Health Promotion Newsletter Issue 39

29 Oct

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Dear Clients and friends,

Fall is well underway, we hope you stay bundled up as the weather gets cooler. Try to get out and enjoy the changing leaves and cozy October atmosphere. Engage your peers and friends and make the most of your time.

Thank you for coming out, it was nice to see most of you at the last 2 educational workshops on Toxicities of HIV medications and HIV & Anal Cancer. If you still want to have a handout of the presentation material, please check with your support staff or myself and we would be more than happy to send it to you.

We have some exciting events coming up that we hope you will join us:

On November 20th, there will be a townhall meeting at 590 Church St. Community Center, starting at 5:30 pm. This will be about Toronto moving towards a fast track city for 90-90-90 and how they are proceeding towards this endgame.

On November 21st we have a social gathering with OPA. Please wait for the invitation from Sucre Lee.

Health Promotion Update:

October 16th, during the Anal Cancer workshop at Lisa Marie Gastropub, we received feedback that there was not enough food for everyone and the start time was a bit late. We have addressed our concerns to the director of operations at Lisa Marie who expressed apologies to all service users. They mentioned that this will not happen the next time and that everyone will have enough food.

On November 26th, we are having a small fundraising event for World AIDS Day. The invitation will be sent out shortly. We hope you can all join us for this special evening. The theme for this year will be: Remembering our History and Building our Future – Moving towards 90-90-90 and Beyond. We will have some of our peers share their stories lived experiences for the first time and I thank them in advance for their bravery and courage. We will be holding this event at Lisa Marie Gastropub again, but don’t worry, there will be no need to eat before coming this time! If you have any guests that would like to come, please share the link with them.

On November 29th, we will hold our Last Macro Workshop – Update on treatment and medications in HIV. The speaker will be Dr. Alice Tseng from Toronto General Hospital. She is the head pharmacist at the Immunodeficiency Clinic. This is a great opportunity to learn about existing medications and the new frontiers that will be coming soon. The venue will be at Bumpkins Restaurant on Gloucester St. Please wait for the invitation.

Lastly, we have received a Positive Innovation Grant from ViiV Healthcare under the title of A Sip of C.A.R.E.- Confidence, Achieving 90/90/90, Reaching out, Engaging. This project aims to use life coaching skills to engage community members within ACAS to set and reach life goals and improve quality of life beyond just managing HIV. We will start recruiting those interested in becoming peer coaches for training in December. Please look out for the application, and if you are qualified there will be compensation as well.

In the News:

Please find a new article in the news for your interest. The government of Newfoundland and Labrador has taken a novel initiative and brave step in covering PrEP.

https://www.cbc.ca/news/canada/newfoundland-labrador/mcp-covering-hiv-prevention-pills-1.4874317

Sincerely yours,

Kenneth Poon

Health Promotion Coordinator

(647) 278-3835

 

 

 

Health Promotion Newsletter Issue No. 38

30 Jul

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Dear Clients,

I hope you are having a wonderful summer. It’s been a real scorcher but now that the heat wave is over, I encourage you to get out and about while the city is lively.

So far, 2018 has been built upon themes of self-love, self-care and resilience. Just as we learned with our meditation sessions, we hope you remember to take care of your mind just the same as your body.

Your support and enthusiasm has made for a great first-half of the year, but we still have a lot planned. We are one big family after all, and every season we hope to grow with your continued support, energy and loyalty.

At this time, we welcome any feedback you may have on our past workshops. We would love to hear your thoughts, what you enjoyed and things you think we could improve. We are also reaching out for any ideas and input you may have for us. Let us know if you have any concerns or suggestions so we could make our future workshops and events a better experience for everyone.

Our Health Promotion Program is still well underway, and we have several exciting events coming up, with some interesting collaborators:

Timeline:

  • In September, we have invited Dr. Gerson Mobo to come speak about toxicity of HIV medications.
  • In October we have a talk from an expert – Dr. Irving Salit, who is coming to speak about HIV and Anal Cancer. This is a rare opportunity to learn about relevant health information from a recognized expert.
  • In December, we will have a workshop with Drs Anthony Chen and Louie Chen, who as per popular request, will come speak about treatment & prevention as well as transgender health.

In the News:

You will find attached an article that may be of interest. This article details a recent report from CATIE, and shows that Canada has made progress to reach a goal of 90/90/90: 90% of people with HIV knowing their infection status, 90% of people diagnosed with HIV are receiving therapy and 90% of people taking therapy have an undetectable viral load.

We hope you have a wonderful summer and look forward to seeing you at future events.

Best Regards,

Kenneth Poon
Health Promotion Worker
Healthpromoacas@gmail.com

CATIE News, 26 July 2018

Canada makes some progress on HIV but much work lies ahead

  • New HIV estimates were released by the Public Health Agency of Canada.
  • 63% of Canadians living with HIV have achieved an undetectable viral load.
  • Canada exceeds some of the 90-90-90 targets in federal prisons, falls behind in First Nations.

Thanks to anti-HIV therapy (ART), researchers expect that if people are diagnosed with HIV soon after infection, start treatment early, stay engaged in care and adhere to their treatment regimen many will have near-normal life expectancy. Also, studies have found that HIV-positive people who achieve and maintain an undetectable viral load do not pass on HIV to their sexual partners.

These twin benefits of ART—on individual health and transmission—are so profound that the Joint United Nations Program on HIV/AIDS (UNAIDS) and the World Health Organization (WHO) have issued a global strategy to help cities, regions and countries improve the health of HIV-positive people and end the epidemic spread of new infections by the year 2030. The strategy can be encapsulated in the phrase 90-90-90 and consists of the following targets for the year 2020:

  • 90% of people with HIV know their infection status
  • 90% of people diagnosed with HIV receive ART
  • 90% of people taking ART have an undetectable viral load

This distribution of people across HIV testing and treatment outcomes is called the cascade of care.

In Canada

Many countries and regions, including Canada and its provinces and territories, are using 90-90-90 to assess how much progress is being made against the HIV pandemic. The Public Health Agency of Canada (PHAC) has recently released a report on the HIV epidemic in Canada based on data analysed to the end of 2016. PHAC estimates that there were 63,110 HIV-positive people at the end of 2016. According to this report, the Canadian estimates for 90-90-90 for that year are as follows:

  • 86% of people with HIV knew their infection status
  • 81% of people diagnosed with HIV were taking ART
  • 91% of people taking ART had an undetectable viral load

These figures show that Canada is moving forward to reach its 90-90-90 goals. According to these estimates, 63% of people living with HIV had achieved an undetectable viral load in 2016, which is up from 58% in 2014. Furthermore, the estimates for Canada are generally within the range seen for other high-income countries, including Australia, Denmark, Germany, the U.K. and United States.

Saskatchewan—Indigenous people living on reserve

Saskatchewan has the highest rate of new infections in Canada and Indigenous peoples are disproportionately affected. In order to better understand the situation for on-reserve communities, PHAC collaborated with public health and Indigenous authorities in Saskatchewan and produced the following estimates:

  • 77% of Indigenous people diagnosed with HIV were taking ART
  • 75% of Indigenous people taking ART had an undetectable viral load

Collecting and analysing this data is a good first step. Indigenous people in Canada have experienced a legacy of colonialism and racism, which has adversely affected their health, increasing their susceptibility to many conditions. More effort is needed to help all Indigenous HIV-positive people (on and off reserve across Canada) access culturally appropriate HIV testing, care and treatment services and ensure they benefit from ART.

Federal prisons

PHAC notes that “all inmates in federal correctional facilities are offered a health assessment on admission, and in 2016, 96% of newly admitted inmates accepted a voluntary HIV test to know their status. Inmates are also referred for, or can request, HIV testing anytime during incarceration.” In April 2017, among the 170 inmates with diagnosed HIV, their distribution across the cascade of care was as follows:

  • 94% of people diagnosed with HIV were taking ART
  • 91% of people taking ART had an undetectable viral load

New infections

PHAC estimates that about 2,165 new HIV infections occurred in 2016 in Canada—a slight increase from 2014. These infections were distributed among the following populations:

  • 56% – gay, bisexual and other men who have sex with men (MSM), including those who inject drugs
  • 14% – people born in a country where HIV is endemic (heterosexual transmission)
  • 14% – people who inject drugs, including gay, bisexual and other MSM
  • 11% – Indigenous people

(These figures do not total 100, due to some overlap in categories.)

Distribution of people living with HIV

PHAC states that the 63,110 people living with HIV in Canada are distributed largely among the following populations:

  • 49% – gay, bisexual and other men who have sex with men
  • 33% – heterosexual people (heterosexual transmission)
  • 15% – people who inject drugs
  • 23% – women
  • 10% – Indigenous people

(These figures do not total 100, due to some overlap in categories.)

Bear in mind

1. PHAC estimates that of the 63,110 people living with HIV in Canada, 14% are not aware that they have this infection.

According to PHAC, “These people are hidden from the health care and disease monitoring systems, and thus cannot take advantage of appropriate prevention, treatment and ongoing care and support services until they are tested and diagnosed…Innovative strategies aimed at reaching the undiagnosed population and increasing the number of people adhering to treatment could help Canada [achieve 90-90-90].”

2. The PHAC report shows that Canada is generally making some progress in reaching the UNAIDS/WHO 90-90-90 goals. However, HIV continues to disproportionally affect some populations, and PHAC states that this “highlights the continued need for evidence-informed programs that are culturally and gender-appropriate to address the unique aspects of these populations and communities.” PHAC also calls for “ongoing, broad-based prevention education” to help other populations, including heterosexual people.

Resources

Summary: Estimates of HIV incidence, prevalence and Canada’s progress on meeting the 90-90-90 HIV targets, 2016 – Public Health Agency of Canada (PHAC)

HIV in Canada – PHAC infographic

90-90-90: An ambitious treatment target to help end the AIDS epidemic – UNAIDS

—Sean R. Hosein

 

REFERENCES:

  1. Public Health Agency of Canada. Summary: Estimates of HIV incidence, prevalence and Canada’s progress on meeting the 90-90-90 HIV targets, 2016. Report. July 2018. Available from: https://www.canada.ca/en/public-health/services/publications/diseases-conditions/summary-estimates-hiv-incidence-prevalence-canadas-progress-90-90-90.html
  2. Centre for Communicable Diseases and Infection Control. A summary of the Pan-Canadian framework on sexually transmitted and blood-borne infections. Canada Communicable Diseases Report. 2018;44(7/8):179-81. Available from: https://www.canada.ca/en/public-health/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2018-44/issue-7-8-july-5-2018/article-5-framework-action-sexually-transmitted-blood-borne-infections.html
  3. Benoit AC, Younger J, Beaver K, et al. Increased mortality among Indigenous persons in a multisite cohort of people living with HIV in Canada. Canadian Journal of Public Health. 2017 Jun 16;108(2):e169–e175.
  4. Cohen MS, Chen YQ, McCauley M, et al. Antiretroviral therapy for the prevention of HIV-1 transmission. New England Journal of Medicine. 2016;375:830–839. Available from: http://www.nejm.org/doi/pdf/10.1056/NEJMoa1600693
  5. Rodger AJ, Cambiano V, Bruun T, et al. Sexual activity without condoms and risk of HIV transmission in serodifferent couples when the HIV-positive partner is using suppressive antiretroviral therapy. Journal of the American Medical Association. 2016;316(2):171–181. Available from: http://jama.jamanetwork.com/article.aspx?articleid=2533066

Health Promotion Newsletter Issue No. 37

20 Mar

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Dear Clients,

Spring is just around the corner even though we are still having some wintery-like weather hanging on! I hope that everyone is doing their best to get themselves physically active and finding happiness in the soon to be changing season.

This year is the Lunar Year of the Dog. The dog’s characteristics are loyalty and honesty — they are truly the most reliable partner you’ll ever need. Since ACAS always believes that our clients are part of one big family, we continuously count on your support, loyalty, and partnership in order to make this relationship thrive. Recently our funding from the government has been decreased in some of our programs, and in light of this, we are asking our family members for their thoughts, feedback, and ideas on how we, as a unit, can move forward. If you have any input whatsoever, please contact your support staff and we will evaluate all input as a whole. Please feel secure in bringing your voice forward in this family as speaking up will not affect you negatively in any of our services.

This year we have lined up an exciting program for the Health Promotion Workshops. ACAS also is building allies with other agencies to broaden the scope of the workshops offered.

  • We continue to have our weekly meditation class on Wednesday evening (until mid-April); 6-7 pm at Casey House (119 Isabella Street). Please register with your support staff.
  • In April, we will have a workshop facilitated by Constantine Carbarios on the topic of Understanding Guilt and Shame.
  • In May, we will have a series of workshops on Holistic Nutrition and Cooking in partnership with ASAAP and OPA+.
  • Pre Pride Pink Party in June will take place.
  • In August, we will have our educational 3-day retreat facilitated by various presenters and practitioners.
  • In September, HPV and ANAL cancer will be the topic of the workshop. It will be facilitated by Dr. Irving Salit.
  • For the month of October, per client request, we will have a workshop on Aging and Sexual Health with REALIZE.
  • In November, the workshop will focus on the most up-to-date HIV Antiretroviral Treatment and Medication.

Our intern nursing student Mr. Andy Zhang will be sadly leaving us in April, but he will occasionally continue to help and provide services in our support program. During his time at ACAS, he provided invaluable efforts and energies into our support programs such as organizing appointments, developing online surveys, providing a presentation to one of our workshops, and funding sourcing. Andy, we wish you well – you will be missed and please find the farewell article provided by him below. We thank you for all your efforts!

Best Regards,

Kenneth Poon
Health Promotion Worker
Healthpromoacas@gmail.com

 

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Emotional Health and Neurocognitive Decline in Aging

By: Andy Zhang, Nursing Student at ACAS
March 20, 2018

What is Emotional Health?

In my opinion, there is no concrete definition for emotional health that applies to all individuals because emotional health may mean different things to different people. For example, emotional health may mean staying in control of one’s life or maintaining a feeling of happiness and fulfillment in life or as simple as having a positive outlook on life in general. In a sense, emotional health is unique and different to everyone.

However, the perspectives on maintaining healthy emotional well-being may differ across cultures. Some cultures may view the expression of feelings as a sign of weakness, while others may fully respect a person’s journey towards achieving a healthy emotional outlook. So, it is important to assess your own beliefs and assumptions about emotional health and how this may impact your ability to effectively manage your emotional health.

Why is Emotional Health Important for Us?

As Taylor (2013) suggests, “living with HIV can be emotionally challenging” (p. 9). We often forget or neglect to take care of our emotional and mental well-being, which often leads to negative coping, emotional instability, distress, and/or burnout. Emotional health constitutes a balance between multiple areas of one’s life, including your physical, mental, emotional, spiritual, and sexual health (Taylor, 2013). So, it is important to think about emotional health as it can potentially influence other aspects of your thinking, behaviours, or overall well-being.

Moreover, our minds and our bodies are intimately connected. The mind and body interact in harmony to make sure we are healthy. However, if this “mind-body connection” (Taylor, 2013, p. 4) is somehow disrupted, it may lead to negative outcomes in our lives. For example, consistent feelings of anxiety may negatively affect our performance on daily tasks and may also contribute to heart disease. As such, it is important to maintain a healthy balance between the two.

How can Emotional Health Impact Neurocognitive Decline?

It is important to sustain emotional health throughout the process of aging. In a study on successful cognitive aging in individuals living with HIV, researchers suggest that “acute affective distress is negatively associated with successful cognitive aging” (Malaspina et al., 2011). In other words, emotional distress may inhibit successful cognitive aging. This finding further suggests that emotional health is an integral aspect of maintaining cognitive health in aging.

Poor emotional health may become a barrier to doing all the things that are suggested to prevent or mitigate neurocognitive decline. In a study on adherence to antiretroviral therapy (ART) in persons living with HIV, researchers found an indirect relationship between emotional avoidance and treatment adherence (Berghoff et al., 2018). Specifically, those who tended to avoid their emotions were more likely to have poorer relationships with their healthcare providers, which had a negative impact on ART adherence. Consequently, these individuals demonstrated poorer ART adherence (Berghoff et al., 2018). Although this study is unrelated to cognitive decline, it still gives valuable insight into the potential consequences of poor emotional management on an individual’s health behaviours. As demonstrated, individuals who cannot effectively manage their emotional health may have trouble with adhering to certain treatments. So, it would be useful to consider how emotional health may have an impact on an individual’s ability to practice the many strategies that are suggested to lessen neurocognitive decline.

Maintaining healthy emotional-wellbeing may not have a distinct, obvious, or direct role in preventing cognitive decline. However, it is still crucial to consider the impacts of emotions on all levels of our being as well as our behaviours and treatment adherence.

Strategies to Enhance Emotional Health

The following strategies to enhance emotional health is from the resource “HIV and Emotional Wellness” by Taylor (2013) from CATIE:

  • Recall and collect positive moments
  • Practice forgiveness
  • Self-expression (i.e. conversations, art activities, journal writing, etc.)
  • Learn how to cope with negative thoughts
  • Treat yourself!

Additional Resources for Emotional Health

HIV and Emotional Wellness: http://www.catie.ca/sites/default/files/emobro-en-2013.pdf

7 ways to practice emotional first aid: https://ideas.ted.com/7-ways-to-practice-emotional-first-aid/

Aging and Emotional Wellness: https://www.mentalhealthkc.org/sites/default/files/resource_files/mentalhealthkc-aging-and-emotional-wellness.pdf

Behaviour and Emotions of Aging: http://www.familycaregiversonline.net/online-education/behavior-and-emotions-of-aging/

Emotional Health: http://www.apa.org/topics/emotion/index.aspx

References

Berghoff, C. R., Gratz, K. L., Portz, K. J., Pinkston, M., Naifeh, J. A., Evans, S. D., . . . Tull, M. T. (2018). The role of emotional avoidance, the Patient–Provider relationship, and other social support in ART adherence for HIV+ individuals. AIDS and Behavior, 22(3), 929-938. 10.1007/s10461-017-1745-2

Malaspina, L., Woods, S. P., Moore, D. J., Depp, C., Letendre, S. L., Jeste, D., . . . The HIV Neurobehavioral Research Programs (HNRP) Group. (2011). Successful cognitive aging in persons living with HIV infection. Journal of NeuroVirology, 17(1), 110-119. doi:10.1007/s13365-010-0008-z

Taylor, D. (2013). HIV and emotional wellness. Toronto: CATIE


Health Promotion Newsletter Issue No. 36

10 Oct

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Dear Clients,

Finally autumn has arrived, despite that we are still getting amazing above average temperature.  I hope everyone can benefit from getting out and enjoy any social activities while you can.

What about the flu shot?  Toronto Public Health has stated that this year we will be experiencing one of the worst flu season based on the evidence from Australia.  On the flip side, the flu shot is one way to prevent getting a flu-like symptom for this Fall/Winter.  Please check with your physician or pharmacist to find out when the flu shot is available.

The Aging workshop video is available on line by Ms. Kate Murzin from REALIZE https://youtu.be/zRo51S-Jkx8.  Based on the responses, we are going to have another workshop from REALIZE focusing on aging and sexual health early next year.

Our upcoming Macro workshop will be presented by Dr. Sean Rourke, Neuropsychologist from St. Michael Hospital on Friday, October 20, 2017. The topic will be “HIV, Mental Illness and Cognitive Health”.  Please check with your support worker if you did not get the invitation yet.

Recently I find this article from thebody.com quite interesting and I like to share with you.  I truly believe we all need to remember to speak up about those being left behind. I am curious what your response will be to this article. Enjoy reading!

 

Best Regards,

Kenneth Poon

Health Promotion worker

(647)2783835

healthpromoacas@gmail.com

 

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TheBody.com

May 22, 2017

Life expectancy for a person living with HIV who is on antiretroviral therapy increased by about 10 years between 1996 to 2013, according to a new study

Analyzing data from Europe and North America, the study, which was published in the Lancet HIV, looked at data from over 88,000 individuals who started HIV treatment with three or more drugs between 1996 and 2010, and who were followed for at least three years.

Overall, the researchers found that life expectancy in 20-year-old individuals starting HIV treatment in 1996 versus 2010 has increased by about nine years for women and about 10 years for men, and nearly matches the general population average of 78 years.

Background

Within the history of HIV treatment, 1996 was important because it marked the beginning of the combination antiretroviral therapy era after studies presented at the International AIDS Conference supported the use of triple-drug regimens. Since then, medications have continued to improve, with regimens getting better at suppressing HIV, being less toxic and less prone to drug resistance, as well as offering reduced pill burden (taking fewer pills each day) and fewer side effects.

“Our research illustrates a success story of how improved HIV treatments coupled with screening, prevention and treatment of health problems associated with HIV infection can extend the life span of people diagnosed with HIV. However, further efforts are needed if life expectancy is to match that of the general population,” said lead author Adam Tricky, Ph.D., according to the study press release.

Study Methods

The researchers analyzed how many people died during the first three years of antiretroviral therapy, causes of death, viral loads and CD4 counts, and whether HIV transmission occurred because of injection drug use. Based on their analysis, the researchers found that fewer people who started treatment between 2008 and 2010 died within three years, compared to individuals who started treatment between 1996 and 2007.

The number of AIDS-related deaths also decreased between 1996 and 2010. The median CD4 count after one year of treatment also increased from 370 in 1996-99 to 430 in 2008-2010. The percentage of individuals with viral loads below 500 also increased from 71% in 1996-99 to 93% in 2008-2010.

Despite the good news, some communities are left behind from these improved life expectancy outcomes. ” [I]individuals who are not white, have a history of injection drug use, or began [antiretroviral therapy] with low CD4 cell counts have no reduction in mortality or improvements in life expectancy,” writes Ingrid T. Katz, M.D., and Brendan Maughan-Brown, Ph.D., in a comment in The Lancet HIV.

“The concern is greatest in the world’s most vulnerable populations, which include people who inject drugs in Europe and North America, and individuals living in resource-constrained settings globally, where access to early [antiretroviral] initiation has been limited,” Katz and Maughan-Brown add.

Life Expectancy Still Trending Up

While some groups and areas still need attention, the life expectancy estimates for those on treatment continue to rise. Last month, a study in HIV Medicine also found that life expectancy is on the rise for people with HIV on treatment, though it was lower for low-to-middle-income countries, and the overall estimates did not match the general population as closely as this latest study.

Last year, the Swiss HIV Cohort Study also found that life expectancy had increased between 1996 and 2013, from about 41 years to about 75 years. The development of combination antiretroviral therapy certainly played a key role in increasing life expectancy, but just having treatment is not enough.

“Since modern treatment is highly effective with low toxicity, deaths in people living with HIV are unlikely to be reduced by further development of drugs. Now we need to focus on the issues surrounding drug adherence, late diagnosis of HIV, and diagnosis and treatment of co-occurring conditions. In drug users we must promote therapy and improve access to therapy to treat addictions as well as increasing access to hepatitis C treatment for people with both infections,” Trickey concluded.

Warren Tong is the senior science editor for TheBody.com and TheBodyPRO.com.

 

 

 

 


Health Promotion Newsletter Issue No. 35

31 Jul

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Hi everyone,

I hope that everyone has enjoyed this summer despite the amount of rain and unsettled weather. During the summertime, it is time for people to get out and enjoy each other either for coffee or other activities. Therefore there are not many workshops scheduled at ACAS in the summer.

However, the Health Promotion Workshops are going back to full force in the months coming from August to November!

In the upcoming weeks ahead we will be revisiting the topic of Aging. In the current environment, the LGBTQ+ community is really focused back on aging. The aging workshop presentation will include aging and its impact on individuals and quality of health, and how to sustain a solid relationship within both your community and your personal relationships.

In September we are going to have two workshops. One will be on the topic of will and estate management, specifically focused on the Asian Community. The other will be a macro workshop on Cognitive Change with Aging for people living with HIV.

Please look out for your workshop invitations from your support staff and I am really looking forward to reconnecting with all of you.

While you are waiting for the invitation, recently I have two articles from the Toronto Star that might interest you as they are quite relevant to our upcoming workshop topics. I would love to hear your feedback on these articles.

Best Regards,

Kenneth Poon

Health Promotion Worker

647 278 3835

healthpromoacaas@gmail.com

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Ways to recognize, stave off Alzheimer’s

Researchers say risks include not getting enough education early in life, high blood pressure

  • Toronto Star
  • 24 Jul 2017

There are no proven ways to stave off Alzheimer’s, but a new report raises the prospect that avoiding nine key risks starting in childhood just might delay or even prevent about a third of dementia cases around the world. How? It has to do with lifestyle factors that may make the brain more vulnerable to problems with memory and thinking as we get older.

They’re such risks as not getting enough education early in life, high blood pressure and obesity in middle age, and being sedentary and socially isolated in the senior years.

Last week’s report in British journal the Lancet is provocative — its authors acknowledge their estimate is theoretical.

A recent U.S. report was much more cautious, saying there are hints that lifestyle changes can help. Brain scans may change care for some people with memory loss Does it really take an expensive brain scan to diagnose Alzheimer’s?

Not everybody needs one, but new research suggests PET scans may lead to treatment changes for a surprising number of patients whose memory problems are hard to pin down.

Researchers tracked nearly 4,000 people with unusual dementia symptoms or who have puzzling early-stage mild memory loss.

Preliminary results show that in about two-thirds of cases, PET results changed doctors’ initial plans for medication, counselling or further testing.

New research suggests PET scans may lead to treatment changes for a surprising number of patients whose memory problems are hard to pin down

The key change: which patients needed drugs that temporarily ease Alzheimer’s symptoms.

The data was reported last week at an international Alzheimer’s meeting in London. Speech may be a clue to mental decline, study suggests A study suggests that changes to your speech may indicate you’re developing thinking problems.

More pauses, filler words and other verbal changes might be an early sign of mental decline, which can lead to Alzheimer’s disease.

Researchers had people describe a picture they were shown in taped sessions two years apart.

Those with early-stage mild cognitive impairment slid much faster on certain verbal skills than those who didn’t develop thinking problems. It’s more than the occasional “um” or trouble recalling names that plagues many people as they age.

If confirmed, the work at the University of Wisconsin in Madison suggests that speech analysis might be a way to help screen people for very early signs of mental decline.

Results were discussed last week at an Alzheimer’s conference in London. For first time, over half of people with HIV taking AIDS drugs The United Nations says that for the first time in the AIDS epidemic, more than half of all people with HIV are on drugs to treat the virus.

AIDS deaths are also now close to half of what they were in 2005, according to the United Nations AIDS agency, although those figures are based on estimates and not actual counts from countries.

Experts applauded the progress, but questioned if the billions spent in the past two decades should have brought more impressive results.

The UN report was released last week in Paris where an AIDS meeting begins this weekend. “When you think about the money that’s been spent on AIDS, it could have been better,” said Sophie Harman, a senior lecturer in global health politics at Queen Mary University of London.

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Girl’s HIV infection seems under control without AIDS drugs

  • ByMARILYNN MARCHIONE, AP CHIEF MEDICAL WRITER
  • Jul 24, 2017

A South African girl born with the AIDS virus has kept her infection suppressed for more than eight years after stopping anti-HIV medicines — more evidence that early treatment can occasionally cause a long remission that, if it lasts, would be a form of cure.

Her case was revealed Monday at an AIDS conference in Paris, where researchers also gave encouraging results from tests of shots every month or two instead of daily pills to treat HIV.

“That’s very promising” to help people stay on treatment, the U.S.’s top AIDS scientist, Dr. Anthony Fauci, said of the prospects for long-acting drugs.

Current treatments keep HIV under control but must be taken lifelong. Only one person is thought to be cured — the so-called Berlin patient, a man who had a bone marrow transplant in 2007 from a donor with natural resistance to HIV.

But transplants are risky and impractical to try to cure the millions already infected. So some researchers have been aiming for the next best thing — long-term remission, when the immune system can control HIV without drugs even if signs of the virus remain.

Aggressive treatment soon after infection might enable that in some cases, and the South African girl is the third child who achieved a long remission after that approach.

She was in a study sponsored by the agency Fauci heads, the National Institute of Allergy and Infectious Diseases, that previously found that early versus delayed treatment helped babies survive.

The girl, who researchers did not identify, started on HIV drugs when she was 2 months old and stopped 40 weeks later. Tests when she was 9 1/2 years old found signs of virus in a small number of immune system cells, but none capable of reproducing. The girl does not have a gene mutation that gives natural resistance to HIV infection, Fauci said, so her remission seems likely due to the early treatment.

The previous cases:

—A French teen who was born with HIV and is now around 20 has had her infection under control despite no HIV medicines since she was roughly 6 years old.

—A Mississippi baby born with HIV in 2010 suppressed her infection for 27 months after stopping treatment before it reappeared in her blood. She was able to get the virus under control again after treatment resumed.

At least a dozen adults also have had remissions lasting for years after stopping HIV medicines.

A study underway now is testing whether treating HIV-infected newborns within two days of birth can control the virus later after treatment stops. It started in 2014 in South America, Haiti, Africa and the United States, and some of the earliest participants might be able to try stopping treatment later this year.

Treatment might get easier if two large studies underway now confirm results reported Monday from a study testing a long-acting combo of two HIV drugs — Janssen’s rilpivirine and ViiV Healthcare’s cabotegravir.

Cabotegravir is experimental; rilpivirine is sold now as Edurant and used in combination with other drugs for treating certain types of HIV patients.

After initial treatment to get their virus under control, about 300 study participants were given either daily combination therapy pills or a shot every four or eight weeks of the long-acting drug duo to maintain control.

After nearly two years, 94 percent on eight-week shots, 87 percent on four-week shots and 84 percent on daily pills had their infections suppressed, with similar rates of side effects.

“The results were good regardless of whether people came monthly or every two months for their treatment. This has important policy implications,” said Dr. Linda-Gail Bekker, deputy director of the Desmond Tutu HIV Centre at the University of Cape Town in South Africa, and a co-leader of the conference.

The study was sponsored by the drugmakers. Results were published in the British medical journal Lancet.

Two large studies aimed at winning approval to sell the treatment are testing the monthly shots. Janssen said in a statement that good results from eight-week shots warrant reconsidering the longer approach.

If it works, “this will have a huge impact on how we manage that very important group of people who are not able to access and take drugs on a day-to-day basis,” such as those with mental health or drug abuse problems, said Dr. Steven Deeks, an AIDS specialist at the University of California, San Francisco.


Health Promotion Newsletter Issue No. 34

20 Apr

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Spring is finally here though the weather is still a tad chilly. Perhaps you can use this time for a bit of spring cleaning and let the fresh air in! Speaking of new growth, which spring is known for, perhaps it is also a good time to try something new and join ACAS for our spring activities and workshops.

From the support program feedback, it has become evident that some of our clients have not been satisfied with the food menu selections. The program was attempting to introduce our clients to foods from a wide variety of cultures within the given budget.  While we do our best to accommodate the needs of our clients, we need your input on this matter. What does “better food” mean? Is this a request for healthier food selections or is it a cultural taste? Understanding that the program runs on a restricted budget, we strive to provide taste and variety in our menu choices. At the same time, I welcome any specific input in regards to menus in terms of their origins or content. Please feel free to contact me or your support staff to express your detailed descriptions of what you would like to see. We will do our best to address your concerns and thank you for your input.

Beginning in April 2017 and going forward, we will have our workshops begin at 5:30 pm instead of 6:00 pm to allow for more socializing time prior to seating for dinner. Another new feature we have added to our workshops is the opportunity to speak privately with the presenter following the presentation. We would ask that any clients, who are interested, sign up with the support staff at the event itself or in your RSVP such that we can book the time accordingly.

This month, the health topic is Turmeric. Recently there has been a lot of media coverage showing the health benefits of Turmeric. Please find below a recipe we have found that was created by a naturopathic doctor. It is a simple recipe to improve your overall health.

I want to wish you all a great blossoming spring!

Best Regards,

Kenneth Poon

Health Promotion Worker

647 278 3835

 

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Golden Milk

Golden Milk- essentially is a mixture of spices mixed into warmed milk (dairy, almond, soy, whatever you’d like). The following recipe is just for the spice mixture that you can store in a jar. Once this is made, you can just add 2 tsp of the spice mixture into warmed milk and enjoy whenever you’d like.

Golden Milk Spice Recipe

1/2 cup turmeric powder

1/4 cup cinnamon powder

2 tsp ground black pepper

1-2 tbsp ground ginger

1/2 tsp cayenne pepper (optional)

 

Directions: add 2 tsp of this spice mixture into a cup of warmed milk, stir and enjoy! (You can add this to bone broth as well for a savory and nutritious hot drink!)

All of these spices are anti-inflammatory, which means that they will help reduce the amount of inflammation present in the body. What this means clinically is that they could help reduce joint pain, indigestion (bloating, gas), and help prevent neurodegenerative diseases like Alzheimer’s.

Turmeric is also an antioxidant that promotes liver function and optimizes liver health, so as you can see, this herb has all around really great effects!

Also, you might find that this might help soothe that tickle in your throat, as turmeric also helps to boost immune function. If you’re finding that the discomfort lasts, you can purchase slippery elm lozenges to help soothe the throat. Slippery elm has anti-inflammatory effects on the mucous membranes (such as the tissues in the mouth, nose, throat, stomach, intestines, etc.) and forms a protective barrier for these tissues to prevent further irritation.


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Health Promotion Newsletter Issue No. 33

16 Feb

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Dear Clients,

I have to say this winter we had not experienced any blistering cold weather except in the month of December.  In February we did have a couple days of chilling weather.

If you are ready to shake off your winter mood please come and join us at our first Health Promotion workshop on Feb. 24, 2017 (Friday).  I am pleased to announce that I have invited Ms. Connie Kim, P.H.D. ,  to present on the topic: CD4 and non-response.  If you’d like to attend please R.S.V.P. to your support staffs.

On March 10, 2017 (Friday) our second Health Promotion workshop will focus on the topic of: Diet and supplements for people living with HIV.  We welcome back Dr. Hal Huff, N.D. to share his wealth of knowledge with us.

On March 11, 2017 (Saturday) our third gathering from OPA+ will be a fun-filled evening,  creative out-of-the-box  activities and an informed  presentation on Asian P.H.A. Resiliency Dialogue Project.   Look out for the invitation from Mr. James Lee (Community Engagement Worker and OPA+ Coordinator).

ACT also offers a couple of Health Forum workshops in the month of February and March. ACT workshops will be held at Ramada Inn on Jarvis street, south of Carlton Street.  Please see information below:

  1. February 23, 2017(Thursday), “Living with HIV and Cancer”
  2. March 16, 2017 (Thursday), “Bi/Gay/Queer Men Navigating Mental and Substance Use Services for People Living with HIV”

There will be a P.H.A. panel discussion in each ACT workshop. Our long standing committed community member Mr. Christian Hui will be one of the panelists on March 16, 2017 workshop.  As an Asian L.G.B.T.Q member it will be nice to attend and celebrate his resiliency.  No R.S.V.P. is necessary for ACT workshops but it will be nice to inform Mr. Rui Pirez (ACT Gay Men Health Education coordinator) Direct: 416-340-8484 for your attendance.

This issue I like to share an article on supporting your mood and mental health created by Ms. Naomi Ha. On behalf of ACAS I sincerely thank Ms. ha for her energy and time to prepare this wonderful article for us to enjoy.  Please see the article as attached.

Kenneth Poon

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Naomi Ha, BSc. (Hons.), 4th Year Naturopathic Medicine Intern (Sherbourne Health Center, Robert Schad Naturopathic Clinic, Brampton Naturopathic Teaching Clinic)

Life can be unpredictable. We make plans, have visions for where we’d like to be in a few years, only to have things fall through and propel us through more uncertainties. We worry, we coast, we ride the wave, often dissatisfied with ourselves and fixated on the goals that still remain unrealized. We ruminate, initiating the downward spiral that traps us within the confines of our own insecurities and perceived shortcomings. We become discouraged, confronted by our failures, and as a result, impeding our forward progression because we become afraid that we will continue to repeat the same futile patterns.

But what we fail to recognize is that these are just thoughts- they do not necessarily reflect the reality. Yet, they have the power to change the way we perceive ourselves and the world around us, and thus making us more vulnerable to the maladaptive thought patterns that are characteristic of many mental disorders. From anxiety and depression, to bipolar disorder and schizophrenia, the common thread that runs through them all is that they remove us from the present moment. We worry, we stress about future maybes, events that may or may not occur, regardless of their probability. Though we can’t distance ourselves from the stressors that accompany our day-to-day lives, we can change the way we react to them through the practice of mindfulness.

Jon Kabat-Zinn, a medical professor in the US, and founder of mindfulness-based stress reduction (MBSR), posits that by remaining in the present moment and observing it from a nonjudgmental standpoint, rather than forming judgments or reactions to our stressors, we can experience them and let them go, without forming the thoughts that later feed our worry. The future and tomorrow are human constructs devised to quantify time that has yet to pass, an eventuality. We worry that our situations today will somehow have that butterfly effect that will have implications on our futures, but as humans, we all have the agency to change our trajectories. We can focus on living every moment with intention, instead of living with the constant worry of what tomorrow will bring, because tomorrow is outside of our control. Mindfulness is a skill that we can all develop, all it takes is an investment of time to increase our awareness of our inner states and the presence of everything around us. It helps us build resilience, so that we may face the storms with the confidence that we’ll get through every rough patch because we’ve overcome them before. Rather than reacting with emotional turmoil, we can ride the wave of emotions, taking notice of any thoughts of physical sensations that we experience and recognizing them for their fleeting nature, and then letting them go (Kabat-Zinn, 2005). In the study conducted by Keng and Tong (2016), it was found that people who regularly practiced mindfulness not only experienced negative emotions for a shorter time period but also reported experiencing positive emotions sooner, after a difficult time/event, compared to those who did not practice mindfulness. The results imply that mindfulness helps to build resilience, that is, the ability to cope and recover from difficult situations.

Fitting in time for a short meditation is also an easy way to get some quiet time during the day to calm the mind. The three-minute breathing space (these meditations are available on YouTube) can be very effective to quiet those daily anxieties and help stave off the complete feeling of overwhelm. These two DIY-treatments are simple and time effective, but can produce great results in stress reduction.

Although stress is not considered a mental disorder, it can be just as debilitating. There are also some commonalities between the signs and symptoms of stress and other mood disorders. For example, anxiety can manifest in a variety of ways, including incessant and unwanted thoughts of failure and danger, and the panic resulting from heart palpitations and shortness of breath, similar to a physical stress reaction. Whether directed towards a particular trigger or generalized, anxiety can be quite debilitating if left unmanaged. During a panic attack, it is key to remember that the episode will pass, and you will not feel like this forever. It can also be helpful to maintain a single point of focus on a surrounding wall and to name all the objects that you see there, which can alleviate anxiety by removing the focus away from the anxiety itself. Acutely, there are supplements that have been shown to be effective in promoting a sense of calm and wellbeing, especially while in the midst of experiencing an anxious episode. L-theanine, an extract from green tea, has been observed  to induce relaxation, and relieve tension when taken at 200 mg (Dietz & Dekker, 2017). Passionflower (Passiflora incarnata) is especially helpful during those anxious episodes where your mind is racing and you can’t seem to collect your thoughts because they continue to pop up one after the other. It can also be indicated if stress and anxiety are causing difficulty falling asleep (Sarris, Panossian, Schweitzer, Stough, & Scholey, 2011).

In contrast to anxiety in which the mind and body feel overstimulated, depression can manifest as low mood, sluggish cognition, withdrawal from interests and friends/family, and low mood, among other symptoms. These might last for only short periods (depressive episodes), or may persist for months at a time (major depressive disorder, MDD). Although these disorders are highly responsive to pharmacological treatment, studies have also shown efficacy for various naturopathic treatments. Remmelt et al. (2016) observed lower brain levels of gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter that helps regulate the nervous system, within actively depressive patients. These results point towards GABA supplementation as a way to balance the neurochemical pathways in depressive disorders, however, results are preliminary and additional research is needed before consensus to its efficacy may be reached. Perhaps the best known herbal remedy for depression is St. John’s Wort (Hypericum perforatum). A study by Seifritz, Hatziner & Holsboer-Trachsler (2016) found that using 300 mg of St. John’s Wort extract each day resulted in a greater reduction in the severity of depressive symptoms as well as improved remission rates, compared to those taking selective serotonin uptake inhibitors (SSRIs), the first-line class of drugs for depression. Despite the promising results for these alternative treatments, not everyone will respond in the same way, so it’s always recommended that you consult a physician before starting any of these treatments, due to any drug-herb interactions that might occur.

As each and every person experiences and copes differently with the various stressors that are engrained in daily life, the small selection of naturopathic supportive treatments mentioned in this article might not work for everyone. However, it is important to spread awareness of the normalcy of stress and mental health concerns, as everyone has experienced them to some extent during their lifetime and to empower everyone to strive for mental wellbeing due to its immense impact upon how we experience our lives and the decisions that we make. It is easier to cope with life’s difficulties when we accept their fleeting nature and overcome them with resilience.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Please consult your physician or naturopathic doctor prior to initiating any treatment.

References

Dietz, C., & Dekker, M. (2017). Effect of green tea photochemicals on mood and cognition. Current Pharmaceutical Design, Jan 5. Epub.