In some ways, the United States has come a long way since Lyndon Johnson declared the “war on poverty.” But in others, we’re still at square one. We now have a variety of federally-supported nutrition programs, but the health care system remains senselessly disconnected from the “social determinants of health.” In this regard, the United States has fallen behind the rest of the world. If a politician in India announced a public health plan that neglected malnutrition, he would be ridiculed. Here, leaders make this kind of omission all the time. Almost all of the debate about the 2010 Affordable Care Act was consumed with questions about health care access and quality. But if we really want to improve the health of millions of people, we have to address the conditions that make them sick.

One of the most impressive organizations in the country that is developing an approach to do this is Health Leads, which mobilizes and trains about 1000 volunteers each year who staff resource desks located in the waiting rooms of 23 hospital clinics or health centers in Baltimore, Boston, Chicago, New York, Providence, R.I., and Washington. At these sites, doctors now regularly “prescribe” a wide range of basic resources — like food assistance, housing improvements, or heating fuel subsidies — which Health Leads’ volunteers “fill” — applying their problem solving skills (and tenacity) to identify resources anywhere they may be available.

Health Leads was co-founded by Rebecca Onie in 1996, while she was an undergraduate student at Harvard University. Onie had first witnessed the intimate relationship between poverty and health while volunteering at Greater Boston Legal Services, where she assisted low-income clients who had housing problems. Many lived in dilapidated apartments with leaky pipes, broken windows, rooms full of mold, and walls infested with cockroaches and rats. Often families couldn’t afford to pay for heat. Towards the end of the month, some ran out of food. Onie found herself interviewing mothers whose children came to the office wheezing and coughing from asthma and lung infections — health problems caused or triggered by bad housing. Often, the children had been in and out of hospitals for years; many had fallen far behind in school.

One day, she read a magazine story about Barry Zuckerman, chairman of pediatrics at Boston Medical Center (B.M.C.), who had established the Medical-Legal Partnership for Children, a program that connected doctors with lawyers to assist patients (it has since spread to more than 235 health institutions nationally). Close to 70 percent of the patients at B.M.C. are poor and Zuckerman, like Geiger, had grown tired of treating children, only to see them readmitted to the hospital because nothing was done to address the causes of their illnesses. In some cases — as when a child has chronic asthma attacks because the landlord refuses to clean up mold — a lawyer could be more effective than a doctor.

“I thought bringing lawyers into the hospital was brilliant,” recalled Onie. She called Zuckerman to see how she could help and he invited her to spend six months talking to people in the unit. There Onie found doctors who were “smart, passionate and totally committed to their patients” and yet “stymied in terms of their ability to bring about the health outcomes they wanted.” Some physicians told her they knew they should be asking more about food, housing or social issues, but they were afraid of opening a “pandora’s box.” “I have no idea where to begin to address the problems,” one physician told Onie. “I have 13 minutes with each patient.” (Studies reveal that doctors are reluctant to inquire about issues — domestic violence, for example — when they feel powerless to intervene.)

Onie thought that students could help. With Zuckerman, she founded Health Leads (formerly Project Health) to recruit and train students to provide patients with connections to resources deemed necessary by doctors and other health care providers. “What are college students built to do?” asks Onie. “Track down information!” She adds: “Say your client is a Latina mother working two jobs. She needs food supplements. She has no transportation. Your job is to locate a food pantry within walking distance of her home that’s open after 8:00 p.m. and has a Spanish speaker on staff. That’s a perfect problem for a college student. It’s like a really fancy Google search.”

From the outset, Onie made the decision to work only with students who demonstrated high levels of motivation and commitment. In some of Health Lead’s sites today, as few as 10 percent of students who apply get selected. This has had the effect of attracting serious volunteers. In 2010, the organization reported that in 57 percent of cases its volunteers secured a needed resource within 90 days. This year, Health Leads will serve 9,300 patients and families — not a huge number given the scope of the problem it seeks to address — but the approach is gaining momentum.

One indication is that, where Health Leads works, doctors are changing their behavior. In the Children’s National Medical Center, in Washington, for example, over the past year, there has been a 300 percent increase in doctors “prescribing” Health Leads through the hospital’s Electronic Medical Record. The resources they request for patients include things like exercise or summer meal programs for children or subsidized child care for mothers, so they can find work and afford better food and housing.

Health Leads is also demonstrating that it can improve the efficiency of social workers. In some of the large urban hospitals where the program operates, the ratio of patient visits to social workers is close to 25,000 to 1. Because students can handle basic — but time consuming — cases, social workers can concentrate on what they’re trained for. At The Dimock Center, in Roxbury, Mass., initial data suggests that the program has doubled the time social workers can devote to therapeutic work.

Health Leads is also preparing a pipeline of new health care leaders. Two thirds of its students are either in pre-med tracks or pursuing careers in health, and the exposures they are getting are likely to shape the way they think about health care. As one volunteer said: “When I’m a doctor, I will never prescribe antibiotics that say ‘take with food’ without making sure that the family actually has food in the house.”

Many health care professionals know that social conditions impact health more than medical care. In a survey conducted by Health Leads at Bellevue Hospital in New York, almost every pediatric primary care provider said the failure to address social and psychological needs “impairs” their ability to treat patients effectively. The vast majority said that the hospital needed a standardized system to screen for these needs on routine well-child visits. But 80 percent said it lacked the capacity to do it.

There is very little money available for this work. Medicaid doesn’t generally reimburse social workers for non-therapeutic tasks. Most of the time, this kind of assistance falls through the cracks. Society then spends oodles of money treating the crises that follow. “There is a tension between what we all know, and agree, needs to be done, and what we are doing,” says Onie. “As a society, we haven’t yet decided that we actually want less emergency room visits.”

Just a year ago, Onie thought that Health Leads’ biggest obstacle would be getting doctors to pay attention to patients’ social needs — given all the demands on their time. Today, the organization is getting so many referrals from doctors, for the first time in its history it has long waiting lists. Five decades after the war on poverty, a work force that can systematically address the social causes of illness is still to be built. Health Leads offers a model of how it might work. A broader system could incorporate students, community health workers, and lay workers. It need not be a perfect solution, nor an expensive one. But something has to be done. And the big challenge is getting health care decision makers to prioritize and pay for it. As Onie says: “How would we ever think that we’re going to secure a return on our health care dollar until we start dealing with these social factors?”

Source: http://opinionator.blogs.nytimes.com/2011/07/28/treating-the-cause-not-the-illness/?hp

A proposed guideline setting a limit for the first time was announced Monday by Health Minister Leona Aglukkaq, and it comes less than a year after her department asked manufacturers to voluntarily stop producing, importing and selling children’s jewelry made with the metal.

Cadmium is often used as a substitute for lead in cheap children’s jewelry. Health Canada says there is no known risk to wearing the products, but they can be dangerous if licked or sucked on repeatedly, or if swallowed.

The government has regulations on the amount of lead that can be used in products, but there were no limits, in the form of guidelines or regulations, on cadmium.

“Our goal is to reduce the level of cadmium in children’s jewelry to a level that is protective of health, so that parents and child care providers can feel confident about the jewelry products that their children wear,” Aglukkaq said when she made the announcement at a daycare in Ottawa.

When Aglukkaq made her appeal to industry last October, she said the government might introduce mandatory limits if companies did not comply with the request.

Health Canada isn’t moving yet to bring in regulations, but the guideline it is proposing suggests a total cadmium concentration in children’s jewelry of 130 parts per million, or 0.013 per cent of its weight.

Regulation still an option

Aglukkaq said regulations take a long time to develop and that Monday’s announcement is part of laying the groundwork for them.

“Everything that we are doing right now is work that is required for regulations and can be used to develop regulations,” she said. “Going through the regulatory process is a much slower process than establishing the guidelines, so we’re moving as quickly as we can and regulation is always an option,” she said.

Aglukkaq said the proposed guideline makes the government’s expectations of industry clear and that Health Canada will monitor the marketplace and “take appropriate action” when levels of cadmium in excess of the guideline are found in children’s jewelry.

The federal government now has more power to ensure manufacturers follow regulations and guidelines since passing the Consumer Product Safety Act. If a product is found to exceed the cadmium guideline, Health Canada may order a risk assessment of the specific item. If it’s deemed to pose an “unreasonable hazard” it could order a recall or take other actions.

Industry stakeholders have until Oct. 10 to provide comments on the proposal and then Health Canada will confirm the guideline.

Aglukkaq said the federal government will be doing another round of product testing this fall to see whether industry has complied with the government’s advisory that it should stop selling products with cadmium.

She said Health Canada believes manufacturers are in compliance, but if they aren’t, the powers afforded to the government through the Consumer Product Safety Act will be used.

Source: http://www.cbc.ca/news/health/story/2011/07/25/pol-health-cadmium.html

Between work, raising a family and coping with an uncertain economy, stress has become a “normal” part of daily life for most people. That could explain why so many Americans — about 16 million at latest count — have started taking yoga classes or doing yoga at home. This ancient practice, which started in India more than 4,000 years ago, connects mind and body through a series of postures, breathing exercises and meditation. By stretching and toning the muscles, flexing the spine and focusing the mind inward, yoga helps reduce stress. That can impact your overall health since stress plays at least some role in many illnesses. Studies show that chronic stress doubles the risk of heart attack, for instance.

How yoga may promote health Research into the health benefits of yoga is still in its infancy. But recent pilot studies point in promising directions. Yoga has been shown to lower blood pressure and heart rate, which can help reduce a person’s risk of heart disease. There may be other heart benefits, too: A 2006 study found that yoga helped lower cholesterol levels and improve circulation in people who have cardiovascular disease. Some hospitals have incorporated yoga into their post-cardiac rehabilitation programs.

While the evidence of yoga’s success in reducing a person’s body mass is mixed, one study did find that yoga can help people lose weight by leading them to a healthier lifestyle. The study reported that people who regularly practiced yoga started eating less, eating more slowly, and choosing healthier foods. They also showed fewer symptoms of eating disorders.

Many people report that yoga gives them an overall feeling of wellbeing. But research shows that it may also help alleviate specific kinds of pain, including migraine headaches, lower back problems, arthritis and pain during childbirth. Researchers are not sure what mechanism is at work, but one theory is that the yoga postures work like the way massage works. When a yoga posture places pressure on a nerve fiber, the signal for “pressure” is sent quickly to the brain via myelinated (insulated) nerve fibers, while the signal for “pain” reaches the brain more slowly via less myelinated nerve fibers. The signal for “pressure” closes the receptor gate and shuts out the “pain” stimulus. Another theory is that yoga causes an increase in serotonin, the body’s natural anti-pain chemical.

While more research is needed into these areas, people who practice yoga have also reported that they experience less insomnia and better digestive health. Pregnant women in particular seem to have an easier time sleeping when they do yoga. They are also less likely to develop high blood pressure or deliver prematurely.

Calming the mind Since yoga involves the mind as well as the body, it’s not surprising that it may help reduce anxiety and depression, especially in people whose anxiety is related to an illness like cancer. More research is needed to learn exactly how yoga affects mood, but a 2007 study may provide a clue: It found that in experienced yoga practitioners, a 60-minute yoga session increased levels of a neurotransmitter called GABA. Low levels of GABA have been linked to depression and anxiety disorders. Another pilot study suggests that yoga may influence depression by increasing the alpha waves in the brain. Alpha waves are associated with relaxation. Yet another possibility is that yoga reduces the amount of cortisol, a hormone that the body releases in response to stress. Some scientists think chronic high levels of cortisol may be tied to depression, as well as impaired immune function.

If the potential health benefits of yoga aren’t enough to make you want to try it, consider this: Yoga can also make you look more toned and fit and help you move with greater ease, especially as you grow older. A 2007 study of the Hatha yoga style showed that it increased muscular strength, flexibility and endurance. It’s no wonder that many athletes use yoga to cross-train.

Getting started You don’t need a lot of expensive equipment or to be in tiptop shape to start practicing yoga. All it takes is loose clothing, a mat (some classes will provide mats) and the desire to learn.

There are several different styles of yoga. Most use a series of postures designed to stretch and strengthen muscles and also use controlled breathing to quiet your mind. The most popular style in the U.S. is Hatha yoga, a relatively slow-moving, gentle style. Other styles such as Ashtanga (also known as power yoga) are more vigorous. Find out about the different kinds of yoga that are offered at classes in your area. Choose the style that fits your goals and level of fitness. You can also get started by using a good instructional book or DVD at home, although it’s useful for beginners to start with a class. If you are pregnant or have any serious health conditions, talk to your doctor before you begin. Once you start a class, let your teacher know about any injuries or health issues.

Whichever style of yoga you choose, take it slowly at first. Don’t try to force yourself into difficult poses at the beginning. After a while, you will develop more flexibility, strength and stamina. Your teacher shouldn’t push you to do poses that aren’t comfortable. If your teacher is going too fast, talk to him or her, or look for a class that is a better fit.

While yoga won’t cure everything that ails you — or make your boss nicer — it will help you deal with stress better. And that could make a big difference in your overall health.

Learn more about the benefits of exercise

It’s a new world for deaf children in Canada.

In February of this year the Hospital for Sick Children in Toronto marked its 1,000th cochlear implant by inviting all the children with a profound hearing loss and who had received a cochlear implant at the hospital to a party. The celebration was noisy and full of laughter. Two of the speakers were young adults. They’ve grown up with cochlear implants; they spoke out strongly and clearly and were heard by the hundreds of children and parents present.

Katie Kilmartin and Mikaeel Valli are in the vanguard of a new cohort — children implanted with the mechanical device while very young and who now live in a world full of sound and speech.

While there is still some controversy around implants, almost all children born in Canada today with profound hearing loss can expect the same choice as Kilmartin and Valli — to communicate using sign language or to hear and speak. As recently as twenty-five years ago this was unheard of.

Kilmartin is 23 and was one of the first five children in Canada to get a cochlear implant, a device that uses existing nerves and electronic signals to restore a sense of hearing.

“It’s amazing. My life has changed dramatically. I’m able to experience so many things like going to any university, reaching my job goals, having more choices.”

She got her first cochlear implant almost 20 years ago, when she was three, and at the time had to go to New York for the surgery. The device failed for her seven years later. By then the program at the Hospital for Sick Children was up and running and there was a more sophisticated device on the market so she had another implant in Toronto.

Valli, now 17 and who received an implant at three years old, says it means a lot to him to experience even ordinary life. “I enjoy hearing the snow scratching against the skis or being at the basketball court and hearing the bouncing against the floor.”

It took a few years for the program at Sick Kids to grow. It started in 1993 with the hospital doing eight implants a year. By the late 90′s Dr. Blake Papsin, the director of the program at Sick Kids, and his team were doing about 24 surgeries a year. The number rose to 55 in the early 2000s and today they do 120 implants a year. Papsin is very proud that three-quarters of the surgeries now are for bilateral cochlear implants — the child gets a device for each ear.

The devices cost about $24,000 and that amount does not include the cost of the surgery. In the early days much of the money for the procedure was raised by charities. Today, the funding comes from government, hospital administration and philanthropy/grant support.

“We now have one of the largest programs in North America and even the world for stand-alone hospitals,” says Papsin. Patients have come from as far away as the Caribbean, Africa and Qatar.

Hearing loss is the most common congenital anomaly, says Papsin, and it is estimated that three per cent of newborns have serious hearing problems. When Papsin came to Sick Kids in 1996 he almost immediately starting lobbying to give cochlear implants to younger children. “Getting the kids hearing earlier has a huge advantage,” he says.

The children can then begin the process of learning to use the device to interpret sound and to speak at the same stages as hearing kids. In the early 90s the kids receiving the implants tended to be older and even into their teen years.

A program to screen babies for hearing loss started in 2002. “[It] was actually the last and missing piece to the whole equation because it really had to detect children younger and younger because at the same time in our laboratory we were finding that the earlier we implanted children, the better they did. So it was almost the missing piece.” Today it is not uncommon for Papsin to do implants on children as young as eight months.

Papsin says that while the actual device hasn’t changed much over the years, the surgical techniques have.

“We’ve developed a very small incision and a very quick technique for putting these in about an hour and 15 minutes which is a lot different from when I started in 1995 [in England]. Back then it took me four hours or more to put one in.” Now a child over five years old, goes home the same day as the surgery.

While the implants give today’s deaf children a world of hearing, Papsin says that down the road what he is doing may appear to be quite primitive. “There’s genetic work and basic physiological work where we’re trying to restore the sense of audition without the need for surgery and neural prosthetic. I know that 200 years from now people are going to exhume the bodies of my patients and laugh hysterically and see that I put a wire in their cochlear, how primitive. But it works because you see Katie, how phenomenal that woman is.”

The implants are not without criticism. There is an ongoing debate especially active among children of deaf parents, as to whether children born with profound hearing loss should embrace their deaf culture and grow up using sign language for communication. They feel that deafness is not a handicap that needs to be treated or corrected but a shared experience and cochlear implants are disrespectful.

Kilmartin remains active in the deaf culture and believes that sign language is still an important tool for those who choose not to have the implant or those who can’t adapt to it. She teaches it and calls it a communication support system. Papsin says he avoids the debate because he feels it is up to parents and children to make the decisions about what he offers.

Kilmartin makes it very clear that she is thrilled at being able to hear and to speak and because her first device failed when she was ten, she was able to be part of the decision to have a re-implant.

Papsin is passionate about his work. “Before I was a doctor I was a musician. And listening and communicating and the process of perceiving through my ears is something that is so critical to me that when this became my field of interest it was just a natural fit. I just can’t think of anything more fantastic than speaking with patients in whom this was not a possibility without the cochlear implant. It’s just a magical sort of thing and it rewards me every time I see one of these patients. …These children are phenomenal, phenomenal communicators, phenomenal contributors to society and to think that I had a role in that is pretty special.”

More reading: http://www.cbc.ca/news/health/

The study, by researchers at the Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center (LA BioMed), found prenatal exposure to toxic components of a newly recognized category of tobacco smoke — known as “thirdhand smoke” — can have as serious or an even more negative impact on an infants’ lung development as postnatal or childhood exposure to smoke. Thirdhand smoke is the newly formed toxins from tobacco smoke that remain on furniture, in cars, on clothing and on other surfaces — long after smokers have finished their cigarettes.

“Thirdhand smoke is a stealth toxin because it lingers on the surfaces in the homes, hotel rooms, casinos and cars used by smokers where children, the elderly and other vulnerable people may be exposed to the toxicants without realizing the dangers,” said Virender Rehan, MD, a principal investigator at LA BioMed and corresponding author of the study. “Pregnant women should avoid homes and other places where thirdhand smoke is likely to be found to protect their unborn children against the potential damage these toxins can cause to the developing infants’ lungs.

Dr. Rehan, a National Institutes of Health-funded investigator who has been researching the effects of smoking on lung development for more than a decade, said this is the first study to show the exposure to the constituents of thirdhand smoke is as damaging and, in some cases, more damaging than secondhand smoke or firsthand smoke.

“We looked at the mechanisms that drive normal lung development and found those mechanisms were clearly disrupted by thirdhand smoke,” he said. “Based on this, we can conclude that prenatal disruption of lung development can lead to asthma and other respiratory ailments that can last a lifetime.”

Thirdhand smoke is aged secondhand smoke, and it attaches to the surfaces in homes and other surroundings. It is composed of smaller, ultrafine particles with a greater molecular weight that pose a greater asthma hazard than firsthand or secondhand smoke. Although concerns about the dangers from thirdhand smoke have been raised recently, this new study is the first to provide biological data to support these concerns.

Dr. Rehan said touching surfaces contaminated with thirdhand smoke, as well as ingesting dust containing the superfine particles of thirdhand smoke, are the most likely major pathways for exposure to these toxins.

“Children and pregnant mothers in busy households are especially susceptible to thirdhand smoke exposure because they could touch or breathe in the toxic substances from contaminated surfaces,” he said. “Among infants, it has been found that the rate of ingesting dust is more than twice that of adults, making babies especially vulnerable to the effects of thirdhand smoke.”

He also noted that nicotine levels are six times lower among infants living in homes with strict no-smoking policies.

“The dangers of thirdhand smoke span the globe because smoking is more prevalent in many other countries than it is in the United States,” he said. “While further study is needed, the alarming data clearly highlight the potential risks and long-term consequences of thirdhand smoke exposure.”

While previous studies had documented the danger of nicotine in thirdhand smoke, this new study measured the effect of two other toxins in thirdhand smoke — 1-(N-methyl-N-nitrosamino)-1-(3-pyridinyl)-4-butanal (NNA) and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK). The researchers found prenatal exposure to thirdhand tobacco smoke components plays a much greater role in altered lung function in offspring than postnatal or childhood exposures.

The study was published online and is scheduled for publication in an upcoming special edition of the American Journal of Physiology on the effects of smoking. The study was funded by the National Institutes of Health (Grant Nos. HL75405, HD51857, HD058948 and HL55268) and the Tobacco-Related Disease Research Program (Grant Nos. 14RT-0073, 15IT-0250 and 17RT-0170.)

By JANE E. BRODY

• Reprogrammed your GPS device?

• Retrieved something you or a child dropped?

• Searched for a particular CD?

• Put on makeup or shaved?

• Struggled to open a package of nuts or chips?

Perhaps you never have texted or talked on a cellphone while operating a motor vehicle. But if you engaged in any of the above activities, you are just as guilty of distracted driving as if you had.

It’s easy to become complacent. Maybe you’re a good driver, and you’ve gotten away with such actions for years. Maybe you managed to avert a near-accident when your attention returned to the road in the nick of time. But one of these days, your luck may run out and you, or someone you hit, could be maimed for life or dead.

“Driving while distracted is roughly equivalent to driving drunk,” Dr. Amy N. Ship, an internist at Harvard Medical School, wrote last year in a commentary in The New England Journal of Medicine. “Any activity that distracts a driver visually or cognitively increases the risk of an accident. None of them is safe.”

Following widespread publicity about the hazards of distracted driving, including a Pulitzer-prize winning series in this newspaper, medical groups are working hard to make patients more aware of the problem. The most recent effort was started last week by the American Academy of Orthopaedic Surgeons and the Orthopaedic Trauma Association, whose “Decide to Drive” campaign calls attention to the increasing number of distractions engaged in by multitasking drivers and the resulting toll on people’s lives.

“We take care of a lot of people injured in car accidents, and distracted driving is a substantial contributor to these accidents,” Dr. Daniel Berry, president of the academy, said in an interview. “If we could get rid of this part of our practice, it would be a great service to the people we care for.”

Orthopedists would do very well, thank you, without the business generated by the 307,369 crashes that have occurred so far this year, according to estimates from the National Safety Council, involving drivers talking on cellphones or texting.

Last year Aaron Brookens of Beloit, Wis., then 19, was driving home at 75 miles an hour after spending a weekend with his girlfriend when he decided to send her a text message — and wound up pinned under a semi. The toll: two broken femurs, a broken kneecap and ankle, nerve damage to both legs, and a lacerated spleen, kidney and liver.

Numerous operations and a lengthy rehab later, Mr. Brookens knows he’s lucky to be alive. “No one thinks it will happen to them,” he said on Wednesday at a news conference convened by the orthopedists. He now realizes that “deciding to drive” is always the best option, and he wants others to learn from his mistake.

“We don’t expect our campaign to change everyone’s behavior overnight,” Dr. Berry said. “It took a lot of years to get the message across about using seat belts or driving drunk. We’re adding our voice to those of others — the more jungle drums, the better.”

Among those beating the drums are the parents of Eric Okerblom, a 19-year-old college student who was struck by a car and killed in 2009 while cycling near his home in Santa Maria, Calif.; the driver, a teenager, was traveling 60 m.p.h. while texting on her cellphone. His father, Bob Okerblom, is now on a cross-country bike ride, blogging along the way in order to spread the word about distracted driving.

Last November, the transportation secretary, Ray LaHood, introduced a Web site called “Faces of Distracted Driving” (distraction.gov/faces) that explores the cost these behaviors inflict on families and communities. “Distracted driving has become a deadly epidemic on America’s roads,” said Mr. LaHood, who urges bans on drivers texting and using phones or other devices.

At the news briefing, Dr. Andrew Pollak, president of the trauma association, said: “It isn’t just cellphones. It’s anything that takes our attention from the task of driving.”

David L. Strickland, administrator of the National Highway Traffic Safety Administration, added: “No one does multitasking well.”

The orthopedists’ campaign will try to raise the national consciousness and change future driving behavior by taking their message to schoolchildren, especially those in grades 5 through 8, who may discourage their parents and siblings from driving distracted and refrain themselves when they become drivers.

Evidence based design involves using up to date research about the relationship between the built environment and health; and seeks to implement those designs to aid the healing process for patients, family, friends, and hospital staff. For example, hospitals are creating more simple building layouts, to allow visitors and staff to navigate throughout the building with greater ease. Loud noises have also been shown to cause stress, so sound absorbing ceiling panels are being used to filter out sound.

To help create a more positive atmosphere for patients and their families, rooms are provided with special areas for family members and visitors, equipped with furniture to create a more comfortable environment for relatives. Previous research has also shown that natural light and views of nature are also beneficial and so are implemented into design practice. Research conducted by Roger Ulrich found that surgery patients that had a view of nature healed faster than those who did not.

In the US, experts have come together to form the “Center for Health Design”, to further research and develop these new findings and also to provide reliable information for hospitals and the general public through its “Pebble Project”.

For more information please see the sources below:

http://www.healthdesign.org/pebble

*Although this is a US site, these standards are being adopted all over the world.

“Healing Spaces: The Science of Place and Well being“. Esther M. Sternberg.  Belknap/Harvard University Press, 2010.

By Brooks DeCillia CBC News

Posted: Mar 10, 2011 2:15 PM ET

Last Updated: Mar 10, 2011 2:15 PM ET

A sports drink promoted as a healthy alternative to sugary sodas is at the centre of potential class-action lawsuits launched in Calgary and Vancouver.

The legal actions claim the companies behind Vitaminwater have been misleading consumers into thinking the product is healthy, when in fact a bottle contains more than 30 grams of sugar.

In Calgary, the law firm Cuming and Gillespie filed a statement of claim with the Court of Queen’s Bench in February, alleging Coca-Cola Ltd. and Energy Brands Inc. deceived plaintiffs with Vitaminwater’s marketing.

The Vancouver law firm Hordo and Bennett filed a similar claim in January with the British Columbia Supreme Court.

Both firms declined interview requests from CBC News.

The Alberta statement of claim names the plaintiff as Calgary resident Larry Guilloux. The lawsuit says Guilloux consumed Vitaminwater regularly and believed it was a healthy alternative to soft drinks.

According to the statement of claim, Guilloux would not have bought the drink if he’d known how much sugar it contained.

A 591-millilitre bottle of Vitaminwater has 120 calories. By comparison, a regular 355-millilitre can of Coke has 160 calories.

The Alberta statement of claim takes issue with the name Vitaminwater and its labelling — a “nutrient enhanced water beverage” — and casts doubt on the health benefits of the drink.

None of the allegations in the statements of claim have been proven in court.

Nor have the lawsuits been certified yet as class actions.

Company defends the product

In a written statement, Coca-Cola told CBC News it did not have any comment on the pending litigation but stressed Glaceau — the Coca-Cola subsidiary that makes Vitaminwater — will take “all necessary steps to vigorously defend any litigation filed against our company.”

The statement adds that the beverage’s label clearly display ingredients and calorie content.

Before a court certifies the plaintiffs’ claims as class actions, it must conclude there are important common legal issues that can be decided together.

Legal scholar Jasminka Kalajdzic told CBC News that proving each person who bought Vitaminwater relied on what they thought were the supposed health benefits of the drinks could be hard.

But the University of Windsor professor predicted lawyers for the plaintiffs will have an advantage since they are claiming the makers of Vitaminwater breached provincial statutes that define deceptive marketing.

“So, in my opinion, it’s very much a different ball game,” Kalajdzic said.

Members of Parliament will vote Wednesday night on Bill C-393, an NDP bill that amends Canada’s Access to Medicines Regime. The changes would permit generic drug makers to manufacture patent-protected medications and ship them to specific developing countries. The generic manufacturers would also not be required to obtain a permit each time they wished to produce and ship a drug.

The drugs affected are those used to treat malaria, tuberculosis and HIV/AIDS, among other illnesses. The bill could help millions of people in Africa who can’t afford life-saving medications.

K’naan, who immigrated to Canada from Somalia, said the bill will save lives.

“It isn’t so much about us, it’s about other people, it’s about people who need us right now,” K’naan told CTV’s Canada AM on Wednesday. “I mean the real important thing to distinguish is we are in a position to be helpful right now. Sometimes we may not be, we may be in a position of need, but at this moment Canada can step up and really live up to the Canadian idea, the Canadian value that we all know about.”

K’naan was on Parliament Hill Wednesday to encourage MPs to support the bill, which squeaked by second reading and is headed to a final vote around 6 p.m. ET. K’naan was joined by Stephen Lewis, former UN special envoy for HIV/AIDS in Africa, and Dr. James Orbinski, founder of Dignitas International, as well as other heads of organizations devoted to combating AIDS in the developing world.

Richard Elliott, executive director of the Canadian HIV/AIDS Legal Network, said the bill will cut the red tape that is preventing medications from getting to developing countries, despite the fact Parliament adopted the Access to Medicines Regime nearly seven years ago.

According to Elliott, under the current guidelines, each generic drug order requires a separate license from the patent-holder. This means, for example, that if one generic drug is to be shipped to five countries, five licenses must be obtained.

“There’s all kinds of inefficiencies and disincentives built into the current legislation and this bill would sweep those away and make it more viable,” Elliott told Canada AM.

Elliott said the big drug makers will not lose money under the generic scheme. Their profits come from North America and Europe, markets in which the low-cost generics will not be available.

“Let’s remember we’re talking about a system that is going to let lower cost generic drugs go to developing countries…and it’s places where people are not purchasing medicines now because they’re out of reach,” Elliott said.

The study, published in the prestigious science journal Proceedings of the National Academy of Science, used mice to compare the effects of a lifetime of regular exercise over a sedentary lifestyle.

The researchers from McMaster University in Hamilton, Ont. worked with a litter of mice that were genetically programmed to age quickly. The mice were engineered to have a defect in a gene that alters the repair system of their mitochondria – which are the cellular powerhouses responsible for generating energy for nearly every cell in the body.

The researchers forced some of the mice to exercise by putting them on a treadmill to jog at a brisk pace three times a week for 45 minutes.

After five months, they found that premature aging was prevented in nearly every organ in the mice that ran on the treadmill.

“We surprised at how effective [exercise] was,” the study’s lead researcher Dr. Mark Tarnopolsky told CTV News. “It turned out to be more effective than we thought.”

The exercising mice looked as young as ever, while the sedentary mice were balding and going grey. They were also inactive, more socially isolated and less fertile. The muscle tissue of the inactive mice showed signs of damage, while those that exercised had muscle structure that was completely normal.

“What really shocked us was the gonads, the spleen, liver – every tissue we looked at was made better with the exercise. It has a systemic effect and even prevented a slight shrinkage of the brain,” said Tarnopolsky, who’s a professor of pediatrics and medicine at McMaster’s DeGroote School of Medicine.

Perhaps most surprising is what the scientists discovered in the mitochondria of the mice. Mitochondria are unique in that they have their own DNA. It’s long been thought that accumulation of mitochondrial DNA mutations over our lifetimes leads to the progressive decline in tissue and organ function that results in aging.

But in the exercising mice, their mitochondria had gone from damaged to young and healthy.

So are the results seen in the mice applicable to humans? Absolutely, says Tarnopolsky, who hopes the mice inspire humans worldwide to get moving .

“When you see the video with the mice barely moving and their sisters moving around healthy, that may shock them into getting their buts off the couch and get some exercise,” he says.

He notes that studies have shown that even those who have spent most of their lives sedentary can reap the benefits of exercise, with increased energy, more mobility and healthier organs.

“Get moving, get active and get your kids moving while they are young,” he advises.