Wednesday, May 25, 2011

Buying Blood? The tale of why Canada really does pay people for blood.

A few disclaimers to start:
  1. I have nothing against blood donation or blood product transfusion- in fact I am very supportive of both.
  2. I do not disagree with the methods used by Canadian Blood Services to obtain blood products to meet the demands of growing Canadian need for said products
  3. I have volunteered with Canadian Blood Services, both as a greeter/guide on the blood mobile, and as a blood typer collecting blood samples from participants as part of promotional events aimed at increasing blood donation.
  4. I am a family member of an individual who has required several blood transfusions in their lifetime, and am grateful for CBS and Canadian blood donors.
Now...

In Canada, the Human Tissue Donation Act of 1989, section 15,subsection I, states that:

15.(l) No person shall buy, sell or otherwise deal in, directly or indirectly, any tissue, body or body part for the purpose of a transplant or for a therapeutic purpose, medical education or scientific research. (1)

And section 15, subsection 3, states that:

(3) A person who contravenes this section is guilty of an offence and liable on summary conviction to a fine of not more than $100,000 or to imprisonment for not more than 1 year, or to both. (1)

Sounds pretty intense...sounds like Canada believes that no one should buy or sell blood or blood products. You can't be paid for blood donation in Canada...let's examine, shall we?

Blood products (or plasma products) refer to concentrated or purified proteins fractions derived from plasma for therapeutic use, such as albumin or intravenous immune globulin (IVIG) (2,3). Canadian Blood Services (CBS) is responsible for collecting blood samples from Canadian donors that are used in the production of plasma products (2). Over the last 10 years, the net usage of IVIG alone in Canada has doubled to more than 3000 Kg/year (3). With this increased demand in plasma products, Canada is no longer (since 1994/1995) a plasma self-sufficient nation (3).

Self sufficiency can be defined as the collection of enough plasma from Canadian donors to meet the needs for manufacturing the product in highest demand (IVIG) (3). Canada is almost self sufficient at producing albumin, but only 20% of the IVIG used clinically in Canada is derived from Canadian plasma (3). The balance of IVIG is purchased as finished product from commercial manufactures (3) by Canadian Blood Services, who purchase the balance of hospital requirements for IVIG from international suppliers (2). In fact, a significant proportion of all plasma protein product inventories are purchased in U.S. dollars (2).
The US collects 3 million litres of recovered plasma (from blood donation) and 14 million litres of source plasma (for further manufacturing) from paid donors.

Like it or not, the blood/plasma products that are used here in Canada were obtained in such a way that would violate section 15(1) of the Human Tissue Donation Act of 1989 if it were done here in Canada. If The Act exists out of some sort of moral obligation to maintain the integrity of human tissues and organs by ensuring that they are not paid for, or sold...then The Act fails to realize that we are already paying people for blood donation, by proxy, for plasma products.


(1) The Human Tissue Donation Act
http://www.ulcc.ca/en/us/index.cfm?sec=1&sub=1h1

(2) Canadian Blood Services annual financial report


3) Dr. Willem K. Stevens- Blood Products Division, Centre for Blood & Tissues Evaluation, Health Canada. Production and Regulation of Plasma Products. Course BPS4102 Biopharmaceutical Regulation, Faculty of Science, University of Ottawa. March 21st, 2011.

Sorry Tories, that's just not good enough

It doesn't seem like the Tory plan to 'reform' health care at a provincial level is very different from the current plan imposed by the Liberals.

The system is broken- has been for some time. Soaring drug costs, ER wait times, coupled with the fact that some people have no access at all to the 'gatekeepers' of the system...but you don't need me to tell you this- recall the last time you waited in an ER, tried to see your GP or were prescribed medication without insurance (despite McGuinty's best efforts last year).

I'm not saying the Tories should be let loose on the issue and have their way with the means to which Canadians obtain health care. This is one of the few issues that I don't mind the Liberals tackling- but some conservative influence would be nice- save for insurance companies, I'll go swinging to avoid insurance in any way, shape, or form. We need to re-open the issue to examine and evaluate the very fundamentals that the system is based on.

It's simple- a 3% increase in funding (both liberals and Tories support this figure) means nothing when health care expenditures are increasing at roughly double this each year. Yes, Harper has promised federal transfers of 6% to the provinces for health care, and considering it's a provincial issue, it seems they've done their due diligence- they've covered the cost of increasing expenses and said "well, the rest is up to you guys." We're still waiting for Ontario to realize that the rest really is up to them...3% will barely cover the cost of subsidized long-term care facilities required for the entire aging population. Oh, and then we have drug costs, ER wait times...hold on, I think I've mentioned these before...

I ask: would you consider investing in a company whose sales were increasing at 3% but whose expenditures were increasing at 6%/year with no end in sight and with a fixed market with which to sell? How about one where the 'sales' are predetermined by external influences, both political and economical? Or how about one where the owners of the company can change as frequently as a few years, with different ideals on how to run the business...I think you'd start looking at something a bit more sustainable.

Sorry Tories, but your 'play it safe' mentality on health care is not making me want to vote for you. Not when health care is the #1 issue provincially...not when the provinces spend upwards of $50 billion on health care...not when a significant number of Ontarians cannot access health care services. And cutting the LHINs...that's your big plan? Might as well buy every resident of Ontario some herbal tea and call it therapeutic...

I get it- health care is a suicide issue: even touching health care with a 10-foot pole can lose a party votes. Does the problem lie with the voters? I urge you Ontarians- fear not of health care reform! It will come whether you like it or not, but you do have a say in when it happens.

http://www.theglobeandmail.com/news/politics/adam-radwanski/hudak-borrows-from-harpers-playbook-to-explain-his-health-care-policies/article2033634/

Monday, May 16, 2011

Another word deriviation...sort of...#4?

The 'word': G.I.

As in G.I. Joe, or some other comando.

It is a military term that is short for Government Issue. The term was used to refer to any piece of equipment used by U.S. servicemen. Apparently, in World War II, the term G.I. was half-jokingly applied to the soliders themselves, as if they were manufactured by the government- they were G.I.!

Word derivation #3- a lesson in marketing 101?

The word: salubrious

It means 'health giving' or 'health promoting'. For example, something can be salubrious...such as exercise.

What a wonderful tool for marketing acai juice or kashi cereal...just tell people that it's salubrious! This seems much better than 'it will promote health and well-being'- just sum it all up with salubrious.

God I hope the marketers don't read blogger...

DNA computers? Smarter-than-human processing 'machines'?

Today was the first time that I had heard of the possibility of DNA computers. I may have heard it in passing once before, but I probably figured it was more likely that I learn how to use the force or accompany a stout, boyish-looking man on a quest in middle earth to throw a ring into a volcano...I'm sure you get the idea.

According to Moore's Law, which describes a long-term trend in computing capacity, the number of transistors that can be placed on an integrated circuit doubles every two years; conversely, microprocessor size is halved every 18 months.

This means that by the year 2023 (roughly and apparently), the silicon chip will hit a physical roadblock- the microprocessor will be too small with too many transistors to allow passage of the very electrons that breathe life (so to speak) into computers. People will have to cope with sub-par processing speed (which would be quite more significant than today's PC), as the silicon chip will have reached it's maximum potential.

Now, aside from the simple solution of linking two chips together (which, perhaps by then or in the future of the future will be an option), some in the tech literature dream of a world where DNA computers exist. Computers that regenerate, grow, adapt, and perform processing tasks at enzymatic rates...all without the use of much raw material (DNA can essentially be amplified forever by techniques like PCR if enough reagents + buffer are available).

This prompts a very philosophical, but increasingly important question: can human beings create machines (or at this point, perhaps life itself) that are more intelligent than we are? Science fiction suggests 'maybe', while intuition and logic may suggest 'no.' Some would argue that computers are already smarter than us...yes, it is true that the processing capacity of computers may well exceed the computational capabilities of the entire human race combined. But this measure of computation does not imply that the computer is 'smarter'- this argument lacks content/face validity.

Perhaps the bio-technical sciences can borrow a lesson from the physicists: we cannot use current knowledge and theory to ascertain the effect of smarter-than-human intelligence because the conditions required for such a hypothetical world may approach a sort of social-singularity. Just as the laws of physics may break down when one tries to model a singularity at the centre of a black hole, perhaps the 'laws' of intelligence, and thus human society, would breakdown if such a singularity were modelled.

In sum, it may be impossible to imagine a world where computers are smarter than humans, because we are currently limited by our own intelligence through our creation of theories and our understanding of knowledge.

Other improvements in computing power may be next in line, such as fibre-optic-based computers, direct brain-computer interface, biological augmentation of the brain and genetic engineering. Whether these devices will be smarter than humans...I cannot be sure...perhaps I am both bound to, and limited by, my own intelligence.

CHEO-HALO Summer studentship

I must say, I am really enjoying my time so far at CHEO. I feel like I am a much bigger part of the team this summer. I was happy with last summer as well, but I knew that I could contribute more- and I am now getting the opporunity to.

The projects are really interesting. I am enjoying everything from background reading, data entry, SOP/protocol development and learning how to use an Actiheat (heart rate monitor + accelerometer).

Up this week: METcart training, Actiheart SOP, Actiheart pilot data, PAE study participant, and a whole lot of reading...what a life! This truly doesn't feel like a job!

I am grateful for the opportunities that the HALO team has given me, and I am excited to continue working with them.

Friday, May 13, 2011

Energy In = Energy Out

After attending a debate yesterday at UOttawa (Fork vs. Feet) I recalled an important principle of physics (thus, of science in general) called the first law of thermodynamics. Very simply put, energy in = energy out. I have, for some time, believed that this is a critical concept that must be understood by any individual interested in weight management- I, along with the large number of health professionals, still believe this today.

The first law of thermodynamics is, to simplify, an expression of the principle of conservation of energy, which states that the total amount of energy in any system remains constant over time: thus energy cannot be created or destroyed. For weight management, this is very important to understand- stored energy as fat simply will not be destroyed (or broken down) without conversion to a more useful form, such as work (exercise) or heat. The latter won't likely make you lose weight- dehydration may kick in first.

Fat is probably the most efficient form of energy storage in the natural world (to the misguided fool who argues that it is glycogen I have 3 words: water of hydration). We humans are truly storage machines- an evolutionary trait that allowed us to maintain energy stores during times of famine when eating infrequent meals- we wouldn't be here without it. But back to the point- stored energy as fat cannot be "burned" without actually burning it!

There are two sides to the coin though...the energy in side of the equation also plays a role and is just as important to understand for one interested in weight management. I would recommend simply thinking about the food that you are eating and ask yourself questions such as: how much of this is natural, or free from processing? How many of the ingredients are 'artificial'? Can you identify, within reason, the exact source of the food, ie/ wheat, oats, beef, etc (if not, it is probably too processed). Questions such as these, as well as others, should form the basis of thought concerning one's food intake- forget dieting, forget cutting food groups, such as carbs...just think a little bit more about the energy in side of the equation.

When in doubt, consider a primitive, ancestral 'you' and their dietary habits- would early humans eat Mars bars, ice cream, or pre-packaged 7-cheese lasagna (yes, even if it's PC blue menu)...I didn't think so. They would likely eat whole foods with natural ingredients and plenty of nutrients...a poor argument to make for choosing foods at the grocery store, but I think it is important to keep in mind what humans are meant to eat. After all...it's us who is eating it.

In sum, an anthropocentric society would have people believe they are above many of the laws of the universe...the law of thermodynamics is not one them. Energy in continues to equal energy out...

Wednesday, May 4, 2011

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Sunday, May 1, 2011

Time to study! Wait, what?

I can't believe that undergrad is over! Throughout the past five years I have been defining myself as a student. I have been associated with everything "student" -well some things...mostly the things that involve me saving money. For the first time in a quite a while, my answer to the question "what is it that you do?" cannot be answered by the phrase "well, I'm a student at UO." Crazy? I think so.

So what did I learn? A lot, it seems- some academic and some non-academic. The latter, as I have learned, is much more important and useful. Consider the following: my recent healthcare program development, midterm. My first answer to the majority of the questions was indeed correct- the answers that anyone off of the street would likely have the common sense to blurt out in response to such ridiculous questions. However, I changed my answers to the more fitting academic responses. They too, were right, but perhaps less-so, some may argue (for the record, I recieved an A+...I'm not just some disgruntled student who didn't like the professor, but I do challenge the external validity[aka real-world transferability] of the material).This was the point at which I realized that my real-world experience (through working, volunteering, a community project, and getting the heck out of the Ivory tower at any chance I could) is actually much more useful than my academic experience.

In short- life is not a multiple choice question. There are no right answers in life- there are better and worse answers, but 'right' is not for us to decide (enter your religious deity of choice here, ie/ God). Society may say that there are right answers...but historically these answers have changed over time- human sacrifice, witch burning, gladiator battles...at one time these were society's 'correct' answers to social injustice or socio-economic hardship.

Having said this, I am grateful to have the opportunity to learn such wonderful things. Some of these things are more applicable in my life than others, but I am grateful for them all.