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Doctors, nurses call for action on crumbling care, health ministers meet in Vancouver

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VANCOUVER — A family doctor who works in British Columbia and Alberta says patients who don’t get the care they need before ending up in overburdened emergency rooms should be a focus for quick action by the country’s health ministers as they meet in Vancouver.

Dr. Carllin Man said sicker patients without a family physician tend to return to ERs where burnt-out doctors and nurses put in longer and longer hours as colleagues leave the profession.

“For a long time, our health systems have relied on our goodwill as health-care professionals,” Man said. “We’re doing more and more when we should have stopped a long time ago, but there’s no one else. What are you going to do, just let those patients suffer? Of course not.”

Man, who works part-time at a walk-in clinic in Burnaby, B.C., as well as in emergency rooms in central Alberta, said he will need to refill some patients’ prescriptions during an upcoming 10-day vacation because there won’t be anyone to cover for him.

“So, every day I have to log into my computer and try to manage the things I can while I’m away,” he said of his chronically ill patients who are not best suited for care by other doctors without full knowledge of their medical history.

Man said it’s time that governments across Canada listened to the concerns of patients and those who look after them.

Health ministers from all 13 provinces and territories, along with their federal counterpart, Jean-Yves Duclos, are set to meet in Vancouver on Monday and Tuesday.

The meetings come four months after premiers from across Canada convened in Victoria to discuss the ills plaguing the health-care system. The premiers asked the federal government to hike the Canada Health Transfer, the money each jurisdiction gets for health care, to 35 per cent, from 22 per cent.

B.C. Health Minister Adrian Dix said the extra cash is needed as the province tackles nursing and doctor shortages, improved access to digital health care, as well as mental health and substance-use services related to the toxic drug crisis.

“We need the federal government to be our partner in this approach,” he said in a statement. “That means having a serious discussion about the Canada Health Transfer.”

The Canadian Medical Association, the Canadian Nurses Association and HealthCareCAN, which represents various organizations and hospitals, have joined forces to push the health ministers to retain workers through incentives like mental health supports.

They are also calling for a Canada-wide strategy to gather data on the workforce, allow doctors to more easily be licensed wherever in the country they are most needed, and to improve access to primary care and virtual visits.

Man completed his training in Alberta seven years ago but said getting his licence to practise in British Columbia was a months-long, arduous process.

“I had to jump through all these hoops. I had to physically travel to Vancouver, to the (College of Physicians and Surgeons’ office), to show my face and my degrees. I mean, they didn’t do that in Alberta. They trusted the fact that I was licensed with the National Medical Council of Canada and all these other national organizations that verify our educational degrees and training.”

Dr. Alika Lafontaine, president of the Canadian Medical Association, said the collapse of primary care is spilling into other parts of hospitals beyond ERs, as well as long-term care, due to cost-cutting.

“There’s a recognition that we have fallen far behind the demand for health services in every part of the country. In Ontario, there are tens of millions of health services and thousands of surgeries that have been delayed,” said Lafontaine, who is an anesthesiologist in Grande Prairie, Alta.

“The biggest fear that I have for the health-care system moving forward is that those of us who believe it will be there tomorrow, it may not actually be there in the same form. And you won’t actually know that until you need the care.”

Lafontaine said he is hoping the meeting of health ministers results in collaboration across Canada “because the crises are too big for any one jurisdiction. If we don’t act, all of our systems will continue to deteriorate. And I think the impetus for action is now because of how severely patients are suffering.”

Sylvain Brousseau, president of the Canadian Nurses Association, said undervalued nurses are leaving their jobs because their mental health is suffering due to poor working conditions.

He said they are often tasked with work that has nothing to do with their training, due to lack of clerical and cleaning staff.

“Nurses are doing 48 per cent of non-nursing duties,” he said.

“When you ask a nurse to clean the floor because someone has been sick, it’s not the role of nurses to do that.”

Brousseau said the time for ongoing discussions by federal, provincial and territorial politicians when it comes to resourcing health care is over.

“We’ve dialogued a lot. Now, it’s time for action,” he said. “No nurses, no health-care system.”

This report by The Canadian Press was first published Nov. 6, 2022.

 

Camille Bains, The Canadian Press

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As sports betting addiction takes hold in Brazil, the government moves to crack down

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SAO PAULO (AP) — “King” doesn’t disclose his real name. Even clients of his Sao Paulo newsstand have to call him by his moniker. The Brazilian online sports gambling addict lowered his profile after a loan shark threatened to put bullets in his head if he didn’t pay up.

Broke and embarrassed, King sought treatment and support earlier this year.

“I was once addicted to slot machines, but then sports betting was so easy that I changed. I got carried away all the time,” he told The Associated Press.

King’s story is that of many vulnerable Brazilians in recent years. The country has become the third-biggest market in the world for sports betting, following the U.S. and the U.K., a report by data analysis company Comscore said last year. But unlike those countries, rampant advertising and sponsorship have been coupled with an unregulated market. The government is now — belatedly, some say — striving to get a handle on the epidemic.

On a recent evening, King’s Gamblers Anonymous meeting took place in an improvised classroom inside a church, with coffee and cookies to keep everyone awake, and supportive messages scrawled onto the blackboard. One that’s become ubiquitous in Brazil and beyond: “Only for today I will avoid the first bet.”

King and other attendees, all Christian, started a prayer and the meeting began.

King said his financial problems arose from his addiction to online sports betting, chiefly on soccer.

“I miss the adrenaline rush when I don’t bet,” he said before the gathering. “I have managed to stop for a couple of months, but I know that if I do it once again, even a small bet, it will all come back.”

Driven by the pandemic

The COVID-19 pandemic was a key driver for Brazilians embracing sports betting. King said he transformed almost every sale during that time into a bet. His hook was the non-stop advertising on TV, radio, social media as well as sponsorship of local soccer teams’ jerseys. He asked for bank loans to pay his gambling debts and then, to cover those, went to the moneylender. His total debt now amounts to 85,000 reais ($15,000) — impossible to pay off with his monthly income of 8,000 reais.

Digging oneself out of debt in Brazil is especially daunting with its sky-high interest rates. Loans from Brazilian banks could add interest of almost 8% per month to the borrowed sum, and from loan sharks could be even more.

Four Gamblers Anonymous meetings attended by the AP in October featured discussions about difficulties paying down debts, forcing working-class members to postpone housing payments and cancel family vacations.

Some members of impoverished Brazilian families have used welfare money for betting instead of paying for groceries and housing, official data suggests. In August, beneficiaries of Brazil’s flagship program Bolsa Familia spent 3 billion reais ($530 million) on sports betting, according to a report from the central bank. That was more than 20% of the program’s total outlay in the month.

A host of gambling related problems

Sports betting was made legal in 2018 in a bill signed by former President Michel Temer. The subsequent turmoil has recently been setting off alarm bells, with addicts venting on social media and media reports of people losing huge sums.

On Oct. 1, the economy ministry prevented more than 2,000 betting companies from operating in Brazil for having failed to provide all the required documents. Soccer-loving President Luiz Inácio Lula da Silva said in an interview on Oct. 17 that he will shut down the entire market in Brazil if his administration’s new regulations — presented at the end of July— fail to work. And Brazil’s Senate on Oct. 25 opened an investigation into betting companies, focusing on crime and addiction.

“There’s tax evasion, money laundering of organized crime, the use of influencers to trick people into betting. These companies need to be audited,” Sen. Soraya Thronicke, who proposed the inquiry, told journalists in Brasilia.

Sérgio Peixoto, a ride-sharing app driver in Rio, is one of many lower-middle-income Brazilians who have reduced their spending due to sports betting debt. Peixoto’s debt currently amounts to 25,000 reais ($4,400). His monthly income is four times less than that.

“It stopped being a game, it wasn’t fun. I just wanted to get the money back, so I lost even more,” said Peixoto, 26. “I could have invested that money. It would surely have given me more benefits.

Pressure to bet

Pressure on people to gamble is everywhere. Current and former soccer players, including Vinicius Júnior, Ronaldo Nazário and Roberto Rivellino, are among the poster boys for local and foreign brands. All but one of the top-tier soccer clubs have betting companies among their main sponsors, with their name and logo emblazoned on their kits. There have been cases of kids and teenagers setting up accounts using their parents’ personal information and money, multiple local media outlets have reported.

Brazil’s economy ministry estimates that Brazil’s sports betting market had $21 billion in transactions last year, a 71% increase compared with the first year of the pandemic, 2020.

The ministry’s newly presented regulations include facial recognition systems for gamblers to bet, the identification of a single bank account for transactions involving sports betting, new protections against hackers and the government-authorized domain, bet.br, which will host all betting sites that are legal in Brazil. Once they are in place, come January, between 100 and 150 betting companies will continue to operate in the South American nation.

The changes in Brazil have prompted some companies to take preemptive action. A report by Yield Sec, a technical intelligence platform for online marketplaces, said several betting companies voluntarily restricted their operations in different places after the latest editions of the European Championships and Copa America in the hopes of presenting “the best possible license application face to the Brazilian authorities.”

Magnho José Santos de Sousa, the president of the Legal Gambling Institute, a betting think tank, said Brazil is currently “invaded by illegal websites that have licenses in Malta, Curação, Gibraltar and the United Kingdom.”

De Sousa expressed hope that the new regulations for advertising, responsible gambling and qualification of sports betting companies will transform the country’s deregulated arena into a more serious one that doesn’t exploit the vulnerable.

“The whole operation could turn from water into wine,” he said.

Gamblers Anonymous in high demand

Meantime, the demand for Gamblers Anonymous meetings in Sao Paulo has grown so much in recent years that the weekly gathering, in place since the 1990s, was no longer enough. Many groups have added a second day in the week to help new people recover, mostly sports bettors.

Earlier in October, a group on Sao Paulo’s northern edge admitted a man who was struggling with sports betting and card games. The 13 other people in the room stressed that he wasn’t alone.

“Welcome,” one long-time attendee said, in a greeting that has become a regular for the group. “Today, you are the most important person here.”

___

Dumphreys reported from Rio de Janeiro.



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Saskatchewan’s Jason Ackerman improves to 6-0 at mixed curling nationals

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SAINT CATHARINES, Ont. – Saskatchewan’s Jason Ackerman remained undefeated on Wednesday with a 7-4 win over Newfoundland and Labrador’s Trent Skanes at the Canadian mixed curling championship.

After going down 3-1 through four ends, Ackerman (6-0) outscored Skanes (3-3) 6-1 the rest of the way, including three points in the seventh end.

Alberta’s Kurt Alan Balderston also earned a win, defeating New Brunswick’s Charlie Sullivan 9-2 in another matchup in the final draw.

The win improved Balderston’s record to 4-2 and sits in third in Pool B.

The top four teams from each pool will play four more games against the survivors from the other pool. The remaining three teams from the pool will play three more seeding games to help set the rankings for next year’s event.

The championship final is scheduled for Saturday.

This report by The Canadian Press was first published Nov. 6, 2024.

The Canadian Press. All rights reserved.



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Oilers fall 4-2 to Golden Knights in McDavid’s return from injury

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EDMONTON – Noah Hanifin had a pair of goals as the Vegas Golden Knights won their first road game of the season, coming from behind to shock the Edmonton Oilers 4-2 on Wednesday.

Jack Eichel had a goal and two assists and Mark Stone also scored for the Golden Knights (9-3-1), who have won two in a row and six of their last seven. The Knights entered the game 0-3-1 on the road this year.

Brett Kulak and Zach Hyman replied for the Oilers (6-7-1), who have lost two straight despite getting captain Connor McDavid back from injury earlier than expected for the game.

Adin Hill made 27 saves for Vegas, while Stuart Skinner managed 31 stops for Edmonton.

Takeaways

Golden Knights: With an assist on the Knights’ second goal, William Karlsson has recorded at least a point in all five games he has played this season (two goals, four assists).

Oilers: McDavid was a surprise starter for the Oilers, coming back just nine days after suffering an ankle injury in Columbus and initially being expected to miss two to three weeks. The star forward came into the contest with 11 points (three goals, eight assists) during a six-game point streak versus the Golden Knights, but was held pointless on the night.

Key moment

With just 48.4 seconds left to play, the Golden Knights won a race to the corner and Ivan Barbashev was able to send it out to a hard-charging Hanifin, who sent a shot glove-side that beat Skinner for his second goal of the third period and third of the season.

Key stat

It was Hyman’s third goal in the last four games after the veteran forward went scoreless in his first 10 games this season following a 54-goal campaign last year. Hyman now has five goals in his last six games against Vegas.

Up next

Golden Knights: Head to Seattle to face the Kraken on Friday.

Oilers: Travel to Vancouver on a quick one-game trip to clash with the Canucks on Saturday.

This report by The Canadian Press was first published Nov. 6, 2024.

The Canadian Press. All rights reserved.



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