We Can’t Change the Minds of the 2% But We Can Save Lives.

If we don’t take action, things will get worse before they get better…

A long read but an important matter facing the majority of school students around the globe. I would have offered more by way of options in this report, but as part of my assignment I had to limit it. However, the key policy option is included.

Policy Analysis- Increasing Child Vaccination Rates

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Savvy Student Consumers!!

My Next Public Board Motion:

Re:         Financial Literacy Programming for School Curriculum

Motion:

That the Board of Trustees lobbies government to develop financial literacy programming for implementation into the school curriculum.

Walmart advertisement: ‘the average family saves $1200 a year shopping at Walmart. What will you buy with the money you have saved?’

 Noted on receipts and verbally shared by salesperson at the time of purchase: ‘you saved $50 on your purchase today’”

Students today are bombarded by complex social media campaigns and commentary that affect perceptions and habits related to money management. Sophisticated advertisements targeting youth consistently reinforce that individuals deserve and need to have the latest and greatest gadgets, games, clothes, etc.  Messaging further stresses a right to immediate gratification in terms of collecting material possessions along with experiences; affordability is not a consideration. As a result, ‘buy now, pay later’ attitudes are increasingly becoming the norm among younger generations. Further, access to quick and easy credit means that attitudes and desires are easily translated into behavior.

Knowing the significant purchasing power of youth, media will continue to bombard students in sophisticated, intentional ways that promote the pervasive ideology associated with modern day consumerism, ultimately supporting attitudes that lead to unnecessary, irresponsible spending practices. The most logical resource/avenue available to combat the power of theses influences and corresponding behaviors is curriculum that equips students with financial skills to empower them to become savvy, critical, analytical and self-constrained consumers. Students need to understand fully the implications of carefree spending, critique and question subtleties in messaging that influence one’s spending habits, budget appropriately, and understand concepts such as affordability.   They need to understand consequences associated with credit/debt acquisition and the importance of long term financial planning.

The economic and psychosocial impact at both the individual and population level is tremendous. We cannot afford (pardon the pun) to leave another generation of youth graduate without a sound grounding in financial literacy given the life-long implications tied to this knowledge. We must successfully impart within all students the importance that money management will play in their lives. Assertions made by Edmonton Public School Board Trustee Michael Janz are indeed correct; financial literacy must be incorporated into the new curriculum. It is a modern-day solution to a profound and prolific modern-day challenges.

Additional cross -provincial support:

https://www.thestar.com/news/gta/2016/11/01/pushing-for-financial-literacy-in-the-classroom.html

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A more factual account of my motion re: Grad Ceremony Participation. (Note the misleading statement in 1st paragraph suggesting an end to religion classes is later clarified in article.) 

Catholic trustee leaving optional religion proposal in hands of administration

‘I think it’s been brought to the forefront, the administration is aware of the issue.

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Edmonton Catholic School Board Trustee Marilyn Bergstra.

File photo

Edmonton Catholic School Board Trustee Marilyn Bergstra.

An Edmonton Catholic School Board Trustee who asked for an end to mandatory religion courses said she will probably not bring the motion back, after it was voted off the agenda at a board meeting earlier this month.

“If I see that the public starts to write in or demand that we re-examine it or something, then absolutely I will (bring it back),” Marilyn Bergstra said Friday.

“But I think it’s been brought to the forefront, the administration is aware of the issue, and I’m going to leave it in their good hands to determine what they feel is the next best step.”

Bergstra proposed a motion April 18 to allow all Catholic high school students who have met Alberta Education’s graduation requirements to participate in grad commencement ceremonies, regardless of whether they’ve completed their religion credits.

Catholic high schools require students to complete nine religion credits if they want to walk across the stage at grad, even though religion courses are not required to earn a high school diploma.

“I’m certainly not trying to suggest that religion in Catholic education is not important, because it absolutely is,” Bergstra said.

“I would like to see some flexibility, because the premise behind high school is they do have choices. They have choice as to the subjects and we don’t know what they’re going through.

“Maybe they’re trying to get into engineering, or they’re working two or three jobs, so this additional requirement – it might seem at a glance that it’s not a big deal, but is it fair to assume it’s always not a big deal?”

Bergstra’s motion eluded debate at the April 18 meeting as a majority of trustees voted it off the agenda.

Edmonton Catholic Schools spokesperson Lori Nagy said the district does not have an official policy of excluding students from commencement if they haven’t completed their religion credits, though she acknowledged it is common practice.

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Important medical info for adolescent boys!

Prior to my motion calling for comprehensive sex ed. reform, I was contacted by Dr. Peter Metcalfe, a Pediatric Urologist at the Stollery. For several years, Dr. Metcalfe has been trying to get something into the sex education curriculum related to one of his most common emergencies. The condition is known as testicular torsion which predominantly affects adolescent boys. Essentially, the testicle twists on itself. If the youth is not in the OR within the critical time frame of in 4-6 hours, it has a high chance of dying and the testicle being removed.  As noted by Dr. Metcalfe, “I operated on 3 last Monday night / Tuesday AM, and likely only saved one.  Unfortunately, nearly all of the families involved have no idea this was possible, so I feel we need to improve our knowledge dissemination”. 

As we continue to wait on sex ed reform, I wish to share this information via my blog to improve awareness on this important matter. As boys tend to suffer in silence in attempts to avoid “embarrassing” conversations with mom/dad it is important that we relay this information so boys fully understand the importance of seeking immediate medical help.

I have attached a Journal Article published by Dr. Metcalfe et al. to provide you with further information. 

Testicular Pain:Might be embarrassing, but certainly is worth attention!

As a pediatric urologist, I often hear families say that “Oh…, I didn’t know that could happen”!  Most of the time, it probably doesn’t matter, but when it comes to testicular pain, a bit of knowledge may make the difference between saving and losing a testicle.

The sudden onset of testicular pain can be due to several causes, but of utmost importance is testicular torsion.  Testicles hang loosely in the scrotum via the spermatic cord (Figure a), which makes them susceptible to spinning or twisting (testicular torsion) (Figure b).  This is significant, as the torsion cuts off the blood supply to the testicle and if not corrected in 4-6 hours, may result in the death of the testicle.  Therefore, it is paramount that this is corrected with minimal delay.

Far too commonly in my practice, however, teenagers will present to the emergency room well beyond this time frame, as neither they, not their caregivers, were aware of the potential consequences.  A recent research article in the UK confirmed that 95% of parents felt that more public awareness is required. Unfortunately, this lack of knowledge results in a dead testicle that needs to be removed, instead of one that is easily saved(Ubee, Hopkinson, & Srirangam, 2014).

It is my goal to increase the general awareness of this issue, with the hope of preventing this unwanted outcome.  Unfortunately, teenage boys, and their families, are often very reluctant to talk about their “privates” with others.  Hopefully, by introducing this topic into the school system, we may be able to reach this vulnerable population, and prevent unnecessary embarrassment, barriers to discussion, and delays to treatment.

Testicular (or scrotal) pain can be divided in to three general groups: a) Chronic pain (orchalgia) which is not common in the teenager, and is defined as a constant pain present for more than three months; b) Acute scrotal pain not due to torsion; c) testicular torsion.  Most (approximately 80%) of episodes of a sudden onset of testicular pain are not due to a testicular torsion, but it is imperative to rule this out.

Although not common, about 80-100 patients present to the Stollery Children’s Hospital emergency department per year with a complaint of testicular pain.  Of these, about 10% have a testicular torsion and need immediate surgical intervention.  The other 90% are due to generalized inflammation (not infectious) or of an unknown (benign) etiology.  Unfortunately, the average time (in our patients) from the onset of symptoms to presentation to the hospital was almost 20 hours(Liang, Metcalfe, Sevcik, & Noga, 2013).

The peak age groups at risk are the 12-16 year old, due to the (newly) increased testicular size.  Before puberty, testicles are much less likely to undergo torsion, as they are too small to generate sufficient force or their testicular cords are not long enough to place the testicle at risk.  

As most would guess, the presentation can be very painful, and likely hard to ignore!  The onset of symptoms can be while the teen is at rest, during activity, or after trauma.  The pain is typically a sudden onset of a dull ache (not unlike being kicked!) and often associated with nausea.  Very often the boy is not able to attend or continue classes, but is generally not “screaming” in pain.  Occasionally, the pain may come and go, which may be a partial or intermittent torsion.  In the torsed testicle, the testicle can have rotated from 270-720 degrees!

If this pain occurs, and lasts for at least one hour, medical attention must be sought immediately.  The goal would be to get the patient to the operating room within 4-6 hours, from the onset of symptoms, as we then have a very high chance of saving the testicle.  If surgery is delayed, certainly if greater than 12 hours, the chance of untwisting the testicle, restoring its blood supply, and salvaging the testicle is very low.  In these cases, we often have to remove the entire testicle.

Often, the patient’s history is sufficient to warrant bringing him straight to the operating room, but if the diagnosis is in question, the physician may decide to do an ultrasound.  This is very accurate in determining the presence or absence of blood flow, pathognomonic for a torsion.  If the ultrasound demonstrates good blood flow to the testicle, the pain is either due to another cause, or the testicle has untwisted itself.   

In summary, the sudden onset of testicular pain can have significant physical and emotional consequences.  Unfortunately, the emotional aspect can result in a delay to diagnosis and treatment.  Hopefully this article will improve awareness of this potentially devastating problem, and we are able to see our patients sooner and save more testicles!

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Edmonton Catholic school board wants mandatory vaccinations for all Alberta students

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Mandatory Vaccinations for Public School Attendance

Motion:

  1. I move that the board of Trustees lobby government to legislate mandatory vaccinations for all student’s in the public education system. Mandatory vaccinations will include the following: diphtheria, tetanus, polio, measles, mumps, and rubella. In extreme cases, whereby a medical doctor has advised that it is in the students best interest to forego vaccination on the grounds of medical complications, exclusion may be applicable. For example, while undergoing cancer treatment.
  2. I move that the Board of Trustees advance an emergent resolution to the ASBA that would call upon the provincial government to legislate mandatory vaccinations for all student’s in the public education system. Exclusions to the practice will be limited to only those extreme cases whereby a medical doctor has advised the child’s family to forego vaccination on the grounds of medical complications such as during cancer treatment.

Background: Surveillance Snapshot-Global Measles outbreaks 2017

As of January 2017, 500 measles cases have been reported by the World Health Organization (WHO) European Region7.  17 deaths were reported in Romania alone in this same time period. Measles continues to spread within and among European countries, with the potential to cause large outbreaks wherever immunization coverage has dropped below the necessary threshold of 95%.6

The Michigan Department of Health and Human services had confirmed Michigan’s first measles case by March of this year6. From January 1 to March 25, 2017, 28 people from 10 states (California, Colorado, Florida, Michigan, Nebraska, New Jersey, New York, Pennsylvania, Utah, and Washington) were reported to have measles2.  Surveillance data published March 31st, 2017 by the Public Health Agency of Canada for epidemiological week 11, 2017, reported 10 cases of measles in Canada, resulting in an outbreak in Nova Scotia4. Since, this reporting period additional cases have appeared including one case in Calgary with warnings of potential for outbreak1.

From 2001 – 2012, the average number of measles cases reported across the United states on an annual basis was about 60. Recently, there have been more, which is of great concern to public health authorities. In 2014, there were 667 cases in the U.S.; the majority of people who got measles were not vaccinated6.

In Canada, measles has been eliminated since 1998. However, Canada will continue to see measles cases stemming from travel to countries where measles is present (endemic) or where there are large outbreaks3. Many developing countries continue to struggle with endemic levels of vaccine-preventable disease. Although such diseases have since been eradicated in the developed world, we grow increasingly at risk for outbreak through transfer from other countries particularly as vaccination rates continue to decline3. China and India alone reported 125,000 cases of measles for 20153. Outbreaks in Canada are linked to travellers to China, India and other regions around the globe.3

“Immunizations are the best way to protect our families and communities from the harmful, sometimes deadly consequences of vaccine-preventable diseases like measles,” said Dr. Eden Wells, Chief Medical Executive with the MDHHS6.

Measles is a vaccine-preventable respiratory infection that can result in hospitalization, pneumonia, encephalitis, and death. The illness initially presents with a high fever, red eyes, cough, runny nose, photophobia, and is followed by a red, raised body rash starting on the head and face that then progresses to the rest of the body. Individuals may be contagious for a few days before they present with symptoms, which increases the potential of exposing others to the infection.

Measles is a highly communicable disease. Vaccination is the best line of defense, and successful prevention and control requires that 95% of the population be vaccinated to ensure herd resistance within a population. Consistent with other childhood vaccines, the measles vaccine is highly effective and very safe6.

Rational:

Although I have provided resent data in relation to measles, outbreaks related to other preventable diseases have also occurred early into this year in Canada. This includes, but is certainly not limited to, a whooping cough outbreak in both Manitoba and Alberta as well as multiple cases of mumps within Edmonton Health Region. These vaccine preventable cases are the direct result of drops in vaccination rates within the population.

As most of these diseases are highly infectious, schools are optimal breeding grounds for epidemic level outbreaks. Couple this with the growing trend to not vaccinate; hence a loss of heard resistance within the localized population and we can logically conclude that our students are increasingly at risk.

Additionally, tremendous financial costs are associated with standard, “outbreak investigation practices”, “follow-up quarantine measures” and medical intervention should even a solitary case be reported.

In Ontario and New Brunswick, students are required to be immunized for diphtheria, tetanus, polio, measles, mumps, and rubella. Vaccinations are a safe and effective preventative measure against several severe and potentially debilitating or deadly childhood diseases. I urge my colleagues to support this motion.

References:

  1. Calgary Herald. AHS issues warning after measles case detected in Calgary. Calgary Herald. April 2017
  2. Centre for Disease Control and Prevention. National Center for Immunization and Respiratory Diseases, Division of Viral Diseases: Measles cases and outbreaks. Centers for Disease Control and Prevention. April, 2017
  3. Government of Canada. Measles: Global Update; Travel Health Notice. Government of Canada. 2016, July. Retrieved from: https://travel.gc.ca/travelling/health-safety/travel-health-notices/98?_ga=1.238850304.1832843257.1487915580
  4. Government of Canada. Measles & Rubella Weekly Monitoring Report: March 12 to March 18, 2017 (week 11). Government of Canada. 2017. Retrieved from: https://www.canada.ca/en/public-health/services/publications/diseases-conditions/measles-rubella-surveillance/2017/week11-march-12-18-2017.html#a1
  5. Irene Ogrodnik. Fact file: Are students required to get vaccinated in Canada? Shaw Media. 2013. Retrieved from:
  6. News Desk. Outbreak news today: Michigan: 1st confirmed measles case of 2017 reported. Outbreak News Today. 2017, Mar. Retrieved from: http://outbreaknewstoday.com/michigan-1st-confirmed-measles-case-2017-reported-11871/
  7. Press Release. Outbreak News Today: WHO update on European measles outbreak. Outbreak News Today. Mar 27. Retrieved from: http://outbreaknewstoday.com/update-european-measles-outbreak-46322/
  8. CBC News: Health. Whooping cough outbreaks in Canada tied to lower vaccine immunity. The Canadian Press. Nov., 2015. Retrieved from: http://www.cbc.ca/news/health/whooping-cough-pertussis-1.3317431

 

 

 

 

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A Call for Sex Education Reform

A Call for Sex Education Reform

Motion:

  1. I move that the Board of Trustees lobby government to revise the existing sex education curriculum. Consideration for a comprehensive curriculum would include, but not be limited to, a program of study that is tailored to a variety of student orientations, be grounded in research, include the concept of consent, relays valuable information and preventative measures against the transmission of sexually transmitted blood borne disease along with prevention of pregnancy. Finally, the Government of Alberta will set out provisions to assure that the delivery of such information is consistently delivered across Alberta in all publicly funded schools.
  2. That in partnership with Edmonton Public Schools we lobby the Alberta Government to review and revised the existing sex education curriculum based on the merits noted above.

Rational:

There are a multitude of reasons as to why revisions are required to our current sex education curriculum.

  1. As a participant in a student lead conversation on sexual orientation at the University of Alberta, it was highlighted that current sex education classes serve little to no value for students who identify as LGBTQ. Like all students, it is vital that these individuals are provided sex related information that allows them a greater understanding of their bodies and issues that would pertain to their orientation.
  2. A great deal of research is now available that has changed our understanding of the world and our bodies. It is important that all students be afforded research based information that supports good health (both physical and mental) and is prevention focused. Students need to understand their physiology and limits. Too many young students are ending up in hospitals due to a lack of understanding surrounding one’s physiology and associated inaccuracies in information.
  3. Disease prevention is pivotal in the promotion of healthy students, healthy populations and hence, improving the economic strength of our province. Currently, sexually transmitted blood borne diseases (STBBD aka STIs) are at epidemic levels in Alberta. Public health officials are calling for better education to help curve the spread of these infectious diseases. It is also important to note, that in some cases, diseases such as gonorrhea are becoming increasingly resistant to drugs with 33% of these cases no longer responding to the medications used for treatment of this disease. The degree to which this is successful is very much tied to consistency and competency of instruction across Alberta. This in and of itself merits review and recommendations for effective implementation.
  4. Tailored programming relating to disease transmission is also urgently needed. Data highlights that some groups within our population are at far greater risk of contracting an STI versus some other cohorts. Just as one example, 1.4 million individuals are currently reported to have HIV in North America (a conservative estimation given that not all cases have been diagnosed or reported). We must empower at-risk groups to make healthy choices. This begins with knowledge and understanding of risks, one’s body, disease transmission and preventative measures.
  5. Consent is a critical issue that has been largely overlooked in our curriculum. Students need to fully understand what consent looks like. Students need a comprehensive understanding that coercion or guilt is not appropriate. They need to learn to stand up to peer pressure. Likewise, they need to understand fully what consent does mean and under what circumstance. Lastly, they need to understand the legal implications. Far too many young students (largely male) end up on the wrong side of the law, left to deal with the dire consequences of a snap decision. Conversely, on the other end of this spectrum is the emotional and possibly physical damage that the victim will suffer. Often these scars last a life time.

In summary, all persons have the right to fully understand their bodies and understand options that can help protect their health; both physically and mentally. Current gaps in the sex education curriculum have the potential to place students at unnecessary risk. Knowledge is the key to prevention and thus to strong physical and emotional well-being. A lack of information can lead to severe consequences from both a health and legal stance. The time for action is now.

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