Today Ont. Min.Health Rhodes Scholar Dr.Eric HOSKINS MD(McMaster) MSc(Lond.Trop.Med.) PhD(Oxon.) Dip.Health.Econ(Aberdeen) made the announcement at the luxurious Dr.Riva (Appleby) GERSTEIN CC O.Ont PhD.(Tor-Psych..) Crisis Centre (10 beds).at 100 Charles St.East.. There is a second GERSTEIN Centre at 1045 Bloor St.West.(14 beds) Both funded by the Central Toronto LHIN (Local Health Initiative Network (Chmn. Mrs Angela FERRANTE) C.-T. LHIN budget $4.2-billion.
This is similar to the plan started in the late 1940s by the London King Edward's Hosp Fund which allowed GPs to phone and find the nearest Hosp bed available. The Fund was first financed in the early 1900s by the then "Richest Canadian" George Stephen 1rst Baron of Mount Stephen GCVO..
25 Feb 2015
23 Feb 2015
American Sexually Transmitted Diseases Assn
Sexually Transmitted Diseases - Current Issue
Chlamydia Test Results Were Associated With Sexual Risk Behavior Change Among Participants of the Chlamydia Screening Implementation in the Netherlands
Sunday, March 01, 2015 1:00 AM
imageObjective: To examine the effect of a laboratory-confirmed Chlamydia trachomatis (Ct) test result on subsequent sexual risk behavior in a large population-based screening program. Methods: The study population consisted of 16- to 29-year-old participants of the Chlamydia Screening Implementation who completed Ct testing and questionnaires in 2 or more rounds. The influence of a Ct test result on sexual behavior was analyzed by generalized estimating equation models, in which the Ct test result of the previous round was the independent variable and 1 of the 8 sexual risk behavior indicators was the dependent variable, adjusted for covariates. Results: Of 48,910 Chlamydia Screening Implementation participants with completed questionnaires and test results, 14.1% (n = 6802) and 2.6% (n = 1272) completed 2 and 3 rounds, respectively, and were included in this study. Analysis showed that Ct positives less often reported to “never” use condoms with a casual partner (%change pretest/posttest = −5.7% [−10.3 to −0.9]), whereas Ct negatives less often reported to “always” use condoms with a casual partner (−4.6% [−6.4 to −2.8]; odds ratio [95% confidence interval], 1.75 [1.09 to 2.80]). Ct positives also had more sexual partners in the subsequent round than did participants with a Ct-negative test result (relative risk [95% confidence interval], 1.14 [1.01 to 1.29]). Conclusions: Ct test results were associated with subsequent sexual risk behavior. In general, Ct positives were more likely to change their behavior after a Ct test result in a more positive and protective direction than Ct negatives, who were more likely to change their behavior toward more risky behavior. Effects over time after a Ct test should be investigated further, especially in the Ct negatives.
Association of the In Vitro Susceptibility of Clinical Isolates of Chlamydia trachomatis With Serovar and Duration of Antibiotic Exposure
Sunday, March 01, 2015 1:00 AM
imageBackground: The presence of persistent Chlamydia trachomatis infection after treatment does not always correlate with in vitro susceptibility testing. Methods: The in vitro minimum inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) of azithromycin, clarithromycin, roxithromycin, doxycycline, tetracycline, ofloxacin, and penicillin were tested against 61 clinical isolates of C. trachomatis on 6 serovars, and the MIC/MBC of azithromycin and ofloxacin at different points in time after antibiotic administration to infected cultures. Results: Of the 7 antibiotics tested, clarithromycin showed the greatest activity against C. trachomatis isolates with MIC90 of 0.032 μg/mL and MBC90 of 0.064 μg/mL, followed by doxycycline with MIC90 0.064 μg/mL and MBC90 0.064 μg/mL, and azithromycin with MIC90 0.160 μg/mL and MBC90 0.320 μg/mL. Azithromycin had roughly the same MIC50 values (0.08 μg/mL) as the other serovars isolates tested, and other antibiotics showed a 2- to 4-fold difference in MICs50 between serovars. In addition, an increase in the azithromyin MIC was observed by 8 hours and the ofloxacin MIC by 16 hours. At 24 hours, the azithromycin MICs were greater than 40 μg/mL and ofloxacin MICs were greater than 64 μg/mL. Conclusions: The current data demonstrated that the antimicrobial susceptibility of C. trachomatis was influenced by both the serovar type and the duration of exposure to antibiotics in infected cultures.
Confirmation of High Specificity of an Automated Enzyme Immunoassay Test for Serological Diagnosis of Syphilis: Retrospective Evaluation Versus Results After Implementation
Sunday, March 01, 2015 1:00 AM
imageBackground: The optimal algorithm for serological syphilis screening is still a matter of debate. We have previously evaluated the performance of the Bioelisa Syphilis 3.0, using a selection of archived sera, and in this study compare these results with the Bioelisa results after clinical implementation. Methods: All Bioelisa Syphilis 3.0 results obtained since clinical implementation were analyzed. Bioelisa-positive or borderline samples were retested using Treponema pallidum particle agglutination, rapid plasma reagin test, fluorescent treponemal antibody-absorption test, and/or immunoblot. On sera sent in together with cerebrospinal fluid, occasionally both the T. pallidum particle agglutination and Bioelisa were performed. Results: The Bioelisa was performed on 14,622 sera. Bioelisa-positive samples, which were not retested by the previously described assays, were withdrawn from the database (n = 36). In 1.3% of the samples (187/14,586), the Bioelisa was positive or borderline and, ultimately, 115 sera were considered true positive (prevalence 0.8%). The specificity of the Bioelisa was 99.5%. Conclusions: Based on the results of all performed diagnostic assays, the specificity of the Bioelisa of 99.5% is very consistent with that found in the initial study (100%; 95% confidence interval was 98.0%–100%). Interpreting (positive) test results is difficult in the absence of a gold standard, especially when the disease prevalence is low. Results should be viewed in the light of the patients’ characteristics.
Chlamydia Test Results Were Associated With Sexual Risk Behavior Change Among Participants of the Chlamydia Screening Implementation in the Netherlands
Sunday, March 01, 2015 1:00 AM
imageObjective: To examine the effect of a laboratory-confirmed Chlamydia trachomatis (Ct) test result on subsequent sexual risk behavior in a large population-based screening program. Methods: The study population consisted of 16- to 29-year-old participants of the Chlamydia Screening Implementation who completed Ct testing and questionnaires in 2 or more rounds. The influence of a Ct test result on sexual behavior was analyzed by generalized estimating equation models, in which the Ct test result of the previous round was the independent variable and 1 of the 8 sexual risk behavior indicators was the dependent variable, adjusted for covariates. Results: Of 48,910 Chlamydia Screening Implementation participants with completed questionnaires and test results, 14.1% (n = 6802) and 2.6% (n = 1272) completed 2 and 3 rounds, respectively, and were included in this study. Analysis showed that Ct positives less often reported to “never” use condoms with a casual partner (%change pretest/posttest = −5.7% [−10.3 to −0.9]), whereas Ct negatives less often reported to “always” use condoms with a casual partner (−4.6% [−6.4 to −2.8]; odds ratio [95% confidence interval], 1.75 [1.09 to 2.80]). Ct positives also had more sexual partners in the subsequent round than did participants with a Ct-negative test result (relative risk [95% confidence interval], 1.14 [1.01 to 1.29]). Conclusions: Ct test results were associated with subsequent sexual risk behavior. In general, Ct positives were more likely to change their behavior after a Ct test result in a more positive and protective direction than Ct negatives, who were more likely to change their behavior toward more risky behavior. Effects over time after a Ct test should be investigated further, especially in the Ct negatives.
Association of the In Vitro Susceptibility of Clinical Isolates of Chlamydia trachomatis With Serovar and Duration of Antibiotic Exposure
Sunday, March 01, 2015 1:00 AM
imageBackground: The presence of persistent Chlamydia trachomatis infection after treatment does not always correlate with in vitro susceptibility testing. Methods: The in vitro minimum inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) of azithromycin, clarithromycin, roxithromycin, doxycycline, tetracycline, ofloxacin, and penicillin were tested against 61 clinical isolates of C. trachomatis on 6 serovars, and the MIC/MBC of azithromycin and ofloxacin at different points in time after antibiotic administration to infected cultures. Results: Of the 7 antibiotics tested, clarithromycin showed the greatest activity against C. trachomatis isolates with MIC90 of 0.032 μg/mL and MBC90 of 0.064 μg/mL, followed by doxycycline with MIC90 0.064 μg/mL and MBC90 0.064 μg/mL, and azithromycin with MIC90 0.160 μg/mL and MBC90 0.320 μg/mL. Azithromycin had roughly the same MIC50 values (0.08 μg/mL) as the other serovars isolates tested, and other antibiotics showed a 2- to 4-fold difference in MICs50 between serovars. In addition, an increase in the azithromyin MIC was observed by 8 hours and the ofloxacin MIC by 16 hours. At 24 hours, the azithromycin MICs were greater than 40 μg/mL and ofloxacin MICs were greater than 64 μg/mL. Conclusions: The current data demonstrated that the antimicrobial susceptibility of C. trachomatis was influenced by both the serovar type and the duration of exposure to antibiotics in infected cultures.
Confirmation of High Specificity of an Automated Enzyme Immunoassay Test for Serological Diagnosis of Syphilis: Retrospective Evaluation Versus Results After Implementation
Sunday, March 01, 2015 1:00 AM
imageBackground: The optimal algorithm for serological syphilis screening is still a matter of debate. We have previously evaluated the performance of the Bioelisa Syphilis 3.0, using a selection of archived sera, and in this study compare these results with the Bioelisa results after clinical implementation. Methods: All Bioelisa Syphilis 3.0 results obtained since clinical implementation were analyzed. Bioelisa-positive or borderline samples were retested using Treponema pallidum particle agglutination, rapid plasma reagin test, fluorescent treponemal antibody-absorption test, and/or immunoblot. On sera sent in together with cerebrospinal fluid, occasionally both the T. pallidum particle agglutination and Bioelisa were performed. Results: The Bioelisa was performed on 14,622 sera. Bioelisa-positive samples, which were not retested by the previously described assays, were withdrawn from the database (n = 36). In 1.3% of the samples (187/14,586), the Bioelisa was positive or borderline and, ultimately, 115 sera were considered true positive (prevalence 0.8%). The specificity of the Bioelisa was 99.5%. Conclusions: Based on the results of all performed diagnostic assays, the specificity of the Bioelisa of 99.5% is very consistent with that found in the initial study (100%; 95% confidence interval was 98.0%–100%). Interpreting (positive) test results is difficult in the absence of a gold standard, especially when the disease prevalence is low. Results should be viewed in the light of the patients’ characteristics.
19 Feb 2015
UK DAILY MAIL Where are the Wealthy in the USA?
The map was made based on income estimates from the
2008-2012 American Community Survey, which were used to determine the
median household income by town. The richest town in each state were
usually small towns with populations between 1,000 and 8,000 and usually
not far from major cities. Hidden Hills, California and Chevy Chase,
Maryland come in at the top of the list, while Jericho Vermont and
Gretna, Nevada were the richest towns in their respective states - but
with much lower median household incomes.
Read more: http://www.dailymail.co.uk/news/article-2959361/The-United-States-Affluence-Map-shows-richest-towns-state-Hidden-Hills-California-Chevy-Chase-Maryland-ranking-10.html#ixzz3SBy7bg2P
Follow us: @MailOnline on Twitter | DailyMail on Facebook
THE RICHEST TOWNS IN EACH U.S. STATE
Hidden Hills, California >$250,000
Chevy Chase, Maryland >$250,000
Short Hills, New Jersey $235,799
Piney Point Village, Texas $233,636
Scarsdale, New York $232,422
Cherry Hills Village, Colorado $231,774
Kenilworth, Illinois $229,792
Coldstream, Ohio $220,263
Mission Hills, Kansas $219,107
Great Falls, Virginia $217,552
Belle Meade, Tennessee $213,375
Clyde Hill, Washington $210,500
Darien, Connecticut $200,724
River Hills, Wisconsin $193,438
Clarkson Valley, Missouri $188,000
Dover, Massachusetts $185,515
Fox Chapel, Pennsylvania $183,750
Anchorage, Kentucky $160,956
Marvin, North Carolina $160,093
Greenville, Delaware $156,635
Orchard Lake Village, Michigan $153,289
Kiawah Island, South Carolina $150,833
North Oaks, Minnesota $144,112
Paradise Valley, Arizona $139,524
Maunawili, Hawaii $137,143
Mountain Brook, Alabama $135,833
Emigration Canyon, Utah $135,469
Berkeley Lake, Georgia $131,944
Indian River Shores, Florida $129,885
Nichols Hills, Oklahoma $124,934
Shorewood Forest, Indiana $118,984
Bayou Country Club, Louisiana $118,571
Rafter J Ranch, Wyoming $117,526
White Rock, New Mexico $112,356
Robins, Iowa $111,652
Hidden Spring, Idaho $108,750
Bethany, Oregon $107,372
East Valley, Nevada $105,536
Dakota Dunes, South Dakota $104,327
Cumberland Center, Maine $101,375
Montana City, Montana $98,362
Gateway, Arkansas $97,269
Madison, Mississippi $96,780
South Hooksett, New Hampshire $93,371
Horace, North Dakota $88,750
Ashaway, Rhode Island $84,500
Maumelle, Arizona $82,122
Shepherdstown, West Virginia $81,029
Jericho, Vermont $78,618
Gretna, Nevada $77,818
Read more: http://www.dailymail.co.uk/news/article-2959361/The-United-States-Affluence-Map-shows-richest-towns-state-Hidden-Hills-California-Chevy-Chase-Maryland-ranking-10.html#ixzz3SBy7bg2P
Follow us: @MailOnline on Twitter | DailyMail on Facebook
18 Feb 2015
ONTARIO MEDICAL ASSOCIATION LOOKING FOR NEW CEO STARTING AUGUST 2015
Two floors in elegant building with indoor parking: 150 BLOOR WEST.(at Avenue Road) In most fashionable area of Toronto.Louis Vuitton & Tiffany next door. Park Hyatt hotel opposite. Royal Ontario Museum and Gardiner ceramics museum across the street.
Would suit applicant with MBA, MHSc & LLB/JD.
Contact ODGERS BERNDTSON AGENCY
RESUME advice from RANDSTAD Exec.Recruiter Danielle KRAUSE
S.A.M.
- What you Saved (as in time or money) - "reduced the month-end close process by four days," or, "saved $100,000 annually by renegotiating vendor contracts"
- What you Achieved (as in awards or goals met) - "chosen for the annual Company Spirit award for contributions to department," or, "completed systems implementation project"
- What you Made (as in something you actually created) - "redesigned aging report in Excel to track all past due accounts," or "implemented internal control procedures to reduce data entry error"
16 Feb 2015
MEASLES IN TORONTO Parents refusing to immunise (Stats Can: 46% Canucks "FUNCTIONALLY ILLITERATE").
MDs in Toronto now have chance to see Clinical effects of Measles including KOPLIK SPOTS.Henry KOPLIK MD(Columbia ,NY) 1858-1927 ."whonamedit"
H. Koplik:
The diagnosis of the invasion of measles from a study of the exanthema as it appears on the buccal mucous membrane.
Archives of Pediatrics, New York, 1896; 13: 918-922.
Koplik spots not mentioned in OSLER "Principle & Practice of Medicine" 1892 D.Appleton,NY
Measles: pp 77-81.
"AMONG THE ERUPTIVE FEVERS IT RANKS THIRD IN THE DEATH-RATE", Osler.
Late (1916-2010) U.Tor Prof.(Epid & Biometrics) W.HARDING le RICHE: MD(Wit.,SA) MPH(Harvard) FRCPC
World incidence and prevalence of the major communicable diseases In: Health and Mankind.(1967) Churchill.
"Cause of deaths
No.7 MEASLES 2.95%"
H. Koplik:
The diagnosis of the invasion of measles from a study of the exanthema as it appears on the buccal mucous membrane.
Archives of Pediatrics, New York, 1896; 13: 918-922.
Koplik spots not mentioned in OSLER "Principle & Practice of Medicine" 1892 D.Appleton,NY
Measles: pp 77-81.
"AMONG THE ERUPTIVE FEVERS IT RANKS THIRD IN THE DEATH-RATE", Osler.
Late (1916-2010) U.Tor Prof.(Epid & Biometrics) W.HARDING le RICHE: MD(Wit.,SA) MPH(Harvard) FRCPC
World incidence and prevalence of the major communicable diseases In: Health and Mankind.(1967) Churchill.
"Cause of deaths
No.7 MEASLES 2.95%"
13 Feb 2015
OMA & MOHTLC Negotiations failure: 2.65% reduction in payments.
"Facilitator" was Past U.Toronto Pres. David NAYLOR MD (Tor. 78) FRCPC ( No MBA or MHSc.)
"Conciliator" was Past Ont. Chief Justice Warren WINKLER QC
Negotiations took 31 weeks.
In 45 years OHIP payments 50% below OMA suggested rate.
OMA CEO R.SAPSFORD will retire from OMA in AUGUST.,2015.
(comment OMA now looking for a new CEO- hopefully with MBA from HARVARD, IVEY, ROTMAN, or WHARTON plus MHSc & LLB..)
28,000 practicing physicians in Ont.
Nurse practitioners, Physician assistants and Pharmacists taking over "GP" role.(Surprisingly OHIP does not pay Clinical Psychologists with PhD.)
Ontario GPs ,(copying UK "GP with Special Interest"), leaving full practice by limiting practice to cosmetic medicine, eye exams, dermatology, , pain medicine, palliative medicine, psychotherapy, surgical assisting, sport medicine and medical clinic development..
OMA GP SECTION issued a 3" button: "ask me how Government actions threaten health care".
The OMA Section printed a letter for faxing to "my MPP + Minister of Health".. In approx 350 words uses
"NEED" 5x and "NEEDS" 3x..
"Conciliator" was Past Ont. Chief Justice Warren WINKLER QC
Negotiations took 31 weeks.
In 45 years OHIP payments 50% below OMA suggested rate.
OMA CEO R.SAPSFORD will retire from OMA in AUGUST.,2015.
(comment OMA now looking for a new CEO- hopefully with MBA from HARVARD, IVEY, ROTMAN, or WHARTON plus MHSc & LLB..)
28,000 practicing physicians in Ont.
Nurse practitioners, Physician assistants and Pharmacists taking over "GP" role.(Surprisingly OHIP does not pay Clinical Psychologists with PhD.)
Ontario GPs ,(copying UK "GP with Special Interest"), leaving full practice by limiting practice to cosmetic medicine, eye exams, dermatology, , pain medicine, palliative medicine, psychotherapy, surgical assisting, sport medicine and medical clinic development..
OMA GP SECTION issued a 3" button: "ask me how Government actions threaten health care".
The OMA Section printed a letter for faxing to "my MPP + Minister of Health".. In approx 350 words uses
"NEED" 5x and "NEEDS" 3x..
9 Feb 2015
Danger of eating NON-FROZEN RAW FISH Ontario Public Health capitulates to Restaurant lobby
As a raw food, sashimi can cause foodborne illness because of bacteria and parasites, for example anisakiasis; a disease caused by the accidental ingestion of larval nematodes in the family Anisakidae, primarily Anisakis simplex but also Pseudoterranova decipiens.[2] In addition, incorrectly prepared Fugu fish may contain tetrodotoxin, a potent neurotoxin with no known antidote.
Traditionally, fish that spend at least part of their lives in brackish or fresh water were considered unsuitable for sashimi because of the possibility of parasites. For example, salmon, an anadromous fish, is not traditionally eaten straight out of the river.[citation needed] A study in Seattle, Washington, showed that all wild salmon had roundworm larvae capable of infecting people, while farm-raised salmon did not have any roundworm larvae.[3]
Freezing is often used to kill parasites. According to European Union regulations,[4] freezing fish at −20°C (−4°F) for 24 hours kills parasites. The U.S. Food and Drug Administration (FDA) recommends freezing at −35°C (−31°F) for 15 hours, or at −20°C (−4°F) for 7 days.[5]
While Canada does not federally regulate freezing fish, British Columbia[6] and Alberta[7] voluntarily adhere to guidelines similar to the FDA's.[citation needed] Ontario attempted to legislate freezing as part of raw food handling requirements, though this was soon withdrawn due to protests by the industry that the subtle flavors and texture of raw fish would be destroyed by freezing. Instead, Ontario has decided to consider regulations on how raw fish must be handled prior to serving.[8]
Some fish for sashimi are treated with carbon monoxide to keep the flesh red for a longer time in storage. This practice can make spoiled fish appear fresh.[9][10]
The intake of large amounts of certain kinds of fish may affect consumer health due to mercury content.
Traditionally, fish that spend at least part of their lives in brackish or fresh water were considered unsuitable for sashimi because of the possibility of parasites. For example, salmon, an anadromous fish, is not traditionally eaten straight out of the river.[citation needed] A study in Seattle, Washington, showed that all wild salmon had roundworm larvae capable of infecting people, while farm-raised salmon did not have any roundworm larvae.[3]
Freezing is often used to kill parasites. According to European Union regulations,[4] freezing fish at −20°C (−4°F) for 24 hours kills parasites. The U.S. Food and Drug Administration (FDA) recommends freezing at −35°C (−31°F) for 15 hours, or at −20°C (−4°F) for 7 days.[5]
While Canada does not federally regulate freezing fish, British Columbia[6] and Alberta[7] voluntarily adhere to guidelines similar to the FDA's.[citation needed] Ontario attempted to legislate freezing as part of raw food handling requirements, though this was soon withdrawn due to protests by the industry that the subtle flavors and texture of raw fish would be destroyed by freezing. Instead, Ontario has decided to consider regulations on how raw fish must be handled prior to serving.[8]
Some fish for sashimi are treated with carbon monoxide to keep the flesh red for a longer time in storage. This practice can make spoiled fish appear fresh.[9][10]
The intake of large amounts of certain kinds of fish may affect consumer health due to mercury content.
7 Feb 2015
Medical Obits in DICTIONARY of CANADIAN BIOGRAPHY
loretta.james@utoronto.ca
Fx: 416-978-2611
130 St.George St., Tor.,Ont.M5S 3H1
5 Feb 2015
$6.4-million from Ont.Govt to Ont.Institute for Cancer Research for the "Health Services Research Program".
On World Cancer Day (Feb.4)at Womens' College Hosp the Ont.Minister of Research & Innovation Dr. Reza MORIDI Liberal MPP (Richmond Hill- a Northern Suburb of Toronto) announced the grant.
Dr MORIDI is Editor of USA HEALTH PHYSICS..
MSc(Tehran) M.Tech. & PhD (UK Brunel Univ.-West London,UK)
Dr Moridi was elected a Fellow of UK's Inst.Physics & Inst.Electrical .Engineers
Ontario's DOCTORS" DAY on May 1 was Dr Moridi's idea.
(There was no representative of the OMA Board or 250-staff)
Dr MORIDI is Editor of USA HEALTH PHYSICS..
MSc(Tehran) M.Tech. & PhD (UK Brunel Univ.-West London,UK)
Dr Moridi was elected a Fellow of UK's Inst.Physics & Inst.Electrical .Engineers
Ontario's DOCTORS" DAY on May 1 was Dr Moridi's idea.
(There was no representative of the OMA Board or 250-staff)
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