OTTAWA — Despite pandemic slowdowns, Correctional Service Canada is still planning to expand the needle exchange programs currently offered at nine federal prisons, government officials say.
OTTAWA — Despite pandemic slowdowns, Correctional Service Canada is still planning to expand the needle exchange programs currently offered at nine federal prisons, government officials say.
At a presentation given to the International AIDS Conference in Montreal on Friday, Henry de Souza, the agency’s director general of clinical services and public health, said “a number of institutions” have been identified for an expansion, and the program will continue to be implemented across the country.
Inmates have been able to request sterile equipment for drug use at two Canadian prisons since 2018, and another seven were added in 2019. Some advocates have expressed fears the program, which is designed to reduce needle sharing and the spread of infectious disease, could be cancelled after numbers showed a low uptake.
Only 53 inmates were actively using the programs in mid-June, officials told the AIDS conference Friday night, out of 277 who had been approved to participate over the last four years.
These programs are in addition to the country’s only prison-based “overdose prevention service,” which began operating in 2019 at the men’s medium-security Drumheller Institution in Alberta. It is essentially a supervised injection site, offering sterile equipment and consumption under observation.
Since the site opened, there have been 55 participants, 1,591 visits and zero overdoses at the site, officials told the conference.The correctional service says it also offers mental health counselling, access to naloxone to counter opioid overdose effects and preventive treatments, such as pre-exposure prophylaxis — medicine taken to prevent getting HIV.
All of these efforts have led to a decrease in infections, said Marie-Pierre Gendron, an epidemiologist at Correctional Service Canada. She said HIV infection among inmates nationally is down from 2.02 per cent of the prison population in 2007 to 0.93 per cent in 2020; and hepatitis C is down from 21 per cent in 2010 to 3.2 per cent in 2021.
Lynne Leonard, a University of Ottawa associate professor who was contracted by the agency to evaluate the programs, said during a Tuesday morning panel that both programs have had “significant beneficial outcomes” for inmates, and she saw “eventual successful institutional adoption” despite initial pushback from staff.
Preliminary results from her study found that the program seemed to lead to a significant decrease in HIV infections at the institutions that put it into place. Overdoses at Drumheller were down more than 50 per cent overall since its supervised consumption site opened.
“I’m encouraged by the way they’re describing the program as something they’re proud of,” said Sandra Ka Hon Chu, co-executive director of the HIV Legal Network.
But a major “red flag” that could be leading to lower participation is the fact that security personnel are involved in the process, she said. That’s not the case in other countries’ prison needle exchange programs, some of which are fully anonymous or even offer syringes in automated dispensing machines.
“It’s really a critical flaw in the program,” she said.
Asked about the low uptake, the correctional service said in a statement Tuesday that it has reviewed evaluation reports that indicate participation rates “may be the result of considerations such as stigma, fear, lack of understanding of harm reduction initiatives, and the nature of addiction.”
Inmates are subject to a threat assessment by security and approval by a warden before being able to access programs, as officials described the process. Almost a quarter of requests to participate in the program have been rejected, according to statistics presented at the conference.
Shawn Huish, the warden at Mission Institution in British Columbia, said it was a challenge to shift the mindset of correctional workers accustomed to searching for drugs, confiscating them and trying to stop inmates from taking them — while at the same time reassuring inmates that participating in the program would not affect their release.
There was a lot of “fake news” to battle, Huish said, including a billboard erected outside the prison that painted the program in a negative light.
“Our biggest focus was talking, educating, breaking down the fear. Having a needle acknowledged in jail can be scary for folks,” he said. “You’re afraid you’re going to get needle sticks. So we looked at the records. In two-and-a-half years, we’ve had one staff member get pricked, and it was while searching, and it was a thumb tack.”
Leah Cook, the regional manager of public health for the Prairies, oversaw the implementation of the supervised injection site at Drumhellerand said it is “the only known service of its kind in a correctional setting on the world stage, for which I am incredibly proud.”
Cook said a “safe zone” was created so that participants in the program could carry their own drug supply to the observation room without the fear of being searched — and it’s been nicknamed the “yellow brick road.”
Leonard’s research found that staff members at Drumheller preferred it to the needle exchange program and thought it was safer and more successful.
The statement from the correctional service says it is committed to “further implementation” of both types of programs as part of its mission to “better support patients with problematic substance use needs.”
Warkworth Institution and Bowden Institution have been identified for an expansion of the needle exchange program, the statement says, while Collins Bay Institution and Springhill Institution are being considered for an expansion of the overdose prevention service.
This report by The Canadian Press was first published Aug. 2, 2022.
(Bloomberg) — Healthy children and adolescents may no longer need Covid shots, the World Health Organization said, updating its guidance on vaccines as the world adjusts to living permanently with the virus.
Older people and higher-risk groups — including those with underlying conditions — should get Covid boosters between six and 12 months after their last injections, the WHO said in a statement announcing a revised vaccine road map for the new stage of the pandemic.
“Countries should consider their specific context in deciding whether to continue vaccinating low-risk groups, like healthy children and adolescents, while not compromising the routine vaccines that are so crucial for the health and well-being of this age group,” said Hanna Nohynek, chair of the WHO’s Strategic Advisory Group of Experts on Immunization.
The Geneva-based organization’s latest advice comes as booster rates fall in countries from China to the US, with just 16% of Americans lining up for the latest round of shots targeting the omicron variant, Bloomberg reported earlier this month.
The dropoff won’t just have financial consequences for vaccine makers — including Pfizer Inc. and Moderna Inc. — but is also sparking concerns among public health experts who say updated vaccinations are the best way to protect against Covid.
Read more: Covid Boosters Sour for Pfizer, Moderna With Uptake Rate at 16%
Healthy children between the ages of 6 months and 17 years are a low-priority group for vaccination, the WHO said, and primary and booster doses are safe and effective for them. They have typically experienced less severe reactions to Covid than adults.
The WHO said context mattered in deciding whether to inoculate younger people given the lower burden of disease.
The organization “urges countries considering vaccination of this age group to base their decisions on contextual factors, such as the disease burden, cost effectiveness, and other health or programmatic priorities and opportunity costs,” the statement said.
–With assistance from Tanaz Meghjani.
©2023 Bloomberg L.P.
The ketogenic diet, or “keto” diet, is a high-fat, low-carb diet that has gained popularity in recent years due to its potential health benefits. The diet aims to induce a metabolic state called ketosis, where the body burns fat for fuel instead of carbohydrates. This can result in weight loss and improved blood sugar control, among other benefits.
Crossfit training is a high-intensity, functional fitness program that combines elements of weightlifting, gymnastics, and cardio. It is designed to improve overall fitness and performance in a variety of physical activities.
When coupled, the ketogenic diet and CrossFit exercise have the potential to be an effective strategy for both weight reduction and an increase in overall physical capability. The ketogenic diet supplies the body with a consistent supply of energy, which may assist in the improvement of endurance while doing Crossfit activities. Moreover, it may assist in the healing of muscles and decrease inflammation.
Nevertheless, it is essential to keep in mind that the ketogenic diet may not be appropriate for everyone, particularly those who are dealing with certain health concerns. Before beginning any new eating plan or workout routine, it is essential to discuss the changes with a qualified medical practitioner.
Those who are wanting to enhance their physical fitness and general health may find that combining Crossfit exercise with the ketogenic diet is a combination that is advantageous to their goals. You may read the reasons why the keto diet and crossfit workout are becoming more popular throughout Georgia in the following paragraph.
One of the primary reasons why the ketogenic diet and Crossfit training are becoming more popular in Georgia is that they both lead to improvements in exercise endurance. The ketogenic diet encourages fat burning inside the body, which, in comparison to the breakdown of carbs for fuel, results in a more consistent and sustained supply of energy. Because of this, people are able to keep up their energy levels even throughout lengthy and strenuous CrossFit sessions, which ultimately leads to increased endurance.
Training in CrossFit, on the other hand, is intended to increase not just general physical fitness but also performance in other aspects of the body, including endurance. Workouts at CrossFit are known for their high levels of intensity, which provide a challenge to the body and force people to test the boundaries of their capabilities. As a consequence, over time, individuals see improvements in their endurance.
Since the keto diet provides the body with a consistent supply of energy that it can utilize throughout exercises and Crossfit training pushes the body to develop its endurance capacities, the combination of the two may be especially helpful in increasing endurance. Because of this, a significant number of people in Georgia are turning to this potent combination in order to boost their physical fitness and overall performance.
Both the ketogenic diet and Crossfit exercise have become more popular in Georgia for a number of reasons, one of the most important of which is weight reduction. The ketogenic diet is designed to guide individuals into a metabolic state known as ketosis, in which the body uses fat for fuel rather than carbs. This may result in considerable weight reduction, particularly when paired with regular Crossfit activities, which help burn calories and build muscle at the same time.
Georgia residents who are interested in this powerful combination can find resources and support through local gyms and fitness centers that offer Crossfit training and nutrition coaching. In addition, Georgia real estate listings often include properties with home gyms, making it easier than ever for individuals to incorporate regular workouts into their daily routines. Overall, the keto diet and Crossfit training are growing trends across Georgia due to their proven effectiveness in improving physical fitness, performance, and weight loss. With the right resources and support, anyone in Georgia can benefit from this powerful combination and achieve their health and fitness goals.
Another reason why the keto diet and Crossfit workouts are becoming more popular throughout the state of Georgia is that they help better regulate blood sugar levels. By limiting the consumption of carbs, which are known to produce rises in blood sugar levels, the ketogenic diet is thought to be beneficial for helping to control blood sugar levels. Those who have diabetes or other diseases connected to high blood sugar may benefit from this in a particularly significant way.
Crossfit training, on the other hand, can also help improve blood sugar control by increasing insulin sensitivity and glucose uptake by the muscles. This means that the body is better able to process and utilize glucose, resulting in more stable blood sugar levels.
Overall, the combination of the keto diet and Crossfit training can be a powerful tool for better blood sugar control, leading to improved overall health and well-being. Georgia residents who are interested in this approach can find support through local gyms and fitness centers that offer Crossfit training and nutrition coaching.
Improved muscle recovery is another reason why the keto diet and Crossfit training are growing trends across Georgia. The keto diet provides the body with a steady source of energy, which can aid in muscle recovery after Crossfit workouts. Additionally, the diet is high in protein, which is essential for repairing and building muscle tissue.
Crossfit training itself can also help improve muscle recovery by increasing blood flow and nutrient delivery to the muscles. This can help reduce muscle soreness and improve recovery time between workouts.
The combination of the keto diet and Crossfit training can be particularly effective in improving muscle recovery, as the diet provides the necessary nutrients and energy for muscle repair and growth, while Crossfit training challenges the muscles and promotes blood flow.
Overall, the keto diet and Crossfit training are growing trends across Georgia due to their ability to improve physical fitness, performance, and muscle recovery.
Reduced inflammation is another reason why the keto diet and Crossfit training are growing trends across Georgia. Inflammation is the body’s natural response to injury or infection, but chronic inflammation can contribute to a variety of health problems.
By limiting the consumption of items that are known to cause inflammation, such as sugar and processed carbohydrates, the ketogenic diet has been shown to have anti-inflammatory effects. This may assist in reducing inflammation throughout the body, which may ultimately contribute to improvements in general health.
Crossfit training may also help decrease inflammation since it increases blood flow and nutrition supply to the muscles, both of which can assist in healing and reduce inflammation. Crossfit training is also known as functional fitness.
The combination of the keto diet and Crossfit training can be particularly effective in reducing inflammation, as the diet provides the necessary nutrients and energy for muscle repair and growth, while Crossfit training challenges the muscles and promotes blood flow.
Improved physical performance is one of the primary reasons why the keto diet and Crossfit training are growing trends across Georgia. The keto diet provides the body with a steady source of energy, which can improve physical performance during Crossfit workouts. The diet’s high-fat content can also aid in muscle recovery and reduce inflammation, leading to improved overall physical performance.
Crossfit training is designed to improve overall physical fitness and performance, including strength, endurance, and agility. The high-intensity nature of Crossfit workouts challenges the body and pushes individuals to their limits, resulting in improved physical performance over time.
The combination of the keto diet and Crossfit training can be particularly effective in improving physical performance, as the diet provides the necessary nutrients and energy for muscle repair and growth, while Crossfit training challenges the muscles and promotes overall physical fitness.
Increased energy levels are another reason why the keto diet and Crossfit training are growing trends across Georgia. The keto diet helps the body enter a state of ketosis, where it burns fat instead of carbohydrates for fuel. This leads to a more sustained and stable energy level throughout the day, reducing fatigue and increasing overall energy levels.
Moreover, improved energy levels are promoted by Crossfit exercise since it forces the body to make better use of the energy resources it already has. The high degree of intensity that characterizes Crossfit exercises may produce an endorphin surge, which not only increases energy levels but also improves mood.
Since the keto diet supplies the body with a consistent stream of energy that it may utilize throughout workouts and Crossfit exercise pushes the body to improve its general energy efficiency, the combination of the two can be especially helpful in improving levels of energy.
As a whole, the keto diet and Crossfit exercise are becoming more popular across the state of Georgia due to their capacity to raise levels of energy and enhance overall physical fitness and performance.
Improved mental clarity is another reason why the keto diet and Crossfit training are growing trends across Georgia. The keto diet provides a steady source of energy for the brain, which can improve mental clarity and focus. This is because the brain requires a stable supply of energy to function optimally.
In addition to this, regular Crossfit workouts have been shown to boost mental acuity by increasing blood flow and nutrition supply to the brain. It has been shown that engaging in physical activity may enhance cognitive function and lower the risk of cognitive decline.
Because the keto diet supplies the necessary nutrients and energy for brain function while Crossfit training challenges the body and increases blood flow to the brain, the combination of the two can be particularly effective in improving mental clarity. This is due to the fact that the diet provides the necessary nutrients and energy for brain function.
Reduced appetite is another reason why the keto diet and Crossfit training are growing trends across Georgia. The keto diet is known to reduce appetite by increasing feelings of fullness and reducing cravings, which can lead to reduced calorie intake and weight loss. This is because the high fat content of the diet promotes satiety and reduces the need for frequent snacking.
Increasing your metabolic rate and the number of calories you burn via CrossFit may also help you feel less hungry. This indicates that those who participate in regular Crossfit exercises may see a natural reduction in their levels of hunger throughout the day.
Because the keto diet supplies the body with a consistent source of energy and Crossfit training challenges the body and speeds up the metabolic rate, the combination of the two can be particularly effective in suppressing appetite and fostering weight loss. This is due to the fact that the diet helps the body maintain a constant source of energy while also promoting weight loss.
Improved insulin sensitivity is another reason why the keto diet and Crossfit training are growing trends across Georgia. The keto diet can help improve insulin sensitivity by reducing the intake of carbohydrates, which are known to cause spikes in blood sugar and decrease insulin sensitivity over time. This means that the body is better able to respond to insulin and process glucose more efficiently.
Crossfit training can also improve insulin sensitivity by promoting muscle growth and glucose uptake by the muscles. This means that the body is better able to utilize glucose for energy, leading to improved insulin sensitivity.
The combination of the keto diet and Crossfit training can be particularly effective in improving insulin sensitivity, as the diet provides a stable source of energy for the body and reduces the intake of inflammatory foods, while Crossfit training challenges the muscles and promotes glucose uptake.
Both the ketogenic diet and Crossfit exercise are becoming more popular throughout the state of Georgia as a result of their capacity to enhance insulin sensitivity, mental clarity, physical fitness, and weight reduction while simultaneously reducing inflammation and hunger. Local gyms and fitness facilities in Georgia that also provide nutrition coaching are great places for locals to go for help.
Montreal, March 28, 2023 – The McGill University Health Centre (MUHC) is proud to launch Quebec’s first multidisciplinary referral centre for multisystem endometriosis. EndoCARES, or the Endometriosis Centre for the Advancement of REsearch and Surgery, aims to provide patients suffering from pain and infertility due to endometriosis with timely access to specialized diagnostic imaging, followed by multidisciplinary care based on individual needs.
Endometriosis is an inflammatory condition where endometrial-like tissue (similar to the inner lining of the uterus) grows outside of the uterus. Affecting about 1 in 10 women of reproductive age, it commonly causes infertility and debilitating pelvic pain, often severe enough to limit a woman’ s ability to carry out normal daily activities.
“While half of women with infertility and up to 70 per cent of those with chronic pelvic pain have endometriosis, studies show an average delay of seven years from the start of symptoms to diagnosis,” explains Dr. Togas Tulandi, chief of the Department of Obstetrics and Gynecology at the MUHC. “EndoCARES aims to significantly reduce this delay by uniting a team of gynecologic surgeons specialized in minimally invasive surgery – more specifically, in the removal of endometriosis lesions – along with other specialists, such as bowel surgeons, urologists, radiologists and fertility specialists, in a single patient-centered clinic.”
EndoCARES specialists come together regularly to discuss complex surgical cases and devise the best treatment strategies to offer patients. Meanwhile, a dedicated nursing staff provides continuity of care for the patients by facilitating the coordination of care between specialists and monitoring post-operative recovery following complex surgeries.
A centre of excellence
Drs. Dong Bach Nguyen and Andrew Zakhari, co-directors of the centre, both pursued additional training at renowned endometriosis hubs in Europe after completing minimally invasive surgery fellowships in Ottawa and Toronto respectively. As a result, patients treated at EndoCARES now benefit from innovative surgeries specific to endometriosis not previously offered in Quebec. “In Europe, several countries have established centres of excellence to provide specialized care to patients affected by endometriosis. Training in these centres allowed us to bring back not only new surgical techniques, but also the foundations to build an endometriosis referral centre for women with multi-organ endometriosis in Quebec,” explains Dr. Nguyen.
“The primary objective of this centre is to provide women with severe endometriosis affecting other organs like the bladder,bowel or diaphragm, with dedicated surgical and radiological expertise,” says Dr. Zakhari. Along with Drs. Srinivasan Krishnamurthy, Fady Mansour, Jessica Papillon-Smith and Togas Tulandi, this team of surgical gynecologists is committed to improving the care of Quebec women suffering from endometriosis.
Many questions remain unanswered
“Today, we still do not understand the exact cause of endometriosis, nor do we have a cure,” explains Dr. Tulandi, who is also an associate investigator at the Child Health and Human Development Program at the Research Institute of the MUHC.
Moving forward, EndoCARES aims to enhance basic, epidemiological and clinical research in endometriosis with the establishment of a patient registry that will function as a database for future research. Additionally, the program will facilitate international networking, collaborative research and the standardization of clinical practice through the exchange of ideas and experiences.
EndoCARES’ state-of-the-art clinical care and forthcoming research are made possible in part by generous donations made to the MUHC Foundation, which has pledged to raise $700,000 in support of personnel and equipment for the EndoCARES program.
“Endometriosis is very common and yet, so many women endure years of pain before receiving a diagnosis. This is completely unacceptable. The MUHC Foundation is proud to support the EndoCARES program, because it will change women’s health care for the better and reduce the pain and uncertainty so many women endure,” says Julie Quenneville, president and CEO of the MUHC Foundation.
Someone to reach out to
It took five long years before Anisa Gjoka was referred to Dr. Andrew Zakhari and diagnosed with stage 4 endometriosis at 25 years old. “On February 8, 2021, in the middle of a pandemic, I finally had my surgery,” recounts Anisa. “After a four-hour surgery, and with only four small incisions, they were able to carefully remove the endometriosis lesions, leaving all of my organs intact!”
Today, at 28 years old, Anisa maintains a pain-free lifestyle, something that seemed unimaginable before entering under the expert care of Dr. Zakhari. “It gives me great peace of mind to know that EndoCARES exists – that there is finally someone for me to reach out to whenever I’m in need, and that the young women experiencing their first symptoms will be spared years of suffering and will be cared for by a multidisciplinary team of experts, all in one place.”
About the McGill University Health Centre
The McGill University Health Centre (MUHC) is one of the world’s foremost academic health facilities. Building on the tradition of medical leadership of its founding hospitals, the MUHC provides exceptional multidisciplinary patient-centric care in French and in English. Affiliated with the Faculty of Medicine and Health Sciences of McGill University, the MUHC continues to shape the course of adult and pediatric medicine by attracting clinical and research expertise from around the world, assessing the latest in medical technology, and training the next generation of medical professionals. In collaboration with our network partners, we are building a better future for our patients and their families; for our employees, professionals, researchers and students; for our community and above all, for life. www.muhc.ca
McGill University Health Centre
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