Sanchez and her graduate students conducted research on intestinal parasites in school children living in the rural community, which included interviews with the children, lab work (blood and stool samples) and treatment.

cause.

By learning about infectious diseases in the classroom and then

This research is important be- delivering these facts to children such cause it is part of a global movement as those in rural Honduras, education to deworm children; having worms is truly becomes a comprehensive packa symptom of life in children living age. Indeed, trips such as this one are in developing communities. It is im- beneficial to both the researcher and portant that new practices are imple- participants of the study. mented rather than simply bringing resources and materials because new This interview revealed a practices, as a result of education, will very important take-home message: provide empowerment to the citizens changing the attitudes and thinking and prevent future infections. These of these children, rather than bringing studies are also beneficial because material things, will empower them they allow the researcher to apply and promote positive changes in their their theoretical knowledge to real community. life.

The interviews revealed that the children regarded noticing worms in their stool as normal and thus, they did not understand that they are unnatural to have. The main objective of this expedition was to empower the community by implementing new attitudes and bringing education to teach the children to recognize intestinal parasites and the harm they can March 2011 - Issue 3

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How Can We Keep Patients Safer?

Vicky Horner

Have you ever wondered what could be in your grandparents’ medicine cabinet? With Canada’s elderly population expected to more than double over the next two decades1 this could become more of a relevant question. As falls and resulting health complications rank fifth amongst the developed world’s causes of death, and particularly affect this specific population, it is an area of prevention that warrants much attention2.

Compared to younger populations, Canadians aged 65 years and older are typically using more prescription drugs, as they often suffer from comorbidities3. Also, it has recently been emphasized that certain classes of prescription drugs are sig- period7. nificantly associated with the occurrence of falls in elderly users2.

It is also of concern that drugs may be inappropriately prescribed to

For example, benzodiaz- elderly patients. In a hospital-based epines are drugs widely prescribed study, 50% of admissions for drugto elderly patients to improve sleep related factors were due to inappropriduration and to reduce anxiety4. Sur- ate prescriptions. Similarly, a clinical prisingly, benzodiazepines have been study revealed that many elderly paassociated with a 34% increased risk tients are prescribed benzodiazepines of fractures in elderly individuals and drugs with similar effects for pecompared to non-users5. riods of time exceeding seven years9.

This is of concern since chronic use of

Based on a study of Euro- benzodiazepines may promote cognipean hospitals6, benzodiazepine use tive decline in elderly users10. resulted in treatment costs totaling nearly 67 million Canadian dollars for Despite the proven risks asfall-related injuries. This was for one sociated with many characteristics of type of prescription drug alone…just prescription drugs, drug-related falls imagine the overall economic burden! continue to burden the elderly population’s health. Prescription drug-relat Moreover, as doses and num- ed falls, and associated costs, can be bers of medications increase, so does prevented with the use of medication the potential for harmful effects. It reconciliation tools 11. has been proven that elderly individuals using high doses of multiple cen- These tools organize the tral nervous system medications had medication history of each patient more than two times the risk of falling to promote effective communication compared to those who were not us- between health care providers, and ing such medication over a five-year consequently reduce adverse events 7

due to issues such as inappropriate prescriptions.

Although there is growing knowledge of how important “seamless care” between all points of the health care system is to patient safety12, it is time to think about how these systems can be linked in order to promote this communication, and consequently, reduce related health issues.

A policy should be established to implement a mandatory, standardized medication reconciliation tool across the health care system in order to reduce drug-related falls in the elderly, and many other preventable health issues.

Although elderly medication use has been mostly discussed here, keep in mind that a mandatory, standardized medication reconciliation tool is beneficial to all individuals. Always tell your doctor about what type of medications you are on, as some common prescription drugs such as antibiotics and birth control pills may cause adverse interactions13.

FACULTY SPOTLIGHT Dr. Deborah O’Leary BSc, MSc,PhD, Post Doc

Yumna Ahmed

Dr. Deborah O’Leary has been a part of the Brock community for the past seven and a half years.

Dr. O’Leary obtained her B.Kin. and M.Sc. at McMaster University, and her Ph.D. at the University of Waterloo. Following that, she completed her post-doctorate fellowship at the University of Western Ontario. Her current research focuses primarily on the cardiovascular health of children.

Dr. O’Leary believes that “health is not just physiological” but is an “overall balance in life”. Her current research examining the “effects of childhood obesity and hypertension on blood pressure regulation, arterial health and left ventricular hypertrophy will have an impact on future studies of pediatric health”. Her interests also extend into the effects of age, maturation, gender and posture. Her research concerning reflex cardiovascular control also applies to

March 2011 - Issue 3

those suffering from cardiovascular disease and blood pressure regulation difficulties following exposure to microgravity.

Dr. O’Leary is also the director of the Brock University Heart Institute (BUHI) and loves every moment of it! She exclaims the members are “great people to be around” and have improved their health greatly through their work at BUHI.

Dr. O’Leary admits the logistics that come with running BUHI are challenging but rewarding and that her graduate supervisors Dan Chirico, Chelsea Pretty and Carly Barron are awesome and always there to help.

She says it is these individuals as well as the fantastic undergraduate volunteers that make BUHI the “great place” that it is today!

Dr. O’Leary has two young boys, ages four and one and a half years, keeping her busy, but she still finds time to work out at the Zone every day. She loves the “community atmosphere” Brock provides and shares that her colleagues are very supportive and that they all work well as a team.

Dr. O’Leary claims that the students are a lot of fun and keep her feeling young! As a professor, Dr. O’Leary hopes to inspire students to do their best and pursue their future goals with GUSTO!

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FUNGUS: medicinal properties Mina Francis

Fungi have been an important resource tool over the course of our history, aiding us in a variety of human endeavours. In ancient times fungi were used to meet the need for sustenance by aiding in production bread, cheese, and wine.

While all of these characteristics are true of certain species, medicinal applications are one of the many reasons we should consider fungi to be a relevant tool for humans. I hope to convince you of this by illustrating a couple of the medical uses that fungi possess.

had the ability to inhibit UV –induced damage to the E.coli. All the mushrooms demonstrated over 50% inhibition of damage caused by UV light (Filipic, 2002). This study later concluded that this has great potential to translate to human medicine in the future.

Several species of fungi have demonstrated strong antioxidant capabilities, all of which can translate well for human usage.

Antioxidants are compounds which prevent oxidative damage, which is

Despite this growth in un- the denaturing of important strucderstanding, fungi have not devel- tures including DNA that lead to a oped the reputation they deserve in host of diseases such as cancer and our culture. They are often viewed diabetes. as a form of delicacy, as nasty molds that should be avoided, or source of In one study water extracts other interesting “recreational” ac- of 89 mushrooms were screened tivities. and tested on E.coli to see if they

Another study was done to test if there was any antioxidative activity in a Chinese Hamster through certain mushroom species.

Multiple mushrooms were used to test the activity including, Lentinula edodes, Pleurotus sajor-caju, and Volvariella volvacea.

They were also used for folk medicine in ancient China, and since the discovery of penicillin scientists have uncovered many potential medicinal applications that certain species of fungi possess.

They found that all of these mushrooms significantly reduced hydrogen-peroxide damage to the DNA. Overall, the mushrooms yielded over 50% inhibition of DNA oxidative damage (Shi, 2002).

In addition to antioxidant activity certain fungi have demonstrated strong antiviral activity, both directly and in directly. An experiment was performed which demonstrating that beta-glucan extracted from Pleurotus tuber-regium had significant inhibiting activity for Herpes Simplex Virus type 1 and 2 (Zhang, 2004).

That’s right certain mushrooms can even inhibit STDs! Lentinula edodes also known as shiitake mushrooms are not only a tasty delicacy but have been demonstrated to reduce the spread of HIV-1 and HIV-2 strains, which is a serious immunodeficiency virus for human beings (Tochikura, 1989).

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There are also a host of other viruses that various fungal species have been shown to be active against including poliovirus and influenza

matory activity.

It is clear that as our knowledge and understanding of fungi grows, we’ll be able to utilize them in even more tangible ways. For

This is only scratching the those who are interested in the field surface in terms of the potential of health science or medicine you medical uses that fungi may serve, should become more acquainted some of which include anti-micro- with your future co-workers! bial, anti-tumoral and anti-inflam-

Plastic makes Perfect:

Interested in joining the Brock Health team?

Contact us at: brockuhealth@gmail.com

Medicalization of Women’s bodies

Eliza Beckett

It is becoming more and more acceptable for people to undergo cosmetic surgery to improve physical appearance. The amount of young women, ages 18-19, receiving cosmetic surgery has risen 35% since 2001. Celebrities, movies, television shows and talk shows are all supporting this idea of going under the knife to change your appearance.

There are influences everywhere in today’s society encouraging us to look a certain way to be considered attractive. This is called the image norm. The image norm for women has been defined as having a small waist and large bust1. This “ideal” body image is hardly ever natural and requires intervention to achieve this notion of perfection.

This “ideal” body image is presented in various forms of media giving women a false image created by our society to idolize. Magazines no longer portray true photos of women.

Pictures are airbrushed and retouched to make a false ideal for the consumer.

Over the last decade women have undergone more elective aesthetic surgery than ever before2. This includes, but is not limited to breast augmentation, liposuction, pectoral implants and rhinoplasty. Breast augmentation is the leading form of cosmetic enhancement surgery, especially among young women2.

Despite the medical risks involved, aesthetic surgery has been found to have a restorative effect between body and image, as well as self and psyche. The correlation between cosmetic surgery and increased selfesteem has been proven despite the patient’s emotional well being prior to the surgery1. There is a change developing where, for the twenty-first century, there is a shift in the sociological focus of medicalization.

There are two streams of cosmetic surgery in Canada, one through the hospital and one through private clinics. Cosmetic surgeons in private clinics are benefitting immensely from this medicalization, which would not have been the case in the past. When it comes down to it, is the risk worth the reward? Are the medical risks worth the gain in confidence? Does plastic really make perfect?

Medicalization is now being driven by commercial and market interests, rather than by professional claims-makers. Elective aesthetic surgery is a medical procedure, although the results are mainly psychological, increasing self-esteem and an elevated self-image. Doctors are the gatekeepers for these treatments much like everything else that has become medicalized. Although, doctors are now benefiting from the medicalization of the physical appearance of the human body3.

Even talk shows such as “the Doctors” have a plastic surgeon on the show to promote new innovations in cosmetic surgery to push these ideas on viewers. It has been found that women’s magazines, along with other forms of media, are contributing to the medicalization of women’s bodies2.

March 2011 - Issue 3

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Dial

d for deficiency: Vitamin D intake Kelsey Fallis

Consider the idea of common health problems in Canada.

For most individuals, this brings up images of cardiovascular disease, diabetes, cancer and autoimmune disease. All of these conditions have effects on health that have been widely publicized in Canada. However, one of the most common health issues in Canada is rarely ever mentioned. Vitamin D insufficiency is found in 7097% of Canadians, and deficiency is linked to all of the above conditions1.

It is estimated that the Canadian government would save at least $14 billion/year in health care by normalizing vitamin D levels in the Canadian population1. However, the majority of Canadians are unaware of the importance of vitamin D or the roles that is plays in the body.

Vitamin D is mostly commonly known for its essential role in the proper development of the skeleton during puberty as it promotes intestinal calcium absorption2. Vitamin D helps the body use other vitamins, such as calcium and phosphorus, for bone and teeth development. In

addition to its role in bone development, vitamin D is involved in other roles in the body such as, the immune response, reducing inflammation and neuromuscular functions3.

The optimal serum vitamin D level is greater than 75 nmol/L, an individual is vitamin D insufficient if their serum level falls between 50-75 nmol.L, and deficiency occurs when levels falls to below 25 nmol/L4.

Though many Canadians have vitamin D insufficiency, it is often left undiagnosed, as the early symptoms are not well known. If the serum concentrations of vitamin D are too low, calcium will leave bone cells and enter the blood stream to restore calcium homeostasis.

This can lead to many unwanted bone conditions including rickets in children and osteomalacia (bone softening) or osteoporosis in adults5. Symptoms of deficiency include bone and muscle pain, depressive behaviour, muscle tingling, stooped posture, bowed limbs and chronic fatigue. There are several factors that lead to vitamin D deficiency such as the amount of exposure to sunlight, skin pigmentation, weight, gender, and malabsorption disorders.

Individuals with darker skin tones or heavier weights have an elevated risk of vitamin D insufficiency and females have a higher risk than males. Up to 50-90% of the vitamin D found in our bodies can be produced in our skin through direct exposure to ultraviolet B radiation (from the sun or specialized tanning beds), the rest can be consumed orally in the form of real foods and supplements6. Studies have demonstrated that only 5-30 minutes

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of direct sun exposure at least twice a week to the face, legs and arms is sufficient for vitamin D synthesis to provide optimal vitamin D serum levels7.

However, the exposure to sunlight is greatly reduced in northern countries during the winter months. Specifically in Canada, vitamin D absorption via sunlight is severely reduced or nonexistent.

As a result, Osteoporosis Canada recommends all Canadians under the age of 50 consume 400100 IU of vitamin D daily during the fall and winter. However, one should not exceed the tolerable upper intake level of 2000 IU/day, as it may result in toxic effects7. While vitamin D can be found in naturally occurring foods, such as fatty fish, Canadians do not eat enough to increase serum vitamin D levels. To remedy this issue in Canada most dairy products are fortified with vitamin D, for example milk, margarine, cheese, and orange juice8.

Just one cup of fortified milk will contain 115-124 IU of vitamin D. Supplements are another way to maintain vitamin D levels. Cod liver oil is the most abundant food source, containing a staggering 1360 IU of vitamin D (340% daily value). It is best to choose a vitamin D supplement, as multivitamins often do not contain high enough vitamin D levels to meet the daily intake level. Vitamin D deficiency is widespread problem in Canada but through the sharing of knowledge, this condition can be prevented.

A NEW FAD GOES UP IN “SMOKE�

The Truth About Electronic Cigarettes Kristie Newton

Cigarettes have been a huge part of society and luckily their popularity in most of North America has drastically reduced over the last 20 years or so1. The reduction of new smokers and the increase in people who have quit is great news for the health of North Americans as well as health care professionals who are happy their patients are eliminating or choosing not to start up a habit that is so dangerous to their health. This new attitude towards smoking is great news for everyone except the tobacco companies, and it appears that a new product, claiming to aid in smoking cessation, may actually be benefiting the companies selling tobacco1.

Electronic cigarettes, also known as E-cigarettes, are small devices that very closely resemble cigarette and emit vaporized nicotine. The device is battery powered and can be charged repeatedly, much like an iPod.

Manufacturers of the E-cigarettes claim that they are an alternative for cigarette smokers who want to stop inhaling the harmful chemicals that are involved with smoking tobacco in cigarette form. The average cigarette contains over 4000 different chemicals which are very dangerous for peoples’ health, the E-cigarette claims to be safe because it does not contain any of these life threatening substances.

Most of the models, when turned on, have a heating element that is activated when the user inhales which heats the nicotine and causes it to vaporize. Some models have a small button that turns them on and the user can chose between flavored or plain cartridges as well1.

March 2011 - Issue 3

The E-cigarette claims to also provide the smoker with the physical attributes of smoking that can in many cases be just as much a part of the addiction as the actual nicotine.

The E-cigarettes are not lit so there is not smoke emitted. Similar to cigarettes the electronic version gives the smoker the physical sensation of holding a cigarette as well as inhaling and exhaling physical vapor that looks almost identical to smoke from a cigarette.

The E-cigarette also allows people to smoke in any environment at the moment, including malls, bars, and even airplanes1. At first glance, to many smokers as well as non-smokers, these electronic substitutes seem like a safe alternative to smoking.

This is not the case. There is currently a ban on selling E-cigarettes, put into affect by Health Canada, because the health implications of these devices is not known.

Health Canada is worried that something you plug into a wall and inhale may not be safe, as well as the idea of E-cigarettes being a cessation aid. Because they still involve nicotine they are not eliminating the addictive factor in a very effective way and this may mislead people who are trying to stop smoking2. All in all the E-cigarettes have not been tested to an extent that they are known to be safe to use.

More research needs to be done surrounding the idea and Health Canada does not recommend their use as of yet. On top of all the possible unknown health risks, the tobacco companies may be benefiting from this apparent cessation aid2. Think about it, if the charge on your trendy little electronic smoking buddy goes out, how long until you need to hop over to the nearest convenience store to buy a real pack of cigarettes?

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Feature Article: Measuring Concious Awareness Brittany Ferren

Although recent studies have suggested that areas of preserved brain function could exist in a small percentage of those diagnosed as vegetative.7 The MCS is very similar to the VS, except the patient will show inconsistent, but reproducible, signs of awareness. These signs include exhibit The VS is typically when ing sustained, reproducible, and/or the patient is awake but not aware; voluntary behavioural responses to they retain sufficient brain func- sensory stimuli.4 tions for survival.4 Those diagnosed as vegetative experience somewhat The overall assessment of

Vegetative State (VS) and regular sleep-wake cycles, reflexive these conditions of consciousness the Minimally Conscious State movements, and some spontane- relies almost entirely on subjective (MCS) are examples of such condi- ous behaviour such as crying, and interpretation of observed behavtions. Following an acquired brain teeth grinding. They are termed `not iour.6 This makes the process of injury - traumatic (from a head in- aware’ or conscious if they show no diagnosing extremely difficult, and jury) or nontraumatic (a result of sign of purposeful or voluntary be- is represented in the alarming misstroke or illness such as meningitis) haviour.4 diagnosis rate - approximately 40% of patients diagnosed as vegetative are actually minimally conscious.5

In

the words of philosopher Descartes, “Cogito ergo sum” (1600’s), I think, therefore I am.8 Self-awareness (consciousness) has been determined a subjective measure for hundreds of years. Because of this, consciousness is a topic still relatively unknown.4 It’s not surprising that disorders of consciousness are some of the most mysterious and least understood conditions of the human brain.4

- patients may fall into a VS or a MCS. According to Toronto Rehab, 50 000 Canadians sustain brain injuries each year. Of those 50 000, 11 000 will die from a traumatic brain injury (TBI), the leading killer and disabler of Canadians under the age of 40.1

In order to successfully diagnose a patient as minimally conscious, the physician must reject a vegetative diagnosis.6 Since this is based on negative findings, the diagnosis is vulnerable to a Type II error or a false-negative. Due to these issues, and the fact that there is no universal definition for consciousness, it is crucial to have an objective and reliable diagnostic tool that can detect awareness and cognition without having to produce any motor behaviour.4

Most would assume that this would be an remarkable finding; however, Owen and colleagues (2006) state that it is not unequivocal evidence that a person is consciously aware.7

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One of the world’s foremost neuroscientist’s, Adrian Owen, who is currently researching at Western University as the Canada Excellence Research Chair (CERC) in Neuroscience and Imaging, generated international attention when he used fMRI (functional Magnetic Resonance Imaging) to measure cognitive and communicative abilities of those diagnosed as vegetative OR minimally conscious.2

Owen and his research team examined a 23-year-old female that was diagnosed as vegetative five months after being in a traffic accident.7 Using fMRI, her neural responses during the presentation of spoken sentences (containing words) were compared with her neural responses to acoustically matched noise sequences (containing sound; no words). During the presentation of spoken sentences, there was observed activity in the speech perception areas of the brain. The fact that she could cooperate with the research team and complete

This was equivalent to that the tasks as indicated shows a clear observed in healthy individuals.7 act of intention, which means that The team then measured her neural to some extent she is consciously responses during the presentation aware of herself as well as her surof sentences containing ambiguous roundings!7 words (i.e. beam/creak), and as before, they observed activity in areas In other similar studies, paof the brain equivalent to that of a tients that were unresponsive at healthy individual. In order for this the bedside - and therefore termed understanding to occur, semantic vegetative - exhibited brain activprocesses that are vital for speech ity similar to healthy individuals comprehension must be operating.7 when presented speech sounds and pictures of faces.5 According to the

Many studies of cognition Stanford Encyclopaedia of Psycholand awareness have demonstrated ogy, consciousness is an `umbrella’ that speech perception and semantic term that covers a wide variety of processes can go on in the absence mental phenomena, and a state of of conscious awareness - such as consciousness is a mental state one during local anaesthesia.7 In an at- is aware of being in.3 tempt to address conscious awareness, Owen and colleagues (2006), I believe the most important did a second fMRI study where the thing to take from this research is same female was asked to perform that the diagnosis of disorders of two mental imagery tasks. consciousness is an ongoing process in each individual.

Her observed brain activity during these tasks was indis- When negative results to tinguishable from the activity ob- tests addressing conscious awareserved in healthy individuals.7 ness are found, it is crucial not to take this as concrete evidence of March 2011 - Issue 3

lack thereof. Owen et al (2006) have proved that there is a presence of reproducible signs of awareness in those diagnosed as minimally conscious, but also in a small percentage of those diagnosed as vegetative.7

From all of these findings, it is clear that no one person can disregard another’s consciousness, no matter what the communication barrier.

Interested in joining the Brock Health team?

Contact us at: brockuhealth@gmail.com

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Sleep Deprivation and Melatonin Therapy Delayed Sleeping Phase Disorder Singha Chanthanatham body to begin the sleep process at night in most healthy individuals1.

Often times, things like exposure to light, caffeine or exercise too close to bedtime may be factors to blame for lack of sleep. So to overcome these barriers some studies suggest melatonin supplementation therapy may help.

If a survey were held to gauge the prevalence of sleep deprived students at Brock University, or any post-secondary institution for that matter, the result would likely be an overwhelming majority of insomniacs. Sleep deprivation has always been an issue with our society, especially the busy crowd who work, go to school or do both.

While the use of any kind of overthe-counter product is a sensitive topic, melatonin use in moderation, can be extremely helpful for those stressed out individuals who might want to avoid prescription-grade medical intervention.

To some of us, it seems like no matter how many times we try and reset our circadian (sleep) rhythm, it always seems to go back to a late night, a later night and sometimes an all-nighter. This article discusses one option for the slumberimpaired. The pineal gland in the brain naturally produces a hormone called melatonin that signals the 15

struggle to get a good nights rest.

A recent meta-analysis demonstrated support for the safety and efficacy of the use of melatonin among insomniacs and concluded that melatonin therapy was effective in reducing the effects of DSPD. However, the authors caution that while the therapy may be effective,

A condition called Delayed users must show discretion and enSleep Phase Disorder (DSPD) may sure the correct dosage and timing be the culprit behind why many of administration is established for among the post-secondary popula- the correct age group and also faction suffer from sleeplessness. Af- tor in any external influences to the fecting approximately 6-16% of individuals’ sleep pattern1. adolescents to young adults, this condition is characterized by the Furthermore, the long-term inability to fall asleep and wake up effects of melatonin use have not during the conventional times of the been fully explored and its safety in day with respect to societal norms2. children has yet to be determined.

There were also short-term, minor

Sleeping is delayed often side effects experienced by participast midnight to late morning, and pants of the aforementioned studies, the common time to wake up is with headaches being the most fretypically past noon. Often, these quent. individuals also exhibit psychiatric co-morbidities such as personality Aside from the use of meladisorders or even signs of depres- tonin, there are always options such sion3. as exercise, relaxation techniques and a healthier diet. Also, if it’s a

One study found that with matter of time management, melaexogenous melatonin therapy over tonin is probably not an option. If a course of four weeks, individuals you find that melatonin and the suffering from both DSPD and de- previously mentioned options are pression significantly reduced their ineffective, it may be time to condepression score, based on the Cen- sult your doctor about more serious tre for Epidemiological Studies De- treatment or maybe participate in a pression Scale, and improved their sleep study to better understand the sleeping habits to a more typical factors affecting you. We all need cycle3. sleep, and we all want to sleep, but some of us just need help to get into the habit that seems so natural to everyone else.

While not everyone is suffering from depression, and by no means should melatonin be used as an antidepressant, this study does show how therapy with this naturally occurring hormone may aid in the

Date Rape:

What you need to know

Michele Leech

A large fraction of the typical university student life is meeting new people and socializing, much of which takes place at events where alcohol is served. However, we fail to recognize the severity of some of the consequences that can potentially arise in these social settings. Unfortunately, a widespread problem among college and university aged students is the prevalence of date rape³, an issue that many individuals are uncomfortable discussing and do not want to confront.

Rape is defined as the sexual penetration of a person against his or her own will by the use of force, threat of force, verbal coercion, or by the inability to consent due to impaired mental status or age of the victim. Research supports that the prevalence of date rape is highest among university-aged women.7

Further, a general survey on date rape by Benson et al. (1992) determined, that 1 in 4 college-aged women have been the victim of a rape,5 These results are quite alarming and raise the awareness for the need of a solution.

However, one of the greatest risk factors acknowledged for both victims and perpetrators is the use of alcohol. Current research states heavy alcohol use is strongly associated with an increased risk for date rape5, and trends show university students have a strong correlation with high amounts of alcohol consumption.4 In high quantities alcohol consumption is known to impair thought processes and cognitive abilities, as well as your ability to detect risk.

Due to the multiple factors involved with an increased risk of being the victim of date rape, it is difficult to pin point exactly what leads to date rape. Some more controversial factors that may be taken into account are the victim’s sexual history or the idea that rape is only a to decrease risks of rape, while also cry for attention. promoting behavioural and attitude changes within the entire commu Another problem is male nity as a whole towards rape. “self-deception” this occurs when the alleged rapist consciously, but There are multiple factors incorrectly, believes that he has the that need to be taken into account woman’s consent when, at some and, this is an exceptionally comless-than-fully conscious level, he plex issue. In order to prevent or knows otherwise.8 These issues and lower the risk of rape, it is extremely opinions make cases tough to dis- important that you be aware of your cern, especially with the interpreta- surroundings and situations you tion of stories.

may find yourself in. Travel with friends, look out for each other, and

Regardless of the situation, remember to monitor your alcohol no one ever deserves to be raped consumption to decrease your risk and the most important thing that of date rape. can be done is to create awareness and prevent this situation from occurring.

It is unclear why there are such high rates of rape in university-aged individuals, however some correlations have been made.

Strong associations for the likely hood of date rape have been established showing individuals who wear suggestive attire and become intoxicated increase their risk of male misperception of friendliness as sexual interest, compared to indi- It is important to create previduals who wear neutral attire and vention programs targeted to imabstain.¹,6 prove womens sexual assertiveness skills in a variety of social settings March 2011 - Issue 3

Disclaimer: the intent of this article is not to put blame on the victim at all, the authour is just presenting research.

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Phototherapy:

to Healing Wounds

From Healing Acne

Carolyn Czyrko

Consumers today are presented with various phototherapy products and gadgets that utilize light to perform a multitude of tasks - from conquering acne to accelerated healing. Many of these products focus on therapeutic applications, and some even claim to speed the healing of physical wounds 1.

They generally tout the benefit of non-invasiveness and ease of use, and therefore come across as very elegant inventions. One has to wonder if there is scientific evidence backing these products – or if they will inevitably be tossed in the Shopping Channel’s “failed” bin.

The answer is yes, there is evidence to support these products, but that doesn’t mean the products actually work.

To understand how light can be therapeutic, one must understand how light is defined. Light is a broad term for the humanly visible, tiny subset of the electromagnetic spectrum (400 – 800nm). Shorter wavelengths (below 400 nm) are classed as ultraviolet (UV) and longer (greater than 800 nm) are known as infrared (IR), both invisible to the human eye. Every colour of light has it’s own specific wavelength. The key to light’s usefulness is the way a specific wavelength interacts with matter (absorption, reflection, etc.). The products that use this technology generate certain wavelengths at certain intensities.

Light therapy is becoming increasingly popular in the health care industry. For example, some of the most intense developments are associated with wavelengths in the red to near-infrared region (630 – 1000nm). Using low-energy lasers or light-emitting diode (LED) arrays, these wavelengths can be used 17

to speed up wound healing or slow degradation of the optic nerve (Eells et al, 2004). For example, the 830 nm wavelength is renowned for its anti-inflammatory action and can improve symptoms caused by acne bacteria up to 80% 2!

ClearMySkin, which supposedly emits specific wavelengths from the LCD screen to emulate phototherapy. However, acne-fighting wavelengths aren’t emitted by the backlight, and even if they were, the LCD screen is an optical filter, so anything this application does

You may be curious as to can be done – probably better – by how infrared light can be used to applying a simple white screen to speed the healing process of ul- your face (white light is a combinacers, lesions, and other wounds. IR tion of all colours, so a white screen wavelengths can penetrate flesh, would include all generated wavewhich allows it to be absorbed sub- lengths by default). Also, the intencutaneously. Scientists have found sity (brightness) of a BlackBerry is that irradiating damaged tissue severely lacking, which means a 1 with IR wavelengths up-regulates minute walk in the sun would probthe expression of genes involved ably supply more energy. in mitochondrial energy production 1 . It also diminishes the effects of There is much literature certain metabolic inhibitors, which supporting the therapeutic effects of effectively increases cellular meta- light and phototherapy is becoming bolic processes, in turn accelerating considerably prevalent in the medithe natural healing process. cal field. However, many commercial products attempt to unsuccess So the science behind these fully mimic the science behind these principles is sound, however, many therapies. Be wary of such products commercial products are not. Take – they won’t zap your zits, they’ll for example an app you can down- only make your wallet “lighter”. load for your BlackBerry called

Professor Research:

Dr. Martin Tammemagi, PhD

When people ask what I do and I tell them that I am an epidemiologist, their eyes glaze over and I usually get “what the **** is that? My street explanation is that I study who gets sick, why they get sick, and what happens to them after they get sick. Although I have broad interests, I have special interests in cancer epidemiology and in recent years have been involved in several screening trials.

I am currently co-investigator and epidemiologist on three exciting cancer screening trials: the US National Institutes of Health (NIH) National Cancer Institute’s (NCI) Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (PLCO), the US NCI National Lung Screening Trial (NLST), and the Pan-Canadian Early Detection of Lung Cancer Study. These studies are now beginning to mature and yield important results.

The NLST, which is evaluating whether computed tomography imaging of the chest can detect early stage lung cancer, lead to more successful treatment and reduced lung cancer deaths in smokers, who are at high risk for developing lung cancer. This study was supposed to draw final conclusions in the fall of 2011.

the cost of the study was over ¼ bil- lion US dollars, such a study is not likely to be repeated, and around the world, health policy decision makers will attempt to decide whether to implement a systematic program of lung cancer screening largely based on the findings of the NLST. Indeed,

I currently am a member of the “Expert Panel on Lung Screening” assembled by the Canadian Partnership Against Cancer. This panel’s mission is to review the scientific evidence for lung cancer screening and synthesize the current scientific knowledge and make recommendations that might guide Canadian health policy makers with

In addition, I have led a reregard to whether and how lung search team that has developed and cancer screening should be imple- validated a lung cancer risk predicmented in Canada. tion model using PLCO data, which promises to be useful in identifying

Although the NLST sug- individuals who might benefit from gests that CT screening should be lung screening, and other endeavbeneficial, harms have not been ors, such as enrollment in chemoevaluated at this time, and it does prevention trials and smoking cesnot answer many questions, such as, sation programs. We anticipate at what intervals should screening publication of this model Journal take place?, what age groups should of National Cancer Institute in the be screened?, and what lung caner near future. risk groups should be screened?

Well I hope that your eyes

I was fortunately invited to have not completely glazed over; be a NLST representative on the US and I’d better shut up before they NIH Cancer Intervention and Sur- do. veillance Modeling Network (CISNET) lung cancer modeling group, which will use mathematical models to address some of these quesInterested in joining the tions.

However, the Data Safety Monitoring Board observed statistically significant findings in the study data in the October 2010 and they required study officials to make public the findings early: CT lung screening led to a 20% reduction in lung cancer mortality. This finding may have a huge impact, as the NLST is the largest, high quality randomized control trial to ever evaluate this intervention. Because March 2011 - Issue 3

Brock Health team?

Contact us at: brockuhealth@gmail.com

18

Are they clumsy or cursed?

Steve Demetriades

Developmental coordination disorder is probably something you have never heard of before. This is despite the fact that 5-8% of all the children you meet suffer from it1. The reason you have never heard of it is because you may know it by its more colloquial name, clumsiness. In fact, the disorder was referred to as clumsy child syndrome in the past, and it wasn’t until a worldwide meeting by healthcare professionals at the International Consensus Conference on Children and

worse for children with DCD, it is often associated with other disorders such as attention deficit hyperactivity disorder, further exacerbating their difficulties3.

This poorly recognized disorder has a major impact on the lives of millions of children and those around them. Children who suffer from DCD are at significantly higher risk of suffering from problems with attention, learning and psychosocial adjustment4. On top of this they are also at increased risk of being less physically active, having

Clumsiness in 1994 that lower levels of self-esteem and bethe term Developmental Coordina- ing overweight or obese5. tion Disorder (DCD) was coined2.

DCD is characterized by several Since the disorder is so percriteria, including performing tasks vasive in the development of nearly involving motor coordination at a every aspect of a child’s life it is level that is significantly below that clear why identifying it accurately is which is expected for a given age, so important. Brock currently housparticularly when this impairment es some of the leading researchers has an effect on the activities of dai- in this field and the Physical Health ly life or academic achievement3.

Activity Study Team (PHAST) is completing a very large multi-year

Children may find every- study that is investigating the efday activities such as handwriting, fects of DCD. sports, dressing and balance more difficult. To make matters even Through their research, they

are working to improve the lives of numerous children. It’s unfortunate that something completely outside of the control of a child can have such a negative impact on their life.

It’s more unfortunate that children and parents remain unaware of the cause of the difficulties and the help that is available. However, it is exciting to know that Brock is helping to make important advances in this field.

HOT HEADLINES! Researchers hope to treat depression with gene therapy by Paul Taylor Nida Ahmed Researchers from the U.S and Sweden believe gene therapy may be used to treat critically depressed patients who respond poorly to antidepressants. Serotonin is a neurotransmitter that sends messages between brain cells and is linked to depression. A research team from Rockefeller University has discovered that patients suffering from depression often lack a particular protein named p11, in the part of the brain called the nucleus accumbens, which is known to be a reward/pleasure centre. The p11 protein brings serotonin binding receptors to the nerve cell surfaces.

Therefore in an individual lacking p11, the receptor will not be able to attach to the neurotransmitter.

During experiments, conducted by injecting depressed mice with p11 producing genes, the animals demonstrated a rapid creation of the p11 protein. These depressed mice became more active and expressed movement such as struggling when caught, which they did not before.Michael Kaplitt of Weill Cornell Medical College agrees that gene therapy will be an effective measure in treating patients suffering from depression in the near future.

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Breakfast: What is there really to gain?

Ryan Schapoks-Siebert

breakfast is a lack of time. Thus, in order to maintain a healthy lifestyle we must put forth an effort to plan ahead and make a commitment to eating breakfast.

The first meal of the day, breakfast, was once considered to be the most important meal of the day. Breakfast is usually consumed before daily activities prior to 10:00 am and should consist of ~35% of total daily energy needs1. However, skipping breakfast has become a common habit, with consumption frequency declining from 1965.

From 1961 to 1991 recorded frequencies of breakfast consumption declined from 89.7% to 84.4% in boys and 74.9% and 64.7% in girls.

With such a decline in consumption, this meal can be in danger of extinction in years to come, especially if the noticed trend continues to progress.

The importance of breakfast is instilled at a young age, where parents commonly yell early in the morning, “Hunny, wake-up! It’s time for breakfast!” Therefore at an early age children depend on their parents for the provision of a healthy breakfast, but as age increases so do one’s responsibilities. As young adults we are expected to learn to provide and care for ourselves and a common excuse used for skipping March 2011 - Issue 3

converted to an energy source ultimately decrease ones muscle composition7.

From a students’ prospective, it is important to note that consistent breakfast consumption is associated with an increase in academic performance 8, 9, 10, potentially through increased attention spans and by optimizing brain function. Glucose, is a sugar and is the fundamental unit of many carbohydrates. It is an energy source in the brain that cannot be stored.

Our brains need glucose in order to function, and therefore must have a constant supply11. By skipping breakfast and depending on stored fats, deprivation of energy occurs with decreased functioning of the brain. Is the lack of a hearty breakfast holding you back from straight A’s? Maybe not, but it’s definitely a great way to kick-start the day, allowing your body the nutrients and energy to optimally function.

Further reasons for the ‘skipping’ trend, other than lack of time, vary from limited food sources3 to weight concerns4, 5. However, these excuses are not substantial enough to risk encountering health problems that directly stem from such a nutritional neglect. Deshmukh-Taskar et al. has shown that individuals who regularly eat breakfast have a more varied and higher quality of diet. This includes an increased intake of fibre, minerals, and vitamins in the diets of individuals who regularly eat breakfast. As well, these individuals also had more preferential intake of fats when compared to those who skip breakfast such as a decline in saturated fats, the detrimental type, and an increase in polyunsaturated and monounsaturated fats, the more beneficial ones6.

The healthier and more nutritionally Breakfast provides one complete breakfast is, the better it with a better quality of diet, more will meet their body’s demands. fuel for your brain, leading to increased attention spans and optimal

Deshmukh-Taskar et al. brain functioning. A few quick tips show that with the decreased intake for time-restraint breakfasts are to of saturated fat, a lower the necessi- make coffee before you jump in the ty of fat expenditure occurs because shower so that it’s ready to go when energy can be drawn from complete you are. Try some breakfast shakes energy sources such as carbohy- or smoothies. No cooking skills are drate breakdown. Without a proper necessary and can be extremely nubreakfast ones body is essentially tritious. Even prepare them before fasted. This leads to an increase in you go to bed. Lastly, try a breakfat catabolism where the body has fast burrito. They are easy to make, to draw from fat storage and can involve nutritious elements such as lead to increased production of ke- protein and carbohydrates, as well tone bodies, which are sub-products as they are extremely mobile. You of this reaction. If persistent fasting can eat them as you are running to occurs, it can cause an increased class. On behalf of your body and acidic pH level of blood from fat ca- you breakfast eating efforts, “Thank tabolism as well as the breakdown you!” of protein, where amino acids are 20

Electronic Health Records: Better Data Better Health Shahla A. Grewal

A Jane Doe has been rushed to the ER and the physician gives her a shot of penicillin; moments later she flat lines and dies. She was fatally allergic to penicillin and electronic health records (EHRs) could have saved her life.

EHRs are the future of health care in Canada. An EHR, defined by the Health Information Management System’s Society (HIMSS) is a “longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting. Included in this information are patient demographics, progress notes, problems, medications, vital signs, past medical history, immunizations, laboratory data, and radiology reports.

The EHR automates and streamlines the clinician’s workflow.”

and outpatient care could average more than $77 billion per year (an average annual savings of $42 billion during the adoption period).2

The patient treatment benefits are quite significant as well.

A study led by Weber et al( 2008), looked at how EHRs affected Type II diabetes intervention.

The percentage of patients with ideal glucose control (HBA1c < 7.0) increased from 32.2% to 34.8% (p < .001), and blood pressure control (<130/80) improved from 39.7% to 43.9% (p < .0001).

They concluded that diabetes care improved significantly in response to a multifaceted intervention featuring the use of an EHR-derived

It is high time that EHRs registry in an integrated delivery begin being the norm. As Richard system.1 Alvarez, CEO of Canada Health Infoway noted, “information technol- Irene Podolak, who has been ogies that have revolutionized virtu- working with EHRs since 1987, ally every other aspect of our lives sheds some light on the current state are painfully absent from the way of EHR usage. “At first glance it we manage and share health data.” 3 would appear that we are not making much progress – data from

The benefits of EHRs are HIMSS Analytics shows that 0% of astonishing and it comes as a sur- Canadian hospitals can claim they prise that Canada is lagging in their have a complete electronic health implementation. Of primary benefit record. are significantly reduced wait times by eliminating wasteful duplicates However, thanks to the fundas well as reduced costs. ing that has been made available by Infoway, early results are starting

A study conducted by Hill- to be realized. Provincial electronic estad et al (2005)., looked at several drug repositories have decreased methodologies used to estimate the inappropriate prescriptions and recurrent adoption of EHR systems duced costs by 55 million dollars. and the potential savings, costs, and As our electronic health record penhealth and safety benefits. At a 90% etration increases, we will definitely adoption level of EHRs, they esti- realize more value for our investmate that the potential HIT (health ment.” information technology)-enabled efficiency savings for both inpatient Podolak goes on further to say “now 21

more than ever we need electronic health data to deal with the challenges in our health system – our population is aging and getter sicker, our clinical practitioners are decreasing and costs continue to escalate.”

Podolak says “we won’t be able to tackle these challenges if we don’t have access to comprehensive, high quality digitized health data – without it we won’t be able to make informed decisions on how to reform our health system. We need better health data for better health both here in Canada and all around the world.”

She recommends that students and others who are interested in this field gain more information on the topic and attend conferences.

One such conference is coming up in Toronto on eHealth May 29-June 1st.

I could not do justice to this topic given the word limit so I highly encourage people to visit Canada Health Infoway for more information to educate yourselves further. www.infoway-inforoute.ca

Maryann Polce-Gordon, BBA: New CHSC Academic Advisor

Prior to becoming a CHSC academic advisor, Maryann worked at Brock University in the capacity of an Information Services Assistant in the Registrar’s Office. That particular occupation allowed her to interact with Brock students from various majors and motivated her to become an academic advisor.

be a part of their degree process. Her wealth of experience working with Brock students and enthusiasm is a great asset to our CHSC department and would be extremely beneficial to our students.

Although Maryann has only started to settle into her academic advising position, she is very friendly

Her experience interacting and approachable, therefore she weland assisting students as a Teaching comes you to book an appointment Assistant and then as an Information with her.

Services Assistant solidified her career choice in academic advising.

We are delighted to have her in our department and if you have

She thoroughly enjoyed time, drop by her office for a quick working as an Information Services “hello” as she is more than happy to Assistant, however she was eager to interact with students! pursue this job opportunity, which would allow her to directly interact with CHSC students one on one and

Master’s Highlight Dan Chirico

HBKin, MSc, PhD (in progress) By: Phuc Dang

Dan Chirico graduated from the Honours Bachelor of Kinesiology program at McMaster University in 2008 and completed his MSc in Applied Health Sciences at Brock University in 2010. Currently, he is in his first year of PhD studies working under the supervision of Dr. O’Leary in the CHSC Department.

His main area of research focuses on cardiovascular disease risk factors in children. He believes that a positive aspect of research is the ability to provide new information that has the potential of improving the health of others.

He acknowledges that research is time-consuming and tedious work however; the end result is very His future career goal is to rewarding. obtain a faculty position at a post-sec Dan was initially interested in ondary institution as that would allow becoming a physiotherapist, however, Therefore, he advises any him to continue researching pediatric after completing a thesis course in the students who are considering gradu- cardiovascular health. final year of his undergraduate stud- ate studies to find an area of study ies; he realized that research was his that they are passionate about because When Dan is not in the lab passion. that passion will allow them to put the working tirelessly on his PhD, he time and effort into successfully com- enjoys playing and coaching soccer pleting their research goals. competitively.

March 2011 - Issue 3

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HOT HEADLINES

Say What?

A look at Earbud Usage

By Jessica Rozman

While walking down the halls

of Brock University, it is not uncommon to see a student listening to an iPod. However, the headphones, or “earbuds”, that usually accompany iPods can pose health risks to young adults, such as noise-induced hearing loss, a condition that can be brought on by leisure noise exposure.

Several peer-reviewed studies have evaluated the potential hearing damage and hearing loss that can result from over-exposure to loud music from earphones in young adults. A study conducted by Mostafapour examined subjects between 18 and 30 who reported listening to personal stereo devices for at least one hour or more per day, and were asked to complete a survey regarding their noise exposure and usage of hearing protection, and undergo an audiologic examination.

The results revealed that young users of personal music devices are at low risk of substantial NIHL(Noise Induced Hearing Loss)1. Another study that was performed by Ahmed and colleagues showed a similar result. The population consisted of undergraduate students who completed a survey used to assess the degree of present and past leisure and work noise exposure.

Some participants went on to receive an audiogram that measured hearing thresholds, and were required to listen to an iPod at five different volumes. It was concluded that although many university students use an iPod, the majority of them listen to them at mid-volume, and that no audiometric evidence of early hearing loss was found2.

23

Although these studies have concluded that there are minimal risks involved with listening to personal music players, other studies such as the following have challenged these conclusions. A study

by Jones and Alarcon randomly selected students from a university who were listening to personal music devices, and a one minute recording of their music at the current volume was analyzed by an “artificial ear” and a dB meter. It was concluded that the noise levels of the personal music devices were much higher than recommended and the subjects were at risk for permanent hearing damage and thus, noise-induced hearing loss3.

Regardless if you listen to Lamb of God or Lady Gaga, the chronic use of earbuds and other personal music devices at a high volume will inevitably damage hearing. The excessive usage and loudness of such devices could lead to a myriad of health complications and unnecessary, avoidable costs to the health care system.

However, the good news is that each of these studies reported that the majority of the subjects were concerned about the issue, and most subjects did not listen to their iPods at an unreasonable volume.

Perhaps more education is necessary to inform young people about the risks of earbuds, especially when combining this noise exposure with other forms of recreational noise.

Just remember this good advice, and the next time you’re on the bus and that guy next to you has Metallica on at full blast, you’ll have the satisfaction of knowing you won’t be the one wearing a hearing aid in ten years.

“Teen caught in limbo in mental health system”

by Kenyon Wallace Summarized by Jacqueline A. Stevenson This article describes a 13-year-old child at risk of falling through the cracks in Ontario’s mental health system. Last month, she was sent to a treatment facility in Utah. The courts and the Ontario Ministry of Heath and Long-Term Care had decided, after a destructive incident in which she kicked out the back window of a police car, that this Utah facility was best equipped to treat her. Only 9 days after she arrived under a peace bond, the facility unexpectedly removed her for allegedly violent behaviour and sent her to a nearby hospital.

Now her parents are afraid they will have to pay her U.S. hospital bills without Ontario’s help and bring her back here. They are also afraid she could face more criminal charges when she arrives in Canada because she will be in breach of her peace bond. The child first showed signs of mental illness at age 2. Her parents claim that one Ottawa-area hospital they dealt with refused to treat their daughter.

This story is not unlike that of Ashley Smith, the 19-year-old woman with a mental health condition who was first incarcerated at age 15 and whose name has also appeared in the news in recent months.

She died in a prison cell in October 2007 in a suspected suicide, while prison guards watched but did not assist her. Ontario is not equipped to handle its demand for mental health services. Mental health services should be available close to home.

Neither children nor their only option for mental health care should be found in Ontario’s prisons and jails.

How much Faith Can We place In Spiritual Health 1. B.E. Faught, M. L. (2008). HEALTH, the basics: Second custom edition for Brock University Pearson Custom Publishing.

2. Benson, H., Dusek, J. A., Sherwood, J. B., Lam, P., Bethea, C. F., Carpenter, W., et al. (2006). Study of the therapeutic effects of intercessory prayer (STEP) in cardiac bypass patients: A multicenter randomized trial of uncertainty and certainty of receiving intercessory prayer. American Heart Journal, 151(4), 934-942.

3. Carei, T. R., Fyfe-Johnson, A. L., Breuner, C. C., & Brown, M. A. (2010).

Randomized controlled clinical trial of yoga in the treatment of eating disorders. Journal of Adolescent Health, 46(4), 346-351.

4. Duru, O. K., Sarkisian, C. A., Leng, M., & Mangione, C. M. (2010). Sisters in motion: A randomized controlled trial of a faith-based physical activity intervention. Journal of the American Geriatrics Society, 58(10), 1863-1869.

5. Harris WS, Gowda M, Kolb JW, Strychacz CP, Vacek JL, Jones PG, Forker A, O’Keefe JH, McCallister BD. (2000). A randomized, controlled trial of the effects of remote, intercessory prayer on outcomes in patients admitted to the coronary care unit.. Arch Interm, 1878, 160.

6. Masters, K. S. (2010). The role of religion in therapy: Time for psychologists to have a little faith? Cognitive and Behavioral Practice, 17(4), 393-400.

7. O’Connor, T. S. J. (2002). Is evidence based spiritual care an oxymoron?

Journal of Religion and Health, 41(3), pp. 253-262.

8. R, B. (1988). Positive therapeutic effects of intercessory prayer in a coronary care unit population. Southern Medical Journal, 81(7), 826.

9. Roberts, L., Ahmed, I., Hall, S., & Davison, A. (2009). Intercessory prayer for the alleviation of ill health. Cochrane Database of Systematic Reviews, (2), CD000368.

10. Vannemreddy, P., Bryan, K., & Nanda, A. (2009). Influence of prayer and prayer habits on outcome in patients with severe head injury. Am J Hosp Palliat Care, 26(4), 264-269.

Human Papilloma Virus - Jaqueline Stevenson 1 The Society of Obstetricians and Gynaecologists of Canada. (2009). Incidence andprevalence in Canada. Retrieved from HYPERLINK “http://www. hpvinfo.ca/hpvinfo/professionals/overview-3.aspx” http://www.hpvinfo.ca/ hpvinfo/professionals/overview-3.aspx2 McGill Medicine HITCH Cohort Study.

(2010). Facts about HPV. Retrieved from HYPERLINK “http://www.mcgill. ca/hitchcohort/hpvfacts/” http://www.mcgill.ca/hitchcohort/hpvfacts/3 McGill Medicine HITCH Cohort Study. (2010).4 The Society of Obstetricians and Gynaecologists of Canada. (2009).5 Centers for Disease Control and Prevention. (2009). Condoms and STDs: Fact sheet forpublic health personnel. Retrieved from HYPERLINK “http://www.cdc.gov/condomeffectiveness/ latex.htm” http://www.cdc.gov/condomeffectiveness/latex.htm6 Steben, M. (2007). Prevention. Journal of Obstetrics and Gynaecology Canada, 29,Supplement 3, S23-S25.7 Centers for Disease Control and Prevention.

(2009).8 McGill Medicine HITCH Cohort Study. (2010).9 Kjaer, S. K., van den Brule, A. J. C., Bock, J, E., Poll, P. A., Engholm, G., Sherman, M.E., Walboomers, J. M. M., & Meijer, C. J. L. M. (1997). Determinants for genital humanpapillomavirus (HPV) infection in 1000 randomly chosen young Danish women withnormal pap smear: Are there different risk profiles for oncogenic and nononcogenic HPVtypes? Cancer Epidemiology, Biomarkers & Prevention, 6, 799-805.10 Steben, M. (2007).11 Tobian, A. A. R, Serwadda, D., Quinn, T. C., Kigozi, G., Gravitt, P. E., Laeyendecker,O., Charvat, B., Ssempijja, V., Stat, B., Riesesel, M., Oliver, A. E., Nowak, R. G.,Moulton, L. H., Chen, M. Z., Reynolds, S. J., Wawer, M. J., & Gray, R. H. (2009). MaleCircumcision for the Prevention of HSV-2 and HPV Infections and Syphilis. NewEngland Journal of Medicine, 360, 1298-1309.12 Steben, M. (2007).13 Shin, H. R., Franceshi, S., Vaccarella, S., Roh, J. W., Hu, Y. H., Oh, J. K., Kong, H. J.,Rha, S. H., Jung, S., Kim, J., Jung, K. Y., van Doom, L. J., & Quint, W. (2004).Prevalence and determinants of genital infection with papillomavirus, in female and maleuniversity students in Busan, South Korea. The Journal of Infectious Diseases, 190, 468-476.14 Steben, M. (2007).15 Bosch, F. X., Lorincz, A., Muñoz, N., Meijer, C. J. L. M., & Shah, K. V. (2002). Thecausal relation between human papillomavirus and cervical cancer. Journal of ClinicalPathology, 55, 244-265.16 Kjaer, S. K., van den Brule, A. J. C., Bock, J, E., Poll, P. A., Engholm, G., Sherman,M. E., Walboomers, J. M. M., & Meijer, C. J. L. M. (1997).17 Murphy, K. J. (2007). Screening for cervical cancer. Journal of Obstetrics andGynaecology Canada, 29, Supplement 3, S27-S34.18 Bosch, F. X., Lorincz, A., Muñoz, N., Meijer, C. J. L. M., & Shah, K. V. (2002). Thecausal relation between human papillomavirus and cervical cancer. Journal of ClinicalPathology, 55, 244-265.19 Kjaer, S. K., van den Brule, A. J. C., Bock, J, E., Poll, P. A., Engholm, G., Sherman,M. E.,Walboomers, J. M. M., & Meijer, C. J. L. M. (1997).20 McGill Medicine HITCH Cohort Study. (2010).21 Deacon, J. M., Evans, C. D., Yule, R., Desai, M., Binns, W., Taylorand, C., & Peto, J.(2000). Sexual behaviour and smoking as determinants of cervical HPV infection and ofCIN3 among those infected: A case-control study nested within the Manchester cohort.British Journal of Cancer, 88, 1565-1572.22 Kjaer, S. K., van den Brule, A. J. C., Bock, J, E., Poll, P. A., Engholm, G., Sherman,M. E., Walboomers, J. M. M., & Meijer, C. J. L. M. (1997).23 Kjaer, S. K., van den Brule, A. J. C., Bock, J, E., Poll, P. A., Engholm, G., Sherman,M. E., Walboomers, J. M. M., & Meijer, C. J. L. M. (1997).24 Deacon, J. M., Evans, C. D., Yule, R., Desai, M., Binns, W., Taylorand, C., & Peto, J.(2000).25 Steben, M. (2007). Prevention.26 Steben, M. (2007). Prevention.27 Office on Women’s Health (2009). Human papillomavirus (HPV) and genital warts:Frequently asked questions. Retrieved from HYPERLINK “http://www.womenshealth. gov/faq/humanpapillomavirus” http://www.womenshealth.gov/faq/humanpapillomavirus.cfm28 Office on Women’s Health (2009).29 Office on Women’s Health (2009).30 Office on Women’s Health (2009).31 Murphy, K. J. (2007).

Screening for cervical cancer. Journal of Obstetrics andGynaecology Canada, 29, Supplement 3, S27-S34.32 Steben, M. (2007). Prevention.33 Murphy, K. J. (2007).34 Murphy, K. J. (2007).35 The Society of Obstetricians and Gynaecologists of Canada. (2009).36 Dr. Darrell Grant, Medical Director of Student Health Services, personalcorrespondence.

How Can We Keep Patients Safer - Vicky Horner (1) Statistics Canada, 2009. Population projections: Canada, the provinces and territories Accessed on January 30, 2011. Retrieved at: http://www. statcan.gc.ca/daily-quotidien/100526/dq100526b-eng.htm (2) Woolcott, J. et al. (2009). Meta-analysis of the Impact of 9 Medication Classes on Falls in Elderly Persons. Archives of Internal Medicine, 169(21), 1952-1960.

(3) Préville, M., Hébert, R., Boyer, R., & Bravo, G. (2001). Correlates of psychotropic drug use in the elderly compared to adults aged 18-64: results from the Quebec Health Survey. Aging & Mental Health, 5(3), 216-224.

(4) Pariente, A., Dartigues, J., Benichou, J., Letenneur, L., Moore, N., & Fourrier-Régal, A. (2008). Benzodiazepines and Injurious Falls in Community Dwelling Elders. Drugs & Aging, 25(1), 61-70.

(5) Takkouche, B., Montes-Martinez, A., Gill, S. S., & Etminan, M. (2007).

Psychotropic Medications and the Risk of Fracture: A Meta-Analysis. Drug Safety, 30(2), 171-184.

(6) Panneman, M. J. M., Goettsch, W. G., Kramarz, P., & Herings, R. M. C. (2003). The Costs of Benzodiazepine-Associated Hospital-Treated Fall Injuries in the EU: A Pharmo Study. Drugs & Aging, 20(11), 833-839.

(7) Hanlon, J. et al. (2009). Number and Dosage of Central Nervous System Medications on Recurrent Falls in Community Elders: The Health, Aging and Body Composition Study. Journal of Gerontology, 6(4), 492-498.

(8) Lindley, C. M., Tully, M. P., Paramsoth, V. & Tallis, R. C. (1992). Inap-

March 2011 - Issue 3

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Fungus: Medicinal Properties - Mina Francis 1.De Carvalho. D. E., Soave. D., Ross, K., & Callaghan, J. P. 2010. Lumbar spine and pelvic posture between standing and sitting: A radiologic investigation including reliability and repeatability of the lumbar lordosis measure.

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Plastic Makes Perfect: Medicalization Women’s Bodies by Eliza Beckett 1) Gimlin, D. (2010). Imagining the other in cosmetic surgery. Body and Society,16(4),57-76.(2) Tiefer, L. (2000). The medicalization of women’s sexuality. The American Journal of Nursing, 100, 11.Conrad, P. (2010). The shifting engines of medicalization. Journal of Health and Social Behavior, 46, 3-14. Dial D for Deficiency - Kelsey Fallis (1)Schwalfenberg, G., Genius, S., & Hiltz, M. (2010). Addressing vitamin D deficiency in Canada: a public health innovation whose time has come. Public Health (Elsevier), 124(6).(2)Ward, L., Gaboury, I., Ladhani, M., & Zlotkin, S. (2007). Vitamin D-deficiency rickets among children in Canada. Canadian Medical Association Journal,177(2), (3)Dietary supplement fact sheet: vitamin D. (2011). Retrieved from HYPERLINK “http://ods.od.nih.gov/factsheets/vitamind/” http://ods.od.nih. gov/factsheets/vitamind/ (4)Gozdzik, A., Barta, J., Wu, H., Wagner, D., & Cole, D. (2008). Low wintertime vitamin D levels in a sample of healthy young adults of diverse ancestry living in the Toronto area: associations with vitamin D intake and skin pigmentation. BMC Public Health, 8.

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A New Fad Goes Up In “Smokes” by Kristie Newton References:(1)Nordqvist, C. (2011, February 15). What Are E-Cigarettes?

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Conventional and Electronic Cigarettes (e-cigarettes) have different smoking characteristics. Nicotine and Tobacco Research. 12.9: 905-912. Print.

Feature Article – Measuring Concious Awareness – Brittany Ferren Acquired brain injury and rehabilitation. Retrieved from: “http://www. torontorehab.com/TorontoRehabCorporate/media/Toronto-Rehab-Corporate/ABI.pdf” http://www.torontorehab.com/TorontoRehabCorporate/ media/Toronto-Rehab-Corporate/ABI.pdf “http://communications.uwo.ca/ cerc/” http://communications.uwo.ca/cerc/Consciousness. Retrieved from: “http://plato.stanford.edu/entries/consciousness/#2” http://plato.stanford.edu/entries/consciousness/#2. Last updated: August 16, 2004. Martin, M. M., Coleman, M. R., & Owen, A. M. 2010. Using functional neuroimaging to assess residual cognition and awareness after severe brain injury. Journal of Pyschophysiology, 24. DOI; 10,1027/0269-8803/a000016. Martin, M. M., & Owen, A. M. 2010. The aware mind in the motionless body. Consciousness and the Vegetative State, 23, 478-481. Owen, A. M., & Coleman, M. R. 2008. Functional neuroimaging of the vegetative state. Nature Reviews Neuroscience, 9, 235-243. Owen, A. M., Coleman, M. R., Boly, M., Davis, M. H., Laureys, S., & Pickard, J. D. 2006. Detecting awareness in the vegetative state. Science, 313, 1402. “http://renedescartes.com/” http://renedescartes.com/. Last modified: December 9, 2002.

Sleep Deprivation and Melatonin Therapy by Singha Chanthanatham 1. Health Canada. Ottawa, Ontario: Health Canada; c2003-2007 [updated 2007 February 16; cited 2010 Oct 8]. Available from: http://www.hc-sc. gc.ca/index-eng.php/ 2. Kim HJ, Silverman CM. Traumatic dislocation of LASIK flaps 4 and 9 years after surgery. J.Refract.Surg. 2010 Jun;26(6):447-452.

3. Wu F, Yang Y, Dougherty PJ. Contralateral comparison of wavefrontguided LASIK surgery with iris recognition versus without iris recognition using the MEL80 Excimer laser system. Clinical and Experimental Optometry 2009;92(3):320-327.

Date Rape: What You Need to Know – Michele Leech 1. Antonia, A (June, 1987) Misperceptions of friendly behavior as sexual interest: a survey of naturally occurring incidents. Psychology of Women Quarterly, 11(2), 173-194.2. Benson, D., Charlton, C., & Goodhart, F. (1992) Acquaintance rape on campus: a literature review. J Am Coll Health, 40, 157-165.3. Bradley, S, D. (2006). Date rape prevention in women: a controlled outcome study4. Bulmer, S., Irfan, S., Mugno, R., Barton, B., & Ackerman, L. (2010). Trends in alcohol consumption among undergraduate students at a northeastern public university, 2002- 2008. Journal of American College Health, 58(4), 383-390.5. Loiselle, M., & Fuqua, W. R. (2007). Alcohol’s effects on women’s risk detection in a date- rape vignette. Journal of

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Phototherapy: From Healing Acne to Healing Wounds – Carolyn Czyrko Eels J. et al. (2004). Mitochondrial signal transduction in accelerated wound and retinal healing by near-infrared light therapy. Mitochondrion 4: 559-567.

Sadick N. (2009). A study to determine the effect of combination blue (415 nm) and near-infrared (830 nm) light-emitting diode (LED) therapy for moderate acne vulgaris. Journal or Cosmetic and Laser Therapy 11(2): 125-128.

Are They Clumsy or Cursed? – Steven Demetriades (1)Barnhart RC, Davenport MJ, Epps SB, Nordquist VM. 2003. Developmental coordination disorder. Physical Therapy,83:722-731 (2)Polatajko, H. J., Fox, M., & Missiuna, C. 1995. An international consensus on children with developmental coordination disorder. Canadian Journal of Occupational Therapy, 62,3-6 (3)Carslaw Helen. 2011. Developmental coordination disorder. InnovAiT 4(2)87-90.

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Breakfast: What is there really to gain – Ryan Schapoks-Siebert (1) Timlin MT, Pereira MA. Breakfast Frequency and Quality in the Etiology of Adult Obesity and Chronic Diseases. Nutr Rev 2007 06;65(6):268-281.

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Say What? – Jessica Rozman 2. Ahmed, Shazia; Fallah, Sina; Garrido, Brenda; Gross, Andrew; King, Matthew; Morrish, Timothy; Pereira, Desiree; Sharma, Shaun; Zaszewska, Ewelina; Pichora-Fuller, Kathy. “Use of Portable Audio Devices By University Students”. Canadian Acoustics. 2007. 35 (1), 35-54.

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1. Mostofapour, Sam P.; Lahargoue, Kelli; Gates, George A. “Noise-induced hearing loss in young adults: The role of personal listening devices and other sources of leisure noise”. The Laryngoscope. 1998. 108 (12), 1832-1839.

Electronic Health Records - Shahla A. Grewal 1)Valerie Weber, MD, Frederick Bloom, MD, Steve Pierdon, MD, and Craig Wood, MS. Employing the Electronic Health Record to Improve Diabetes Care: A Multifaceted Intervention in an Integrated Delivery System. J Gen Intern Med. 2008 April; 23(4): 379–382.

2)Richard Hillestad, James Bigelow, Anthony Bower, Federico Girosi, Robin Meili, Richard Scoville and Roger Taylor. Can Electronic Medical Record Systems Transform Health Care? Potential Health. Benefits, Savings, And Costs.

Health Affairs, 24, no.5 (2005):1103-1117 3)Richard Alvarez, President & CEO. A Special Report from Canada Health Infoway. Electronic Health Records for Canadians. If Canadians want to realize the benefits of electronic health records, it’s up to the public to demand them. Canada Health Infoway Inc. http://v1.theglobeandmail.com/partners/ free/infoway/article_canadians.html Photo Credits 1. Cover Photo by Emily Loveday - From top left clockwise: Whitney Brown, Brittany Ferren, Stephanie Bryenton, middle: Phuc Dang For complete photo credits, see the online version on www.issuu.com

24

THE TEAM

Yumna Ahmed

Brittany Ferren

Phuc Dang

Scott Alguire

Vicky Horner

Whitney Brown

Jessica Rozman

Gregory McGarr

Nida Ahmed

Singha Chanthanatham

Michele Leech

Eliza Beckett

Steve Demetriades

Shirin Pilakka

Kristie Newton

Daniel Korpal

Jaqueline Stevenson

Ryan SchapoksSiebert Absent: Emily Loveday Stephanie Bryenton Kelsey Fallis Mina Francis

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