Monday, January 31, 2011

The world is flat

This is an idea by Thomas L. Friedman in his book, The World is Flat.
Friedman's argument spans the better part of his book, but luckily for you, I'm here to summarize.

 The world is flat. We all know that this is a ridiculous statement- the world is clearly round. Well...it's more of an oval, depending on where the moon is, but that's neither here nor there.

 Sorry...ah yes...the world is flat.

I've grossly oversimplified Friedman's point here in an effort to make it somewhat comical. What he's really saying is that the world is flat, not in a geographical sense, but in an available-opportunities sense. The playing field has been leveled. Someone in a developing country now has comparable resources for success to that of someone in a developed country.

This didn't just happen overnight, mind you. There have been three stages of 'globalization.' The following is an excerpt from a presentation I gave about 2 months ago.
Jump to today. You live in India. An average country, with a huge population. You're an average person, you don't come from money but you do want to make some. Today there are many more tools to get you there- the Internet, wifi, cell phones, online degree/diploma programs, open access literature. Suffice it to say, if you want to make it big, all you have to do is buy a high-speed connection!
 Some will correct me and say that, yes, there have been a handful of people who have done it. But, as epidemiologists say, 'remember the denominator'. The proportion of people who 'made it big' 100 years ago while starting from less than average is pretty low.
 Picture the world 100 years ago. Say you're not living in one of the few dozen developed countries in the world and you're not a member of a royal family or some other inherited fortune. You don't have a cell phone, the Internet, your own vehicle...you can't even afford to take a boat to another part of the world. You're just an average person in an otherwise average country. What are your chances of becoming the richest person in the world? Ok, maybe that's a bit far. How about this- what are your chances of having the same type of lifestyle as the average person in a more developed country? As you've probably guessed, next to nil.


The first, globalization 1.0, existed from about 1492, when Columbus set sail for the new world, until about 1800. The driving force of information growth this era was countries and nations, where individuals asked themselves “How can my country participate in a global market?”
The second era, globalization 2.0, takes place from 1800 to the year 2000. The driving force of economic and information growth in this era was the multinational company. In this era, individuals may have asked themselves, “How can my company access information on a global scale?”

From about 2000 to the present, the third era, Globalization 3.0, can be thought of as the age of the individual. Three major advances in technology have allowed individuals to compete for information on a global scale: the PC, the fibre optic cable and work-flow software.

The PC enabled individuals around the world to easily communication with one another, while the fibre optic cable allowed them to do so in an instant. Finally, work-flow software allowed multiple individuals to collaborate on the same digital project from anywhere in the world. Websites that focus on health-related content are a great example of how globalization 3.0 has shaped how individuals access information: they communicate with one another in the blink of an eye to collaborate on the same content.

Individuals may now ask themselves, "How I can access information and collaborate with others on a global scale?"

 Do people in developing countries have the same resources that people in developed countries have?

Comment!

Memory

Did you you forget how your memory works? (pun intended).

(No Dad, I won't be discussing gigabytes or megabytes here)!

When we say memory what we are really talking about is our ability to 'consolidate' our short-term thoughts into long-term thoughts. This consolidation is done by strengthening the nerves in various parts of your brain (mainly, the hippocampus) to ensure that they will fire more readily and consisently next time. But how do nerves get stronger, exactly?

When neurons (nerves) in the brain are stimulated, they mainly use the excitatory neurotransmitter called glutamate (an amino acid-part of many protiens). When some glutamate receptors receive the neurotransmitter they simply 'fire'- just like a copper wire from a cord being plugged into the wall. But sometimes, the impluse reaches a specific type of glutamate receptor that changes the neuron. It makes it more excitable by increasing the efficacy and number of glutamate receptors.  In short, it's glutamate that can make these neurons 'stronger'. (Anyone who is interested in the cell signaling/genetic explanation, grab a copy of Neuroscience by Bear, Connors, and Paradiso...it's just too much to type out)

I know what you're thinking. What the heck is glutamate, right? Well it's the main part of the food additive MSG (monosodium glutamate) commonly found in western-chinese foods. It's health effects are currently being investigated, and it may play a role in the development of some diseases such as asthma and obesity- nothing conclusive though.

It is also the major part of the 5th taste called umami. We're all familiar with the other 4- sweetness, sourness, bitterness and saltiness. Ever wonder why chinese food tastes just a little different? Some scientists would say that you're tasting umami. Others would say it's all in your head :) Which side are you on?

Comment!

Sunday, January 30, 2011

Applications

Seems to pretty much sum up the past 6 months of life: med school, OGS, CIHR, epidemiology, health systems, pharmacology/toxicology, summer studentships, IJHS...the list does go on!

It's interesting to think that at the end of university I end up writing so much about just what the heck I've spent that past four years doing!

Those in 1st/2nd/3rd year...enjoy your time while you have it!

Off to bed, good night world!

Well you can do anything but stay off of my blue suede shoes...

Thursday, January 27, 2011

Winterlude!

We had our skate patrol supervisor meeting last night, and I think it went pretty well! It really got me pumped up for winterlude.

I don't like seeing people get hurt- let me get that straight. But it is nice when it's busy around the shack.

Each year, winterlude offers new challenges and new opportunities. It is a high-stress time for skate patrol, and you really get to see who's great for the job.

I must say...even with all of the experience I have had both on the ice and in the shack, I still get nervous. "What if I do something wrong?" or "How will I know what to do?" I've learned over the years that we can practice first aid on each other all we like- until the cows come home- but when an injured skater approaches you it is no longer textbook. It becomes a simple matter of "hello, how can I help?" Working with real people offers a unique opportunity to learn about something far more challenging than textbook material- compassion. I've learned that some have a difficult time learning about this- each and every time an injured skater walks into rescue or falls on the ice, some first aiders will always run through a set protocol. This is great, because it means they're thorough and professional, making sure that nothing is left out- but when they forget about compassion is no longer treatment for a person- it is just first aid.

It's the experience that counts, because each encounter is different. I've splinted countless forearms for broken wrists and every case truly is different. Every person offers a unique opportunity for us as first aiders to learn about emotion, compassion, human instinct and personality. This is what makes a good skate patrollers- translating these learning experiences into on-ice practice. Remember- you're there for the people, not just for the first aid.

Comment!

Tuesday, January 25, 2011

What University actually teaches you

As the old saying goes, college prepares you for a job, university prepares your for a career. What's meant here is that college will prepare someone for a specific task that they will be able to do better than other people without the corresponding eduction. University, on the other hand, prepares people for many different jobs by providing base skills with which to work upon. Some examples:
1) Time management
2) Critical thinking/reasoning
3) Individual learning/working
4) Teamwork (occassionally)
5) Writing, listening, reading

This is great! Who knew I could graduate and be a model employee for any job that I want!

Wrong.

What university cannot teach people about is the "real world." I'm the UO library, so I figured I should be academic-like and put that term in quotations. What's the real world? Pretty much everything besides school! The vast majority of us will work with people in our lifetime. Shouldn't university teach us how to work with real people, instead of literature research and grant agencies? By "real people" (damn you and your quotes academia), I'm talking about the everyday things...car trouble, credit card interest rates, mortages, interviews, small-talk, politeness, courtesy, 'when do I need a lawyer?', budgeting money and time, the work/home balance...etc, etc.

Keep this in mind if you're in university, or are thinking about appying. While you're in school get some real world experience to help you along- work, volunteer, travel...anything non-academic. Trust me, it'll make you a better person. I've done these things- and at the end, I've realized why medical schools want people to have experiences with real people- it shows them that you're a real person too.

Comment!

Abstract

Who knew that I could write an abstract in 2 hours?

Not bad eh?

This should prep me well for the ANHSSA conference in Toronto, and for the IJHS journal!

Monday, January 24, 2011

Our biggest fear: the wait

That's right. I'm talking about the hospital emergency room wait time. In case you're not familiar, it is estimated that one can wait anywhere from 6-8 hours on an average day.

This is an issue that people avoid talking about in Canada. Doctors. Nurses. Politicians. Macleans said it best in their most recent issue when, in an article describing Canada's health care system ranking as being probably the worst in the G8, they said that people feel scared to address the issue because of how nationalized it is. National health care- it's a part of being Canadian. Any attempts to change the system, even slightly, has consistently been met with near-accusations of heresy or treason, as if the changes would somehow lead to a ban on ice hockey.

Canada- Our system doesn't work anymore. If I've kept you reading this long, you're about to learn why. I've also proposed solutions for each of these problems. Note that all of my solutions involve money- if anyone can reasonably propose a solution to one of these without spending a cent while maintaing current spending, then you should contact the CMA, health canada, and the public health agency asap. Macleans is hosting a discussion on the future of health care in the maritimes on the 26th in collaboration with the CMA, which will be broadcast on CPAC.

Reason #1: the difference between acute and chronic conditions.
Acute conditions affect people immediately and last a very short time- hours or maybe a couple of days. These are the types of conditions that our health care system is set up for- quick-fix medical interventions. This is reflected in the historial context with which the system was envisioned.
Today, chronic conditions are by far the largest killers of canadians. Chronic conditions are those that last a long time- they can be managable, but they normally aren't cured easily (ie/ heart disease, diabetes, some cancers, and psychological disorders).
Solution: designate specific physicians, family health teams, and nurse practitioners to deal specifically and solely with chronic conditions.

Reason #2- Health Care limbo
Beds. Simple eh? Not quite. Some hospitals are operating at upwards of 180% capacity, largely because of the number of elderly patients in "health-care limbo". This is a situation where people no longer require hospitalization, but aren't well enough to go home, or they do not have the proper resources available at home. The lucky ones are housed in long-term care facilities- LTCs for short. These facilities can drastically increase the number of open beds in hospitals.
Solution: It's obvious- build more long-term care facilities. Now if only there were some sort of elected body of representatives at the provincial level with the authority to propose and implement subsidies or partial funding for such facilities...I'm lookin' at you Liberals of Ontario, this is an easy fix and could win you some votes.

Reason #3- The concept of medicalization
This is a tough concept to understand, but I'll sum it up in lay terms. It means that an issue that was previously not the responsibility of a medical professional is now the responsibility of that professional- there is more to it than this, but it really means that doctors now deal with things that they didn't have to before.

For example: colds and flus. In our politically correct society if I told people not to go their doctor if they have a cold I would be told that I have no right informing people of what to do and that I don't fully understand the risks/benefits or the individual susceptibilities...blah blah blah. So what I'll do is provide a historical view of what people did when they were feeling under the weather. They: stayed in bed, ate soup, drank lots of water or ginger ale (for the flu), got lots of sleep and tried not get anyone else sick. Does this sound familiar? Because that's exactly what you'll be told in the ER if you walk in feeling under the weather. We have medicalized catching a cold- you don't need a doctor, you need bedrest and fluids. And still, this year alone, thousands of people will visit the ER with minor symptoms only to be told to go home and rest, all the while spreading their individual bug to everyone else in the ER.

Point: we need to educate people about what kinds of issues are ER-worthy. Further to this, maybe we should intice young, healthy people to forfit their roster with a family physician to allow someone who needs one to have one. An incentive could be a guarantee that you'll have a doctor when you're 50+.

Solution: When public health officials tell you to stay home if you're sick- stay home. This doesn't mean go to the hospital and infect everyone else. The real solution: perhaps if you don't need a family doctor, don't fill a spot that someone else does need- but this doesn't really help in the long run and is only a last resort.

Reason #4: Unnecessary visits
It's not your fault, I know. You can't get in to see your family doctor (if you're lucky enough to have one) to get an updated prescription or to simply modify an existing one. So of course you're going to go to the ER- that's where all the doctors are, right?
Pharmacisists can now modify some prescriptions in most provinces- it seems to be slow moving though. The point: people certainly don't need to visit the ER for prescriptions.
Solution: Firstly, provide pharmacists with the proper education and training to prescribe some medications- the key here is education and training, because it is equally important to know when something is over your head or when a situation cannot be mediated by prescription drugs alone- this is where the education needs to be focused.
Secondly, create new and reinforce existing IT systems for interoperability between pharmacists, nurses, physicians, nurse practitioners, PT/OTs, etc. Only those professions that are subsidized by the provincial government should have access to these documents. And, of course, always ensure that appropriate privacy and confidentiality measures are in place as outlined by PHIPA and PIPEDA.
Thirdly, subsidize the hiring of pharmacist assistants and allow them more training opportunities to be able to do more in the workplace. This may actually allow pharmacists to have some time to consult with their patients/clients.

Reason #5 Lack of individual responsibility for one's own health
The widespread societal perception that one can act however they please because of the safety net of physicians and medications in the future in utterly embaressing.
Solutions:
I'm going to be a bit bolder than most in public health seem so afraid to be:
-Smoking: QUIT. Enough. I don't buy the argument that you are simply supporting the tobacco farmers. If you want to support farmers how about buying local fruits and vegetables. Which segweys me into the next point.
-Diet: eat better. This one can be tough, but I'm here to help. Look at your plate and make sure that 2/3 of it is vegetables and grains, and 1/3 is meat. Drink more water. Eat breakfast. Cut out empty calories (pop, donuts, and whatever starbucks is calling their triple chocolate fudge "breakfast" cake now). Try consulting a dietician- they really can help.
-Exericse: get more of it. Walk instead of driving where you can. Try biking if it's a bit further. Do something you enjoy and it won't feel like exercise. (and your body will thank you)
-Educate yourself, but use your head. Try learning about health topics or how to eat better, but don't get sucked into the latest tree root from Venus because it's supposed to contain 0.0000001% magic. Be smart about it.

The issues that I've brought up are all Canada-specific. They exist in other parts of the world, but they are some big factors for us to consider as we try to make ourselves a healthier nation, in body, mind and spirit.

Comment!

We all do it...

You're sitting at home watching television or reading the paper, when all of sudden the light starts to hurt your eyes. You compensate by tilting your head down or squinting, but eventually your neck gets sore and you eyes get dry. You give in. You have a headache.

Most of us will deny it at first. "Oh I'm probably just hungry. Or maybe I'm thirsty- ya that's it!" Good call, because the majority of headaches are actually caused by dehydration. Unfortunately, by the time you feel the headache it's already too late to just drink some water and be done with it.

SO when the denials and quick fixes don't work we reach for the meds. Ah, yes...the meds. You know which ones I'm talking about- tylenol, advil, aspirin, excedrin, etc. You run to the medicine cabinet to rid yourself of this unnecessary pain. But...uh oh...you're all out!

Now. You're at the pharmacy and your head hurts so bad that you just grab the first pain medication that you can reach for (or if you read my post on coke vs pepsi...maybe you choose the one that's on sale?).

WHOA! Hold it right there buster. How do you know what you're buying? Do you even know what that 'drug' is? Any idea who made it, or where it comes from? And why is it that price, why not $1, or why not $100?

We are fortunate in Canada to have such a good lot release system. A lot release is the system used by the national regulatory authority (a sub-branch of Heath Canada in our case) to ensure that the lot (or 'batch) of the drug meets all of the in-process controls and final product testing.

The next time you reach for something from the shelf of your local pharmacy, consider the work that was undertaken to ensure that the product is safe, effective, and reliable. Of course this doesn't apply to 'natural' remedies, which is precisely why their efficacy cannot be evaluated (if it was, they likely wouldn't make any money at all).

Comment!

An asteroid hit where?

Hello again friends! This time I'm here to share with you a tale of asteroids. Specifically, how the heck do 'they' (whoever those scientists are), know that an asteroid struck the earth around 65 million years ago and contributed to the extinction of the dinosaurs?

Firstly...if you know me well enough, you also know that I have had an obsession with dinosaurs since I was born- no really, ask my mom- my first word was "Stegosaurus" :D

But before your attention span with my tale of dinos goes extinct, I'll cut to the chase. There is an element about halfway down the periodic table (the one with all of the chemicals) called Iridium. It's symbol is IR, and it's atomic number is 77 (simply, it's the 77th element). This otherwise boring metal  is very VERY rare on Earth- its estimated that it exists in 1 part per billion in crustal rock (or for every 1 iridium atom, there are about 1 billion other atoms). To put this rarity into context, gold is about 4x as common, platinum about 10x, and mercury and silver are about 80x. Simply- there isn't much iridium on Earth.

But there is one place that iridium is very common- asteroids. When asteroids impact the earth they can leave a layer of burnt (they burn because they release a lot of heat when they impact) crust that is rich in iridium. One such layer exists at the K-T boundry- precisely the period in geological history that the dinosaurs became extinct. It is now known that this was not the only factor in the extinction of the dinosaurs- there were flood basalts, changing global temperatures, anoxic oceans, etc...but the asteroid sure did speed things up quite a bit.

If you're intersted in asteroids, check out the Manson Crater in Manson, Iowa. The crater has since been filled in via erosion over the past ~70 million years.

Comment!

Sunday, January 23, 2011

The history of new coke

Hello friends! The following is an interesting story that I was told by...well let's just say a role model of mine.

Today, in my generation at least, everyone knows coke and Pepsi as the two largest cola companies (major conglomerates aside, I'm just talking beverages here). Typically we make our decision as consumers while standing in front of both of them looking at the price tags. Ok, ok, besides the odd person who goes out of their way to purchase one product over the other, people will generally buy the one that's on sale. That's how we know it today: Pepsi vs. Coca-Cola "Classic". Well, what does that 'classic' stand for anyway?

Coca-cola always held a pretty strong grip on the cola market (at least in north America- I'm not sure about elsewhere). That is until Pepsi came along and began to steal a bit of their market share. Not much- about 20-30% apparently. Obviously coke didn't like this. Thus they created a product to compete with Pepsi, and called it "new coke".

If you are around my age you have no idea what new coke is. Apparently it is a coca cola product that pretty much tastes like Pepsi. This was a good strategy, right?- Create a product that is just like your major competitor's and, since you have been around longer, consumers will gravitate towards your product. The key here is that this was an age where the term 'price war' didn't really apply to beverages- it was an age of marketing based on quality of product (consult your nearest history of business text). As it turns out, people didn't buy the "new coke" that tasted just like Pepsi- instead they bought Pepsi. Coca-cola then decided to create "coca-cola classic"- and apparently the name stuck. Or so I'm told...

Comment!

Saturday, January 22, 2011

Careers in Health

I just got back from the careers in health presentation, put on by the students and faculty of Health Sciences. I think it reinforced and removed some of the impressions that I have about grad studies.

I'm not longer interested in the MSc. health systems. I had always considered the MHA because I thought it would be a better fit for me- and it sounds like it is. It requires 3 years of work experience, but I learned that management experience on the canal during university will contribute to those three years. MHA...perhaps.

I think I recieved some useful tips from the faculty of medicine as well. I should hear back about an interview in the next week or so. It will be nice to hear back from the faculty about an interview so that I can resume my life- it feels like it has been on hold ever since I applied.

Most importantly, today I learned that my feelings about the health care system are shared by several of the role models of the faculty, including the dean, vice-dean, and others. As I have said before, there is more to health care than doctors and nurses...this notion was reinforced today.

An interesting point was made by the presentation's keynote speaker. She quoted CIHI data and told us that helping very few sick people (as medicine does) does not actually contribute to the health of a society, but that making small changes to the daily lives of millions of people (as public health does) can have a profound impact on the health of a society. I am interested in this concept of societal health...this may be one that I have to look outside the classroom to find the answers to.

Enjoy my thoughts, and Comment!

Friday, January 21, 2011

Typical Weekend

As I sign off for the night I look forward to another great weekend, filled with data entry at CHEO, working on the canal, doing school-work and spending time with Michelle.
Goodnight!

Thursday, January 20, 2011

Perspective: Can we travel to other planets? Sci-fi to the test...

Can we travel to other planets, as science fiction seems so compelled to suggest?

Here's a thought experiment. Remember the charts of the solar system on the wall in elementary school? All of the planets are spaced roughly evenly, right? Well it turns out that they're not exactly drawn to scale.

This makes sense, of course. If we tried to draw a to-scale version and started with Earth (about the size of a pea maybe), Jupiter would be about 10 000 feet away.

And Pluto? Oh about a mile and a half (and not to mention about the size of a bacterium).

So the next time someone tells you that travelling to other planets may be a reality, remind them that we have difficulty sending people to our moon, or about 240 000 miles away- a mere hop, skip, and a...well not quite a jump on our to-scale model.

Comment!

Overpopulation...somebody's got to say it.

Hey friends, this one is about my experiences on the Rideau Canal, and comparing two of the largest threats to humankind's existance: global warming and overpopulation.

Somebody's got to say it. I would hate for it be me, but I do pity the guy who decides that it's a good campaign slogan.

While skating the Rideau Canal this past Friday, on my regular shift from 5-11, I stopped to look at the eco-art on Dow's Lake. Most of the paintings/pictures were very well done. They included pristine images of ecosystems and focused snapshots of a myriad of organisms all co-existing happily. Most of them even contained inspiring captions. All was well in the world of eco-art.

But then I began to read more and more of these captions and realized that some of them weren't even pretending to be neutral. No - some of them contained blatant attacks on "industry", "humankind", etc, for causing, or contributing to, global warming. So I thought about it.

We human beings are very interesting creatures. We have always, and continue to, elevate ourselves above the natural world, into some advanced realm of "we're better than you, you dumb animals." This was done in ancient dendograms (charts depicting the relative hierarchy of organisms in the natural world), where humans were placed on the top. We haven't changed- today we grant ourselves the privilidge of not only a separate species name (sapien), but also a genus name (homo) dispite the fact that, for all logical purposes, homo may very well include chimpanzees.

As a result of our perceived patriarchy over the natural world, people have developed such ridiculous arguments such as "global warming will be the end of the world." Suckers relax...planet Earth would exist for a very long time without us (perhaps even better off?). End of the world? Not for the Earth...maybe for us.

Back to the point. Overpopulation. The real issue. Yes, global warming sucks- unless of course you live in the Northern hemisphere and are otherwise ecstatic about saving money on snowblower fuel. Global warming could kill us eventually- but before then we are going to run out of food, clean water, and adequate shelter (what with all the flooding). Oh ya, and with all of these people that the world's public health agencies certainly could not look after, we could experience outbreaks of deadly communicable diseases- not a big deal though...just ask anyone from England circa 1348-1350. (Yes- that was a bad Plague joke).

Point: Global warming: Grab your swim trunks. Overpopulation: where's dinner?

Comment!

Impending problem anyone?

Hey friends, I wanted to share this idea with you guys from the book "Green Cities" by Matthew Kahn. The author discusses environmental issues from various perspectives, including an economic perspective.

The idea: The Environmental-Kutnetz Curve (EKC)

This is derived from the Kutnetz curve, where economic inequality increases for a short while during the development of a nation (estimated by average GDP), but eventually decreases as the nation becomes more wealthy- or something like that! Imagine inequality on the vertical, and GDP on the horizontal of a graph. Now imagine that the line is the top half of a circle, for a while the line goes up, but at about halfway it goes down.

This can be applied to the environment only on very small scales- not that of an entire nation, but rather individual cities (hence Green Cities). On the horizontal in average municipal GDP, and on the vertical is impact on the environment (with the same top-half of a circle graph). Simply stated, as people get richer their impact on the environment increases until, at some specific point in development, their increased income allows them to invest in more eco-friendly living-options and their effect on the environment diminishes (for more info, Wiki it!) There are obvious limitations to this- but that would require another blog post!

Example: Ottawa, Canada is a relatively wealthy city, when compared internationally, which is said to be a reason why there is a developing culture of eco-friendliness. On the other hand, Mexico City is a relatively poor city, thus their impact on the environment in much more profound. Simply: Ottawa is on the right half of the circle, and Mexico City is on the left.

WHO CARES?

You should. Guess where the vast majority of people in the world live? That's right- on the left side of the curve. This means that as countries develop higher average incomes they will purchase their way into wasteful practices and have a significant negative impact on the environment. In fact, the majority of the cities in the US do not actually qualify to be placed on the right side of the curve.

Something to think about while contemplating why humanity is reluctant to actually change our wasteful, consumerist habits in lieu of Planet Earth crying for help...most people can't afford to be eco-friendly.

Comment!