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COVID data void in Canada could hamper understanding of lingering impact: experts

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VANCOUVER — A lack of data tracking Canadians who have had COVID-19 could hinder efforts to understand potential post-infection conditions, such as diabetes and brain fog, experts have warned.

They say the impact of the pandemic on Canadian health systems and society could linger for years but preparing for this is challenged by the data void.

Dr. Kashif Pirzada, an emergency physician at Toronto’s Humber River Hospital, said reliance on at-home rapid testing for COVID-19 is a major hurdle in data collection.

“They’re not centrally tracked and there are very few resources available to these patients,” he said, even though COVID-19 seemed to cause diabetes, brain fog or other conditions “very frequently.”

“If five or 10 per cent of our population becomes disabled, which is some of the rates we’re looking at, that’s going to be a huge issue for our workforce, for overall health,” said Pirzada, who is also an assistant clinical professor at McMaster University.

Dr. Akshay Jain, an endocrinologist in Surrey, B.C., said Canada “might be seeing an avalanche of diabetes cases coming out of the COVID pandemic.”

But Jain said that as far as he knows, Health Canada is not collecting data on the after-effects of COVID-19.

People with mild symptoms often failed to follow up with their doctors, worsening the data situation, said Jain, who also highlighted the reliance on home testing as problematic.

“I just feel that the health-care system as well as the public needs to know about both the immediate short-term as well as the long-term effects of COVID,” Jain said.

“You know, the repercussions of the pandemic will stay with us for many more years. So, I think we need to be cognizant of this and watch out for conditions like diabetes and complications that arise as a result.”

Asked whether and how it was tracking post-COVID-19 conditions and people who had had the illness, Health Canada provided a series of links to information about vaccination, and a daily update of new cases.

“Health systems are the responsibility of each province and territory,” it said.

Jain said studies in the United States and Germany show the risk of developing diabetes is about 46 per cent higher for those who have had COVID-19 compared with those who haven’t been infected.

It’s not clear why people with COVID-19 are developing diabetes, said Jain.

One theory is that COVID-19 causes a “tsunami of inflammation,” which increases insulin resistance, he said, while another is that steroids used to treat severe COVID-19 might lead to diabetes.

About nine per cent of Canadian adults have been diagnosed with diabetes, Jain said. But pre-diabetes and undiagnosed diabetes push the figure to nearly 30 per cent, he said.

“This is already a very high number and then throwing COVID in the mix, these numbers are probably going to go up even higher.”

In October 2020, Madhu Rao of Toronto tested positive for COVID-19. Eighteen months later he said he still “felt breathless every now and then.”

Rao said he worried it was something to do with his heart, because he read COVID-19 was causing cardiac problems.

A checkup revealed instead that he was a “borderline diabetic” with high blood glucose levels, said Rao.

He said he had no issues with his blood sugar before getting COVID-19 and described himself as otherwise healthy and active with weight in the normal range.

His doctor told him that she was seeing a lot of patients with high blood sugar levels and some developing diabetes after COVID-19, and put him on a strict diet, he said.

“She told me all I can do is to keep postponing its onset.”

A November 2020 study in the journal Diabetes, Obesity and Metabolism said 14.4 per cent of COVID-19 patients had been diagnosed with diabetes.

“Recent reports have shown that newly diagnosed diabetes may confer a greater risk for poor prognosis of COVID-19 than no diabetes or pre-existing diabetes,” it said.

“Therefore, COVID-19 patients with newly diagnosed diabetes should be managed early and appropriately and closely monitored for the emergence of full-blown diabetes and other cardiometabolic disorders in the long term.”

Jain said he agreed, and “everyone with mild COVID” should talk to a doctor about whether they should be screened for diabetes.

Another condition commonly associated with COVID-19 is the sense of confusion known as brain fog. An analysis of several studies on the issue in the Journal of the Neurological Sciences in March said up to 32 per cent of patients reported brain fog about three months after getting COVID-19.

Prof. Teresa Liu-Ambrose, the Canada Research Chair at the University of British Columbia’s Djavad Mowafaghian Centre for Brain Health, said there isn’t enough data to know how many Canadians have been affected by the condition, how permanent it is, and what the symptoms and consequences are.

Liu-Ambrose said the Canadian Longitudinal Study on Aging, a long-term countrywide research project, is imaging subjects’ brains and assessing their cognition over the next three years to identify differences between people who had COVID-19 and those who had not.

However, she said memory fog was largely a subjective complaint, so quantifying it could be challenging.

Dr. Jurgen Maslany of Saskatchewan tested positive for COVID-19 in March, then went back to work about two weeks after he thought he had fully recovered.

But after attending a patient he couldn’t remember the details of what they had discussed, and he realized “something was off”.

“And so, I immediately took myself off work because it wasn’t safe,” Maslany said.

There was also a sense of anxiety, although he wasn’t sure if this was a symptom of brain fog or worrying about it.

“It felt like something was just sort of chemically off in my head,” he said.

It took about three weeks for the symptoms to plateau, and now he feels back to normal, he said.

But Liu-Ambrose said no one knows what will happen if brain fog is left untreated.

“Any long-term impact of COVID-19 on the brain and our cognition can be significant,” Liu-Ambrose said.

“These changes could potentially be related or predictive of future decline or dementia risk. We don’t know — but there certainly is that possibility if these subjective complaints are reflective of actual changes in the brain.

“It’s an emerging area that needs to be addressed and needs to be studied to a greater extent.”

Even a modest risk of post-COVID conditions could add up to a substantial burden on health care, given a high number of COVID cases.

Jain, the diabetes expert, said American data showed an additional 18 cases of diabetes per 1,000 people if they had COVID-19.

That could translate into “thousands more Canadians at the risk of developing Type 2 diabetes,” he said, requiring closer monitoring for diabetic complications including heart attack, stroke, kidney damage and vision loss.

“If we look at the entire picture together, we’re looking at a huge burden on the Canadian health care system that we haven’t yet acknowledged but it’s just waiting to happen.”

As for former COVID-19 sufferer, Rao said, it’s probably a good idea to pay attention to every single symptom after getting the illness.

“Had I just ignored it as getting tired physically or something, I wouldn’t have found out that my blood sugar levels are rising.”

Maslany, speaking both as a doctor and a person who experienced the lingering after-effects of COVID-19, said it was “critically important to keep on top” of complications of this disease.

“I am not confident that we’re going to be able to find certain therapeutic options, especially in the short term, but I think it’s important to collect the data,” he said.

“First of all, you can’t analyze and fix a problem unless you have all the proper data.”

This report by The Canadian Press was first published June 4, 2022.

 

Hina Alam, The Canadian Press

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What’s the greatest holiday gift: lips, hair, skin? Give the gift of great skin this holiday season

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Give the gift of great skin this holiday season

Skinstitut Holiday Gift Kits take the stress out of gifting

Toronto, October 31, 2024 – Beauty gifts are at the top of holiday wish lists this year, and Laser Clinics Canada, a leader in advanced beauty treatments and skincare, is taking the pressure out of seasonal shopping. Today, Laser Clincs Canada announces the arrival of its 2024 Holiday Gift Kits, courtesy of Skinstitut, the exclusive skincare line of Laser Clinics Group.

In time for the busy shopping season, the limited-edition Holiday Gifts Kits are available in Laser Clinics locations in the GTA and Ottawa. Clinics are conveniently located in popular shopping centers, including Hillcrest Mall, Square One, CF Sherway Gardens, Scarborough Town Centre, Rideau Centre, Union Station and CF Markville. These limited-edition Kits are available on a first come, first served basis.

“These kits combine our best-selling products, bundled to address the most relevant skin concerns we’re seeing among our clients,” says Christina Ho, Senior Brand & LAM Manager at Laser Clinics Canada. “With several price points available, the kits offer excellent value and suit a variety of gift-giving needs, from those new to cosmeceuticals to those looking to level up their skincare routine. What’s more, these kits are priced with a savings of up to 33 per cent so gift givers can save during the holiday season.

There are two kits to select from, each designed to address key skin concerns and each with a unique theme — Brightening Basics and Hydration Heroes.

Brightening Basics is a mix of everyday essentials for glowing skin for all skin types. The bundle comes in a sleek pink, reusable case and includes three full-sized products: 200ml gentle cleanser, 50ml Moisture Defence (normal skin) and 30ml1% Hyaluronic Complex Serum. The Brightening Basics kit is available at $129, a saving of 33 per cent.

Hydration Heroes is a mix of hydration essentials and active heroes that cater to a wide variety of clients. A perfect stocking stuffer, this bundle includes four deluxe products: Moisture 15 15 ml Defence for normal skin, 10 ml 1% Hyaluronic Complex Serum, 10 ml Retinol Serum and 50 ml Expert Squalane Cleansing Oil. The kit retails at $59.

In addition to the 2024 Holiday Gifts Kits, gift givers can easily add a Laser Clinic Canada gift card to the mix. Offering flexibility, recipients can choose from a wide range of treatments offered by Laser Clinics Canada, or they can expand their collection of exclusive Skinstitut products.

 

Brightening Basics 2024 Holiday Gift Kit by Skinstitut, available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.

Hydration Heroes 2024 Holiday Gift Kit by Skinstitut – available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.

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Here is how to prepare your online accounts for when you die

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LONDON (AP) — Most people have accumulated a pile of data — selfies, emails, videos and more — on their social media and digital accounts over their lifetimes. What happens to it when we die?

It’s wise to draft a will spelling out who inherits your physical assets after you’re gone, but don’t forget to take care of your digital estate too. Friends and family might treasure files and posts you’ve left behind, but they could get lost in digital purgatory after you pass away unless you take some simple steps.

Here’s how you can prepare your digital life for your survivors:

Apple

The iPhone maker lets you nominate a “ legacy contact ” who can access your Apple account’s data after you die. The company says it’s a secure way to give trusted people access to photos, files and messages. To set it up you’ll need an Apple device with a fairly recent operating system — iPhones and iPads need iOS or iPadOS 15.2 and MacBooks needs macOS Monterey 12.1.

For iPhones, go to settings, tap Sign-in & Security and then Legacy Contact. You can name one or more people, and they don’t need an Apple ID or device.

You’ll have to share an access key with your contact. It can be a digital version sent electronically, or you can print a copy or save it as a screenshot or PDF.

Take note that there are some types of files you won’t be able to pass on — including digital rights-protected music, movies and passwords stored in Apple’s password manager. Legacy contacts can only access a deceased user’s account for three years before Apple deletes the account.

Google

Google takes a different approach with its Inactive Account Manager, which allows you to share your data with someone if it notices that you’ve stopped using your account.

When setting it up, you need to decide how long Google should wait — from three to 18 months — before considering your account inactive. Once that time is up, Google can notify up to 10 people.

You can write a message informing them you’ve stopped using the account, and, optionally, include a link to download your data. You can choose what types of data they can access — including emails, photos, calendar entries and YouTube videos.

There’s also an option to automatically delete your account after three months of inactivity, so your contacts will have to download any data before that deadline.

Facebook and Instagram

Some social media platforms can preserve accounts for people who have died so that friends and family can honor their memories.

When users of Facebook or Instagram die, parent company Meta says it can memorialize the account if it gets a “valid request” from a friend or family member. Requests can be submitted through an online form.

The social media company strongly recommends Facebook users add a legacy contact to look after their memorial accounts. Legacy contacts can do things like respond to new friend requests and update pinned posts, but they can’t read private messages or remove or alter previous posts. You can only choose one person, who also has to have a Facebook account.

You can also ask Facebook or Instagram to delete a deceased user’s account if you’re a close family member or an executor. You’ll need to send in documents like a death certificate.

TikTok

The video-sharing platform says that if a user has died, people can submit a request to memorialize the account through the settings menu. Go to the Report a Problem section, then Account and profile, then Manage account, where you can report a deceased user.

Once an account has been memorialized, it will be labeled “Remembering.” No one will be able to log into the account, which prevents anyone from editing the profile or using the account to post new content or send messages.

X

It’s not possible to nominate a legacy contact on Elon Musk’s social media site. But family members or an authorized person can submit a request to deactivate a deceased user’s account.

Passwords

Besides the major online services, you’ll probably have dozens if not hundreds of other digital accounts that your survivors might need to access. You could just write all your login credentials down in a notebook and put it somewhere safe. But making a physical copy presents its own vulnerabilities. What if you lose track of it? What if someone finds it?

Instead, consider a password manager that has an emergency access feature. Password managers are digital vaults that you can use to store all your credentials. Some, like Keeper,Bitwarden and NordPass, allow users to nominate one or more trusted contacts who can access their keys in case of an emergency such as a death.

But there are a few catches: Those contacts also need to use the same password manager and you might have to pay for the service.

___

Is there a tech challenge you need help figuring out? Write to us at onetechtip@ap.org with your questions.

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Pediatric group says doctors should regularly screen kids for reading difficulties

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The Canadian Paediatric Society says doctors should regularly screen children for reading difficulties and dyslexia, calling low literacy a “serious public health concern” that can increase the risk of other problems including anxiety, low self-esteem and behavioural issues, with lifelong consequences.

New guidance issued Wednesday says family doctors, nurses, pediatricians and other medical professionals who care for school-aged kids are in a unique position to help struggling readers access educational and specialty supports, noting that identifying problems early couldhelp kids sooner — when it’s more effective — as well as reveal other possible learning or developmental issues.

The 10 recommendations include regular screening for kids aged four to seven, especially if they belong to groups at higher risk of low literacy, including newcomers to Canada, racialized Canadians and Indigenous Peoples. The society says this can be done in a two-to-three-minute office-based assessment.

Other tips encourage doctors to look for conditions often seen among poor readers such as attention-deficit hyperactivity disorder; to advocate for early literacy training for pediatric and family medicine residents; to liaise with schools on behalf of families seeking help; and to push provincial and territorial education ministries to integrate evidence-based phonics instruction into curriculums, starting in kindergarten.

Dr. Scott McLeod, one of the authors and chair of the society’s mental health and developmental disabilities committee, said a key goal is to catch kids who may be falling through the cracks and to better connect families to resources, including quicker targeted help from schools.

“Collaboration in this area is so key because we need to move away from the silos of: everything educational must exist within the educational portfolio,” McLeod said in an interview from Calgary, where he is a developmental pediatrician at Alberta Children’s Hospital.

“Reading, yes, it’s education, but it’s also health because we know that literacy impacts health. So I think that a statement like this opens the window to say: Yes, parents can come to their health-care provider to get advice, get recommendations, hopefully start a collaboration with school teachers.”

McLeod noted that pediatricians already look for signs of low literacy in young children by way of a commonly used tool known as the Rourke Baby Record, which offers a checklist of key topics, such as nutrition and developmental benchmarks, to cover in a well-child appointment.

But he said questions about reading could be “a standing item” in checkups and he hoped the society’s statement to medical professionals who care for children “enhances their confidence in being a strong advocate for the child” while spurring partnerships with others involved in a child’s life such as teachers and psychologists.

The guidance said pediatricians also play a key role in detecting and monitoring conditions that often coexist with difficulty reading such as attention-deficit hyperactivity disorder, but McLeod noted that getting such specific diagnoses typically involves a referral to a specialist, during which time a child continues to struggle.

He also acknowledged that some schools can be slow to act without a specific diagnosis from a specialist, and even then a child may end up on a wait list for school interventions.

“Evidence-based reading instruction shouldn’t have to wait for some of that access to specialized assessments to occur,” he said.

“My hope is that (by) having an existing statement or document written by the Canadian Paediatric Society … we’re able to skip a few steps or have some of the early interventions present,” he said.

McLeod added that obtaining specific assessments from medical specialists is “definitely beneficial and advantageous” to know where a child is at, “but having that sort of clear, thorough assessment shouldn’t be a barrier to intervention starting.”

McLeod said the society was partly spurred to act by 2022’s “Right to Read Inquiry Report” from the Ontario Human Rights Commission, which made 157 recommendations to address inequities related to reading instruction in that province.

He called the new guidelines “a big reminder” to pediatric providers, family doctors, school teachers and psychologists of the importance of literacy.

“Early identification of reading difficulty can truly change the trajectory of a child’s life.”

This report by The Canadian Press was first published Oct. 23, 2024.

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