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Canada should delay MAID for people with mental disorders: psychiatrists

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Canada is not ready to expand medical assistance in dying for people with a mental disorder, leaving psychiatrists across the country “incredibly concerned” about patients needing better access to care, including for addiction services, says a group representing the specialists across the country.

The Association of Chairs of Psychiatry in Canada, which includes heads of psychiatry departments at all 17 medical schools, issued a statement Thursday calling for a delay to the change set to be implemented in mid-March.

Lack of public education on suicide prevention as well as an agreed-upon definition of irremediability, or at what point someone will not be able to recover, are also important, unresolved issues, the statement says.

“As a collective organization, we recognize that a lot of work is being done in Canada on this issue,” Dr. Valerie Taylor, who heads the group, said in the statement.

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“Further time is required to increase awareness of this change and establish guidelines and standards to which clinicians, patients and the public can turn to for more education and information,” said Taylor, who is also chair of the psychiatry department at the University of Calgary.

A statement from the office of federal Health Minister Jean-Yves Duclos says Canada is committed to implementing MAID for those with a mental disorder by keeping their safety and security at the forefront.

“We will continue to listen to the experts, including those at the front lines and those with lived experience, and collaborate with our provincial and territorial counterparts to ensure that a strong framework is in place to guide MAID assessors and providers before MAID becomes available to those for whom mental disorders is the sole underlying condition.”

The office did not say whether the implementation expected on March 17 would be delayed.

Dr. Jitender Sareen, head of the psychiatry department at the University of Manitoba, said many controversial issues were discussed at the group’s annual meeting in October regarding which patients with a mental disorder could be eligible for MAID, seven years after the practice was legalized in Canada for those with a physical ailment.

“If a person wants MAID solely for mental health conditions, we don’t have the clear standards around definitions of who’s eligible. How many assessments and what kinds of assessment would they actually need?” he said.

Sareen also called for training for health providers doing the assessments to begin sooner than its expected rollout next fall. Psychiatrists want clarity on what could be a request for suicide compared with MAID, leaving them to determine a path toward treatment or providing euthanasia, he added.

“There is still controversy around that between providers. Some people believe suicide is impulsive and self-destructive. But that’s not necessarily the case. People can have thoughts about suicide without a mental health condition, an active condition like depression or schizophrenia.”

Patients in rural communities may lack access to mental health care, and those struggling with addiction who have little to no access to harm-reduction services like supervised injection sites could also be left suffering until they try to seek MAID as a way out, said Sareen, who specializes in addiction services.

“We’re in the middle of an opioid epidemic. And we’re in the middle of a mental health pandemic. Post-COVID, wait times for access to treatment are the highest ever,” he said.

“As a group of department heads in the country who are responsible for medical education both for psychiatrists and residents, we’re saying, ‘Look, let’s put things aside as far as whether we agree with this law change or not.’ We’re just concerned we’re not ready for March.”

The federal parliamentary committee reviewing the law to expand MAID to those with a mental disorder issued an interim report in June and expected to publish a final report in October. However, it has been delayed until February.

The final report of an expert panel was released in May with 19 recommendations, including training for doctors and nurse practitioners assessing MAID requests to address topics like the impact of race, socioeconomic status and cultural sensitivity.

The report also said the expansion of MAID raises additional challenges involving those who are elderly, have neurodevelopmental or intellectual disabilities and people who are in prison, where the prevalence of mental disorders is high compared with the general population.

The panel relied on evidence from Belgium and the Netherlands, which it said have the most extensive set of safeguards, protocols and guidance overall.

Dr. Derryck Smith, a psychiatrist in Vancouver and a past board member of Dying With Dignity, said that while there is no doubt that MAID is a divisive topic among his peers across Canada, he believes there’s a need to wait for the special parliamentary committee’s final report “before we try to slow the process down.”

Smith said lack of access to care for mental health is no different than that for physical ailments so any delay in implementing the new law is a basis for discrimination.

“The health-care system is crumbling around us but that’s a different matter altogether,” he said. “What concerns me as well is what is so special about psychiatric illness? Why are we putting stigma around psychiatric illness?”

The Canadian Mental Health Association said it is focused on ensuring Canadians have access to universal mental health care with supports that are fully integrated into the public system and available for free.

“This includes recognizing the social determinants that are prerequisites for good mental health by providing housing and income and food supports that help keep people well, safe and out of poverty, and which create conditions that may mitigate requests for MAID,” it said in a statement.

This report by The Canadian Press was first published Dec. 1, 2022.

This story was produced with financial assistance from the Canadian Medical Association.

 

Camille Bains, The Canadian Press

Health

Many good health reasons to eat an apple every day – Delta Optimist

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Apples are one of the oldest cultivated fruit, dating back at least 6,500 years, and have some of the greatest health benefits.  There is truth behind the old adage “An apple a day keeps the doctor away.”

They are high in soluble fibre, low calorie, low on the glycemic index, and contain beneficial vitamins like Vitamin C, quercetin, pectin and potassium. They are a good antioxidant (especially the peel) and are the number one fruit to help prevent diabetes, cancer and heart disease. They help lower cholesterol as the soluble fibre in apples binds with saturated fat (preventing it from entering the bloodstream). 

To aid weight loss, it is beneficial to eat an apple prior to a meal, as they curb your appetite. Apples encourage more saliva production, which protects your teeth. Some studies show mental health benefits of increased intellectual capabilities and a slowing down of mental aging and Parkinson’s (due to their antioxidant properties). The fibre and quercetin (a plant polyphenol) builds immunity to combat virus and bacteria, especially when one is stressed. The antioxidant properties help regulate ocular muscles and nerves, helping to preserve one’s eyesight.

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Apples also speed up liver regeneration. The pectin in apples binds with heavy metals in the gut (aluminum and lead) and helps eliminate them. Heavy metal poisoning is one of the leading causes of Alzheimer’s disease.  Apples are also proven to reduce anxiety when eaten regularly. The soluble fibre pectin aids IBS symptoms and ulcerative colitis.

Apple cider vinegar (fermented apple juice) has become a health rage and has its own set of health benefits including aiding digestion and weight loss, lowering inflammation and boosting energy.

Consuming it before a meal is said to help reduce blood sugar spikes afterward. It also helps with the absorption of the following nutrients: protein, calcium, iron, carbohydrates, fats, Vitamins A,B,C and E and magnesium.  Apple cider vinegar is an antifungal, antibacterial and antiviral helps with absorption of calcium and other minerals. Even though it is acidic, once absorbed in the gut it is slightly alkaline.  As it is acidic before digestion, it shouldn’t sit on the teeth as it may soften enamel. It is best to drink apple cider vinegar through a straw or rinse your mouth out afterwards with water.

These are some (proven and unproven) folk remedies using apple cider vinegar. Here are several but not all: removes age spots, as a soak for arthritic hands and feet or for athlete’s foot, soften foot corns, prevents asthma, heals bruises, fights cancer, helps prevent cataracts, eliminates cold sores, soothes a sore throat, eliminates cramping, treats dandruff, lowers blood sugars, kills diarrhea causing bacteria, soothes eczema and itching due to rashes, bites or stings, eliminates fatigue, increases stomach acid for those with gallbladder issues (associated with low stomach acid), aids hay fever, reduces headaches, dissolves the glue that holds nits (head lice eggs) onto the hair, treats hiccups, lowers blood pressure, aids osteoporosis by aiding calcium absorption, stops nose bleeds, aids absorption of all vitamins and minerals, treats smelly feet and warts.   

As with any alternative remedy, it is important to talk to your naturopath and doctor beforehand to make sure there are no contra-indications with existing medicines, but there doesn’t seem to be any doubt that apples and apple cider vinegar contribute to healthy living.  There are also many beauty aids but space prevents me from covering them in this article.

I personally use apple cider vinegar in a wonderful salad dressing with our Lemon-Honey Elixir, crushed garlic, avocado oil and a pinch of dried mustard. 

Claire Nielsen is a health coach, author, public speaker and founder of www.elixirforlife.ca. The information provided in the above article is for educational purposes only and is not a substitute for professional health and medical advice. Please consult a doctor or healthcare provider if you’re seeking medical advice, diagnoses and/or treatment.

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Hospitalizations fall at North Vancouver’s Lions Gate – North Shore News

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COVID-19 infections haven’t gone away on the North Shore.

But serious illnesses from respiratory diseases of all types are on the decline.

That’s the latest information this week that can be teased from statistics from both B.C.’s Centre for Disease Control and the Ministry of Health.

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One of the biggest indicators of serious illness – hospitalizations – are thankfully on the decline.

Number of people in Lions Gate Hospital drops over 7%

Between Jan. 6, when Health Minister Adrian Dix first raised the alarm about high numbers of hospitalizations, the number of people in hospital at Lions Gate on the North Shore has fallen 7.2 per cent, according to the Ministry of Health. The number of people in hospital at Lions Gate went from 319 on Jan. 6 to 296 on Jan. 26.

A similar trend was seen at most major hospitals in B.C.

In Vancouver Coastal Health, hospitalizations fell 10.6 per cent in Richmond, 6.5 per cent at St. Paul’s and 4.2 per cent at Vancouver General. The only hospital where that didn’t happen was B.C. Children’s, where numbers remained stable.

As of Jan. 26, there were 42 people hospitalized who had tested positive for COVID-19 in VCH, two of those in critical care. There were also three new deaths in VCH among people who recently tested positive for COVID-19.

According to the B.C. Centre for Disease Control, flu – which peaked early in November – has now fallen to low levels. RSV infections – which have hit children hardest – remain high but have continued to decline. COVID cases have remained relatively stable.

North Shore sewage plant data shows small COVID uptick

According to recent data from wastewater sampling, levels of COVID-19 measured on the North Shore rose slightly from early January, although levels of virus being shed in sewage water were still not as high as they were over the Christmas period. Levels of the virus in most other Lower Mainland plants had declined as of Jan. 16.

Numbers of people vaccinated haven’t changed much on the North Shore. Between 92 and 95 per cent of adults 18 and over received at least two doses of the vaccine. But those numbers fell with each subsequent booster shot. Only 47 per cent of adults on the North Shore have received two boosters. There is also a relatively small uptake for children. Between 52 and 64 per cent of children age five to 11 have received two doses of vaccine, while under 20 per cent of the youngest children have received two doses.

Monday marks the third anniversary of the World Health Organization declaring COVID-19 as a global public health emergency.

On Friday, a committee of WHO voted on whether to maintain that designation. A final decision will be announced on Monday, but it isn’t expected to change anything in practical terms in Canada.

jseyd@nsnews.com

twitter.com/JaneSeyd

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COVID-19 outbreak declared at Seaforth Community Hospital – My Stratford Now

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A COVID-19 outbreak has been declared at the Seaforth Community Hospital.

Huron Perth Healthcare Alliance officials say it’s in the hospital’s Inpatient Unit which is now closed to admissions until further notice.

Outbreak status refers to two or more confirmed positive COVID-19 cases among patients or team members that could have possibly been acquired in the hospital.

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HPHA is working with Huron Perth Public Health and patents, family/caregivers and team members impacted by the outbreak are being notified with necessary contact tracing
taking place.

Family and caregiver pesence on the unit has been restricted with the only exception is for palliative patients at end of life.

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