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A clinician's perspective on Canada's new health minister

We've already heard what the politicians and the pundits have to say about Stephen Harper's decision to name first-time Inuit MP Leona Aglukkaq, from Nunavut, to be the new federal health minister.

But what do Nunavut doctors think about the decision? I asked Dr Aaron Johnston, who until recently was working full-time in the territorial capital, Iqaluit. Although he has moved back down south to the Vancouver area, Dr Johnston, a family practitioner, still flies up north occasionally to help out.

Here's what he emailed me about Ms Aglukkaq:

"As you well know Nunavut has health care challenges that are unique in Canada. She has managed the health system for a territory with the lowest health status in all of Canada, and during her time as minister the system has made slow but steady improvements and gains. She has always seemed to have a good grasp of both acute health care and the underlying social determinants of health. Obviously the federal health minister manages a system orders of magnitude larger than the system in Nunavut and with different challenges, but her experiences in managing the ultimate 'have-not' system should serve her well.

"I think there are 2 other important points to make about Leona's appointment. First, it is a refreshing change to see an Inuit woman in this kind of high profile cabinet post. Hopefully she will be able to provide some focus on the health status of Canada's First Nations people. Second, although Leona is a Conservative MP her background is as an MLA in a consensus parliament rather than a partisan parliament, and perhaps that will be of some use to her in this minority government situation.

"I think people will be surprised by how well she will do in her new position!"
What do you make of the controversial decision to make Ms Aglukkaq our new health minister? Leave us your thoughts in the 'Comments' section below.

Fewer heart attacks, more cancer after Daylight Saving Time ends Sunday

'Falling back' an hour with the end of Daylight Saving Time reduces your risk of suffering a heart attack, but it may raise your longterm chances of contracting breast, prostate and colorectal cancers.

Seriously.

First of all, how can the time change decrease the risk of heart attacks? A in the New England Journal of Medicine, published yesterday, by a pair of Swedish researchers, explains that the cardioprotective benefit of the end of Daylight Saving Time only appears on the very first Monday after the switch. On that day, there are around 5% fewer heart attacks than on other Mondays. (The opposite is true, and even more pronounced in the spring, however, when losing an hour of sleep causes a 5% rise in heart attacks for a full week.)

"The most plausible explanation for our findings is the adverse effect of sleep deprivation on cardiovascular health," wrote Drs Imre Janszky and Rickard Ljung. "According to experimental studies, this adverse effect includes the predominance of sympathetic activity and an increase in proinflammatory cytokine levels. Our data suggest that vulnerable people might benefit from avoiding sudden changes in their biologic rhythms."

How did they come up with the idea to perform this study? Simple, Dr Janszky : "I was on the bus, quite sleepy, and I thought of this."

As for the increased longterm risk of cancer, the evidence is rather thin -- though that didn't stop the Canadian Cancer Society from issuing a plea to Canadians to take more cancer-counteracting 1000 IU of vitamin D to balance out the decrease in sunlight exposure after Daylight Saving Time ends.

"Because of our country's northern latitude, the sun's rays are weaker during fall and winter months and Canadians don't produce enough Vitamin D from sunlight during this time," the society's Heather Chappell said in a release. "Our Vitamin D recommendation is based on the growing body of evidence about the potential link between Vitamin D and reducing risk for colorectal, breast and prostate cancers."

Of course, you can ignore the news about heart-attack risks if you live in most of Saskatchewan, parts of eastern British Columbia and northern Ontario and far-eastern Quebec, or if you are one of the several hundred residents of Coral Harbour, Nunavut, on Southhampton Island. You don't get to enjoy the heart-pounding excitement of Daylight Saving Time changes.

Everyone else: don't forget to set your clocks back on Sunday morning.

Photo: Shutterstock

What's in the news: Oct. 31 -- Aglukkaq, known unknowns, and more

A round-up of Canadian health news, from coast to coast to coast and beyond, for Friday, October 31.

The Globe and Mail's Adam Radwanski, on yesterday's cabinet appointments:

Finally, there's one that I'm reluctant to judge either way just yet. Leona Aglukkaq is a fascinating choice as Health Minister, with the potential to get the government focused on challenges in Inuit and aboriginal communities that it's long neglected. She's also a huge leap of faith, since being a minister in Nunavut is a long, long way from being a senior federal minister within about five minutes of getting to Ottawa. This is one that could either be regarded as a stroke of genius by Harper, or completely blow up in his face.
More reactions to yesterday's news that Leona Aglukkaq will become the new federal health minister:
"I thought it was a small but important step for Canada that we have a woman of Inuit origin in a senior portfolio. It doesn't mean we're not going to be as tough on her as anybody else, as an opposition should be, but I think there's some things you shouldn't be too partisan about and I strongly support that." - Michael Ignatieff, deputy leader of the Liberal Party [CTV.ca News]

Jane Taber has a profile of Ms Aglukkaq in today's Globe and Mail. She declined to be interviewed for the article, unfortunately, but there are a few great details (including, yes, a comparison to Sarah Palin). Ms Taber asked the man who she beat out to become a territorial representative for his memories of her: "Although he remembers her as a quiet girl, he recalls, too, that she had a mischievous streak, especially when at 12 years old, she and his younger sister took off for a joy ride on his motorcycle without asking, and without any worry about their safety." Nunatsiaq News editor Jim Bell is quoted as saying, "She's very tough... She doesn't back away from a fight and she knows how to duke it out with the guys... she's not scared of anybody."

The Canadian Press, describing Aglukkaq as "scrappy," quotes Dr Robert Ouellet, the president of the Canadian Medical Association: "She's an experienced person in health care issues... she knows the problem in a remote area. She knows the problem of the shortage of doctors and lack of resources. We have those problems in the rest of Canada too." Sid Ryan, a VP of the union CUPE, said, "At first blush, it signifies to me the lack of importance that the federal government pays to health care. There's a massive drive by the doctors' associations... to attack medicare and to attempt to privatize it. You put in somebody that's got no experience, and it just makes it all the more easy."

"... I think the appointment of Leona Aglukkaq as Health Minister is the right choice, as her years of public service in Nunavut and the Northwest Territories will bring a fresh new perspective to Ottawa about First Nations and all people who live in northern and remote communities." - Stan Beardy, grand chief of the Nishnawbe Aski Nation, in Ontario [news release]

"Ms. Aglukkaq is the first Inuk in a federal cabinet, and hooray for that. She had extensive experience as a top civil servant and a finance minister in Nunavut. She was not slotted therefore into a token post, but given a huge department with responsibility. Mr. Harper, to his credit, has taken Arctic matters seriously. That she won Nunavut testified to that; that he put Ms. Aglukkaq in an important cabinet post confirms it." - Jeffrey Simpson

"At a time when balancing the budget is about to become a major headache, the rookie health minister will have to learn the ropes quickly if she is to shelter her portfolio from the revenue-grabbing fingers of her finance colleague." - Chantal Hébert

"Minister Aglukkaq understands the very real respiratory health challenges facing Canada's First Nations, Métis and Inuit communities - and we stand ready to work with her to meet these challenges. We are confident that Minister Aglukkaq will be as strong as an advocate for better lung health as her predecessor, and look forward to working with her to improve the respiratory health of the one in five Canadians living with lung disease." - Nora Sobolov, president/CEO of The Canadian Lung Association [news release]

"It seems like an awful lot of responsibility for a rookie MP... This is a big step up for her. Let’s hope that she proves that she is up for the job. This is a risky appointment but it is also one that could have a big payoff."

"I am glad HM Minister for Health will now be Leona Aglukkaq. She had those responsibilities in the North... I had heard Tony Clements [sic] was not happy at health. I hope he will be happier as HM Minister For Industry."

"Few had predicted this, but it’s a good choice, she was Health Minister in the Nunavut government so she’s obviously got the background. She also makes for the first female Health Minister I believe since Diane Marleau in the Chretien government."

A new law in Prince Edward Island will give pharmacists the authority to renew prescriptions, as many other provinces have been doing in the past year or two. The legislation is expected to be passed next month, CBC News reported.

Quebec hospital pharmacists are planning a teaching boycott. They want pay parity with pharmacists working in private pharmacies, and they want the government to redress the worsening shortage of hospital pharmacists across the province.

99% of Ontario hospitals have hand-washing policies in place. How effective have those policies been? Well, according to a new study by the Canadian Institute for Health Information, there's really no way for us to know: only 38% have an auditing process to determine whether the hand-washing policies are being followed.

Another thing Ontario doesn't know: the health impact of recycling human and industrial waste as fertilizer.

After the Ontario Health Coalition accused the Ontario government of encouraging health boards to eliminate elected representation, Health Minister David Caplan denied there has been any such encouragement. He said, "I think that independently, these individuals are looking at what is the best governance model for the particular communities they've gone into and where they have rescued very troubled hospital corporations from some very difficult situations."

Alberta Liberal Party leader Kevin Taft thinks self-regulating medical professions need more government oversight to keep them in order, in light of the reused-syringe scandal. [Metro]

Saskatchewan is investigating another hospital that was reusing syringes, in the Alberta border town of Lloydminster. Lloydminster was the centre of another health safety scandal in Alberta two years ago when the College of Physicians and Surgeons of Alberta didn't initially disclose its investigation of improper equipment sterilization by two obstetricians.

According to The Hill Times, the federal government plans to reintroduce its proposed legislation that would tighten regulations on natural health products. (Before Parliament dissolved in September, the bill was known as Bill C-51.) The only other legislation with any relation to health that died on the floor when the election was Bill C-54, the Human Pathogens and Tissues Act, which would streamline the safety regulations on biological materials. No word yet on whether that too will be reintroduced during the new session of Parliament. [Hill Times]

Dr Maria Soledad Barría, Chile's minister of health and former nephrologist, resigned on Tuesday as calls for impeachment mounted after it was reported that 25 patients at a northern hospital had not been informed they were HIV-positive. Her last decision as minister was to fire several officials at the hospital. The deputy health minister, Jeanette Vega, has been appointed to replace Dr Barría. [ (Spanish)] [ (Spanish)] Dr Barría is the second member of the cabinet to exit prematurely this year; Education Minister Yasna Provoste was impeached in April. The news of Dr Barría's departure has prompted speculation that the right-wing National Renovation opposition party could replace the current, left-wing coalition government in next year's federal election. A recent poll placed the opposition at 40% and the government at 38%. [ (Spanish)]

Cabinet shakeup introduces new health minister

Goodbye, Tony Clement. Hello, Leona Aglukkaq.

Ms Aglukkaq (right), an Inuit woman from Nunavut and rookie Member of Parliament, has been named the new federal health minister. She takes over for Tony Clement, who becomes industry minister.

Ms Aglukkaq was minister of health of Nunavut until last month when from the territorial legislature to become the Conservative Party's candidate for Nunavut's one federal riding. She narrowly defeated the Liberal and NDP candidates, successfully flipping the riding from red to blue.

First as Nunavut's finance minister, then later as health minister, Ms Aglukkaq, a long-time government employee, was a frequent target of criticism from opposition members in the Nunavut legislature.

The territory's health system struggled at times over the last few years, prompting speculation at times that Ms Aglukkaq would be removed from her post.

Under her watch, the province's only major hospital at the time, Baffin Regional Hospital, in Iqaluit, lost its voluntary accreditation from the Canadian Council on Health Services Accreditation (now called Accreditation Canada) in 2006 for the first time since it was first accredited in the early 90s. The hospital was to have too few nurses and housekeepers and out-of-date information and risk management systems. The government at the time that the loss of accreditation might threaten clinical placements for students and residents, but injected new money into the hospital to fund 26 positions.

Ms Aglukkaq faced criticism in the legislature for referring to the loss of accreditation as a "hiccup" in healthcare governance. According to in the local newspaper, Nunatsiaq News, Ms Aglukkaq's "demanding" leadership style came under fire, too. Her deputy minister and two other senior staffers resigned while she was health minister. The deputy minister, Bernie Blais, left after a disagreement about a proposal to airlift some patients to Winnipeg, which Ms Aglukkaq did not favour.

In June 2006, Hunter Tootoo, a fellow territorial legislator, proposed a motion of non-confidence in Ms Aglukkaq, but it was not seconded.

Last year, Ms Aglukkaq oversaw the opening of the new Qikiqtani General Hospital, in Iqaluit, to replace Baffin Regional Hospital as the main medical centre for inpatient services.

This past March, however, Qikiqtani General suffered an operating-room nurse staffing shortage and for nine days by the Canadian Forces, which sent a military nurse to fill in. A military physician had to briefly do the same thing in 2007.

Last week, I speculated on Ms Aglukkaq as a potential replacement for Mr Clement as health minister, but I dismissed the idea, writing, "a more experienced hand is likely required to guide Health Canada." I admit it: I was wrong.

Mr Clement's exit from the healthcare portfolio is what he has been rumoured to have wanted for some time now. When I spoke to him earlier this year, he called the job of health minister a "very difficult, complex portfolio that has been the frequent graveyard of political aspirations in the past." Mr Clement, however, has managed to emerge relatively unscathed after over two years at the helm of Health Canada, even earning what is perceived as a promotion within cabinet to take on the country's industrial management. Perhaps his political success after a tenancy in the health ministry will change the way future health ministers look at their job prospects.

In other health-related cabinet news, Steven Fletcher, who had been the parliamentary secretary for health, becomes the new minister of state for democratic reform.

For the rest of the cabinet changes, consult the Prime Minister's (PDF).

Update, October 31: How are Canadians reacting to the appointment of Ms Aglukkaq? Read about the reactions from Ottawa here, and from one individual MD here.

Photo: Leona Aglukkaq

Halloween health scares are overblown... mostly

Poisoned M&Ms! Drug-filled syringes stuck into Zagnut bars! Halloween is dangerous.

Fortunately, the dangers are, for the most part, imaginary.

Plenty of parents worry about health risks on Halloween, but the American Council on Science and Health wants them to : "Parents should ignore fake scares, relax, and help their kids enjoy a safe and healthy Halloween," said the group's president, Dr Elizabeth Whelan, in a release.

For instance, she advises: "There's no need to be concerned about health problems being caused by flame retardants (one of the latest scares making the rounds) in ghost or goblin getups, for instance -- a greater risk would be a lack of such protection for flammable materials."

Seems like sound advice. Another good idea is to give your kids a big meal before they head out trick-or-treating. Their binge will be less grotesque later on.

Other groups have repeatedly pointed out that much of the fear that parents have about Halloween health risks is unfounded. Poisoned candies are an and although a few needles have been found in treats in the past, that kind of thing is incredibly rare and has been out of all proportion.

But panicking might be therapeutic -- cathartic, perhaps -- for some parents. If you'd prefer to ignore the advice above, here's a novel, Canadian Halloween warning to panic about: Decorative contact lenses may cause permanent eye damage and vision loss, the Ottawa-based National Coalition for Vision Health warned.

Federal legislation to regulate alternative health products would have designated contact lenses as medical devices, but the bill died when Parliament dissolved last month. The coalition refers to the bill as Bill C-50, but I believe they mean Bill C-51. Bill C-50 was a budget implementation bill with a number of other initiatives, including some changes to immigration laws, and it was passed in June. The Conservative government has it plans to reintroduce the proposed law in the coming session, reported The Globe and Mail.

Image: Shutterstock

What's in the news: Oct. 30 -- Psych waits, Taser death, and more

A round-up of Canadian health news, from coast to coast to coast and beyond, for Thursday, October 30.

Psychiatric-care wait times across Canada worsened over the past year, rising slightly from 18.5 to 18.6 weeks, according to a new Fraser Institute study. “The national median wait time for psychiatric care measured in 2008 exceeds the longest national median wait time we have ever measured for physical treatment by approximately two days,” Nadeem Esmail, the think-tank's Director of Health System Performance Studies, said in a release. Prince Edward Island has the longest wait for psychiatric care; PEI's wait times rose almost 40% since 2007, and are now the longest in the country at 54 weeks. [ (PDF)]

Another incident of what seems to be becoming an all-too-common occurrence: a man died in Edmonton after being shot at with a Taser by police. Officers attempted to arrest the man for attacking someone inside a pawn shop and wrecking the store's interior. An investigator told the Canadian Press that it hadn't been determined whether the man was actually hit by the Taser's shock or not, and that the gun hadn't had any effect. The man was held down by police and handcuffed, then lost consciousness. He was declared dead when he was taken to the hospital. "We don't understand why they still use tasers," said a cousin of the dead man. "They obviously kill people. They may not kill everybody that they use it on. But they kill lots."

Jim Wilson, a former Ontario Progressive Conservative health minister, flipped out in the legislature yesterday when current Liberal Health Minister David Caplan didn't answer his complaint that the government had allowed user fees to creep into the healthcare system. Mr Wilson was charged $125 to schedule a visit with a dermatologist because he didn't have a family doctor's referral -- because he doesn't have a family doctor. (A great bit of colour from the CP story: "That comment prompted an angry rant from Wilson, whose face turned various shades of red as he screamed across the legislature at the health minister.")

One allegation of professional misconduct still remains in Alberta against Dr John O'Connor, the physician largely responsible for attracting attention to concerns about increased cancer rates near Fort Chipewyan, which is downstream from the oil-sands industrial development. Dr O'Connor maintains the charge -- "raising undue alarm" -- is bogus. "There is definitely no undue alarm -- there is no alarm at all," he explained in a telephone interview with Canadian Medicine. "The chiefs are saying, 'We have been crying out for decades.' They are calling it 'due concern' not 'undue alarm.' I am puzzled to say the least." [Canadian Medicine]

The latest edition of the Health Wonk Review, a collection of the top health policy blogging from across the internet, is online now. Included from this side of the border was Canadian Medicine's article on the controversial ratification of the new Ontario Medical Association contract. This edition's editor was Massachusetts health lawyer David Harlow.

A BC judge ordered physicians to hold on to medical information about anonymous sperm and egg donors for the time being, until further rulings clarify the legal issues involved. The case originated with a complaint that knowledge of a donor parent's genetics could be vital to a child's health.

The Ontario Health Coalition yesterday criticized the provincial government's recent moves that would eliminate several elected hospital boards. [news release]

A ballot initiative in Arizona in Tuesday's US election proposes to introduce an amendment to the state's constitution to outlaw universal healthcare.

Blood-supply crisis strikes Canada: Sudden 40% drop is unprecedented

Emergency blood reserves have shrunk 40% in the last two months, leaving stocks at the lowest point they’ve been since Canadian Blood Services (CBS) came into existence 10 years ago.

In response, CBS has already begun to ration shipments of blood to hospitals and may have to consider changing its policies on eligible blood donors.

The organization is issuing an urgent call for more donors.

Normally, CBS reserves are large enough to cover four to six days of demand for blood from hospitals. As of yesterday, only two days of blood was available for the most common blood types.

“It is a dramatic shift downwards,” said Canadian Blood Services communications director Ron Vezina.

Hospitals are still receiving enough blood to meet emergency needs, but some elective surgeries and routine procedures may be delayed by the reduced reserves, a CBS statement warned today.

The cause of the sudden shortfall is unknown at this point. “We are still trying to get to bottom of this,” said Mr Vezina.

“The number of donations coming in have not kept up with hospitals’ demand,” he said. “Because of the imbalance in deposits and withdrawals, we’ve had to dip into our reserve.”

However, the organization responsible for blood services in Quebec said there is no shortage of blood supplies there. In fact, Héma-Québec -- which is independent of Canadian Blood Services -- currently has a reserve of 7.5 days, slightly above its average target of seven days.

On Monday, CBS asked Héma-Québec to help shore up their blood reserves. Héma-Québec communications director Laurent Paul Ménard said the organization obliged. “We were able to help them out and we were glad to do so,” said Mr Ménard. He said he didn’t know why CBS was suffering from an unprecedented crisis while Héma-Québec’s stocks were at above-average levels.

Over the last three years, the demand for blood from CBS has risen by 3%, while the number of donations has fallen slightly, by 0.7%.

It is estimated that although one in two Canadians are eligible to donate blood, only one in 60 has done so this year. “We are still analyzing why we are not getting enough bookings,” Mr Vezina said. September and October have been known in the past as strong months for donations; Mr Vezina called this year an “abnormality.”

Mr Vezina said CBS could not rule out the possibility of considering changing its policies about eligible blood donors if the level of the emergency blood reserve remains as low as it is now for an extended period of time.

“If we are in a situation where there are not enough donors, do we have to look at other policies that may have a potential impact on safety, or vice versa?” he asked. “If we were into a full-blown crisis, we would have to look at all our policies,” he said. Those policies that could be reevaluated include the ban on donations by men who have had sex with men (MSM) since 1977, and restrictions based on travel. A CBS review of the MSM policy is already underway.

To try to encourage more donors to come forward, CBS has bought extra advertising time on radio stations over the last two months. The organization is sending 30,000 voicemail messages to Canadians who have donated before, and also plans to reevaluate its donation centres’ operating hours and capacities.

Mr Vezina urged Canadians to visit a Canadian Blood Services donor clinic or one of the organization’s 40 permanent locations across Canada.

Image: Canadian Blood Services

What's in the news: Oct. 29 -- Immigrant MD, overtime, and more

A round-up of Canadian health news, from coast to coast to coast and beyond, for Wednesday, October 29.

That rumoured Quebec provincial election? It now sounds like a certainty, most likely to be called next week and to take place December 8. The front page of today's edition of La Presse has the latest poll numbers: 38% for the incumbent Liberals, 32% for the Parti Québécois, 17% for the ADQ. [La Presse] "New polls give Charest good reason to smile," read one headline. One thing is all but certain: the ADQ will lose official opposition status.

Stanley Muwanguzi, a South African citizen who practises as a critical care physician in Calgary, had his Canadian immigration request denied because his daughter has cerebral palsy and could put "excessive demand on health or social services" agencies -- even though she will not be moving to Canada. Dr Muwanguzi, who has been working in Calgary since 2002 on a temporary work permit, is appealing the decision. He plans to move to the United States if he can't get permanent status in Canada.

Canada placed 10th out of 16 countries in a new health-outcomes ranking by the Conference Board of Canada. Canada's worst areas of performance were in diabetes, mortality due to musculoskeletal diseases, and infant mortality. The US and the UK both finished lower. Japan and Switzerland earned the highest marks. The same ranking methodology pegged Canada at 5th in the 1990s. [news release]

Beginning tomorrow, pharmacists in New Brunswick will be permitted to prescribe drugs for preexisting conditions and renew some scrips, excluding narcotics.

Quebec signed a major labour-mobility deal with France, which will give doctors, lawyers, engineers and other professionals the ability to work in either country. There's been some talk of a wider Canada-EU free-trade pact that would provide similar benefits, but that doesn't appear to be imminent.

Quebec nurses are doing lots of overtime work, in some cases because hospitals require them to do so in order to fill in staffing gaps. The profession is "going to crack," said Lina Bonamie, the head of the nurses' union. According to a Statistics Canada study, nurses who perform overtime work commit over 50% more dosage errors than nurses who do not. [La Presse]

Ontario's policy of offering free flu shots to all residents -- which makes it the only jurisdiction in the world to do so, apparently -- saves 300 lives, 1,000 hospitalizations, 30,000 emergency room visits, 200,000 visits to the doctor, and $26.5 million each year, according to a new study published in the journal PLoS Medicine. One expert from the British Columbia Centre for Disease Control disputed the study's claims, however, saying that it didn't prove that flu shots were responsible for the observed trend.

Doctors have clashed with hospital administrators over plans for the proposed French-language Montreal "superhospital" affiliated with the University of Montreal. The administration's plans were short about 100 to 150 beds, doctors complained. [La Presse]

A team of McMaster University researchers examined the effect of the media on people's perceptions of disease prevalence.

CanadianEMR has an audio feature online about medical office design. You can read more about medical office design in this article published in 2006.

Christopher Hitchens on "Sarah Palin's war on science" and her disdain of valuable fruit fly research.

Columbia Journalism Review writer Trudy Lieberman blasted CNN's Dr Sanjay Gupta for what she calls his "confusing and ultimately misleading" explanation of John McCain's health insurance reform plan. Dr Gupta, Ms Lieberman concluded, missed the basic point: Senator McCain's plan to move US health insurance towards individual policies rather than employer-based policies would not be sufficient to provide reasonable insurance coverage.

What's in the news: Oct. 27 -- Immigrants, Shock Doctrine, and more

A round-up of Canadian health news, from coast to coast to coast and beyond, for Monday, October 27.

A new infection scandal has arisen in Alberta, after two previous sterilization and infection-control problems, in Vegreville and Lloydminster the province's medical regulatory system over the past several years. The new incident is in High Prairie, in northern Alberta, where 1,300 patients who underwent endoscopies over the last four and a half years and 1,400 dental surgery patients are being given blood tests. Syringes were used in multiple IVs at the High Prairie Health Complex. Officials report the risk of infection is very low.

The government of New Brunswick is being sued over allegedly eliminating a francophone health authority by merging the province's eight health authorities into two.

The Supreme Court of Canada has agreed to hear a lawsuit brought by a man against his insurance company after it denied his claim for care he required after having unprotected sex and contracting genital herpes, which infected his spinal cord and caused paraplegia. The Port Coquitlam, BC, man has already won in the BC Supreme Court and the BC Court of Appeals based on his lawyer's argument that his injury was "accidental." The company disagrees, calling the unprotected sex "inordinate risk."

The Newfoundland nurses' union will hold a strike vote in January as their negotiations with the government continue to go nowhere.

Indo-Canadians in the Vancouver area are experiencing a spike in typhoid fever cases.

You may have heard of the "healthy immigrant effect" -- the phenomenon of immigrants to Western countries being healthier than the established residents. According to new research from Simon Fraser University, that is only true when immigrants first arrive; the longer they stay in Canada, the more unhealthy they become. In new research by kinesiologist Scott Lear, presented at the Canadian Cardiovascular Congress today, length of time in Canada was found to be a predictor of atherosclerosis, perhaps due to the stress of immigration and setting up a new life. [news release]

Canadian women are getting shortchanged by doctors when it comes to heart failure diagnoses. Many women with heart problems suffer from diastolic heart failure, the University of Toronto's Dr Peter Liu told the Canadian Cardiovascular Congress. That condition -- as opposed to systolic heart failure, which is more common in men -- is chronically underdiagnosed. "We can expect a seismic change over the next decade as women with heart failure begin to swell the patient population," he predicted. Another presentation at the conference gave a grim view of the medical profession's knowledge of and treatment for heart failure in women. "Their perception of women being at low risk for heart disease leads to inaction," Dr Susan K Bennett, the direct of the women's heart health program at George Washing University said in a release. "We need more emphasis on women's uncontrolled hypertension, high cholesterol levels, and lifestyle risks." She discussed a program introduced this year in Canada, called Heart Truth, which urges women to speak to their physicians about cardiovascular health. [news release]

Most sudden deaths among Quebecers under 40 are caused by heart failure resulting from atherosclerosis, a Montreal doctor reported at the Canadian Cardiovascular Congress. Dr Dabit Arzamendi's conclusion is particularly disturbing, given that atheroscleoris -- unlike heart defects, say -- is largely the product of lifestyle. He said that the problem appears to be much worse here than in Barcelona, where he worked before. [news release]

Canadian psychologists are suffering from the same kind of regulatory confusion about e-counseling as physicians are still battling with in telemedicine.

The friction created by sticking and unsticking pieces of Scotch tape from one another produces X-ray radiation strong enough to create viable images, according to bizarre new research published in Nature. It's due to something called triboluminescence, which is apparently the same thing that makes Tic-Tacs seem to spark when you bite down on them in the dark. It's really worth your while to watch the excellent video news report on the Nature website.

The credit crunch may imperil start-up drug companies' solvency, putting at risk the prospects for a great deal of new R&D. The subject is being debated today at the Genomics and Society conference. "Investing in biotech companies is now seen as risk taking, and will not be for the timid. What will happen to investment in biotech research if finance cannot even be found for relatively everyday expenses which are increasingly becoming more of a struggle?" said Professor David Wield.

Canadian Medical Association President Dr Robert Ouellet, discussing the "threats and opportunities" of the economic crisis at the organizations's policy conference, made an oblique reference to an increased potential to implement healthcare reform in Canada. A CMA News report said Dr Ouellet remarked that "times of economic insecurity also promote innovation in the delivery and financing of health care because they place renewed emphasis on goals such as improved productivity. He said productivity and financing will be among the issues he and a team of CMA researchers will be raising when they visit Europe this fall to study innovative health delivery methods that have been developed there." What would fellow Montrealer Naomi Klein say? .

Using an electronic nose, a team of Winnipeg researchers found that baby formula and breast milk have similar aromas.

COPD patients with depression have over a 50% higher risk of exacerbations and a 72% higher risk of hospitalization, a joint Canadian-Chinese study in the new issue of the American Journal of Respiratory and Critical Care Medicine showed.

Unmarried COPD patients are four times as likely to be admitted to hospital for an acute exacerbation than married patients, reported a new paper in the Canadian Respiratory Journal. The confidence interval, however, for that measure was very wide.

Dr Liana, the Albertan physician who writes the blog Med Valley High, is currently practising in East Timor. Her latest entry is about a pregnant 18-year-old with TB who was denied treatment by her grandfather and, despite the best efforts of the workers at Dr Liana's clinic, died. "It makes me think that sometimes, there's room for community-based, culturally sensitive discussions," she wrote. "And other times, maybe you just need a big white guy in an ambulance."