Dispatches from the Front: The Life of Matthew Halton, Canada’s Voice at War (Book Review) by David Halton

Review of Dispatches from the Front: The Life of Matthew Halton, Canada’s Voice at War by Matthew Halto

The Anatomy of a Weight Recidivism and Revision Bariatric Surgical Clinic

Abstract. Weight recidivism in bariatric surgery failure is multifactorial. It ranges from inappropriate patient selection for primary surgery to technical/anatomic issues related to the original surgery. Most bariatric surgeons and centers focus on primary bariatric surgery while weight recidivism and its complications are very much secondary concerns. Methods. We report on our initial experience having established a dedicated weight recidivism and revisional bariatric surgery clinic. A single surgeon, dedicated nursing, dieticians, and psychologist developed care maps, goals of care, nonsurgical candidate rules, and discharge planning strategies. Results. A single year audit (2012) of clinical activity revealed 137 patients, with a mean age 49 ± 10.1 years (6 years older on average than in our primary clinic), 75% of whom were women with BMI 47 ± 11.5. Over three quarters had undergone a vertical band gastroplasty while 15% had had a laparoscopic adjustable gastric band. Only 27% of those attending clinic required further surgery. As for primary surgery, the role of the obesity expert clinical psychologist was a key component to achieving successful revision outcomes. Conclusion. With an exponential rise in obesity and a concomitant major increase in bariatric surgery, an inevitable increase in revisional surgery is becoming a reality. Anticipating this increase in activity, Alberta Health Services, Alberta, Canada, has established a unique and dedicated clinic whose early results are promising

Surgeon Involvement in Pre-Clinical Medical Education: Attitudes of Directors of Education

Background: Application rates to surgical residencies have shown a downward trend recently. Introducing students to surgeons early in medical school can increase interest in surgery as a career and enhance the instruction of important surgical topics. Directors of undergraduate medical education have unique insight and influence regarding the participation of surgeons in pre-clinical education. Methods: To understand the attitudes of these educators towards surgeons as teachers in pre-clinical programs, a survey was administered to the directors of undergraduate medical education at each of the English-language medical schools in Canada. Results: Educators estimate the participation of surgeons in all categories of pre-clinical education to be low, despite being valuable, and think that it should be increased. The most significant barrier to participation identified was a lack of surgeons’ time. Conclusions: Despite the value of surgeons participating in pre-clinical education, their rate of participation is low. Steps should be taken to facilitate the involvement of surgeons in this phase of education, which may lead to improved education for students and increased student interest in surgery residencies.

Digital Falsehoods and their Analog Consequences: The “Fake News” Strategy and its Mitigation.

Capítulo 7 - MIL Cities and MIL Citizens: Informed, Engaged, Empowered by Media and Information Literacy (MIL).Governments worldwide struggle with “fake news” and disinformation. While “fake news” is not an accurate term, it is critical in describing the intentionally disruptive propaganda or disinformation using a news media format. “Fake news” may be executed by malevolent state-level or grassroots actors to disrupt elections and civic life. Current discourses often misidentify “fake news” as simply wrong information, rather than evaluate political motivations for its spread and identify the groups vulnerable to its influence. As more cities strive to adopt an “MIL cities” mandate, the means to tackle misinformation must be included to ensure efficacy. This paper evaluates the dangers of neutral conceptions of “fake news” to MIL, and why addressing discontent rather than disinformation is a better approach for reducing the harms of “fake news

H2O2 Signature and Innate Antioxidative Profile Make the Difference Between Sensitivity and Tolerance to Salt in Rice Cells

Salt tolerance is a complex trait that varies between and within species. H2O2 profiles as well as antioxidative systems have been investigated in the cultured cells of rice obtained from Italian rice varieties with different salt tolerance. Salt stress highlighted differences in extracellular and intracellular H2O2 profiles in the two cell cultures. The tolerant variety had innate reactive oxygen species (ROS) scavenging systems that enabled ROS, in particular H2O2, to act as a signal molecule rather than a damaging one. Different intracellular H2O2 profiles were also observed: in tolerant cells, an early and narrow peak was detected at 5 min; while in sensitive cells, a large peak was associated with cell death. Likewise, the transcription factor salt-responsive ethylene responsive factor 1 (TF SERF1), which is known for being regulated by H2O2, showed a different expression profile in the two cell lines. Notably, similar H2O2 profiles and cell fates were also obtained when exogenous H2O2 was produced by glucose/glucose oxidase (GOX) treatment. Under salt stress, the tolerant variety also exhibited rapid upregulation of K+ transporter genes in order to deal with K+/Na+ impairment. This upregulation was not detected in the presence of oxidative stress alone. The importance of the innate antioxidative profile was confirmed by the protective effect of experimentally increased glutathione in salt-treated sensitive cells. Overall, these results underline the importance of specific H2O2 signatures and innate antioxidative systems in modulating ionic and redox homeostasis for salt stress tolerance

Failure of Administrative Data to Guide Asthma Care

Rationale: Asthma is a chronic inflammatory disease of the airways that is very common (7.9% ofCanadians over the age of 12). Despite numerous clinical guidelines, education events and administrativedata reviews, there has been little change to the way asthma is managed in the Canadian health caresystem for nearly 30 years. We evaluated, through the Physician Learning Program (PLP) in Alberta,possible reasons why administrative datasets have not been able to provide meaningful information toadjust health policy. Methods: Provincial data was attained through Alberta Health Service and Alberta Health on pulmonaryfunction testing from 2005-2011 (through the PLP). The number of asthma diagnosis made during the sametime frame were then compared. Results: The preliminary results of the PLP found that spirometry was billed for roughly half as often asthe asthma diagnostic codes were utilized during the same time frame. However, the review also revealedinconsistencies in how administrative data are captured, making it difficult to determine whetherspirometry is being underutilized by physicians in making asthma diagnoses. Conclusions: Inconsistencies in how administrative data are captured in Alberta may be contributingto an incomplete picture of the rates of asthma diagnosis and physiological testing, and may explain, inpart, the limited influence of administrative datasets on guiding meaningful change within the healthcaresystem