Some doctors are struggling with allowing Canadians to die on their own terms.
Here I share a powerful article by Krista Stevens.
Some doctors are struggling with allowing Canadians to die on their own terms.
Here I share a powerful article by Krista Stevens.
Have a Fitbit? Do you pound the pavement? Hit the road? Do you do it for body? Or mind? Likely both!
In January 2017, psychotherapist William Pullen published a new book, Run For Your Life. It’s an interesting read.
Here’s a description of the work:
“Anyone who has ever gone for a run, jog or even a walk knows that uplifting, happy feeling they get at the end of their journey. Some call it the ‘runner’s high’, others put it down to endorphins, here William Pullen teaches us focus that incredible energy to experience our emotions in motion.
“In Run for Your Life, Pullen argues that we need a radical new approach to mindfulness – an approach which originates in the body itself. DRT offers just that.
“Whether the you are looking for strategies to cope with anxiety, anger, change, or decision-making, Run for Your Life offers carefully-tailored thought exercises (and talking therapies for pairs or groups) inspired by mindfulness and Cognitive Behavioural Therapy, specifically designed to be implemented whilst on a run or walk. The book is designed to offer space for you to reflect on your practice and see your progress as you run through life’s ups and downs.”
It immediately made me think of the first (silly) article I wrote as a PhD student in London.
(Man, it’s funny to recognize that eleven years have elapsed since the publication of the article above!)
The idea then was that running might alleviate some of the PhD blues. But Pullen has taken it to a whole new (and more) comprehensive level. His book is definitely worth a read.
How will the pharmaceutical industry be impacted under the Trump administration? Who’s the new FDA Commissioner? How will e-cigarettes be effected? How will the opioid crisis be impacted?
Trump’s FDA and “the United States of Oxy”
By Lucas Richert
The US Food and Drug Administration (FDA) may be headed for a major overhaul under the Trump presidency and the agency’s new head, Scott Gottlieb. At a recent meeting with pharmaceutical industry leaders, President Trump asserted that “we’re going to be cutting regulations at a level that nobody’s ever seen before.” His most recent statements, made at a White House confab, echoed loudly throughout the medical and pharmaceutical industries.
Just talk? It’s tough to say, yet supporters of pharmaceutical deregulation have long wanted to reduce bureaucracy and lessen oversight of drugs and devices. Critics, by contrast, contend the drugs market could be destabilized and public health undermined. The tricky task will be to strike the proper balance of speed and safety, as well product innovation and consumer protections.
Scott Gottlieb, a physician and regulator recently approved to lead the agency by the US Senate in a 57-42 vote, pledged he would lower prices, reduce approval times, and fight the widespread abuse of opioid painkillers. This kind of addiction, said Gottlieb, was “a public health crisis of staggering human and economic proportion.”
This rhetoric and attempted reforms at FDA are not new, but the devastating painkiller crisis certainly is.
Gottlieb’s critics noted that he was too closely tied with the pharmaceutical industry to tackle the opioid epidemic. “We are suffering this public health epidemic because big pharma pushed pills they knew were dangerous and addictive, the FDA approved them, Senator Ed Markey (D-Mass) told reporters. The United States had been turned into the “United States of Oxy,” Markey added.
The FDA approved OxyContin, a powerful opioid to treat severe pain, such as in the case of patients with terminal cancer. With mild pain, though, the FDA deemed the dangers of addiction too great, and has not allowed the marketing of Oxy for such pain.
Not able to solve the opioid alone, the FDA nonetheless will play an important role. He has made this case quite forcefully. However, Gottlieb’s critics (mainly Democrats) have pointed to his past views on the regulation of opioids. In particular, he has suggested that policies restricting pharmacies and drug distributors might burden innocent patients.
This will be one of the defining issues of his career.
The Food and Drug Administration’s move in May, 2016 to crack down on e-cigarettes brought regulation in line with existing rules for cigarettes, smokeless tobacco and roll-your-own tobacco. This had been highly anticipated after the FDA issued a proposed rule over two years ago.
“Millions of kids are being introduced to nicotine every year, a new generation hooked on a highly addictive chemical,” U.S. Secretary of Health and Human Services Sylvia Burwell stated during the announcement of the new rules. She asserted, too, that health officials still didn’t have the scientific evidence showing e-cigarettes can help smokers quit, as the industry asserts, and avoid the known ills of tobacco.
The Trump administration recently approved a delay in the FDA’s e-cigs guidelines. It was a decision that divided officials in the public health establishment. And it’s undoubtedly true that several Trump administration officials, including FDA chief Gottlieb, have connections to the e-cig and tobacco industry.
From March 2015 to May 2016, according to Bloomberg, Gottlieb was a director of Kure Corp., a Charlotte, North Carolina-based firm that distributes e-juices and vaping pens in coffeehouse-style lounges known as vaporiums. Of course, he had a financial interest in the company as of March, according to financial and ethics disclosures, and promised to sell his stake if confirmed as head of the FDA.
“How to regulate e-cigarettes is one of the most critical questions on tobacco regulation that the FDA is going to be facing in the coming years,’’ said Vince Willmore, a spokesman for Washington-based Campaign for Tobacco-Free Kids.
Vaping will also be a significant issue for Gottlieb and the FDA. Getting the regulation right matters – not just in the U.S., but places like Glasgow and Vancouver.
FOR MORE ON E-CIGARETTES:
The writer Matthew Herper suggested recently how “talk of speeding up [drug] approvals for serious diseases first gained traction in the early 2000s.” Actually, the trend extends much further back. Debate about quickening drug approvals has a complex and compelling history.
The FDA under President Ronald Reagan, for instance, offers a useful tool to evaluate the Trump administration’s approach to the FDA and the drug industry.
In mid-January, as Mr. Trump awaited his inauguration and the transition team worked furiously to establish his cabinet and select suitable agency nominees, the FDA generated serious debate. Trump met with Jim O’Neill, a venture capitalist, and a close friend of PayPal’s Peter Thiel. He met with Balaji Srinivasan, a cofounder of genetics testing firm Counsyl.
Both men subscribed to the idea – now conservative doctrine, according to Forbes – that the FDA prevented a flood of new drugs from hitting the market. Neither held an M.D., which has been for years a prerequisite for the FDA’s top job. Yet, by 20 January the frontrunner for the Commissioner’s job was Gottlieb, who had made it known publicly he believed the FDA should trim bureaucratic red tape and approve drugs in a speedier fashion.
Trump ultimately settled on Gottlieb, whose selection was welcomed by the pharmaceuticals sector. His ties to industry were questioned by Democrats, but the vote wasn’t close.
The Gipper’s FDA
Ronald Reagan, whether as a candidate or later President of the United States, did not desire the dismantling of the FDA, but neither did he trust it. In his optimistic view, its authority, like that of many other regulatory agencies, simply needed curtailing.
In 1975, he told an audience at the American Enterprise Institute, a conservative think tank, that the FDA was hurting Americans, yet also made clear he did not wish to totally “eliminate the responsibility of the FDA…”
The problem, as Reagan saw it, rested in the restriction of freedom of choice for American consumers, since the agency had established itself “as the doctor and decided that they will tell us what medicines are effective.” He felt that a degree of regulation was necessary to protect Americans from each other, but the FDA had overreached and, as bureaucracies do, went beyond “protecting us from poisonous or harmful substances…”
In 1980, the Republican presidential ticket of Ronald Reagan and George Bush promised to change Washington. President Jimmy Carter represented failure, Republicans argued, be it botched rescue attempts and helicopter crashes in the desert, the loss of the Panama Canal, or an impotent economy. The jaunty and upbeat Reagan succeeded in shifting the policy discourse about the size and scope of federal government programs; harkening back to halcyon days, he moved the conversation about which government program to launch (or expand) to how much of a program’s or agency’s budget ought to be cut.
In 1981, the debate about drug regulation continued to polarize people; finding a middle ground was often difficult, and as the new administration took power, the outgoing FDA Commissioner Goyan articulated a consensus-oriented, centrist approach to drug regulation. Think tanks such as the Heritage Foundation and American Enterprise Institute promulgated changes to the FDA’s mission as a means of unleashing the once-mighty American pharmaceutical industry. This would fuel the U.S. industry and the greater economy.
For some, the FDA transcended presidential politics and ideology. It protected all Americans – conservative and liberal – as it carried out its duties. “My view,” said the bearded, grey, and somewhat feisty Jere Goyan, “is that government regulation needs to strike a balance between preserving the maximum freedom for individuals while at the same time establishing the rules that are needed for us to live together, to survive as a society.”
By voting for Reagan, Americans indicated they wanted “modifications” to the current models – reform rather than removal. “It would be a mistake,” Goyan argued, “a tragic one, to interpret the election results to mean that the public wants a lessening of the standards that provide the foundation for the food and drug industries in this country, standards that make our food and drug supply the best in the world.”
Often, his approach went unheeded, overwhelmed by disputes about individualism and consumer choice and bureaucratic incompetence. One the one hand, many Americans regarded FDA staff members “as a bunch of demented bureaucrats running amok,” even though the agency’s “balanced” regulation of drugs was both “socially valid and moral.”
On the other hand, the president of the Pharmaceutical Manufacturers Association illustrated an alternative. Lewis Engman felt that taking medicines, like smoking cigarettes, was a matter of personal choice. “Any time you interfere with the basic market system,” he said in 1981, “you’re in trouble…the consumer is his own best guardian.”
Impossible as it was to know how the new president would transform the FDA in early 1981, political pundits, economic analysts and pharmaceutical industry insiders suggested that Reagan meant less regulation, which meant industry growth. The President of the National Association of Retail Druggists (NARD), Jesse M. Pike, sent a congratulatory letter to Reagan. It emphasized how delighted NARD was to see him in the White House and just how his regulatory reform beliefs would be good for business. In Pharmaceutical Technology, James Dickinson wrote, “everyone expects life to be easier for industry under the new Reagan Administration.”
Apparently, the Washington cocktail circuit was rife with speculation about the new administration repealing the Kefauver-Harris 1962 drug efficacy requirements – a move that would further enhance prospects for industry growth. This was nonsense, according to knowledgeable policymakers and reporters. Still, the fact that the notion was even bandied about, however fancifully, represented a substantial change in the debate about drug regulation.
The press envisaged a pharmaceutical industry boom in the near future. Newspapers reported how “The Drug Business Sees a Golden Era Ahead” and that pharmaceutical associations were positively giddy. Rep. James Scheuer (D-NY) publicly denounced the agency’s over-cautiousness and emphasized the need for immediate reform. It was risk averse, to the detriment of sick Americans. Moxalactum, he argued, was an American-made antibiotic for pneumonia used by Marshal Tito in Yugoslavia – yet it was not available in the United States. The narrative Scheuer framed was that the FDA was protecting Americans to death – and this before the onset of the HIV/AIDS crisis.
Mounting enthusiasm about pharmaceutical growth in the wake of the Reagan election was palpable. Reports indicated that the pharmaceutical industry and investors were confident about the future – a golden era – in this new regulatory climate. There was bullishness about drug stocks in general, and many predictions that pharmaceutical companies would start to generate more and more earning in 1981 and 1982. Overall, these stories proved to be accurate.
Ronald Reagan, however, had pledged in 1980, with trademark sincerity, not to gut the FDA. Rather, he made oblique references to the agency’s storied history and resorted to prosaic comments about the danger of hidebound power-hungry bureaucracies. “There’s a certain amount of regulation that is always necessary to protect us from each other,” he told CBS’s Walter Cronkite. “And that I recognize. We don’t want to, for example, eliminate the responsibility of the FDA…”
Much can be gleaned from Reagan’s public statements about the Food and Drug Administration, but they fail to reveal the entire picture. On May 20, 1986, Reagan described a meeting between Paul Laxalt, Jack Dreyfus, and himself. Dreyfus, who had “spent $50 mil. of his own money” was attempting to have the epilepsy drug Dilantin approved and found a roadblock in the form of the FDA. According to Reagan’s personal diary: “The villain in the case is the Fed. Drug Admin & they are a villain.”
Red Herrings and Empowered Patients
Under the Trump administration, will the FDA play the villain role? President Trump will build on earlier Republican efforts to streamline the agency, whether these took place during Reagan or Bush presidencies. He has promised to remove barriers for overseas drugs and support ‘Right to Try’ laws, which will attempt to provide access to unapproved drugs. Indeed, some of these measures may help patients. And the Trump administration will be the right track if it can safely accelerate drug approvals, promote production and use of generics, and lower drug prices through increased competition.
Gottlieb and others have suggested they would radically restructure the drug approval process – even if that remains something of a red herring argument. QuintilesIMS Institute, among various other organizations, have determined that the total time between patent and approval has dropped 31% since 2008. Yale researchers hold that the FDA is already considerably faster than Europe and Canada when it comes to approving drugs.
Another area of regulation that ought to be monitored closely is advertising. Every other nation besides the US and New Zealand has concluded that advertising powerful drugs for treating complex illnesses makes no sense when your target market lacks the qualifications to fully grasp the risks. How will powerful painkillers be regulated in the years ahead.
The drug industry wants to empower patients, to invest them in the writing of prescriptions. Looking ahead, it will be important to watch the administration’s and FDA’s role in faciliating this.
FOR MORE ON PATIENT ACTIVISM
“The [industry] idea is that consumers are central players in their health management and therefore have a right to be informed of different drugs,” Lewis Grossman, a specialist in food and drug law, told the Los Angeles Times.
Yet, the practice of medicine should not be placed in the hands of amateurs and junk scientists. In the post-truth era, however, when an opioid epidemic soars and drug prices are hitting Americans in the pocketbooks, these “facts” could be lost in the noise.
Thanks for reading. For more, please follow the blog.
Lucas Richert is a Lecturer in History at the University of Strathclyde (Glasgow, UK). He is the author of Conservatism, Consumer Choice, and the Food and Drug Administration during the Reagan Era. He’s currently at work on a second book, tentatively called Strange Medicines: Drugs, Science, and Big Pharma in Culture.
Editors: Professor Matthew Smith and Dr Lucas Richert (University of Strathclyde, UK)
This article collection will examine how the relationship between socioeconomic factors and mental health has been and is understood in an array of different places and periods. Although much of the focus of current mental health research and clinical practice is on the neurological aspects of mental illness and psychopharmacological treatment, historical research demonstrates that a wide range of factors — from vitamin deficiencies such as pellagra, and infections such as syphilis to traumatic life events — have contributed to the onset and exacerbation of mental health problems. Among all these factors, one looms largest: socioeconomic status. On the one hand, socioeconomic inequality has been long recognised as a potential cause of mental illness, as the history of mental hygiene and social psychiatry during much of the twentieth century demonstrates. On the other hand, however, the mentally ill have also historically faced much socioeconomic hardship; today, a high proportion of the homeless and incarcerated in many countries suffer from mental illness.
By exploring this topic across time and place, this collection aims to provide a historical context for today’s mental health crisis, and also to inform current mental health policy, especially attempts to prevent or alleviate mental illness through social change.
Insights on a broad spectrum of themes are welcomed, including, but not restricted to
This is a rolling article collection and as such proposals and submissions will be welcome throughout 2017. However, full submissions received by November 1 will be considered for publication as part of the collection’s formal launch in 2018.
Please do think about submitting.
From the NIH. A post by Professor Erika Dyck on the history of LSD.
Circulating Now welcomes guest blogger Erika Dyck, PhD, Professor and Canada Research Chair in the History of Medicine at the University of Saskatchewan. Today, Dr. Dyck shares some insights on a recently digitized film in the Library’s collection highlighted in our Medical Movies on the Web project.
It’s the late 1960s. Teenagers, a hip voice clues us in, are always looking for kicks, and today’s teens express themselves with cool fashions, groovy hairstyles, and kooky pranks. Not so long ago, our narrator played the character of “Plato,” a troubled teenager, in the 1955 classic Rebel Without a Cause. In that film, Plato idolizes the reckless machismo of young Jim Stark (played by James Dean). In an epic display of bravado, Jim and another boy play a game of “chickie run” in which they drive their cars in parallel directly toward a cliff. Jim leaps…
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It’s my pleasure to promote the publication of an important Policy Brief on Cannabis by Kathleen Thompson. Over the past few years she has helped drive conversations about the consumption and control of marijuana. Her recent Policy Brief ought to be read by anyone and everyone! Here’s an extract.
LEGALIZATION OF CANNABIS: THE POLICY CHALLENGES AND OPPORTUNITIES
By Kathleen Thompson, PhD, MSW, RSW, BA (Hons)
“The commitment by the Government of Canada to legalize cannabis
and cannabis products presents a complex range of socio-economic
challenges and opportunities. Creating the right legal and regulatory
framework to address the implications, both good and bad, will be
key in determining whether legalization is deemed successful public
The federal government plans to introduce cannabis legislation in the
coming spring session of Parliament. The legislation will be based on
the recommendations contained in a report issued on November 30 by
a Task Force of experts who studied the issue for the past year. The Task
Force received input from more than 30,000 Canadians, organizations
and professionals. Entitled “A Framework for the Legalization and
Regulation of Cannabis in Canada”, the report recommends allowing
more flexibility in the current federally controlled cannabis cultivation
model. Specifically, the federal government would regulate a safe and
responsible supply chain of cannabis.”
ABOUT KATHLEEN THOMPSON
Dr. Thompson has worked in health policy analysis and research as a bureaucrat and as a consultant for the last 25 years, specializing in the mental health, disability and corrections sectors.
In 2015, Dr. Thompson created the Cannabis Regulatory Research Group. The focus of the policy research group is on promoting collaborative public policy processes and evidenced-based research with the cannabis industry, governments, academia, civil society and at the United Nations. Additionally, Dr. Thompson consults with individuals and organizations on how to enter the legal cannabis industry.
(It’s an honour to have Dr Adam Montgomery share his thoughts on trauma, the military, and PTSD. You can read more of his work in a forthcoming book, The Invisible Injured: Psychological Trauma in the Canadian Military from the First World War to Afghanistan.)
PTSD, Peacekeeping, and Politics
In the twenty-first century, it seems that trauma is everywhere. From soldiers to emergency medical workers, there has been a growing awareness since the new millennium about the effects of psychological trauma on long-term mental health outcomes. We now routinely hear about post-traumatic stress disorder (PTSD) after natural disasters, car or train accidents, sexual assault, and even war journalism.
But while the Western world is now keenly attuned to trauma and PTSD, each nation has had its own unique historical experience with this complex and thorny disorder. In America, the PTSD concept first grew out of the Vietnam War and the social alienation felt by returning American soldiers. Working with anti-war psychiatrists in the late 1970s, Vietnam veterans were able to gain recognition (and in some cases, compensation) for both the traumatic events they witnessed and a social ostracism which stripped them of any ability to tie their service to a nationally supported cause. PTSD was, for better or worse, as much a political disorder as a medical one in 1980s America.
Stemming as it did from socio-political turmoil, PTSD was initially dismissed by other Western nations as a unique, American-specific phenomenon; that is until they, too, discovered PTSD symptoms in their own citizens. In Britain, the Falklands War and subsequent difficulties faced by British veterans spotlighted the reality of PTSD and slowly forced the British government, psychiatrists, and military brass to accept the reality of war trauma. By the late 1980s, trauma and PTSD were seen as a natural outcome of witnessing death and destruction.
In Canada, a nation that had not been at war since the Korean conflict of the 1950s, PTSD was also viewed as an American-specific phenomenon throughout the 1980s. Despite ample experience with shell shock and battle exhaustion in the First and Second World War, the Canadian military quite simply forgot about trauma from the 1950s until the end of the Cold War.
Then, everything changed overnight. With the fall of the Soviet Union in 1991, the United Nations and its allied countries were thrust into a plethora of peacekeeping missions; in several regions where there was little or no peace to keep. In Rwanda and the former Yugoslavia, for example, Canadian peacekeepers were faced with numerous traumatic events, such as ethnic cleansing and combat with belligerent forces. Unfortunately, they returned to a Canada that cared little for their service.
Caught up in a series of scandals such as the murder of a Somali teenager by Canadian paratroopers in Somalia in 1993, the Canadian military and Department of National Defence wished to suppress any unpalatable overseas experiences. Thus, they initially denied peacekeepers faced any post-tour issues. But by the late 1990s, with Lieutenant-General Roméo Dallaire’s public battle with PTSD following his time as Force Commander in Rwanda in 1993-94, and a growing chorus of traumatized rank-and-file peacekeepers, PTSD became a cause for national concern.
The Croatia Board of Inquiry, called in 1999 to investigate the possible exposure of Canadian peacekeepers to toxins in Croatia, found quite another cause for soldiers’ suffering. After dozens of testimonies from peacekeepers, many of whom told tales about cleaning up dead bodies, watching belligerents’ bodies being dragged through the streets, and having guns pointed at their heads by Croat and Serb soldiers, the board concluded that soldiers’ trauma and subsequent health difficulties were caused not by toxins, but intense psychological duress.
Canadians at first demurred. Peacekeeping had become Canada’s defining contribution to global politics in the 1950 to 1980s period; it was viewed as a relatively benign and adventurous experience for Canadian soldiers. How could ostensibly peaceful tours cause the same after-effects as war? By questioning peacekeeping, Canadians had to turn inward and question their own national identity. Naturally, this introspection took time, and to some degree the peacekeeping myth – a belief that peacekeeping involves simply patrolling a well-defined zone of separation between belligerents and handing out candy to local children – endures.
What has changed, though, is Canadians’ understanding that a percentage of soldiers exposed to traumatic events, whether on peacekeeping or war operations, will return with long-term mental health challenges – the most obvious being PTSD. My book, The Invisible Injured, explores all of the aforementioned themes and events, and argues that PTSD and its antecedents should be viewed not just as medical conditions, but also as profoundly shattering social experiences which are intimately linked to politics as well as Canada’s need to define itself as a middle power in world events. PTSD’s effects include not just nightmares and flashbacks; they also include possible release from the military, pension battles, and social ostracism. In the post-Afghanistan era, when the Canadian government is making plans to once again commit Canadian soldiers to peacekeeping missions in Africa, history can once again play a role in demonstrating not just where we have come from, but where we are going.
Adam Montgomery is the author of the forthcoming The Invisible Injured: Psychological Trauma in the Canadian Military from the First World War to Afghanistan (McGill-Queen’s University Press, 2017).
Tis the season. Turkey. Stuffing. Mince meat tarts and more. Many of us worry about that extra helping during the holiday season. And so I was interested to read this on Canada’s story on the BBC site today!
I was especially pleased to hear Dr Ian Mosby’s thoughts! He visited the University of Saskatchewan before I left in August 2016 and he was extremely informative and generous with his time – for both faculty and grad students alike.
* Food History * (Robin Levinson-King)
Since World War Two, the Canadian government has been telling people what to put on their plate to stay healthy. But with obesity rates on the rise, is it time to start focusing on what to leave off?
Canada’s food guide first appeared in 1942 under the title Official Food Rules and was originally created to help Canadians stay strong and healthy despite meagre wartime rations.
The guide recommended drinking fruit juice, loading up on bread and eating plenty of liver.
Over the years, the publication has used many designs to illustrate the different food groups. In the US, the “food pyramid” became an instantly recognisable illustration of nutritional categories but Canada switched from a “food wheel” to a “food rainbow”.
The Canadian government used to be concerned about people getting enough food, now it’s worried people are getting too much. In the new year, Health Canada will start drafting a new food guide aimed at getting people to eat less.
Despite the commitment to changes, food historian Ian Mosby says the guide may have simply outlived its usefulness.
“It was started as a way to prevent malnutrition. But it’s hard to see what it’s doing in an era where those are not the main health problems facing Canadians.”
When the Canadian government released its rules for healthy eating in 1942, it was marketed as a guide to “health-protective foods”. The rules laid out the bare minimum that a person should eat in order to stay nourished.
“Eat more if you can,” the rules advised.
Daily servings of Vitamin-C rich citrus fruit or tomatoes were advised, along with weekly servings of liver for iron.
Food was expensive in the 1940s and 1950s, and overeating was a luxury few experienced. According to a 1955 survey of household spending, the average family spent about 30% of their earnings each week on groceries, the bulk of which was spent on meat and dairy products.
But by the 1970s, rising incomes and the growing commercialisation of food had completely transformed how people eat, says Mosby.
Sugary cereals, trans fats and TV-dinners became a staple of many people’s diets.
As the price of packaged foods high in sugar and salt plummeted, overconsumption became a bigger problem. The government could no longer just tell people what they should eat, they had to tell people how much.
Consequently, the old black-and-white list of Official Food Rules got a Technicolor makeover and was transformed into Canada’s Food Guide, a consumer-friendly guide for making better food choices.
Critically, a warning to eat sugar, fats and salts in moderation was added in 1982.
But Canada’s overeating problem didn’t go away. Since 1985, the obesity rate has tripled. Canadians are spending less and less on food overall, but more on eating out and sugary beverages.
It’s possible, food historian Mosby says, to be both obese and malnourished.
The full story is here
And be sure to look at my other posts and articles on weight loss, diet pills, and health!
Here’s one vintage healthy-eating advert from my youth…
The Northern Teacher Education Program (NORTEP) in Saskatchewan, Canada commenced in 1976 to facilitate access to teacher education and certification for northerners, particularly those of Aboriginal ancestry.
It covers tuition costs, books, and a living allowance for students who have lived in the north for 10 years or half their life.
By most accounts, it has been a success. Which is why the recent decision to cut funding to NORTEP and transfer its $3.4 million in funding to another institution, has raised somber questions about the priorities of the Wall government.
According to Saskatchewan’s Advanced Education Minister Bronwyn Eyre, the decision was “about equity … it’s not about necessarily getting rid of the bursary structure.”
Unfortunately, this signals tremendous lack of forethought. The optics are dreadful, especially at a moment when Colton Bushie weighs on the hearts and minds of many in the province. And the decision also carelessly flies in the face of ongoing tragedies in Northern communities, including suicides, shootings, and missing women.
More than that, Saskatchewan has garnered international attention in the pages of The Atlantic magazine for its ground-breaking (but long overdue) approach to Aboriginals in higher education. The NORTEP decision is a step backward.
In short, the long-term benefits of the program should be weighed up more sensibly. Luckily, there are useful historical lessons to draw from.
In June 1987, pennies were being pinched. The “great barbeque was over,” according to the NDP’s Janice McKinnon, and the “bills for the wild spending were coming due.”
The Saskatchewan Urban Native Teacher Education Program (SUNTEP) identified the need for a review of the program’s progress. Worried about cuts and reallocations, SUNTEP reached out to experts in education.
One of those was Ruben Richert, a former teacher, principal, and past-president of the Saskatchewan Teachers Federation. In 1987, he was asked to evaluate the program and produce a report on its sustainability in the province’s educational eco-system.
SUNTEP ran in Prince Albert, Regina, and Saskatoon, and operated out of the Gabriel Dumont Institute. For Director James McNinch, it offered a “measure of control and participation in the education of Native teachers and Native children and in the maintenance and affirmation of a cultural identity which prevents assimilation of the minority culture.”
In a period of provincial fiscal restraint, there was significant concern that programs such as SUNTEP might be “erroneously regarded as expendable frills or fringes” and money could be shunted elsewhere.
The 52-page report evaluating SUNTEP determined that the social costs of cuts to the program could be far more expensive in the long-term than the program dollars involved.
A number of recommendations for improvement were made, and the need for introspection was underlined. But the ultimate conclusion held that:
“The question as to whether there is a need for a program like SUNTEP should not have to be asked…We know it is an investment that actually bears interest rather than being a drain on the economy.”
At the time, Grant Devine’s Progressive Conservatives used privatization and public-service reduction to shrink the government. And Devine pointed to the financial necessity of restraint in the province. Over 1,100 civil servants were offered early retirement.
The budget of 1987-88 saw an absolute decline in spending of roughly five percent. Yet, he included an 11 percent increase for education. He did not undermine SUNTEP’s ability to operate at its current service levels.
The NDP often takes credit for SUNTEP and NORTEP, and deservedly so. But it should be noted there was often general bipartisan agreement – if not absolute harmony – about the value of these programs.
This seems far from the case in the present. Budgets have been cut for Saskatoon’s Lighthouse homeless shelter, and the same is true for the Saskatchewan Assured Income for Disability (SAID) program and the general Saskatchewan Assistance Program (SAP). Pinching pennies is one thing, but as Murray Mandryk argued, it’s wise not to be pound foolish.
If NORTEP plays a role in minimizing alienation and redressing lack of educational options in the North, the program should be maintained.
The 1987 report framed SUNTEP’s usefulness as a minor way of “helping to maintain a culture and heritage and preventing assimilation.”
It wasn’t big money, but the results were important. Much the same can be said of NORTEP. It would be advantageous to let the BBQ continue.
Essentially, the Royal College of General Practitioners, the official channel for General Practice of Medicine in the UK, has given their informed recommendations to health professionals regarding smoking cessation and the use of e-cigarette.
1. GPs provide advice on the relative risks of smoking and e-cigarette use, and provide effective referral routes into stop smoking services.
2. GPs engage actively with smokers who want to quit with the help of e-cigarettes.
3. Where a patient wants to quit smoking, and has not succeeded with other options, GPs should recommend and support the use of ENDS.
[GENEVA – Electronic nicotine delivery systems (ENDS), of which electronic cigarettes are the most common prototype, are devices that do not burn or use tobacco leaves but instead vaporise a solution the user then inhales. The main constituents of the solution, in addition to nicotine when nicotine is present, are propylene glycol, with or without glycerol and flavouring agents. ENDS solutions and emissions contain other chemicals, some of them considered to be toxicants.The World Health Organization (WHO) submitted a report on Electronic nicotine delivery systems to the sixth session of Conference of the Parties to the WHO Framework Convention on Tobacco Control (COP 6), which occured in Moscow, Russian Federation, from 13 to 18 October 2014.]
4. GPs recognise ENDS offer a wide reaching, low-cost intervention to reduce smoking (especially deprived groups in society and those with poor mental health, both having elevated rates of smoking).
5. All GPs encourage smokers who want to use e-cigarettes as an aid to quit smoking to seek the support of local stop smoking services.
Harm-reduction has come out on top. Vape Fear has lost this one.
I have written my fair share about e-cigarettes in Canada, the United States, and Great Britain.
* ‘Why Aren’t we Regulating E-Cigarettes?,’ Regina Leader-Post [May 16, 2016]
* ‘Let’s Get Proactive with E-cigarettes,’ Saskatoon Star Phoenix [April 24, 2015].
* ‘Lot of Smoke and Mirrors with Vape Policy,’ Saskatoon Star Phoenix [November 28, 2014]
Often, I have suggested a measured response. My sense is, a little bit of regulation can go a long way. Minor rules can make a major difference. Don’t go overboard, but the waters are rough. Vaping should play by the rules, basically.
With my last op-ed back in May, people in Canada weren’t impressed with my approach. Folks were not interested in a middle-ground perspective. Here’s a list of the harshest responses to my articles on vaping. I’m basically the Red Skull mixed with Lex Luthor for suggesting some thoughtful rules might be in order.
1. “Please take the check that you earned from writing this trash and take an ethics course. Or a journalism degree.”
(Uh, I didn’t get paid. Woulda been nice.)
2. “It’s pretty obvious you don’t quite understand how the system works here in Canada…”
(Does anybody. There are no regulations? Ha.)
3. “You help tobacco companies profit from murder.”
(Jeez, really?! C’mon it’s my birthday.)
4. “…governments are making decisions based on MONEY, NOT PUBLIC HEALTH.”
5. “What tobacco lobbyist wrote this trash?”
(I’m no tobacco lobbyist, but I sure do think they’re funny in the movies. Aaron Eckhart, anyone?)
Anyway, read the piece and decide for yourself. And share. http://leaderpost.com/opinion/columnists/why-arent-we-regulating-e-cigs