WATERLOO -- How electronic technologies can advance public health response times in emergencies is one of the topics to be addressed at a special University of Waterloo seminar on May 24.

The Smarter Health Seminar is presented by the Waterloo Institute for Health Informatics Research (WIHIR) and the InfraNET Project, based at UW. Health informatics is the discipline that investigates how information, information management, and information and communications technologies can deliver value in the area of health.

Guest seminar speaker is Dr. George Pasut, executive lead, Public Health System Transformation, Ontario Ministry of Health and Long-Term Care. His talk is titled "Ontario's Public Health E-Health Strategy-Supporting Public Health Renewal."

The public seminar runs Wednesday, May 24 from 3 to 4:30 p.m. in the Davis Centre, Room 1302, on the UW campus. There is no charge for the seminar. However, please register to attend or to view the live web cast at: link The names of people who pre-register are entered in a draw to win a BlackBerry.

The public health system is often described as an invisible component of the health-care system, working in the background to protect and promote health, as well as to prevent disease and injury at a local community and systemic level.

Over the last decade, the importance of a strong public health system has been highlighted by Canada's experience with infectious disease outbreaks, such as the Walkerton Ontario E. coli and North Battleford Saskatchewan cryptosporidium outbreaks, West Nile virus and the SARS outbreak.

Though those recent public health experiences have been largely shaped by infectious disease issues, epidemics of obesity and tobacco-related diseases also underscore the importance of integrated health promotion programs to ensure optimal growth and development and improved health at all ages.

But the public health system, along with much of the health-care system, has lagged other sectors in the development and implementation of e-health solutions.

"The presentation will offer an opportunity to learn about current developments, and exchange ideas on possible future directions," said Shirley Fenton, managing director of WIHIR. "The public health e-Health strategy has evolved along with the changes to the public health system."

The presentation will highlight several key priorities. These include a recently introduced province-wide information system for effective disease control and inter-jurisdictional information sharing for outbreak response, an "Important Health Notice" emergency alerting system, development of two communication portals to support collaborative planning, as well as planning of next generation public health case management information systems.

Pasut's ministry office is responsible for supporting the renewal of public health system, including an update of the public health legislation and program standards, and a response to the Capacity Review Committee recommendations that together frame a strategic direction for public health programs and services in Ontario.

Previously, Pasut was the medical officer of health and chief executive officer for Simcoe County, and following amalgamation, the Simcoe Muskoka District Health Unit. He also worked at the Ministry of Health as a senior medical consultant and physician manager in the Public Health Branch and as acting director of the Health Promotion Branch.

New OMA president points to 9,000 Canadian trained doctors who have left the country.

TORONTO - On May 8, Dr. David Bach committed to making physician retention a top priority in his inaugural speech as the 125th president of the Ontario Medical Association (OMA). A radiologist from London, Ontario, Dr. Bach expressed deep concerns about Ontario's ability to recruit and retain physicians and highlighted the fact there are 9,000 doctors who have graduated from a Canadian medical school who are practising in the U.S.

"Significant progress has been made in recent years to train more doctors in Ontario; however, it takes many years to increase our pool of new doctors," said Dr. Bach. "In the mean time, we need to find innovative ways of keeping our current doctors caring for their patients - if we are not able to retain our doctors, quality of care and access to care for patients will not improve."

Ontario is short more than 2,300 doctors, affecting 1.4 million patients. In addition to the current shortage, our physician population is aging and many specialties are facing up to a 25 per cent retirement rate in the next five years. With 19 per cent of practising physicians over 60 years of age and 11 per cent over 65, the OMA believes that steps must be taken to ensure these physicians continue to care for patients.

At the OMA's Annual General Meeting, which brings together almost 500 doctors from across the province, Dr. Bach outlined several priorities for the coming year including:

1. Developing a spectrum of incentives aimed at retaining practising physicians in Ontario and recruiting back Canadian trained physicians who have left the country.

2. Developing health prevention and promotion initiatives to ensure that Ontarians have the education and tools necessary to live healthy lives.

3. Working to establish partnerships with health care providers, policy makers, business leaders and economists to discuss the best ways to improve care for patients.

4. Establishing a regional mechanism for physicians to provide much needed advice and input into Local Health Integration Networks, in the interests of patients.

"The provincial government's Local Health Integration Networks need to have a formal, meaningful, mechanism for doctors to provide input into the decision-making process," said Dr. Bach. "Doctors are on the front lines of caring for patients and are a vital component in finding solutions to provide better care in Ontario."

Dr. Bach reaffirmed that physician input into all aspects of the health care system is necessary to ensure that Ontario's health care system can meet the needs of patients.

"We need to engage in more meaningful discussions that will help us foster new ideas and find best practices," said Dr. Bach. "We are committed to working with the government and provincial leaders to guide good policy decisions and help implement changes that will result in real improvements to the whole health system not just a few wait-lists."

Exactly what factors led to the jump in Ontario's rates is not known, whether it be the availability of free flu shots for everyone, easier access, extensive advertising, some other cause, or a combination of causes.

Vaccination rates in Ontario stabilized between 2001 and 2003, but continued to rise in the rest of the country. Even so, Ontario's 2003 rates still exceeded those for the other provinces combined.

Ontario remains the only province with a universal influenza immunization program.

Big jump in Ontario rates

By 2000, most provinces had publicly funded programs that offered free flu shots to seniors, people with chronic conditions and health care workers. The Ontario program, which began offering free flu shots to the entire population aged six months or older in the fall of that year, was the first large-scale program of its kind in the world.

Flu vaccination rates in Ontario rose substantially between 1996/1997 and 2000/2001. For example, among people aged 12 to 49 who had no chronic conditions, only 8% had had a flu shot in 1996/1997. By 2000/2001, the proportion had risen to 25%. This 17 percentage-point gain was nearly three times the increase of 6 percentage points among people in the same age group in all other provinces combined.

At the same time, the vaccination rate among Ontario residents aged 12 to 49 who had a chronic condition more than doubled from 18% to 39%, an increase of 21 percentage points. In the other provinces, the vaccination rate for this group rose about 5 percentage points from 13% to 18%.

Two years later, in 2003, rates for the other provinces combined were still below those in Ontario. For example, among Ontario residents aged 12 to 49, 22% of those with no chronic condition had been vaccinated in Ontario, compared with 11% in the other provinces combined. And for those with at least one chronic condition, the Ontario rate was 36%, compared with 21% in the other provinces.

Target met for seniors in Ontario

A national conference in 1993 set a target coverage rate for influenza vaccination of 70% for seniors and all adults with chronic medical conditions. By 2003, Ontario had met this target for seniors, among whom the overall vaccination rate was 74%.

However, the province still fell short of the target for younger adults with chronic conditions. Among Ontario residents aged 50 to 64 with at least one chronic condition, 59% had had a flu shot in 2003. While this was higher than the rate of 45% in the other provinces, it was below the 70% target. Thus, even in the context of a universal vaccination program, there appears to be room for improvement, the study noted.

Other provinces have reached the 70% target only for seniors with a chronic condition. In 2003, in the other provinces combined, the vaccination rate for seniors with chronic conditions was 71%, still well below the comparable rate of 80% in Ontario.

Provincial trends in flu shots

A separate article in Health Reports, "Flu shots — National and provincial/territorial trends," provides vaccination rates in Canada and each province in 2003.

Nationally, 28% of Canadians aged 12 or older had received a flu shot in 2003. Only two provinces, Ontario (35%) and Nova Scotia (31%), had rates significantly above the national average.

Among people with at least one chronic condition, about 47% had had a flu shot. Rates were significantly higher in two provinces: Ontario (55%) and Nova Scotia (54%).

In the case of seniors, nationally, two-thirds (67%) of people aged 65 or older reported having had a flu shot in 2003. This was almost unchanged from 2000/2001, but up considerably from 51% in 1996/1997. Again, Ontario and Nova Scotia had rates above the national average.

Since flu shots have been available, immunization has been recommended for health care workers. In 2003, however, less than half (46%) of individuals employed in health care settings such as hospitals and nursing homes reported having had a flu shot.

For more information, or to enquire about the concepts, methods or data quality of this article and "Flu shots — National and provincial/territorial trends," contact Helen Johansen (613-722-5570), Health Statistics Division.

The May 2006 issue of Health Reports also contains two other studies.

"Survival from cancer — Up-to-date predictions using period analysis" provides predictions of short- and long-term relative survival rates of Canadians recently diagnosed with cancer. It concludes that survival for many forms of cancer is higher than that estimated by previous studies using different methods. For more information, contact Larry F. Ellison (613-951-5244), Health Statistics Division.

"Medication use among pregnant women" examines the use of prescription and non-prescription drugs among pregnant women aged 15 to 49. It shows that while smoking and alcohol consumption declined among expectant mothers during the past 10 years, the use of medication by this group increased. The gain is mainly attributable to the growing use of non-prescription drugs. For more information, contact Didier Garriguet (613-951-7187), Health Statistics Division.

Note to readers

This release is based on two articles in the latest issue of Health Reports: "The effect of universal influenza immunization on vaccination rates in Ontario" and "Flu shots — National and provincial/territorial trends." The first article is a joint effort by Statistics Canada and the Institute for Clinical Evaluative Sciences. The data used in the analyses are from the Canadian Community Health Survey and the National Population Health Survey, both conducted by Statistics Canada.

TORONTO - Future public health physicians of Ontario are asking the provincial government to commit to an action plan for the implementation of the Capacity Review Committee's final report released today. "Since 2002, the provincial government has commissioned ten reports to determine how local public health can be strengthened," says Dr. Vinita Dubey, a future public health physician. "We know that local public health's capacity needs to be improved, now let's develop a plan to put the recommendations into action."

Ontario's public health system has been challenged following the emergence of outbreaks such as E.Coli in Walkerton, SARS, West Nile virus, Rubella among others. With Avian influenza and its potential for a pandemic on the horizon, public health needs to be strengthened now. "It is time to take the lessons learned from outbreaks such as SARS and invest in public health infrastructure to be ready for the next crisis," added Dubey.

Medical Officers of Health (MOH) are physicians who are responsible for the health of the community. Currently in Ontario, one third of public health units are without a full-time MOH. "Not having a full-time MOH in a health unit puts the whole community at risk. In the event of an outbreak, a MOH is key to prevent the spread of disease and halt the outbreak. The public's safety is at risk," said Dr. Kathleen Dooling, a second year resident in Toronto's five-year training program.

"We endorsed a comprehensive public health human resource revitalization strategy, including increased capacity for education and training, promotion of public health careers, and improved recruitment and retention strategies for MOH and their staff," says Dr. Walker, Dean of the Faculty of Medicine, Queen's University and chair of the final report of the Ontario Expert Panel on SARS and Infectious Disease Control. However, since Dr. Walker's report, Medical Officers of Health have been drifting out of local public health because the work conditions have not been sustainable.

The conclusion from all ten reports is that strengthening local public health infrastructure, governance and human resources are essential to protect the public from serious infectious diseases and potential outbreaks. "The provincial government needs to act now," says Dr. Dooling.

Investing in 5,417 New Procedures to Reduce Wait Times and Improve Health Care

WATERLOO REGION – The Ontario government is continuing to reduce wait times in five key areas ¾ cancer surgery, cardiac procedures, hip and knee joint replacements, cataract surgery and MRI/CT exams – with an investment of $10,717,123 for regional hospitals, John Milloy, MPP for Kitchener Centre announced April 28 on behalf of Health and Long-Term Care Minister George Smitherman.

The $10,717,123 investment in Waterloo Region will result in 5,417 more procedures including:

$709,023 for 173 additional cancer surgeries

$5,273,300 for 870 more cardiac procedures

$2,792,600 for 403 more total hip and knee joint replacements

$1,403,200 for 1,871 additional cataract surgeries

$539,000 for 2,100 more MRI exams

“Our government’s Wait Time Strategy continues to provide people in Waterloo Region with faster access to better health services,” said Milloy. “This investment will ensure that patients continue to receive the care they need, and that they receive it more quickly.”

Marion Bramwell, Chief Operating Officer and Chief Nursing Executive at St. Mary’s General Hospital said, “This is an important investment to improve access to health care in Waterloo Region. With more than $6 million in additional funding for St. Mary’s General Hospital, this infusion of dollars will help us to further reduce our wait times for cardiac procedures, cataract operations and cancer surgery and it strengthens our commitment to excellent patient care.”

Today’s announcement is part of an overall province-wide investment of $222 million to fund 154,000 new procedures. The investment represents the largest single increase in cataract surgeries, hip and knee replacements, and MRI scans in more than a decade.

Today’s funding announcement coincides with the government’s release of updated and comprehensive wait times data which confirms that province-wide wait times are clearly dropping.

Data on the government’s wait times website indicates that, during the last six months, cataract surgery median wait times dropped 21 per cent, times for hip and knee replacements decreased 19 per cent and 17 per cent respectively, and cancer surgery wait times dropped by four per cent. Further information is available at: www.ontariowaittimes.com.

“It’s clear that our efforts to reduce wait times are working, and today’s investment builds on that success,” Smitherman said. “Obviously it’s too early to declare victory, but it’s good to see that our wait times strategy is working. Our challenge now is to continue with this progress.”

Today's initiative is part of the McGuinty government's plan to build a health care system that delivers on three priorities - keeping Ontarians healthy, reducing wait times and providing better access to doctors and nurses.

New look - VON meets changing homecare needs

OTTAWA - By choice or by default home care is becoming a growing reality for Canadians. VON Canada (Victorian Order of Nurses), the country's longest serving national, not-for-profit, charitable, home and community care organization, is repositioning itself to reflect its role as a vital component of today's health care system.

"There simply aren't enough hospital beds and buildings to cope with patient needs, and the gap is growing," says Dr. Judith Shamian, VON President and CEO. "At the same time, not every ailment requires hospitalization, and more and more patients can be properly cared for in a home or community setting. VON has grown to provide more than 50 home care and community services to meet these needs on a national basis".

While more and more Canadians in rural and urban centres are in need of home care and other community services, not everyone is aware that VON offers more than nursing care, and is often just around the corner. To remind people of the breadth and scope of VON's services, the organization today unveiled an eye-catching new logo, tagline, print and television ad (see www.von.ca). Radio ads will follow.

The accompanying tagline - Touching lives since 1897 - reinforces VON's core philosophy that clients are at the centre of home and community care. The new television ad and print campaign features the story of a patient whose wheelchair is now "for sale" because he no longer needs it thanks to the care of VON.

"For more than 100 years, VON has provided innovative, dynamic and responsive community-based care, and our services have evolved and grown to meet changing needs", says Dr. Shamian. "VON is the only national, not-for-profit, charitable organization that fills the inevitable gaps in the health care system in communities across Canada. VON's charitable character ensures that we can deliver services so that Canadians receive a seamless continuum of care - as close to home as possible. Studies show people recover faster at home and are happier."

VON's revitalization campaign is multi-pronged and includes: <<

- A growth strategy to increase primary health care, improve workplace wellness, deliver integrated disease management programs to assist people to manage conditions like diabetes and improve health services to aboriginal Canadians;

- Renewing the organization to allow us to build a better workplace, to increase our ability to recruit and retain quality people at a time when Canada faces a shortage of health human resources in the home and community care sector;

- Raising awareness of the role of home and community care and the need for increased resources to support this neglected sector of the health care system. An OECD Long-term care study shows that Canada spends very little on home care. Sweden spends 0.72% of its GDP on home care, Canada spends 0.16%(1);

- Highlighting the impact of the voluntary sector;

- Highlighting the impact of an estimated 2.85 million caregivers(2) who save the system an estimated $5 billion(3) annually; and,

- An upcoming launch of a model of care that will revolutionize the way care is delivered in the home and community. >>

VON's campaign to highlight the integral role of home and community care comes at a time when the Government of Canada and the provinces and territories are exploring ways to reduce wait times and increase access to health care.

"Homecare can reduce wait times, plain and simple", added Dr. Shamian. "When VON cares for Canadians in their homes or in their communities, it means they are not in hospitals, leaving the possibility for those that are in greater need of hospitalization to be seen more quickly. A strengthened home and community care system benefits patients at home and patients in hospital. We continue to urge governments at all levels to put in place the policies that reflect these realities".

Demand for home and community care rose by an astounding 60 per cent between 1995 and 2002(4), clearly demonstrating the need for additional resources targeted to these services. Based on historical trends, today's $4 billion home care market in Canada is estimated to grow to $10 billion by 2010(5).

In 2005 alone, VON volunteers gave 667,146 volunteer hours providing meals on wheels, caregiver respite and school breakfast programs among other programs. VON's more than 19,000 staff and volunteers deliver more than 50 programs to millions of Canadians 24 hours a day, 7 days a week through more than 55 branches and 1,400 communities across Canada. VON's staff and volunteers include specially trained Registered Nurses, Registered Practical Nurses, Licensed Practical Nurses, Certified Health Care Aides, Personal Support Workers and Home Support Workers.

VON is a national health organization and registered charity offering a wide range of community health care solutions that meet the needs of Canadians from coast to coast. VON is committed to continuous quality improvement and has earned Canadian Council of Health Services accreditation.

OTTAWA - On April 26 a study released described substance abuse as a significant burden on the Canadian economy in terms of both its direct impact on health care and criminal justice costs, and its indirect toll on productivity resulting from disability and premature death. The Canadian Centre on Substance Abuse (CCSA), Canada's national addictions agency, estimates the total annual cost of substance abuse in Canada to be $39.8 billion (based on 2002 data), which represents a cost of $1,267 to each individual Canadian.

The study reveals that

- Legal substances (tobacco and alcohol) account for almost 80% of the total cost of substance abuse (79.3%); illegal drugs make up the remaining 20.7%;

- Tobacco imposes the greatest cost at $17 billion (42.7%);

- Alcohol accounts for $14.6 billion (36.6%); and

- Illegal drugs cost $8.2 billion (20.7%).

The impact of substance abuse was relatively uniform across Canada, except in the territories where costs are higher than in the provinces. For a more detailed breakdown on the estimated costs, including regional breakdowns, please refer to the Costs of Substance Abuse in Canada 2002: Highlights.

"The costs of substance abuse in Canada are significant and rising," said Michel Perron, CCSA's Chief Executive Officer. "This cost study has the potential to help reverse that trend if it succeeds in convincing governments and other stakeholders to make substance abuse a high priority on the public agenda. It is an important step toward determining where we can best allocate resources to start reducing the burden of substance-related death and illness on Canadian society."

Comparing the costs of substance abuse

CCSA published the first Canadian cost study in 1996 based on 1992 data. The total cost of substance abuse was then estimated to be $18.5 billion. However, the authors of the new study caution against making direct cost comparisons with the previous study. Cost estimation methods have evolved since then and data contained in one study were not always available for the other. Inflation and demographic shifts also make comparisons difficult. Although it may not be possible to determine the exact magnitude of changes in costs from 1992 to 2002, there is no doubt that costs have risen. A more telling comparison can be made in terms of the underlying estimates of death and illness linked to substance abuse:

- Alcohol was more of a problem in 2002 than it was in 1992. Increases in alcohol-attributed death and illness between 1992 and 2002 may be linked to changes in patterns of use, including increased consumption of five or more drinks on a single occasion.

- Tobacco was stable or falling. The reduction in smoking-attributed death and illness may result from improved tobacco control measures in the 1980s and '90s.

- Illegal drugs saw a substantial increase. Drug-attributed deaths, for example, more than doubled between 1992 and 2002, largely because of an increase in drug overdoses and the spread of hepatitis C, which was not measured in 1992.

"The methodology for this study is complex and it's important to note that estimating social costs is not a simple accounting exercise," said Jurgen Rehm, Senior Scientist, Centre for Addiction and Mental Health and principal investigator for The Costs of Substance Abuse in Canada 2002.. "The results of this study are based on well-documented economic theories and assumptions and represent an accurate estimate of the impact of substance abuse on Canada. In all cases where we could have used different assumptions to estimate costs, we routinely adopted the most conservative approach."

Partners

The cost study was undertaken by CCSA in partnership with the Addictions Foundation of Manitoba (AFM); the Alberta Alcohol and Drug Abuse Commission (AADAC); the British Columbia Ministry of Health; the Canadian Institutes of Health Research (CIHR)- Institute of Neurosciences, Mental Health and Addiction; the Centre for Addiction and Mental Health (CAMH); Health Canada; Quebec's Ministère de la Santé et des Services sociaux (MSSSQ); the New Brunswick Department of Health and Wellness; Nova Scotia Health Promotion and Protection; and Public Safety and Emergency Preparedness Canada. It was guided by a steering committee composed of representatives of government, addiction agencies, private industry and academia.

Highlights of The Costs of Substance Abuse 2002 are available at www.ccsa.ca.

New Study Reveals Substance Abuse Costs Ontarians $14 Billion

TORONTO - A new study released today indicates that the abuse of tobacco, alcohol and illegal drugs cost Ontario $14 billion over a one year period, representing $1,185 per person in the province. According to the Costs of Substance Abuse in Canada 2002 study, this severe economic burden is comprised of both direct health care and criminal justice costs, as well as the indirect drain on productivity resulting from disability and premature death.

<< The study also reveals that in Ontario:

- Tobacco use imposes the greatest cost at $6.1 billion (42.4 per cent of the total cost of substance abuse)

- Alcohol accounts for $5.3 billion, or 37.2 per cent of the cost

- Illegal drugs cause the relatively lowest economic burden at $2.9 billion (20.4 per cent).

>> It is interesting to note that legal substances - tobacco and alcohol -account for 80 per cent of the cost of substance abuse (which is defined by the study as substance use that imposes costs on society that exceed the costs of providing the substance in the first place). Ontario's distribution of costs is consistent with the overall results for Canada, which indicate that tobacco imposes the greatest cost at $17 billion (42.7 per cent), alcohol $14.6 billion (36.6 per cent), and illegal drugs $8.2 billion (20.7 per cent), with a total cost to Canadians of almost $40 billion. The direct health care costs of substance abuse in Canada are higher than either heart disease or cancer.

Ontario differs from provinces like British Columbia, which has a 50 per cent higher per capita cost of illegal drugs, or Newfoundland where per capita tobacco costs are 36 per cent higher. In fact, Ontario's per capita cost for tobacco is the lowest of all ten provinces.

According to Dr. Jurgen Rehm, principal investigator for the Costs study and Senior Scientist at the Centre for Addiction and Mental Health (CAMH), "while we cannot make direct comparisons between this study and the previous Costs study done 10 years ago, the data does indicate that harm attributable to tobacco has gone down, whereas the harms of alcohol and illegal drugs have relatively increased."

Dr. Rehm points out that "Substance abuse remains a substantial public heath problem for Ontario, and not just for those with a psychiatric diagnosis of dependence or abuse. For example, 50 per cent of the costs of alcohol use and abuse are by people who do not have a diagnosis of alcohol dependence or abuse."

"There is an urgent need to address the devastating costs of substance abuse," said Dr. Rehm. "Research in Canada and internationally clearly demonstrates that government regulation and policy measures are by far the most effective and cost-effective tools in decreasing these costs."

Government has put extensive resources into reducing the costs of tobacco, and we are now seeing the results of these efforts. Nevertheless, compared to other substances, tobacco continues to impose the greatest cost burden on Ontarians. According to Dr. Roberta Ferrence, Director, Ontario Tobacco Research Unit and Senior Scientist, CAMH, "There is still a lot of public policy work to be done. Key strategies for reducing the costs of tobacco use include tax increases, restrictions on use, reduced availability, and support for quitting. We know that quitting relatively early in life greatly reduces lifetime health and productivity costs."

There is also a lot of evidence on how the costs of alcohol abuse can be reduced. For instance, Dr. Robert Mann, Senior Scientist, CAMH, has estimated that reducing the legal blood alcohol content (BAC) level for drivers from the current level of 0.08 to 0.05 would decrease the number of driver fatalities by between 6 and 18 per cent. Research demonstrates that alcohol monopolies are an important tool for governments to implement alcohol policies that control sales, promote public health, curtail risk and reduce drinking-related damage. Recent studies are also showing that alcohol advertising can act to increase alcohol consumption and harms, and has been linked to increases in drinking and drinking-related problems seen among youth.

Reducing the social costs of illegal drugs requires a different approach. "According to international research, a 'harm reduction' approach, integrated with prevention, enforcement and treatment, has proven to be the most effective. This is the approach adopted in the new Toronto Drug Strategy. A province-wide drug strategy would greatly enhance the effectiveness of both the Toronto Drug Strategy and the proposed National Framework as they are implemented, and is a necessary bridge between these efforts," said Gail Czukar, CAMH Executive Vice-President, Education, Policy and Health Promotion, today.

TORONTO - The Prostate Cancer Research Foundation of Canada is pleased to announce that it has awarded over $1 million to Canadian researchers actively investigating the causes, cure, treatment, and prevention of prostate cancer.

"The Foundation is thrilled that we are a part of history-making research today and for the future," says John Blanchard, President & CEO of the Foundation. "The research that the Foundation funds will improve treatment for patients, find better ways of diagnosing the disease, and will one day bring us closer to finding a cure."

Since 1999, the Foundation has awarded over $5.8 million to researchers at health science centers and universities across the country. Continuing the tradition of the Foundation's funding guidelines, this year's grantees have proposed pilot studies that take innovative new approaches to the treatment, prevention and diagnosis of prostate cancer. Grants have been awarded to researchers in British Columbia, Ontario, Quebec and Nova Scotia. This year's grantees are pursuing investigations across a diverse spectrum of topics. These include:

- Dr. Jeremy Squire of the University Health Network in Toronto, who is investigating a gene fusion protein that is specific to prostate cancer, and could yield a new, highly accurate diagnostic marker of the disease in as little as 12 months of study.

- Dr. Wilfred Jeffries of the University of British Columbia who is researching a new method of enhancing the body's immune system to better identify and eradicate cancerous cells in the prostate, positively affecting the outcome of therapies.

- Dr. Jacques Lapointe of McGill University in Montreal, who is using a novel technique that accurately measures thousands of genomic changes at a time in a large number of prostate tumours. This could lead to an identification of the "good genes" that are lost during cancer development and aid in the development of better treatments for the disease.

Through a standardized scoring process, the committee awarded the 16 grants in March of this year. The Foundation is grateful to AstraZeneca for their generous sponsorship of our peer review panel meeting.

The Foundation's Scientific Medical Advisory Committee is comprised of some of the most highly respected urology and cancer specialists across Canada, including our committee Chair, Dr. Robert Bristow, clinician-scientist at Princess Margaret Hospital in Toronto. The committee's important work includes soliciting and reviewing research proposals, recommending grants to fund the most promising projects, and reviewing their progress.

The Prostate Cancer Research Foundation of Canada is the leading national organization dedicated to a future where men no longer die from prostate cancer. Its mission is to raise funds for research into the prevention, treatment and cure of prostate cancer by engaging Canadians through awareness, education, and advocacy. For more information please visit www.prostatecancer.ca.

Guelph researchers will play a key role in a new national group intended to help fight a growing epidemic in obesity that threatens the health of millions of Canadians.

The Canadian Obesity Network (CON), one of five new federal Networks of Centres of Excellence announced recently, will bring together researchers, health professionals, industry and policy-makers to study, prevent and reduce the health and economic consequences of excess body weight. It will involve scientists at 21 universities, including researchers from Guelph’s departments of human health and nutritional sciences, food science and family relations and applied nutrition. In addition, more than 10 international institutes in North America and Europe, 15 non-profit organizations and 20 industry partners are involved.

“More than half of the Canadian population is classified as overweight or obese,” said U of G Prof. Terry Graham, chair of the Department of Human Biology and Nutritional Sciences. “What people often lose sight of is that obesity is often associated with many other diseases. There are about two million Canadians with type 2 diabetes. Not only are those numbers increasing, but also the age at which people are developing the disease is decreasing.”

People with type 2 diabetes are at greater risk of developing cardiovascular disease and eye and kidney damage. Obesity also increases the risk of developing several kinds of cancer, added Graham.

Arya Sharma, CON’s scientific director says the network “will provide an urgently needed response to this growing epidemic affecting 18 million obese and overweight Canadians and costing the Canadian health-care system in excess of $4.3 billion annually.”

Guelph will play a “dominant role” in the network through studies of nutrition, metabolism and obesity interactions. “We bring a really multidisciplinary team to the table,” said Graham.

For example, U of G Prof. Arend Bonen, Canada Research Chair in Metabolism and Health, will lead a network team focusing on the role of fat and muscle in obesity. His own studies suggest that hormones and metabolic signals in these tissues in people with excess body weight lead to cardiovascular disease and diabetes.

Other U of G scientists involved in the network will draw on longstanding connections with local and campus organizations, from the Guelph Food Technology Centre and Human Nutraceutical Research Unit to the Ontario Ministry of Agriculture, Food and Rural Affairs and Agriculture and Agri-Food Canada.

“The biggest Guelph contribution is that we have recognized and encouraged interactions between agriculture, food and human health. No other university around is better positioned in all three,” Graham said.

Far from “curing” obesity, he said, the new network will propose ways to reduce the problem, including health promotion in schools, public dissemination of research results, development of innovative foods and pharmaceuticals, and ideas for the food industry to investigate more healthful products.

He also expects researchers will explore the emerging field of nutrigenomics, or understanding how nutrients interact with individual consumers’ genes and metabolism. Researchers will probably learn more about how human evolution has made people obesity-prone by selecting for genes that enabled our less sedentary ancestors to store energy more efficiently, he said.

Better Access to Health Care For Thousands of Ontarians

WATERLOO REGION – The McGuinty government is improving access to health care in Waterloo Region with the creation of a new Family Health Team, John Milloy, MPP for Kitchener Centre announced today on behalf of Health and Long-Term Care Minister George Smitherman.

The Two Rivers Family Health Team in Cambridge is one of 50 new Family Health Teams announced today by the Ontario government. Today’s announcement means the government has reached its goal of creating 150 Family Health Teams by 2007/08. These teams are expected to improve access to health services for more than 2.5 million Ontarians.

“We’re changing the way health care is delivered in our community by making it more responsive to the needs of the community,” said Milloy. “More people will now have access to a family doctor and health team of their own to help keep them healthy and treat them when they get sick.”

Family Health Teams are made up of doctors, nurse practitioners, nurses, dieticians, pharmacists, mental health workers and many others – depending on the needs of each community. These teams provide comprehensive care around the clock, seven days a week. After hours, patients can call a registered nurse through the Telephone Health Advisory Service.

“Family Health Teams are the next evolution in primary health care services and are changing the way health care is being delivered right across the province,” Smitherman said. “They mean a stronger health care system now and for generations to come.”

The report stateted that the April 6 initiative is part of the McGuinty government’s plan for innovation in public health care, building a system that delivers on three priorities – keeping Ontarians healthy, reducing wait times and providing better access to doctors and nurses.

The McMaster satellite on UW's new campus will start with 14 students and grow to a complement of 84 within seven years. Physicians will be recruited to Waterloo Region to teach them and, overall, it's estimated that more than 450 students and residents would have medical training in Waterloo Region by 2012. These changes will have a noticeable effect in alleviating the shortage of physicians in this area, university officials told regional council on Wednesday.

The Michael G. DeGroote School of Medicine, the second-largest medical school in Ontario, produces doctors faster than other schools -- in three years rather than four. The first class in Kitchener will begin in September 2007 and graduate by the end of the decade.

"It makes sense to train medical students from the local area right here in their home community," said McMaster University President Peter George. "If we train them here, they will practice here. Simple as that."

"What a wonderful opportunity for the University of Waterloo to give back to the community by welcoming McMaster's Michael G. DeGroote School of Medicine to the Health Sciences Campus," said UW President David Johnston. "Combining our respective strengths, we contribute to the development of health sciences for Canada, and address the doctor shortage. Accessibility and quality of health care, so critical to the future well being of our community, will also be improved."

Anchored by UW's new School of Pharmacy and the medical school, the UW Downtown Kitchener Health Sciences Campus will include an optometry clinic and the Centre for Family Medicine, a residency program for students wishing to specialize in family medicine.

The innovative project builds on Kitchener's $30-million commitment and gift of land to the University of Waterloo. The Health Sciences Campus will attract a wide range of health professionals and address the need for expertise in health technology, health informatics, biosciences, population studies and biomedical engineering, while filling the urgent demand for more pharmacists and doctors in Ontario.

Among the benefits for the community in Waterloo Region:

* Locating a medical school in Waterloo Region will improve attraction and retention of doctors to an under-serviced community. It is widely known that a high percentage of physicians tend to practice where they are trained.

* McMaster University will offer its students a choice of campus based on preference and geographic background.

* The development of a primary care clinic and specialist clinics across the Local Health Integration Network (LHIN) will improve community access to an integrated spectrum of health care services.

* UW is ready to collaborate with McMaster in several integrated teaching opportunities, including some joint learning with students in the School of Pharmacy, scheduled to open in September 2007. Others may include combined degrees in health informatics, public health, imaging and so forth.

* Waterloo Region has the largest Ontario cluster of hospitals that are not currently teaching hospitals, providing an ideal opportunity for practicums and experienced-based learning.

* A dynamic community with innovative thinking as its hallmark, along with a rapidly growing population, will allow for transformation of research advances and knowledge into health benefits, economic opportunities and improved health care.

TORONTO - Sixty nine Ontario doctors have signed onto a letter asking Premier Dalton McGuinty to stop the privatization of Ontario's hospitals through so called Public Private Partnerships, or P3s.

The McGuinty government has gone further than any other government in Canada in privatizing formerly public and non-profit hospital assets and services through P3s. There are at least 24 planned P3 hospital projects in Ontario, with 22 of them created entirely by the current government.

The release of this letter comes a week before the Ontario Health Coalition's Hamilton plebiscite (citizen-called referendum) asking Hamilton residents to vote to keep the four hospitals in Hamilton fully public and to reject P3 privatization. On Saturday March 25, more than 80 voting stations will open across Hamilton garnering tens of thousands of votes. The results will be released to the media on Monday, March 27.

Says Dr. Ted Haines, author of the letter:

"We looked at the peer-reviewed evidence in the most prestigious international medical journals. We informed the Premier that we are deeply concerned about the government's plans to impose privatized P3s on our hospitals. P3s have proved to cost more and to result in compromised services. Hospitals funded through P3s have almost invariably provided less capacity than the hospitals they are intended to replace.

"The funding mechanism promoted by the government's 'Alternative Funding and Procurement' is a version of a Private Public Partnership, or P3, in which for-profit consortia take over financing, construction, facility management, maintenance and some hospital services for long term deals stretching up to 40 years. The companies often seek additional revenue through commercial land deals on public hospital lands, and service charges or user fees for patients and their visitors. This for-profit health industry has an interest in two tier healthcare from which they can take profit, further increasing the cost of healthcare."

"We are reminding the Premier of the findings of the Romanow Commission that looked at all the evidence regarding these private hospital deals. Mr. Romanow found that there was no evidence that these hospitals are better or cheaper. Moreover, he found them to be inconsistent with the values of Canadians or with the tenets of the Canada Health Act.

"We are calling on the Premier to act in the public interest and use citizens' tax dollars responsibly. Hospital construction and services must be publicly funded and hospitals must remain fully publicly managed and serviced," concluded Dr. Haines.

The full letter is available on line at www.ontariohealthcoalition.ca and www.hwcn.org/link/mrg

Formal consultations with Canada's healthcare professionals have yet to occur. Rather than wait to be asked for their input, the physicians and pharmacists participating in this week's forum are taking their message to Ottawa.

The NPS is part of Canada's 10-year plan to strengthen the delivery of health care. Announced in September 2004, the NPS is initially mandated to address five significant areas:

- catastrophic drug coverage for Canadians with high medication costs or little or no coverage;
- accelerated access to expensive, breakthrough drugs;
- a single, national drug formulary to replace current provincial listings of drugs eligible for coverage;
- improved evaluations of "real-world" drug safety and effectiveness;
and
- purchasing strategies to obtain best prices for Canadians.

The doctors and pharmacists at next week's event will draw from their experiences with patients to voice their opinions on these components of the NPS - as well as put forward new priorities. Timely access to optimal therapy is central to the well-being of Canadian patients and their relationships with their physicians and pharmacists. This is the foundation of the Canadian healthcare system and should be a central part of any discussion of a proposed NPS.

The Ottawa Forum is hosted by The Medical Post and Pharmacy Practice, Canada's leading independent medical publications. Together, they have a 68-year history serving Canada's physicians and pharmacists.

WATERLOO -- A University of Waterloo researcher who participated in a major international study measuring the impact of smoking on air quality in Irish pubs around the world says the results made public today underscore the need for smoke-free laws to protect public health.

The study on air quality in Irish pubs found that indoor air pollution in authentic Irish pubs in Ireland, where a smoke-free law has been in effect for two years, is 91 per cent lower than in Irish pubs located in other countries and cities where smoke-free laws do not apply. The report is titled, How Smoke-free Laws Improve Air Quality: A Global Study of Irish Pubs.

Geoffrey Fong, a UW professor of psychology, coordinated the Canadian and Beijing part of the global study on air quality in Irish pubs located in 45 cities in 13 countries. Fifteen of the 45 Irish pubs were in smoke-free communities, while the other 30 were in smoking-permitted communities. Waterloo was one of the test sites.

Besides Fong, researchers from Harvard School of Public Health, Roswell Park Cancer Institute and health authorities in Ireland collaborated on the global study that assessed air samples from a total of 128 "Irish pubs" in 15 countries in North America, Europe, Australia and Asia.

In March 2004, the Republic of Ireland became the first country to have a nationwide ban on indoor smoking in all public spaces, including restaurants and pubs. The policy provides an opportunity to assess the effectiveness of comprehensive smoke-free laws by comparing Irish indoor public spaces to public spaces elsewhere.

Despite claims that the law could have a negative economic impact, Ireland has seen no decline in business at pubs and restaurants. In fact, business in that sector has improved, according to the Central Statistics Office in Ireland

"This study demonstrates so clearly the power of smoke-free laws to reduce and eliminate a source of extreme hazard for the public," Fong said. "Tobacco smoke pollution is a leading cause of premature death."

He also said that it has been estimated that for every eight smokers who die of a smoking-related disease, one non-smoker dies of second-hand smoke. "People have very little idea how poisonous tobacco smoke is. It's far more than a mere inconvenience; it is very dangerous."

He added that improved ventilation within pubs is not a solution. "The ferocity of the ventilation required to reduce tobacco smoke to non-hazardous levels has been compared to a tornado. So claims that ventilation systems can significantly reduce health hazards of tobacco smoke are not accurate."

Fong said the comprehensive smoke-free law in Ireland has been a resounding success.

The presence of tobacco smoke in Irish pubs went from 98 per cent of pubs to about five per cent after the law. By comparison, tobacco smoke remained at 97 per cent of pubs in the United Kingdom.

As well, smokers supported the smoke-free law after its implementation, with 83 per cent of puffers saying that the smoke-free law in Ireland was "a good thing" or "a very good thing" for Ireland, and 64 per cent saying they supported "the total ban on smoking inside pubs."

"The Irish Pub study demonstrates at the global level both the successes of smoke-free laws and the challenges to health that still exist in countries that have not yet implemented smoke-free laws," Fong said.

Protection against exposure to tobacco smoke is one of the policies of the Framework Convention on Tobacco Control (FCTC), the world's first international health treaty. The 120-plus countries that have ratified the FCTC now are obligated to pass laws that will indeed protect people against tobacco smoke in public places.

On May 31, the Smoke-Free Ontario Act will be implemented in the province, which will prohibit smoking in all enclosed workplaces and public places, including bars, restaurants, bingo halls and private clubs (such as legion halls). Still, smoking will be allowed on outdoor patios that do not have a roof.

"This is a significant advance in public health laws in Ontario," Fong said. "But the technical definitions of what a roof is will likely be a challenge for regulators and for owners of hospitality establishments. Beyond that challenge, there will still be restaurant and bar staff who will be exposed to significant levels of tobacco smoke."

TORONTO - A growing number of Canadians are researching health information on the Internet to diagnose their own medical conditions, says HealthInsider, a national survey by IBM.

IBM's latest health survey of 2,500 Canadians found of those who used the Internet to obtain health information, 37 per cent had done so in an attempt to diagnose themselves. This is a 48 per cent increase over 2003. Additionally, more than a quarter of those seeking health information looked to confirm or question their physician's diagnosis. The study also revealed the number of Canadians using the Internet to check the results of medical research, speak to others with the same health condition or to manage a health condition has increased since 2003.

"The Internet has become the main source of health information for approximately three in 10 Canadians," said Neil Stuart, a partner in IBM Business Consulting Services' healthcare practice. "In 2003, the Internet surpassed the physician as Canada's primary source for health information. Now we see a trend toward Canadians using physicians and the Internet equally, indicating online medical information is being used more prudently." While more Canadians are using the Internet for diagnostic purposes, the vast majority feel it is difficult to determine which information found online can be trusted and that the quality of medical information on the Internet needs to be improved, the study said.

The top criteria used to determine the validity of the health information on a particular Web site are: endorsement by a recognized expert or authority; an affiliation with a credible health organization (such as a medical school); or third-party content control (such as accreditation by the government).

Canadians use the Internet to get health information because it's convenient, with 44 per cent of respondents saying that it was "easy and simple to get health information online," and 30 per cent saying online information is "accessible 24 hours a day."

Other findings of interest:

- Those who use the Internet in Ontario are most likely to use it to get health information, and Saskatchewan Internet users are the least likely.

- Of the Canadians who obtained health information on the Internet, almost 50 per cent in BC and Ontario spoke with their doctors about the health information they found online, compared to 42 per cent in Alberta and 38 per cent in Saskatchewan

- While Internet use was highest among Canadians age 15-24, this group used the Internet the least to find health information

- Males and females reported similar rates of Internet use, but females were more likely to search for health information online

London School of Economics Validation: "High Probability of Underestimation" in Half-Billion Health Interventions 2000-2005, Valued at US$4.4 Billion, Recorded by IFPMA Survey

LONDON, UK, March 8 - The London School of Economics (LSE) Health & Social Care Unit today issued a formal Validation Report on the Health Partnerships Survey undertaken last year by the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA).

The Health Partnerships Survey, unveiled in December 2005 by Dr. Daniel Vasella, IFPMA President and Chairman and CEO of Novartis, determined that, over the five years since the United Nations announced its Millennium Development Goals (MDGs), the 126 health partnerships created by the R&D pharmaceutical industry have provided enough health interventions to help up to 539 million people, or more than two-thirds the population of sub-Saharan Africa (1). In the process, the industry made available medicines, vaccines, equipment, health education and manpower worth US$4.38 billion (2), with the cost of donated medicines valued conservatively at their wholesale price.

The lead author of the report, Dr. Panos Kanavos, Lecturer in International Health Policy at the LSE, said "Having thoroughly reviewed the raw data and compared it with publicly available sources of information, our conclusion is that the IFPMA Survey is a conservative measure of the pharmaceutical industry's overall philanthropic effort to improve the health of people living in developing countries. Where contributions were difficult to value, they were excluded from the total, which therefore very probably underestimates the sector's combined contribution. For example, companies' investments in R&D into tropical diseases offering little or no commercial return was not counted."

He continued: "As far as we could discern, the Survey represents a first attempt by any industry to provide a global estimate of its role in the partnership to achieve the MDGs. It sets a standard to which other important industries might aspire, encouraging them to measure their commitment to the developing world."

The authors of the LSE report recommended that the IFPMA repeat the Survey on a regular basis, using a consistent methodology, to provide an up-to-date record of the industry's overall commitment to the MDGs. They also felt that the decision to exclude expenditure on R&D in neglected diseases disproportionately affecting developing countries helped to underestimate the overall industry contribution and that measurement of this R&D investment would be a welcome addition to future surveys.

(1) The survey measured the number of people potentially receiving help by counting (a) the delivery of sufficient medicine to cure one person of one disease, (b) the provision of a course of therapy sufficient to manage one disorder in one person for one year, (c) provision of sufficient vaccine to immunize one person against one disease for at least one year, or (d) delivery of a proven program of health education to one person. These metrics were used because, while companies know the number of doses they make available, they have a less precise view of the number of patients actually treated. The total number of people receiving health assistance may be reduced if individuals are treated more than once by the same program or receive help from more than one program, but this is very difficult to quantify.

(2) This valuation includes cash contributions, donated drugs, diagnostics and vaccines valued at wholesale price, and other in-kind contributions such as direct provision of health care services, education and training, and infrastructure development and support, for developing countries only (the 153 countries classified as low or medium income by the World Bank). It excludes the value foregone of drugs sold at preferential prices and assistance provided via long-term health development programs in other countries, as well as all industry emergency relief contributions to natural disasters in developed countries, as with Hurricane Katrina, or in developing countries, as with the Indian Ocean tsunami. It also excludes spending on R&D into neglected diseases, disproportionately affecting people in developing countries.

The World Bank said malnutrition is costing developing countries as much as three percent of their annual gross domestic products and called for a new push to combat the problem in pregnant women and children younger than two years old, reports The Wall Street Journal.

A new World Bank report issued Thursday entitled “Repositioning Nutrition as Central to Development,” estimated lost productivity resulting from an undernourished population. According to the report, the effect is significant suggesting that Africa and the South Asian economies together are losing as much as $36 billion a year, or 3 percent of those regions’ 2003 GDPs, said Meera Shekar, Senior Nutrition Specialist in the World Bank's Human Development Network in Washington and lead author of the report.

The BBC (UK) writes the World Bank estimates that nearly 60 percent of children who die across the world each year from common diseases such as diarrhea and malaria could have survived had they not been malnourished in the first place. "Poor nutrition is implicated in more than half of all child deaths worldwide - a proportion unmatched by any infectious disease since the Black Death," said Jean-Louis Sarbib, Senior Vice President for human development at the World Bank. "It is intimately linked with poor health and environmental factors, and yet policymakers, politicians and economists often fail to recognize these connections," he added.

The Washington Post notes that in many countries where malnutrition is widespread, food production is not the limiting factor unless there is famine, according to the report. Rather, some of the most important factors stem from the fact that pregnant and nursing woman eat too few calories and too little protein, have untreated infections that lead to low birth weight or get too little rest. Mothers have too little time to take care of their young children or themselves during pregnancy and often discard their first breast milk in the first few days after birth which strengthens the child's immune system. In addition, mothers often feed babies food other than breast milk during their first six months even though exclusive breast milk is the best source of nutrients and gives the best protection against disease.

The New York Times writes the study notes that the irreversible damage malnutrition causes to children occurs by age two, long before they begin primary school, and the World Bank contends that efforts to combat this scourge must concentrate on the brief window of opportunity between gestation and age two, with a focus on teaching mothers to properly feed and care for babies and toddlers.

Agence France Presse adds that the problem is at its most severe in South Asia and not, as might be supposed, in Sub Saharan Africa. Rates of under-nutrition in children in India, Bangladesh, Afghanistan and Pakistan range from 38 to 51 percent, compared to 26 percent for countries in Sub Saharan Africa. "Nearly half of India's children are undernourished, compared with a quarter of those in Sub Saharan Africa," said Praful Patel, World Bank Vice President for South Asia. The report warned however, that malnutrition is on the rise in Sub Saharan Africa, and noted that since malnutrition and HIV/AIDS reinforce each other, the success of HIV/AIDS programs in Africa depends in part on paying more attention to nutrition.

The Times of India notes the report states that India has one of the world's worst rates of childhood malnutrition, a fact that keeps the country from developing even faster. “Twenty-six percent of children in the highest income bracket in India are underweight and 65 percent are anemic,” said Shekar. "Anaemic children perform less well in school, are more likely to drop out and have lower intellectual and physical productivity as adults. Everyone talks about how well India is doing in the IT industry. Imagine how much better it could do, if 65 percent of the richest and 88 percent of the poorest children were not anemic," the report said.

Reuters writes the report urged aid donors and development