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North Metro Health inquiry avoids probing redundancy payouts

A further probe into the North Metropolitan Health Service contracts bribery scandal is holding off on investigating why three crooked executives were given six-figure redundancies in the lead-up to a damning Corruption and Crime Commission report.

In a recent letter to the Australian Medical Association, Premier Mark McGowan said the circumstances behind the approval of the redundancies were not being investigated as part of the inquiry’s terms of reference at this stage “for legal reasons”.

Senior executives John Fullerton and David Mulligan walked away from their positions with a total of $440,396 in 2016, while Shaun Ensor took a $163,506 redundancy payout in June.

Two months later the CCC report, which found the men had accepted bribes of travel, hospitality and cash, was released.

The payouts have raised eyebrows and were in the inquiry’s terms of reference because Health Department chiefs knew about the CCC investigation before signing off on the redundancies.

But a State Government spokeswoman said the payouts were being pursued by the State Solicitor’s Office in the hope of recovering the money and there was no need to duplicate the SSO’s work at the moment.

AMA president Omar Khorshid said he was surprised by the decision not to look into the payouts and was disappointed that the Government’s follow-up inquiry to the CCC expose was “too narrow”.

“If we really want a system that delivers better value for money, good patient outcomes and has staff that do the right thing, then you have to look at organisational culture and accountability,” Dr Khorshid said. “We need to get rid of the bad eggs. Some have been recognised, but it’s difficult to get rid of them and hold them to account.”

The CCC found evidence of systemic rorting by the executives who were wined and dined in return for lucrative NMHS contracts.

Mr Fullerton even had extensive renovations to his house paid for by the taxpayer using a bogus invoicing system involving the NMHS.

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Opinion: Healthiest diets include meat and dairy, say health professionals

We have read the opinion article titled “Health Canada’s new Food Guide is on the right track” (Calgary Herald, Nov. 27) with interest. We represent a growing number of Canadian physicians and health professionals, called the Canadian Clinicians for Therapeutic Nutrition, who use whole-food nutritional strategies, which often include meat, eggs and dairy, to prevent and often put into remission the burden of chronic non-communicable disease in our patients. This usually involves lower levels of carbohydrates and higher levels of natural fats than is currently recommended, a therapeutic nutritional strategy well supported in the literature.

We wholeheartedly agree with ensuring the food industry is not involved in creating new guidelines, but we do not believe the evidence supports a global, population-level switch to a plant-based diet. In fact, a comprehensive review of the scientific evidence for a plant-based diet published this year concluded that the current evidence is insufficient to conclude that a plant-based diet is generally healthy, and expressed concerns related to specific subgroups of the population. We believe that Canadians should be encouraged to maintain nutritious, whole food animal-based products such as meat and cardio-protective full-fat dairy in their diet if they choose, not because of any impact on the meat industry’s profits, but because animal products have always been a cornerstone of a healthy diet for humans. To our knowledge, there is no record of a population eating a “plant-based diet” in the history of human evolution; humans evolved eating meat and eggs and eventually, dairy.

A Food Guide directive encouraging a plant-based way of eating may have unintended, but not unforeseen, consequences. Nutrient requirements must continue to be met, and plant-based diets must be carefully constructed to include supplementation of the nutrients that are difficult and/or impossible to obtain when excluding meat products, such as B12, absorbable iron, zinc and long-chain omega 3 polyunsaturated fats. The potential negative effect of phytoestrogens on children is also a serious concern. The authors mentioned a reduced incidence of cancer. In fact, while some studies found that although the overall incidence of cancer was reduced, the incidence of some cancers is actually increased in an exclusively plant-based diet, as are some other diseases. More scientific study is needed before it would be safe to suggest a plant-based diet for the entire Canadian population.

Advocating for a reduction of sugar and processed food and a focus on whole foods are positions we strongly agree with, and we applaud Health Canada for making those suggestions. However, the proposed focus on a plant-based approach lacks sound scientific support. Several dietary patterns have been shown to improve people’s health, when compared to a western diet, including Mediterranean, Paleo, low fat/DASH, low carbohydrate/healthy fat, and whole foods plant-based/vegan. There are no scientific studies that show plant-based diets to be superior to these other dietary patterns, a fact not discussed by the authors of this opinion piece.

If Health Canada concentrated their message to Canadians to highlight the commonalities of these diets, which is the elimination of processed foods, Canadians would experience health benefits related to improved food quality with less sugar, refined flours and nutritionally deplete industrial foods, regardless of whether they choose to include animal products or not. Canadians deserve to be informed of all scientifically equal choices so they can tailor an individual dietary strategy based on dietary preferences, philosophical or religious beliefs, and metabolic health. Health Canada should help them choose and implement one of these equivalent dietary options, and should not overstate the evidence for one diet because it agrees with the personal views of a small number of Canadians, even if those Canadians predominate the guideline planning and discussion groups. Imposing the views of a small minority of Canadians on the whole population without sound scientific reason would be irresponsible, and potentially harmful.

Barbra Allen Bradshaw, MD FRCPC, anatomical pathologist, Abbotsford Regional Hospital and Cancer Care Centre, Abbotsford, B.C.; associate professor at UBC department of pathology and co-founder of Canadian Clinicians for Therapeutic Nutrition.

Carol Loffelmann, MD FRCPC­, Toronto anesthesiologist and co-founder of Canadian Clinicians for Therapeutic Nutrition.

Andrew Samis, BSc(Hon) MSc MD PhD FCCP FRCSC FACS, trauma team, RACE team and cardiac surgery intensivist KHSC, intensivist, general surgeon, physician stroke champion QHC; investigating coroner, Kingston area; assistant professor, department of surgery, Queen’s University, Kingston, Ont.

Eliana Witchell, MSc (Applied Human Nutrition), RD, founder/CEO of Eat ;Different RD, private practice RD, Toronto.

Jasmin Levallois-Gignac, MD FRCPC, nephrologist, Moncton, N.B.

Jay Wortman, BSc MD CCFP, family physician, assistant clinical professor, UBC, West Vancouver.

Èvelyne Bourdua-Roy, MD CCFP, family physician, Contrecoeur, QC, director, Clinique Reversa.

Miriam Berchuk, MD FRCPC, anesthesiologist, Rockyview General Hospital, Calgary.




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Top 10 workplace safety articles in 2018 — Safety+Health magazine, published by the National Safety Council

The National Safety Council eliminates preventable deaths at work, in homes and communities, and on the road through leadership, research, education and advocacy.

Learn more about the NSC mission.

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Your Good Health: Doctor leery of stem-cell treatment for multiple sclerosis

Dear Dr. Roach: My 45-year-old daughter was diagnosed with multiple sclerosis about a year ago following alarming bladder problems and numbness. She received steroids that effectively treated the bladder problem. She subsequently had a relapse with more widespread numbness and a feeling of being off balance. Within a short time, she started on Ocrevus. She continues to have symptoms.

She is considering going out of the country for stem cell treatment. Her neurologist does not support this step. He would like her to wait until the research data supports the treatment and/or new and better treatments become available. My daughter is considering the stem-cell treatment because she believes it gives her the best chance of impeding the progression of the disease. Where do you stand regarding stem-cell treatment for MS?


Stem cells are cells that have the ability to differentiate into many different types of cells, under the right conditions. Multiple sclerosis is thought to be an autoimmune disease directed at the myelin, the protective layer around nerve cells that make up much of the white matter of the brain. Cells that have been used for treatment of MS include the patient’s own stem cells (usually obtained from the patient’s blood after giving medication to release it from the bone marrow) or umbilical cord blood. There are some results of studies about these therapies.

One type of study collected stem cells from the patient, then used chemotherapy to largely but not completely destroy the person’s existing immune system, then replaced the immune cells in the bone marrow with the person’s own stem cells. (This is referred to as “rebooting” the immune system.) Participants in the study showed improvement in their rates of relapses, but also improvements in the activity of MS as seen by MRI scan. However, this should still be considered preliminary, and the regimen has significant toxicity (three per cent to eight per cent of people died from complications).

Umbilical cord blood also has been used without the chemotherapy that damages the person’s immune system. A study of 20 subjects was published in 2018 showing improvements in symptoms and an apparent slowing of disease seen by MRI.

Neither of these types of treatments have been subjected to the most rigorous type of trial, a controlled study. I suspect that’s why your daughter’s neurologist would like to wait and see whether ongoing trials can better define the risks and benefits of stem cell treatments.

On the other hand, there is clearly potential for benefit, and I understand why your daughter would wish to try an unproven therapy. Since you asked for my personal opinion, as a conservative physician by nature, I would recommend against going out of the country to use these treatments, and agree with her neurologist. However, I would understand if she disagreed.

I found at least eight studies currently enrolling subjects with multiple sclerosis for stem cells at If she were to consider enrolling in a trial, she could help advance the state of the science as well as potentially get a promising new treatment.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to


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I’ve tried logging my exercise and diet – but are health apps really a good idea?

There is no way to write this without sounding as if I am bragging: every morning, I wake up and do a 12-minute mini-workout, shower, then learn some Japanese over breakfast.

I know, I know. But I am also one of an increasing number of people who have turned to apps to make themselves fitter, healthier and more productive – or, at least, to accrue a few more good habits. Take Ed, a writer from London, who has lost 70kg (11st) using calorie-counting app Lose It!; Gareth, a developer, who credits the Drink Free Days app with helping him to get a handle on his drinking; and Sarah, from Newcastle, who says her period-tracking app has helped her to predict PMT.

Health and fitness-focused apps are wildly popular, and studies have shown that they can have a real impact. Research by Flurry mobile analytics found that usage of such apps grew by 330% between 2014 and 2017, and that more than 75% of active users accessed their app at least twice a week. More than 25% opened them at least 10 times, reflecting high engagement and, the analysis suggested, high retention rates. The NHS has even approved some apps to help with problems such as anxiety, self-harm and depression.

But for every success story, there seem to be as many failures. I have tried calorie counting and found that, after a couple of months, I stopped using the app. Even the Flurry research, which found people using health and fitness apps to be “the most loyal users in the app industry”, noted “fluctuating engagement levels”.

Some apps are so irritating that they have the opposite effect to that intended. Agnes, who used an app to remind her to drink water, says: “It pissed me off so much that I drank less water than before.” Worse still, they can be too effective. Madeleine says calorie-counting apps played a part in her developing an eating disorder: “Central to recovery, after losing dangerous amounts of weight, was deleting [them].”

The very habits that apps seek to cultivate – rigorous self-assessment, competition and a single focus on bringing down one number – have the potential to become self-destructive. Many aim to build a habit; in a minor way, rewiring your brain. But what makes some apps useful and others useless? And how much of that has to do with the app itself, and how much is to do with how it is used?

My morning workout is courtesy of Streaks Workout, which shows me how many days each month I have managed to fit in some training. It is a spinoff of Streaks, another app by the same developer, Crunchy Walnut, which aims to help users build good habits or ditch bad ones.

Quentin Zervaas, the company’s founder, says the secret is breaking the long-term rewards of successfully keeping up a habit into more immediate reinforcement: “If you’re trying to do anything, such as losing weight, it takes so long before you see results. You don’t get a reward straight away, but you don’t get punished either. With an app such as Streaks, you get the feedback instantly – it’s about being conscious, being aware of doing something.”

He continues: “Someone at Apple told me that something you need to look for is the moments of delight – if you can give the user moments of delight, that’s what keeps them involved.”

Tap an icon and feel a sense of achievement and maybe you will be more likely to do it the following day; keep doing it and, eventually, you will not need the app at all. That is the goal of all these apps – so why do some fail? A big problem, it turns out, is that many of the habits they are attempting to build are not the habits users think they are building.

Getting into the habit of working out every morning is, by and large, a good thing; getting into the habit of logging it isn’t, necessarily. Declan’s experience of MyFitnessPal chimes with mine. He says: “After a while, it stopped giving me anything of real use and began to feel like something tacked on at the end of the day. My goals were just kind of there – I could either complete them or not.”

If there is one distinguishing feature of people who have had success with these apps, it is that they consciously and deliberately link real-world improvement with the habits the app is building. When I used MyFitnessPal, I very quickly built the habit of logging my food into the app – but I didn’t change my diet.

Contrast that with the experience of Ed, who said that LoseIt!’s non-intrusive reminders helped him to lose that 70kg. “If people are actually honest and accurate, logging will make them lose weight. Logging automatically makes you eat less, as you’re far more aware.”

It is possible that MyFitnessPal – which invites you to dig into nutrition reports, pay for a premium version and share your diet with friends – may be asking too much. After finding other apps too clunky and not compelling to use, Ed was attracted to the simplicity of LoseIt!: “All you can do is log food and weight.”

Streaks, too, is minimalist by design, charging a one-off fee to download. Other apps try to find ways to monetise that serve the overall goal, rather than complicating it. Healthy-eating app Lifesum, for instance, charges users for premium plans that come with specialised diets. Mattias Storm, the company’s head of growth, argues that it provides simplicity for those who need it, with extra support for those who want it. “Habit-forming in general is not trivial,” he says. “It takes 20 days of doing something to get into the swing, and 60 to get into the habit.

“To do it for that long requires a fairly heavy level of motivation. Our users have a very high motivation to live a healthier life … But we’re seeing with some people that they might not want to be tracking what they eat, and so one of the big areas for us right now is around meal plans. You have to understand three concepts to lose weight: how to switch bad foods to healthier meals, portion control and planning ahead. Meal plans are going to help a lot of that.”

In one area of health apps, however, logging a little information can offer useful insights. Ida Tin, the founder of Clue, one of the most popular period trackers on the market, says most apps used to be “calendars that could count to 28 – which is really not that helpful”.

Clue’s processing of inputted data offers an accurate prediction of when your period will begin, which is valuable in a way that passively recording weight fluctuations or cravings may not be. “It’s why we started: we wanted to help women understand their bodies,” says Tin.

Period trackers have another advantage: there is no obvious time to stop using them. Where calorie-counting apps can see users hit their target weight and stop using the app, or gain weight, start using it again, and yoyo painfully for years, with a period tracker, “cycles change. You’re a teenager, you might go through a pregnancy, you might have a period of endometriosis, your body is constantly changing. So you never quite figure it out.

“I think it’s meaningful to have something more like a companion. But one that must, of course, change with you.” Clue even allows users to export a PDF of their data, formatted to be easily understood by a doctor.

That approach has spread from tech to the medical sector. OWise, for instance, allows users undergoing treatment for breast cancer to share information about nausea, sleep quality and fatigue with their doctors. The app “shows benefits for patients and their medical teams”, according to an article in the journal JMIR Cancer.

Healum offers similar tracking for people with type 2 diabetes; My Possible Self is promoted by the NHS as helping to ease stress and anxiety; and Activ8rLives sells smart products, from blood pressure monitors to smart inhalers, that blur the lines between consumer tech and medical devices.

It is a long way from the self-improvement goals of most health apps. But, hopefully, ideas and evidence can flow in both directions: app developers sharing what they know about how to build habits, and medical experts assessing whether those habits really are healthy.

Until then, the best advice is to be driven by your goals, rather than an app; to focus on active change, not passive tracking; and to keep up what works for you. As Ed says: “The main thing that keeps me logging is I don’t want to lose my 310-day streak. Once you’re in the groove, you want to keep going.”

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Is a glass of red wine a day good for you? Health myth DEBUNKED

Drinking alcohol consistently can have huge effects on a person’s body and health. 

The body is more than equipped to cope with the odd binge, but anything more than this, especially for prolonged periods, can have serious effects, according to Dr Andrew Thornber, chief medical officer at Now Patient.

He said: “Drinking long-term can increase the risk of cancer of the liver, mouth, throat, voice box, oesophagus, colon, and rectum.

“Even a few drinks a week is linked with an increased risk of breast cancer in women.”

Dr Thornber lists six health problems prolonged drinking is linked to:


Dr Thornber said: “Heavy drinking can cause high blood pressure, irregular heartbeat, and in very severe cases, sudden death from heart failure.

Weight gain

Alcohol is calorific and high in sugar, and if you drink every day for a month the impact on your waist line will be visible, warned Dr Thornber.

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Healthy Living: CDC closer to answers on mysterious illness, AFM

We expect to learn more soon about a rare and mysterious illness affecting kids across the country.

We’re learning more about Acute Flaccid Myelitis , or AFM.  It’s a serious, and rare condition that resembles polio.  This year the Centers for Disease Control says there have been nine confirmed cases in Washington state.  Although we still don’t know what’s causing AFM, a team of experts are getting closer to some answers.

AFM affects the spinal cord and causes limb weakness and even paralysis.  What we know, according to the latest update from the CDC is most patients who have AFM had a mild respiratory illness or fever consistent with a viral infection before contracting the condition.  What doctors don’t know is why some people get AFM from a virus and others don’t.

AFM has been reported in 46 states.  With nine confirmed cases, Washington state is on the higher end.  Only Colorado, Texas and Ohio have more cases.  The CDC says more than ninety-percent of the AFM cases are in children.

Right now, the CDC is gathering a task force, working to find possible risk factors and causes for AFM.  Important answers may come down to finding a pathogen or germ in the fluid that surrounds the spinal cord.

While we wait for results, their message to the public and health care providers is to familiarize yourself with the symptoms of AFM and report it to state health departments.

AFM cases have been showing up nationwide since 2014.  Although people are hearing more about the mysterious illness this year, 2016 actually had more cases than what we’re seeing currently.

If you’d like to read more about AFM and follow the latest update from the CDC, click here

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8 Surprising Health Benefits of Music

Upbeat songs get our toes tapping. Sad songs can reduce us to tears. But music has many more powerful effects on the body you might not even realize. Here are eight surprising health benefits of music.

1. Keeps your brain young

Just like reps in the gym exercise your body, music trains the brain, according to Johns Hopkins Medicine. “If you want to keep your brain engaged throughout the aging process, listening to or playing music is a great tool,” a Johns Hopkins otolaryngologist says. “It provides a total brain workout.”

For optimal benefits, keep expanding your music library as you age, instead of constantly listening to your old favorites. Unlike familiar songs, new music forces the brain to work to understand it. And this helps you maintain an active, creative mind.

2. Helps you recall memories

Have you ever heard an old song and flashed back to a specific moment in your youth? Recalling memories is much easier for your brain if there’s a song attached to them. “Reach for familiar music, especially if it stems from the same time period that you are trying to recall,” Johns Hopkins says. “Listening to the Beatles might bring you back to the first moment you laid eyes on your spouse, for instance.”

This recall boost can be especially helpful for people with dementia. “Because the ability to engage with music remains intact late into the disease process, music therapy can help to evoke memories, reduce agitation, assist communication, and improve physical coordination,” according to Harvard Medical School.

3. Reduces chronic pain and depression

woman relaxing and listening to music with headphonesCredit: shironosov/Getty Images

Listening to music has the ability to reduce chronic pain and depression, according to a study published in the Journal of Advanced Nursing. Researchers divided 60 people into three groups: one that listened to their favorite music, one that listened to songs the study provided and a control group. The participants had various conditions, including arthritis and disc problems, that caused them chronic pain.

At the end of the trial, the music groups reported their pain had fallen by up to 21 percent, compared to an increase in pain of 1 to 2 percent for the control group. And the music groups reported up to 25 percent less depression than the control group. Thus, the researchers concluded listening to music can help people cope with chronic pain.

4. Lessens stress

Many people turn to their favorite tunes to relieve stress. And science has found that’s a pretty good idea. One study gave 60 healthy women a psychosocial stress test after they either listened to music, listened to the sound of rippling water or rested in silence. The researchers found the participants who listened to music experienced a faster physical recovery from the stress compared to the other groups.

Furthermore, similar research has found people undergoing medical procedures experience less anxiety and discomfort when they listen to music, according to Harvard Medical School. Consequently, they have less of a need for sedatives and painkillers.

5. Restores speech

Music therapy is an important tool for people who experience damage — such as a stroke or an injury — to the left-brain region responsible for speech. “Because singing ability originates in the right side of the brain, people can work around the injury to the left side of their brain by first singing their thoughts and then gradually dropping the melody,” according to Harvard Medical School.

Both the melody and rhythm of music seem to help promote speech, research has found. In fact, Congresswoman Gabby Giffords used this technique to relearn how to speak after she was shot in the head.

6. Aids patients undergoing cancer therapies

Just like music can help patients manage pain and stress of medical procedures, it also can help those undergoing cancer treatments. “Listening to music reduces anxiety associated with chemotherapy and radiotherapy,” according to Harvard Medical School. “It can also quell nausea and vomiting for patients receiving chemotherapy.”

A review of studies on cancer patients also found music is effective at lessening pain, as well as fatigue. Plus, it can reduce recovery and hospitalization time and improve patients’ quality of life.

7. Enhances exercise and physical therapy

A woman runs on a treadmill listening to music on her headphones.Credit: vgajic/Getty Images

Have you ever skipped a workout because you forgot your headphones and couldn’t listen to your music? You’re not alone. Many people swear by music while they exercise — and for good reason. “Most people have an instinct to synchronize their movements and expressions with music,” according to Scientific American. And this rhythmic movement can help the body to use energy more efficiently. In fact, one study on cyclists found those who kept pace with music used less oxygen than cyclists who did not.

Plus, because of its effects on the body, music can help those undergoing physical therapy. “Music therapy enhances people’s physical, psychological, cognitive, and emotional functioning during physical rehabilitation programs,” according to Harvard Medical School.

8. Improves heart health

A good song can warm your heart in more ways than you might realize. Music can actually change your brain chemistry, resulting in cardiovascular benefits, according to Harvard Medical School. Studies have found listening to music can relax arteries to improve blood vessel function. Plus, after physical exertion, music can more rapidly return your heart rate and blood pressure back to baseline levels.

And don’t fret if you have a very specific taste in music. “Research suggests that patient-selected music shows more beneficial effects than music chosen by someone else,” Harvard Medical School says. So listen to whatever you’re in the mood for, and let your heart sing its praises.

Main image credit: bluebird13/Getty Images

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Health calendar: Updated Dec. 8, 2018 | Health Living

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Human brain responds to aggressive voices more quickly: Study

Human brain responds to aggressive voices more quickly: Study

London: Human brains notice a voice much faster when it is considered threatening or aggressive than when it is perceived as normal or happy in an auditory environment, according to a new study. The study demonstrated that in a few hundred milliseconds, our brain becomes sensitive to the presence of angry voices. 

Sight and hearing are the two senses that allow human beings to detect threatening situations. “We are interested in how fast our attention responds to the different intonations of the voices around us and how our brain deals with potentially threatening situations,” said Nicolas Burra, researcher from the University of Geneva in Switzerland. 

The researchers presented 22 short human voice sounds (600 milliseconds) that were neutral utterances or expressed either anger or joy to a small group of people while an electroencephalogram (EEG) – diagnostic test - measured electrical activity in the brain down to the millisecond. 

The findings, published in the journal Social Cognitive and Affective Neuroscience, revealed that when the brain perceives an emotional target sound, N2ac activity is triggered after 200 milliseconds.  However, when it perceives anger, the N2ac intensifies and lasts longer, which is not the case for joy.

N2ac is a component related to the focusing of attention within an auditory scene. Also, LPCpc activity - a cerebral marker of auditory attention – is also stronger for angry than for happy voices, findings revealed. 

This rapid detection of the source of a potential threat in a complex environment is essential as it is “critical in crisis situations and a great advantage for our survival”, noted Leonardo Ceravolo, researcher from the varsity.

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