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Nunavut admits to large tuberculosis outbreak in Pangnirtung months later – The Globe and Mail

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St. Luke’s Mission Hospital, in Pangnirtung. The Nunavut Department of Health said on May 26 that 139 cases of TB have been identified in Pangnirtung in the past 18 months.Pat Kane/The Globe and Mail

Pangnirtung, a small hamlet on Baffin Island, is grappling with the largest tuberculosis outbreak in Nunavut since 2017, according to data the territorial government released on Thursday after refusing for months to reveal the extent of the disease’s spread.

The Nunavut Department of Health said on Thursday that 139 cases of TB have been identified in Pangnirtung in the past 18 months, 31 of which were active, meaning the patients were sick and infectious. The rest were cases of latent or “sleeping” TB, an asymptomatic version of the bacterial infection that isn’t contagious, but that puts patients at risk of developing active TB in the future.

The Globe and Mail travelled to Pangnirtung earlier this month as part of a continuing investigation into health care in Canada’s youngest territory. In interviews, community leaders have expressed frustration at the lack of official information about the TB outbreak, which Michael Patterson, the territory’s chief public-health officer, first declared on Nov. 25 without providing a tally of cases.

The size of the outbreak came as a surprise to Pangnirtung Mayor Eric Lawlor who, along with the rest of the hamlet’s elected council, wasn’t privy to official statistics on the ballooning health problem in his own community.

“The information should have been provided to us regularly to begin with,” Mr. Lawlor said on Thursday. “This is more concerning than COVID, actually. With the numbers being so high, it’s kind of worrisome and bothersome that we haven’t been addressing it more seriously from the government side.”

The Nunavut Department of Health published the figures in a news release a week after receiving a list of questions from The Globe about the ongoing tuberculosis outbreak in Pangnirtung, a community of about 1,600 people an hour’s flight north of Iqaluit, the territorial capital.

“I don’t know why they’re so secretive,” said Madeleine Qumuatuq, Pangnirtung’s community wellness co-ordinator. “You can’t be secretive and then do prevention. I mean, they’ve got to be truthful to us.”

Ms. Qumuatuq was one of several Pangnirtung residents who raised concerns about the pace of the government’s response to the TB outbreak. She pointed out that the health department rented the community hall – one of Pangnirtung’s few public spaces – beginning March 1 for a satellite TB clinic that still isn’t up and running.

“We’re missing out on a lot of age groups that would normally be coming here to play checkers, pool, whatever it might be. And the teenagers hang out here,” she said. “All that is taken away because they’ve rented the space. But they’re not even here yet.”

Danarae Sommerville, a spokesperson for the Nunavut Department of Health, said by e-mail that the delay has been caused by a shortage of skilled workers “required to ensure the Hamlet building has the appropriate wiring and network to set up workstations for staff.” Those workers were waylaid responding to the aftermath of a fire that consumed a government building in another hamlet, she added.

In responses to earlier questions about the outbreak, she pointed out that the Department of Health sent extra nurses and other front-line staff to Pangnirtung to help manage the outbreak – no easy feat during a national nursing shortage exacerbated by the pandemic.

Active tuberculosis infections, which are caused by bacteria that spread through the air and usually lodge in the lungs, can cause fever, weight loss, night sweats, fatigue and a chronic, sometimes bloody cough. Antibiotics can cure active TB and prevent latent cases from turning into serious disease. The infection can be fatal if left untreated.

Tuberculosis is a disease that most Canadians think of as a scourge of the past. But it remains a scourge of the present in Indigenous communities, particularly Inuit communities, where deep-seated poverty, overcrowded housing and limited access to medical care make residents particularly vulnerable.

The federal Liberal government, along with Inuit Tapiriit Kanatami, a national Inuit organization, promised in 2018 to eliminate TB in Inuit communities by 2030.

The most recent data from the Public Health Agency of Canada show there were 72.2 active cases of TB per 100,000 population among Inuit people in 2020, compared with a national case rate of 4.7 per 100,000.

Despite being 15 times higher than the national average, the TB rate among Inuit in 2020 was down significantly, from 188.7 cases per 100,000 in 2019 and from a 10-year annual average of 184.14 per 100,000 from 2010 to 2019. The decline likely reflects cases of TB going undiagnosed in the first year of the pandemic, experts on the disease have said.

Nunavut, which is home to the majority of Inuit in Canada, recorded 34 active cases across the territory in 2020, or 86.40 per 100,000, down from an average of 66 active cases per year territory-wide over the previous four years.

In February, Nunavut’s privacy commissioner ruled in The Globe’s favour after the newspaper appealed the territorial government’s refusal to release TB case counts by community, age and gender.

But privacy commissioner decisions aren’t binding in Nunavut. Health Minister John Main rejected the call to release community-level data, saying at the time that doing so could risk identifying patients and stigmatizing entire communities.

Neither Mr. Main nor Dr. Patterson were available for interviews Thursday.

Chris Puglia, another spokesperson for the Nunavut Department of Health, said in an e-mail that the department doesn’t plan to release TB data by hamlet, except during outbreaks. “Community level data outside an outbreak does not offer additional protection to public health and could further stigmatize the disease and create hesitancy in people seeking testing,” he wrote.

He added that Dr. Patterson’s office decided to compromise in the case of Pangnirtung and release updates every three months that “might assist in outbreak management.” The Department of Health released community-level data during Nunavut’s last major TB outbreak, in Qikiqtarjuaq in 2017-2018. A 15-year-old girl died in that outbreak.

Nunavut Privacy Commissioner Graham Steele said the government should go further and follow his ruling on TB data.

“I continue to believe that the law requires that community-level numbers be released, and not only at a time and place selected by the government,” he said Thursday. “It’s hard to hold the government to account for tuberculosis policy when it holds all the numbers in secret.”

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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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